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Prevalence of Dysphagia in China: An Epidemiological Survey of 5943 Participants

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Abstract

Objective

To determine the prevalence of dysphagia among an older population and patients with stroke, head and neck cancers (HNCs) or neurodegenerative diseases (NDDs) in China, to identify the factors associated with this condition, and to explore the relationship between dysphagia and nutritional status.

Methods

This study included participants 65 years and older living in the community or in nursing homes and patients who had sustained a stroke, HNC, or NDD also recruited in hospitals from 14 provinces of China. The presence of dysphagia was determined by use of a questionnaire, water swallowing test, and/or a videofluoroscopic swallowing study. Logistic regression analysis was used to assess the possible associated risk factors. Body mass index was assessed as an indicator of malnutrition.

Results

A total of 5943 persons met the inclusion criteria and 2341 (39.4%) were identified with dysphagia, including the following: 51.14% of patients with stroke, 34.4% in HNCs, 48.3% in NDDs, and 19.2% of otherwise healthy older adults. The elderly with comorbidity (OR = 2.90, p < 0.01) and stroke patients (OR = 2.27, p < 0.01) were significantly more likely to exhibit signs of dysphagia. Dysphagic participants were at significantly greater risk of malnutrition (OR = 1.91, p < 0.01) compared to those without dysphagia.

Conclusion

Dysphagia is prevalent in China among older individuals and people who have suffered a stroke, HNCs, or NDDs. The prevalence of dysphagia increases steadily with increasing age and presence of comorbid disease. People with dysphagia are more likely to suffer from malnutrition.

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Funding

This work was supported by the following grant: National Science Foundation of China (Grant No. 81672256), National Science Foundation of China (Grant No. 81472153).

Author information

Author notes

  1. Mengqing Zhang and Chao Li have contributed equally to this work.

Authors and Affiliations

  1. Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, No. 600, Tianhe Road, Guangzhou, 510630, Guangdong, China

    Mengqing Zhang, Chao Li, Fang Zhang, Xiaoxiao Han, Qinglu Yang & Zulin Dou

  2. Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China

    Tuo Lin

  3. Department of Rehabilitation Medicine, The First People’s Hospital of Foshan, Foshan, Guangdong, China

    Huichang Zhou

  4. Department of Neurological Rehabilitation Medicine, Ningbo Rehabilitation Hospital, Ningbo, Zhejiang, China

    Min Tang

  5. Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangzhou, Guangdong, China

    Jungui Zhou

  6. Department of Rehabilitation Medicine, Third People’s Hospital of Yunnan Province, Kunming, Yunnan, China

    Hongling Shi

  7. Department of Rehabilitation Medicine, The Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, Shanxi, China

    Yanping Hui

  8. Department of Rehabilitation Medicine, First Affiliated Hospital of Army Medical University, Chongqing, China

    Mingfeng Xiong

  9. Department of Rehabilitation Medicine, China-Japan Union Hospital of Jilin University, Jilin, Changchun, China

    Ling Pang

  10. Department of Rehabilitation Medicine, The First Affiliated Hospital of Xinjiang University and Xinjiang Medical University, Urumqi, Xinjiang, China

    Baolan Wang

  11. Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China

    Zhen Feng

  12. Department of Rehabilitation Medicine, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China

    Zhanfei Li

  13. Department of Rehabilitation Medicine, Fujian Longyan Longgang Hospital, Longyan, Fujian, China

    Changbing Cao

  14. Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China

    Xiao Lu

  15. Department of Rehabilitation Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Yuanyuan Ding

  16. Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Shukun Shen

  17. Department of Rehabilitation Medicine, Qinghai Provincial People’s Hospital, Xining, Qinghai, China

    Zhengyue Xu

  18. Department of Rehabilitation Medicine, Shanghai General Hospital, Shanghai, China

    Fan Yu

  19. Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China

    Chen Chen

  20. Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

    Ling Meng

  21. Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China

    Guiqing Liao

  22. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China

    Jinxin Zhang

  23. Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, Centre for Gastrointestinal Sciences, School of Medical Sciences, The University of Manchester, Clinical Sciences Building, Salford Royal NHS Foundation Trust, Manchester, UK

    Ayodele Sasegbon

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  1. Mengqing Zhang
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  2. Chao Li
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  3. Fang Zhang
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  4. Xiaoxiao Han
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  5. Qinglu Yang
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  8. Min Tang
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  27. Ayodele Sasegbon
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  28. Zulin Dou
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Correspondence to Zulin Dou.

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Zhang, M., Li, C., Zhang, F. et al. Prevalence of Dysphagia in China: An Epidemiological Survey of 5943 Participants. Dysphagia 36, 339–350 (2021). https://doi.org/10.1007/s00455-020-10138-7

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