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Which swallowing difficulty of food consistency is best predictor for oropharyngeal dysphagia risk in older person?

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Key summary points

AbstractSection Aim

Our aim was to investigate which swallowing difficulty of food consistency in older people who did not have any disease that might affect swallowing functions, and which symptoms were most likely related to oropharyngeal dysphagia (OD) risk.

AbstractSection Findings

We have found that the eating/drinking difficulty of thick liquids was the highest predictive value with respect to OD risk and the eating difficulty of mixed content food had the highest diagnostic ratio.

AbstractSection Message

The present study reports that even in older person who do not go to the hospital with the complaints of swallowing difficulty, the difficulty of swallowing thick liquids and especially the mixed content food should be questioned.

Abstract

Purpose

The present study aimed to investigate which swallowing difficulty of food consistency in participants over 65 years of age who did not have any disease that might affect swallowing functions, and which symptoms were most likely related to oropharyngeal dysphagia (OD).

Methods

The cross-sectional and multicenter study was conducted at 12 hospitals including 883 participants aged ≥65 years who were fed orally and who were admitted to the physical medicine and rehabilitation outpatient clinics between September 2017 and December 2018. Demographic characteristics were recorded. Katz Daily Living Activities Index (KDLAI), swallowing-related quality of life scale (Swal-QoL) and 10-item Eating Assessment Tool (EAT-10) were used. The participants were asked the “yes” or “no” questions including swallowing difficulty of various types of food consistency with the face-to-face interview.

Results

Participants were divided into two groups as normal swallowing (EAT-10 < 3 group) (n = 639) and OD risk groups (EAT-10 ≥ 3 group) (n = 244) according to the EAT-10 scores. While there was no difference related to number of teeth and KDLAI scores between groups (p = 0.327 and p = 0.221, respectively), the significant difference was found between groups in terms of yes/no questions and Swal-QoL scores (p < 0.05). Receiver operating characteristic analysis revealed that eating difficulty of mixed content food provided maximum sensitivity (99%) and eating/drinking difficulty of thick liquid had maximum specificity (77%). The higher area under curve was in eating/drinking difficulty of thick liquid (0.891), and higher positive likelihood ratio (LR) was eating/drinking difficulty of thick liquid (4.26) as well as lower negative LR was eating difficulty of mixed content food (0.01). The higher diagnostic odds ratio was eating difficulty of mixed content food (367.0), and the higher posttest probability was eating/drinking difficulty of thick liquid (0.211).

Conclusion

While eating difficulty of hard solid food is the most common symptom in healthy participants over 65 years of age, the eating difficulty of thick liquids is the highest predictive value related to oropharyngeal dysphagia risk. Also, the eating difficulty of mixed content food had the highest diagnostic ratio.

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Funding

There is no funding source for this study.

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation Clinic, Ankara Diskapi Training and Research Hospital, University of Health Sciences, Altindag, Ankara, Turkey

    Ebru Umay & Ibrahim Gundogdu

  2. Department of Physical Medicine and Rehabilitation, Ege University, Izmir, Turkey

    Sibel Eyigor

  3. Department of Physical Medicine and Rehabilitation, Usak University, Usak, Turkey

    Ali Yavuz Karahan

  4. Department of Physical Medicine and Rehabilitation, Kırıkkale University, Kirikkale, Turkey

    Dilek Keskin & Gulten Karaca

  5. Department of Physical Medicine and Rehabilitation, Celal Bayar University, Manisa, Turkey

    Zeliha Unlu & Canan Tıkız

  6. Department of Physical Medicine and Rehabilitation, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

    Meltem Vural & Banu Aydeniz

  7. Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, University of Health Sciences, Ankara, Turkey

    Ebru Alemdaroglu & Emine Esra Bilir

  8. Department of Physical Medicine and Rehabilitation, Istanbul University, Istanbul, Turkey

    Ayse Yalıman & Ekin Ilke Sen

  9. Department of Physical Medicine and Rehabilitation, Gaziantep University, Gaziantep, Turkey

    Mazlum Serdar Akaltun & Ozlem Altındag

  10. Department of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey

    Betul Yavuz Keles

  11. Department of Physical Medicine and Rehabilitation, Antalya Training and Research Hospital, Antalya, Turkey

    Meral Bilgilisoy

  12. Department of Physical Medicine and Rehabilitation, Izmir Tepecik Training and Research Hospital, Izmir, Turkey

    Zeynep Alev Ozcete & Aylin Demirhan

Authors
  1. Ebru Umay
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  20. Ibrahim Gundogdu
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Corresponding author

Correspondence to Ebru Umay.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards (Ethics committee of University of Health Sciences, Ankara Diskapi Training and Research Hospital).

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All participants or the relatives of illiterate participants were informed about the study, and their written informed consents were obtained at the beginning of the study.

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Umay, E., Eyigor, S., Karahan, A.Y. et al. Which swallowing difficulty of food consistency is best predictor for oropharyngeal dysphagia risk in older person?. Eur Geriatr Med 10, 609–617 (2019). https://doi.org/10.1007/s41999-019-00206-z

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  • DOI: https://doi.org/10.1007/s41999-019-00206-z

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