Abstract
United States census data project dramatic increases in the geriatric population ageing demographics by 2060 with concomitant health-care consequences. The purpose of this replication and continuation study was to collect new 2014 demographic data relative to ageing, swallow evaluation referral rates, and oral feeding status in geriatric-hospitalized patients for comparison with published data from 2000 to 2007. This was a planned data acquisition study of consecutive hospitalized patients referred for swallow assessments. Swallow evaluation referral rates for 2014 were described according to inpatient discharges, age range 60–105 years grouped by decade, gender, admitting diagnostic category, results of swallow evaluations, and oral feeding status. Determination of aspiration risk status was made with the Yale Swallow Protocol and diagnosis of dysphagia made with fiberoptic endoscopic evaluation of swallowing (FEES). There were 1348 referrals and 961 patients ≥60 years of age participated. Overall swallow evaluation referral rates increased an average of 63 % between the comparison years 2007 and 2014 with consistent increases corresponding to the decades, i.e., 60–69 (46 %), 70–79 (68 %), 80–89 (53 %), and 90+ (222 %). A total of 75 % of participants resumed oral alimentation and oral medications. Swallow evaluation referral rates increased by 63 % for 60–90+ year-old acute care geriatric-hospitalized participants despite only a 23 % increase in inpatient discharges for the years 2007 versus 2014. This corroborated previously reported increases for individual years from 2000 to 2007. For timely, safe, and successful initiation of oral alimentation, it is important to perform a reliable swallow screen for aspiration risk assessment with the Yale Swallow Protocol and, if failed, instrumental testing with FEES. More dysphagia specialists are needed through 2060 and beyond due to projections of continued population ageing resulting in ever increasing referral rates for swallow assessments.
Similar content being viewed by others
References
Schindler JS, Kelly JH. Swallowing disorders in the elderly. Laryngoscope. 2002;112:589–602.
Achem SR, DeVault KR. Dysphagia in aging. J Clin Gastroenterol. 2005;39:357–71.
Roy N, Stemple J, Merrill RM, Thomas L. Dysphagia in the elderly: preliminary evidence of prevalence, risk factors, and socioemotional effects. Ann Otol Rhinol Laryngol. 2007;116:858–65.
Leder SB, Suiter DM. An epidemiologic study on aging and dysphagia in the acute care hospitalized population: 2000–2007. Gerontology. 2009;55:714–8.
U.S. Census Bureau, Population Division. Table 2. Projections of the population by selected age groups and sex for the United States: 2015–2060 (NP2012-T2), December, 2012.
Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest. 2003;124:328–36.
Leder SB, Suiter DM. The Yale swallow protocol: an evidenced-based approach to decision making. New York: Springer; 2014.
Leder SB, Suiter DM, Warner HL. Answering orientation questions and following single step verbal commands: effect on aspiration status. Dysphagia. 2009;24:290–5.
Leder SB, Suiter DM, Murray J, Rademaker AW. Can an oral mechanism examination contribute to the assessment of odds of aspiration? Dysphagia. 2013;28:370–4.
Suiter DM, Leder SB. Clinical utility of the 3 ounce water swallow test. Dysphagia. 2008;23:244–50.
Langmore SE, Schatz MA, Olsen N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia. 1988;2:216–9.
Leder SB, Murray JT. Fiberoptic endoscopic evaluation of swallowing. Phys Med Rehabil Clin N Am. 2008;19:787–801.
Leder SB, Ross DA, Briskin KB, Sasaki CT. A prospective, double-blind, randomized study on the use of topical anesthetic, vasoconstrictor, and placebo during transnasal flexible fiberoptic endoscopy. J Speech Hear Res. 1997;40:1352–7.
Daniels SK, Schroeder MF, DeGeorge PC, Corey D, Rosenbek JC. Effects of verbal cue on bolus flow during swallowing. Am J Speech Lang Pathol. 2007;16:140–7.
Leder SB, Acton LM, Lisitano HL, Murray JT. Fiberoptic endoscopic evaluation of swallowing with and without blue-dyed food. Dysphagia. 2005;20:157–62.
Logemann JA. Evaluation and treatment of swallowing disorders. 2nd ed. Austin: Pro-Ed; 1998.
Leder SB, Suiter DM. Five days of successful oral alimentation for hospitalized patients based upon passing the Yale Swallow Protocol. Ann Otol Rhinol Laryngol. 2014;123:609–13.
Leder SB. Serial fiberoptic endoscopic swallowing evaluations in the management of patients with dysphagia. Arch Phys Med Rehab. 1998;79:1264–9.
Warner HL, Suiter DM, Nystrom K, Poskus K, Leder SB. Comparing accuracy of the 3-ounce water swallow challenge dysphagia screening protocol when administered by registered nurses and speech-language pathologists. J Clin Nurs. 2014;23:1908–15.
Acknowledgments
We wish to thank Amy Richards, Director of Planning, Yale New Haven Health System and Diana Russo, Senior Data Management Coordinator, Department of Planning, Yale New Haven Health System, for providing the inpatient discharge data for Yale–New Haven Hospital (York Street Campus).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors have no conflict of interest.
Rights and permissions
About this article
Cite this article
Leder, S.B., Suiter, D.M., Agogo, G.O. et al. An Epidemiologic Study on Ageing and Dysphagia in the Acute Care Geriatric-Hospitalized Population: A Replication and Continuation Study. Dysphagia 31, 619–625 (2016). https://doi.org/10.1007/s00455-016-9714-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00455-016-9714-x