Performance of swallowing function between older people with and without clinical complaints

TL;DR

This study compares swallowing function in older adults with and without swallowing complaints, finding differences in evaluations and a link between lower oral intake and higher swallowing issues.

Contribution

The study provides empirical evidence on the correlation between swallowing difficulties, nutritional risk, and oral intake levels in older adults.

Findings

Older adults with swallowing complaints showed differences in speech-language-hearing evaluations and pharyngeal residues.

Lower oral intake was moderately negatively correlated with the severity of pharyngeal residues and nutritional risk.

Escape oral posterior and laryngeal penetration were more common in the group with swallowing complaints.

Abstract

To compare the findings of speech-language-hearing evaluations, signs in fiberoptic endoscopic evaluation of swallowing, and nutritional risk between healthy older adults with and without self-reported swallowing difficulties and correlate the level of oral intake with the severity of pharyngeal residues and nutritional risk.

This cross-sectional retrospective study included 71 older people and divided them into two groups based on the presence of swallowing complaints. Data were collected from speech-language-hearing evaluations, oral health status, and videoendoscopy signs with four food consistencies classified by the International Dysphagia Diet Standardisation Initiative (IDDSI) to compare the groups. Pharyngeal residues were analyzed and classified using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS), the level of oral intake was assessed using the Functional Oral Intake Scale (FOIS), and nutritional risk was evaluated using the Malnutrition Screening Tool (MST).

Differences were found in speech-language-hearing evaluations, as well as signs of posterior oral spillage and pharyngeal residues with levels 0, 2, and 4 consistencies and laryngeal penetration with level 0 consistency. The level of oral intake was moderately negatively correlated with the severity of pharyngeal residues and nutritional risk.

The group of older adults with complaints had differences in speech-language-hearing evaluations, posterior oral spillage, and pharyngeal residues with levels 0, 2, and 4 consistencies, and laryngeal penetration with level 0 consistency. The correlation indicated that the lower the level of oral intake, the greater the severity of pharyngeal residues and nutritional risk in the sample.

Comparar os achados da avaliação fonoaudiológica, sinais da videoendoscopia da deglutição e o risco nutricional entre idosos saudáveis com e sem dificuldades autorreferidas em deglutir, além de correlacionar o nível de ingestão oral com a gravidade dos resíduos faríngeos e o risco nutricional.

Trata-se de um estudo transversal e retrospectivo. Foram incluídos 71 idosos divididos em dois grupos de acordo com a presença de queixas de deglutição. Foram coletados dados da avaliação fonoaudiológica e estado oral, além dos sinais videoendoscópios em quatro consistências alimentares classificados pelo International Dysphagia Diet Standartisation Initiative (IDDSI) para comparação entre os grupos. Os resíduos faríngeos foram analisados e classificados pelo Yale Pharyngeal Residue Severity Rating Scale (YPRSRS), o nível de ingestão oral pelo Functional Oral Intake Scale (FOIS) e o risco nutricional foi avaliado utilizando-se o Malnutrition Screening Tool (MST).

Houve diferença na avaliação fonoaudiológica, além de sinais de escape oral posterior e resíduos faríngeos nas consistências alimentares de nível 0, 2 e 4, e penetração laríngea na consistência de nível 0. Houve correlação negativa moderada entre o nível de ingestão oral, gravidade dos resíduos faríngeos e o risco nutricional.

O grupo de idosos com queixas apresentou diferenças na avaliação fonoaudiológica, além de escape oral posterior e resíduos faríngeos nas consistências alimentares de nível 0, 2 e 4, e penetração laríngea na consistência de nível 0. A correlação indicou que, quanto menor o nível de ingestão oral, maior a gravidade dos resíduos faríngeos e o risco nutricional na amostra.