ABSTRACT
BACKGROUND: Dysphagia is a geriatric syndrome. Changes in the whole body that occur with aging also affect swallowing functions and cause presbyphagia. This condition may progress to oropharyngeal and/or esophageal dysphagia in the presence of secondary causes that increase in incidence with aging. However, no study has been published that provides recommendations for use in clinical practice that addresses in detail all aspects of the management of dysphagia in geriatric individuals. This study aimed to answer almost all potential questions and problems in the management of geriatric dysphagia in clinical practice. METHODS: A multidisciplinary team created this recommendation guide using the seven-step and three-round modified Delphi method via e-mail. The study included 39 experts from 29 centers in 14 cities. RESULTS: Based on the 5W and 1H method, we developed 216 detailed recommendations for older adults from the perspective of different disciplines dealing with older people. CONCLUSION: This consensus-based recommendation is a useful guide to address practical clinical questions in the diagnosis, rehabilitation, and follow-up for the management of geriatric dysphagia and also contains detailed commentary on these issues.
ABSTRACT
PURPOSE: To investigate the risk of sarcopenia in hospitalized older patients and to assess the associations between sarcopenia risk and health care outcomes including dependency, malnutrition, and dysphagia. METHODS: This multicenter cross-sectional study was a part of the annual National Prevalence Measurement of Quality of Care (LPZ) in Turkey. Hospitalized patients age 65 and older were included in the study. The SARC-F was used to assess risk of sarcopenia. Dependency was appraised according to the Care Dependency Scale (CDS). Nutritional status was established with respect to the Malnutrition Universal Screening Tool (MUST). Dysphagia was screened by two structured questions. RESULTS: A total of 492 patients were included in the analysis. Two hundred and forty patients (48.8%) were at risk of sarcopenia. Sarcopenia risk was more prevalent among women (p = 0.007) and patients with risk of sarcopenia were older (p < 0.001). Hospital stay was longer and malnutrition and dysphagia were more prevalent in patients with sarcopenia risk than without (all p < 0.001). All nutritional interventions were applied mostly to patients with sarcopenia risk than without. In multivariate analysis, advanced age (OR: 1.068, CI 1.032-1.104, p < 0.001), female gender (OR: 2.414, CI 1.510-3.857, p < 0.001), and dependency (OR: 5.022, CI 2.922-8.632, p < 0.001) were independently associated with sarcopenia risk. CONCLUSIONS: Sarcopenia risk is related with unfavorable outcomes in hospitalized patients. Primarily older female patients are at risk for sarcopenia. It is important to recognize sarcopenia at an early stage and to prevent its progression, before dependency develops. The SARC-F may be a useful tool for screening sarcopenia risk in hospitalized patients.
