Nutr Res Pract.  2018 Oct;12(5):406-414. 10.4162/nrp.2018.12.5.406.

Socio-demographic factors and diet-related characteristics of community-dwelling elderly individuals with dysphagia risk in South Korea

• Lim Y
• Kim C
• Park H
• Kwon S
• Kim O
• Kim H
• Lee Y

• KMID: 2447000
• DOI: http://doi.org/10.4162/nrp.2018.12.5.406

Abstract

BACKGROUND/OBJECTIVES
The objective of this study was to determine dysphagia risk among community-dwelling elderly people living at home. We also examined the impact of socio-demographic variables on dysphagia risk as well as the relationship between dysphagia risk and dietary characteristics.
SUBJECTS/METHODS
The study sample included 568 community-dwelling individuals, aged 65 years and above, who were living independently in their own home in Seoul, Gyeonggi, or Gwangju in South Korea. We used a dysphagia risk assessment scale to screen for dysphagia risk and the Mini nutritional assessment to evaluate the nutritional status. Associations between dysphagia risk and other variables were assessed using logistic regression analysis.
RESULTS
Of the 568 subjects, 350 (61.6%) were classified into the dysphagia risk group (DR) and 218 (38.4%) were classified into the normal group (non-DR). Being female (odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.28-2.59), being 75 years and older (OR = 2.40, 95% CI = 1.69-3.42), having a lower education level (OR = 2.29, 95% CI = 1.33-3.97), and having a lower perceived economic status (OR = 2.18, 95% CI = 1.32-3.60) were more frequently observed with dysphagia risk compared to those who did not have such characteristics. Lowered mastication ability (OR = 14.40, 95% CI = 4.43-46.95), being at risk of malnutrition or malnourished (OR = 2.72, 95% CI = 1.75-4.23), lowered appetite (OR = 3.27, 95% CI = 2.16-4.93), and decreased food intake (OR = 2.95, 95% CI = 1.83-4.78) were observed more frequently in the DR group than in the non-DR group when adjusting for potential confounding factors.
CONCLUSIONS
It is necessary to develop and apply integrated programs to improve the dietary habits and nutritional status of elderly individuals at risk for dysphagia, especially for women aged 75 years or older with lower educational and economic levels.

Keyword

Dysphagia; elderly; socio-demographic factor; nutritional status; malnutrition

MeSH Terms

Aged*
Appetite
Deglutition Disorders*
Eating
Education
Female
Food Habits
Gwangju
Gyeonggi-do
Humans
Korea*
Logistic Models
Malnutrition
Mastication
Nutrition Assessment
Nutritional Status
Risk Assessment
Seoul

Reference

1. He W, Goodkind D, Kowal P. An aging world: 2015. International Population Reports [Internet]. Baltimore (MD): National Institute on Aging;2016. cited 2017 January 30. Available from: http://www.census.gov/library/publications/2016/demo/P95-16-1.html.

2. National Statistical Office of Korea. 2018 senior citizen statistics [Internet]. Daejeon: Statistics Korea;2018. cited 2018 July 1. Available from: http://kosis.kr/conts/nsportalStats/nsportalStats_0102Body.jsp?menuId=10.

3. World Health Organization. World health statistics 2016: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization;2016. cited 2017 January 30. Available from: http://www.who.int/iris/handle/10665/206498.

4. Schindler JS, Kelly JH. Swallowing disorders in the elderly. Laryngoscope. 2002; 112:589–602.

5. Cinocco D. The difficulties of swallowing at the end of life. J Palliat Med. 2007; 10:506–508.

6. Rofes L, Arreola V, Almirall J, Cabré M, Campins L, García-Peris P, Speyer R, Clavé P. Diagnosis and management of oropharyngeal Dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterol Res Pract. 2011; 2011:818979.

7. Forster A, Samaras N, Gold G, Samaras D. Oropharyngeal dysphagia in older adults: a review. Eur Geriatr Med. 2011; 2:356–362.

8. Okamoto N, Tomioka K, Saeki K, Iwamoto J, Morikawa M, Harano A, Kurumatani N. Relationship between swallowing problems and tooth loss in community-dwelling independent elderly adults: the Fujiwara-kyo study. J Am Geriatr Soc. 2012; 60:849–853.

9. Turner MD, Ship JA. Dry mouth and its effects on the oral health of elderly people. J Am Dent Assoc. 2007; 138:Suppl. 15S–20S.

10. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2016: Korea National Health and Nutrition Examination Survey (KNHANES VII-1). Cheongju: Korea Centers for Disease Control and Prevention;2017.

11. Lieu PK, Chong MS, Seshadri R. The impact of swallowing disorders in the elderly. Ann Acad Med Singapore. 2001; 30:148–154.

12. Puisieux F, D'Andrea C, Baconnier P, Bui-Dinh D, Castaings-Pelet S, Crestani B, Desrues B, Ferron C, Franco A, Gaillat J, Guenard H, Housset B, Jeandel C, Jebrak G, Leymarie-Saddles A, Orvoen-Frija E, Piette F, Pinganaud G, Salle JY, Strubel D, Vernejoux JM, de Wazières B, Weil-Engerer S. Intergroupe PneumoGériatrie SPLF-SFGG placé sous l'égide de la Société de pneumologie de langue française (SPLF) et de la Société française de gériatrie et gérontologie (SFGG). Swallowing disorders, pneumonia and respiratory tract infectious disease in the elderly. Rev Mal Respir. 2011; 28:e76–e93.

13. Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest. 2003; 124:328–336.

14. Sue Eisenstadt E. Dysphagia and aspiration pneumonia in older adults. J Am Acad Nurse Pract. 2010; 22:17–22.

15. Sura L, Madhavan A, Carnaby G, Crary MA. Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging. 2012; 7:287–298.

16. Mann T, Heuberger R, Wong H. The association between chewing and swallowing difficulties and nutritional status in older adults. Aust Dent J. 2013; 58:200–206.

17. Ekberg O, Hamdy S, Woisard V, Wuttge-Hannig A, Ortega P. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002; 17:139–146.

18. 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; 116:858–865.

19. Ney DM, Weiss JM, Kind AJ, Robbins J. Senescent swallowing: impact, strategies, and interventions. Nutr Clin Pract. 2009; 24:395–413.

20. Chen PH, Golub JS, Hapner ER, Johns MM 3rd. Prevalence of perceived dysphagia and quality-of-life impairment in a geriatric population. Dysphagia. 2009; 24:1–6.

21. Kawashima K, Motohashi Y, Fujishima I. Prevalence of dysphagia among community-dwelling elderly individuals as estimated using a questionnaire for dysphagia screening. Dysphagia. 2004; 19:266–271.

22. Holland G, Jayasekeran V, Pendleton N, Horan M, Jones M, Hamdy S. Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: a self-reporting questionnaire survey. Dis Esophagus. 2011; 24:476–480.

23. Miura H, Kariyasu M, Yamasaki K, Arai Y. Evaluation of chewing and swallowing disorders among frail community-dwelling elderly individuals. J Oral Rehabil. 2007; 34:422–427.

24. Serra-Prat M, Palomera M, Gomez C, Sar-Shalom D, Saiz A, Montoya JG, Navajas M, Palomera E, Clavé P. Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study. Age Ageing. 2012; 41:376–381.

25. Ministry of Health and Welfare. 2008 survey on the elderly status: national survey results on the elderly life conditions and welfare need [Internet]. Seoul: Ministry of Health and Welfare;2009. cited 2017 January 30. Available from: http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=0321&CONT_SEQ=264469&page=1.

26. Park S. Dysphagia risk and associated factors among community-dwelling elders. J Korean Soc Food Sci Nutr. 2015; 44:49–56.

27. Whang SA. Prevalence and influencing factors of dysphagia risk in the community-dwelling elderly. J Korean Gerontol Soc. 2014; 34:37–48.

28. Kim MS, Park YH. The risk of dysphagia and dysphagia-specific quality of life among community dwelling older adults in senior center. Korean J Adult Nurs. 2014; 26:393–402.

29. Yim SW, Kim YH, Son HM. Risk for dysphagia and nutritional status in community-dwelling elders. J Korean Gerontol Nurs. 2014; 16:288–298.

30. Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005; 36:2756–2763.

31. Kalf JG, de Swart BJ, Bloem BR, Munneke M. Prevalence of oropharyngeal dysphagia in Parkinson's disease: a meta-analysis. Parkinsonism Relat Disord. 2012; 18:311–315.

32. Kim YJ, Choi YH, Kim JY, Lee HK. The effect of orophysical exercise for the elderly on oral function and nutrient intake. J Korean Acad Oral Health. 2011; 35:414–422.

33. Yang S, Jeong G, Kim S, Kim K, Lee SH, Saung S, Baik S. The effects of oral function improving exercise on the UWS, oral function and OHIP in elderly. J Korean Public Health Nurs. 2012; 26:478–490.

34. Yun O, Lee Y. The effect of singing intervention for women elderly with dysphagia risk. Korean J Adult Nurs. 2012; 24:380–389.

35. Fukada J, Kamakura Y, Kitaike T, Nojiri M. Development of dysphagia risk assessment scale for elderly living at home. J Jpn Soc Nurs Res. 2002; 25:87–99.

36. Fukada J, Kamakura Y, Manzai T, Kitaike T. Development of dysphagia risk screening system for elderly persons. Jpn J Dysphagia Rehabilit. 2006; 10:31–42.

37. Butler SG, Stuart A, Leng X, Rees C, Williamson J, Kritchevsky SB. Factors influencing aspiration during swallowing in healthy older adults. Laryngoscope. 2010; 120:2147–2152.

38. Choi YH. Relationship between number of residual teeth and masticatory function [dissertation]. Yongin: Dankook University;2008.

39. Nestlé Nutrition Institute. Mini Nutritional Assessment [Internet]. [place unknown]: Nestlé Nutrition Institute;cited 2016 January 30. Available from: http://www.mna-elderly.com/mna_forms.html.

40. Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, Albarede JL. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999; 15:116–122.

41. Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature--What does it tell us? J Nutr Health Aging. 2006; 10:466–485.

42. Cereda E. Mini nutritional assessment. Curr Opin Clin Nutr Metab Care. 2012; 15:29–41.

43. Llido LO, Mirasol R. Comparison of body mass index based nutritional status using WHO criteria versus “Asian” criteria: report from the Philippines. PhilSPEN Online J Parenter Enteral Nutr. 2011; 1–8.

44. Won Y. The relationship of oral state and dietary habit to health condition among elderly people [master's thesis]. Seoul: Yonsei University;2003.

45. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2015: Korea National Health and Nutrition Examination Survey (KNHANES VI-3). Cheongju: Korea Centers for Disease Control and Prevention;2016.

46. Kwon SH, Park HR, Lee YM, Kwon SY, Kim OS, Kim HY, Lim YS. Difference in food and nutrient intakes in Korean elderly people according to chewing difficulty: using data from the Korea National Health and Nutrition Examination Survey 2013 (6th). Nutr Res Pract. 2017; 11:139–146.

47. Clark HM, Solomon NP. Age and sex differences in orofacial strength. Dysphagia. 2012; 27:2–9.