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Age and Ageing Advance Access published online on June 26, 2009
Age and Ageing, doi:10.1093/ageing/afp100
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia

Mateu Cabre1, Mateu Serra-Prat2, Elisabet Palomera2, Jordi Almirall3, Roman Pallares4 and Pere Clavé5

1 Acute Geriatric Unit, Department of Internal Medicine, Hospital de Mataró, Carretera de Cirera, s/n 08304, Mataró (Barcelona), Spain
2 Research Unit, Consorci Sanitari del Maresme, Carretera de Cirera s/n 08304, Mataró (Barcelona), Spain
3 Intensive Care Unit, Hospital de Mataró, Barcelona, Carretera de Cirera s/n 08304, Mataró (Barcelona), Spain
4 Clinical Research Unit and Infectious Diseases Service, IDIBELL, Hospital de Bellvitge, University of Barcelona, L’Hospitalet, Barcelona, Spain
5 Unitat d’Exploracions Funcionals Digestives, Department of Surgery, Hospital de Mataró, Carretera de Cirera s/n 08304, Mataró (Barcelona), Spain

Address correspondence to: M. Cabre. Tel: (+34) 93 741 7700; Fax: (+34) 93 741 7733; Email: mcabre{at}csdm.cat

Background: oropharyngeal dysphagia is a common condition among the elderly but not systematically explored.

Objective: to assess the prevalence and the prognostic significance of oropharyngeal dysphagia among elderly patients with pneumonia.

Design: a prospective cohort study.

Setting: an acute geriatric unit in a general hospital.

Subjects: a total of 134 elderly patients (>70 years) consecutively admitted with pneumonia.

Methods: clinical bedside assessment of oropharyngeal dysphagia and aspiration with the water swallow test were performed. Demographic and clinical data, Barthel Index, Mini Nutritional Assessment, Charlson Comorbidity Index, Fine's Pneumonia Severity Index and mortality at 30 days and 1 year after admission were registered.

Results: of the 134 patients, 53% were over 84 years and 55% presented clinical signs of oropharyngeal dysphagia; the mean Barthel score was 61 points indicating a frail population. Patients with dysphagia were older, showed lower functional status, higher prevalence of malnutrition and comorbidities and higher Fine's pneumonia severity scores. They had a higher mortality at 30 days (22.9% vs. 8.3%, P = 0.033) and at 1 year of follow-up (55.4% vs. 26.7%, P = 0.001).

Conclusions: oropharyngeal dysphagia is a highly prevalent clinical finding in elderly patients with pneumonia and is an indicator of disease severity in older patients with pneumonia.

Keywords: deglutition disorders, dysphagia, elderly, functional status, oropharyngeal aspiration, pneumonia

Received 19 August 2008; accepted in revised form 12 April 2009.


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