Prevalence of Dysphagia and Its Health Implications Among Elderly Residents in Long-Term Care Facilities in the Liguria Region (Italy): An Observational Cohort Study.

Background/

Objectives

Dysphagia is a common condition among older adults, associated with significant health risks. This prospective, open-label observational cohort study aimed to determine the prevalence of dysphagia and its impact on nutritional status and clinical outcomes in elderly residents of six long-term care facilities.

Methods

Patients aged ≥ 65 years were screened using the 3 oz Water Swallow Test (WST); those with dysphagia were followed for 6 months. Nutritional status was evaluated with the Mini Nutritional Assessment short-form (MNA-SF), the Global Leadership Initiative on Malnutrition (GLIM), and the SARC-F questionnaire. Anthropometric and body composition measurements were also obtained.

Results

Among 656 patients screened, 188 (28.6%) had dysphagia (median age 90 years; 89.9% females). Mild dysphagia was present in 34.0%, while 66.0% had moderate-to-severe dysphagia. At baseline, patients with moderate-to-severe dysphagia had significantly lower BMI (18.4 vs. 20.6 kg/m2, p = 0.014), smaller calf circumference (24.0 vs. 28.0 cm, p = 0.005), and higher SARC-F score (8 vs. 7, p = 0.028). Bioimpedance analysis showed lower fat mass (6.7 vs. 12.9 kg, p < 0.001) and fat mass% (14.7 vs. 25.4%, p < 0.001), and higher FFM% (85.3 vs. 74.6%, p < 0.001). At 6 months, BMI, calf circumference, handgrip strength, fat mass, and fat mass% resulted significantly lower in patients with moderate-to-severe dysphagia. A total of 23 participants (12.2%) died during follow-up, with a higher mortality rate in the moderate-to-severe group (HR 2.58, 95% CI 1.20-7.59, p = 0.044); aspiration pneumonia was the leading cause (21.7%).

Conclusions

Dysphagia significantly affects nutritional status and survival in elderly residents of long-term care facilities. Early personalized nutritional intervention is pivotal to improve outcomes.