Dysphagia in Hospitalised Older Adults: Prevalence, Incidence and Predictors in the Multicentre NUTRIFAG Cohort: Empirical Research Quantitative.

AIMS: To determine the prevalence, incidence, associated factors and progression of suspected and clinically diagnosed dysphagia in hospitalised adults aged 65 years and over.

DESIGN

A multicentre prospective observational cohort study in nine public hospitals.

METHODS

Older adults (≥ 65 years) staying ≥ 48 h were consecutively recruited. Sociodemographic, functional, cognitive, nutritional and clinical data were collected at admission and discharge. Dysphagia was screened using the Eating Assessment Tool-10 and clinically diagnosed with the Volume-Viscosity Swallow Test. Descriptive, bivariate and multivariate analyses included logistic and Cox regression models. The study was approved by participating ethics committees.

RESULTS

The study included 3139 patients with discharge data available for 2817. Suspected dysphagia affected 16.01% at admission and 12.96% at discharge; among clinically assessed patients, diagnosed dysphagia affected 69.66% and 76.57%, respectively. New cases appeared during hospitalisation (2.50% suspected; 8.33% diagnosed). Lower calf circumference, functional dependence and mild cognitive impairment were independently associated with both suspected and confirmed dysphagia. The presence of dysphagia was linked to longer hospital stays.

CONCLUSION

Dysphagia was common and often persisted or worsened during hospitalisation in older adults. Its association with functional, cognitive and nutritional vulnerability reinforces the need for systematic screening and follow-up.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurses can integrate dysphagia screening and reassessment into geriatric care, prioritising older inpatients with functional, cognitive or nutritional vulnerability.

IMPACT: Dysphagia persisted or emerged during hospitalisation; findings support the potential value of nurse-led screening and reassessment in hospitalised older adults.

REPORTING METHOD: Reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology statement for cohort studies.

PATIENT OR PUBLIC CONTRIBUTION: A patient representative contributed to study design and variable selection. The NUTRIFAG Public Advisory Group supported the interpretation of findings and clinical relevance.