The Risk of Dysphagia and Dysphagia-specific Quality of Life among Community Dwelling Older Adults in Senior Center

Min-Su Kim; Yeon-Hwan Park

doi:10.7469/kjan.2014.26.4.393

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Kim and Park: The Risk of Dysphagia and Dysphagia-specific Quality of Life among Community Dwelling Older Adults in Senior Center

Original Article

Korean J Adult Nurs 2014;26(4):393-402.

Published online: NaN August 2014

DOI: https://doi.org/10.7469/kjan.2014.26.4.393

The Risk of Dysphagia and Dysphagia-specific Quality of Life among Community Dwelling Older Adults in Senior Center

Min-Su Kim¹, Yeon-Hwan Park^2,

^¹Seoul National University, Bundang Hospital, Seoul

^²Collegeof Nursing The Research Institute of Nursing Science, Seoul National University, Seoul, Korea

Corresponding author: Park, Yeon-Hwan College of Nursing, Seoul National University, 28 Yeongeon-dong, Jongro-gu, Seoul 110-744, Korea. Tel: +82-2-740-8846, Fax: +82-2-745-8017, E-mail: hanipyh@snu.ac.kr

Received 25 February 20142 July 2014 Accepted 6 July 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study was to describe the risk of dysphagia among older adults in senior centers and to find therelationshipsbetween the risk of dysphagia and dysphagia-specific qualityof life.

Methods

Theparti-cipantswere 260 community-dwellingolder adults, aged 65 years in two senior centers. Data werecollected by self-report questionnaires or face to face interviews. The instruments were the modified dysphagia risk assessment scale for elderly and dysphagia-specific quality of life questionnaire. The data were analyzed using t-test, x²-test, logistic regression, andpearson's correlation.

Results

162olderadults (62.3%) wereclassifiedashaving the risk of dysphagia. Severe dry mouth (OR=15.677, CI=2.986~82.297), neurologic disease (OR=10.125, CI= 1.092~93.899), gastritis (OR=5.731,CI=1.482~22.173), denture discomfort (OR=2.969, CI=1.016~8.677), teeth discomfort (OR=2.61, CI=1.311~5.196) were the significant factors predicting the risk of dysphagia. There is a significant correlationbetweenthe riskof dysphagia and dysphagia-specificquality of life.

Conclusion

Dysphagia could be a major health problem among community dwelling older adults. It can affect the dysphagia-specific quality of life. Older adults having severe dry mouth, neurologic disease, or gastritis should receive dysphagia risk assessment and proper management on a regular basis. An effective nursing intervention needs to be developed for the older adults with risk factors of dysphagia.

Keywords: Aged, Dysphagia, Quality of life

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Table 1.

Differences to Dysphagia Risk by Process of Swallowing

Variables	Non-risk (n=98)	Risk (n=162)	t	p
Variables	M±SD(Range)	M±SD(Range)	t	p
Pharyngeal dysfunction	0.19±0.59 (0~3)	2.37±2.98 (0~17)	-9.006	.001 ＜
Deglutition dysfunction	0.49±0.93 (0~5)	2.85±2.48 (0~13)	-10.911	.001 ＜
Oral dysfunction	0.90±1.34 (0~5)	8.05±4.86 (0~20)	-17.646	.001 ＜
Esophageal dysfunction	0.27±0.71 (0~4)	2.08±2.38 (0~9)	-9.051	.001 ＜

Table 2.

Differences to Dysphagia Risk by Socio-demographic Characteristics of the Subjects

Characteristics	Categories	Non-risk(n=98)	Risk (n=162)	x² or t	p
Characteristics	Categories	n (%) or M±SD (Range)	n (%) or M±SD (Range)	x² or t	p
Age (year)		75.21±6.10 (65~90)	76.12±6.31 (65~93)	-1.142	.255
Gender	Female	62 (63.3)	113 (69.8)	1.168	.172
Gender	Male	36 (36.7)	49 (30.2)	1.168	.172
Level of education	Elementary school ≤	38 (38.8)	87 (53.7)	7.928	.160
	Middle-High school	57 (48.0)	63 (38.9)
	College ≥	13 (13.2)	12 (7.4)
Living arrangement	Alone	33 (33.7)	86 (53.1)	14.913	.005
	Couple	26 (26.5)	44 (27.2)
	2 generations ≥	39 (39.8)	32 (19.7)
Number of family		2.42±1.58 (1~8)	1.77±1.12 (1~6)	3.582	.001 ＜
Monthly expense (10,000 won)		56.43±58.76 (0~300)	42.70±36.80 (0~200)	2.080	.390

Table 3.

Differences to Dysphagia Risk by General Health and Oral Health Related Characteristics

Variables	Characteristics	Categories	Non-risk (n=98)	Risk (n=162)	x² or t	p
Variables	Characteristics	Categories	n (%) or M±SD (Range)	n (%) or M±SD (Range)	x² or t	p
Health related characteristics	Number of chronic disease		1.40±1.13	1.78±1.25	-2.524	.012
	Type of chronic disease	Neurology disease	1 (1.0)	14 (8.6)	6.524	.007
		Heart disease	53 (54.1)	92 (56.8)	0.182	.383
		Diabetes mellitus	18 (18.4)	40 (24.7)	1.409	.151
		Gastritis	6 (6.1)	25 (15.4)	5.039	.018
		Depression or insomnia	3 (3.1)	15 (9.3)	3.640	.044
	Number of medication (a day)		2.27±2.23	3.08±3.42	-2.326	.021
	Body weight (kg)		58.82±9.53	56.26±9.09	2.141	.033
	Body weight (kg)		(40~90)	(30~83)
	Perceived dysphagia	Yes	5 (5.1)	33 (20.4)	11.407	.001 ＜
	Attitude toward dysphagia	No	93 (94.9)	129 (79.6)	0.448	.295
	Attitude toward dysphagia	Yes	57 (58.2)	101 (62.3)
Oral health related characteristics	Number of teeth	No	41 (41.8)	61 (37.7)
	Number of tooth brushing (a day)		2.27±1.20	2.04±1.21	1.484	.001 ＜
	Teeth discomfort	Yes	35 (35.7)	86 (53.1)	7.407	.005
	Teeth discomfort	No	63 (64.3)	76 (46.9)
	Denture user	Yes	37 (37.8)	84 (51.9)	4.877	.019
	Denture user	No	61 (62.2)	78 (48.1)
	Duration of denture usage (hour/a day)		6.41±9.31	9.51±10.04	-2.530	.012
	Duration of denture usage (hour/a day)		(0~24)	(0~24)
	Denture discomfort	Yes	11 (29.7)	46 (54.8)	11.303	.004
	Denture discomfort	No	26 (70.3)	38 (45.2)
	Dry mouth during the day	None	66 (67.3)	45 (27.8)	44.308	.001 ＜
		A little	28 (28.6)	73 (45.1)
		Severe	2 (2.0)	25 (15.4)
		Very severe	2 (2.0)	19 (11.7)

Table 4.

Logistic Regression Analysis of Factors which Influence Dysphagia Risk

Classification	Factor		OR	95% CI	p
Risk	Dry mouth during the day	Severe	15.677	2.986~82.297	.001
		Very severe	9.047	1.680~48.726	.010
		A little	4.147	2.075~8.286	.001 ＜
		None	1
	Neurology disease		10.125	1.092~93.899	.042
	Gastritis		5.731	1.482~22.173	.011
	Denture discomfort		2.969	1.016~8.677	.047
	Teeth discomfort		2.610	1.311~5.196	.006
Protective	Number of teeth		0.947	0.903~0.993	.024
		Predicted			Percentage correct (%)
		Yes	No	Total	Percentage correct (%)
Observed (dysphagia risk) -	Yes	61	37	98
	No	30	132	162	74.2
	Total	91	169	260
2LL=268.009, x²=76.511 (df=6, p .001), Nagelkerke R²=0.347.

Table 5.

Correlation Dysphagia risk with Dysphagia Specific Quality of Life for the Subjects

Variables	Dysphagia risk
Variables	r	p
Global dysphagia specific quality of life	-0.560	＜.001
Emotional dysphagia specific quality of life	-0.582	＜.001
Functional dysphagia specific quality of life	-0.575	＜.001
Physical dysphagia specific quality of life	-0.686	＜.001
Total sum	-0.687	＜.001

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