February 05, 2019
A new study, published online in the Journal of the American Medical Directors Association, found that early diagnosis and optimal management of dysphagia should be addressed as a priority issue in nursing homes.
Nursing home residents often experience dysphagia, which is associated with higher mortality rates. In order to better understand the prevalence of dysphagia, researchers led by Nikolina Jukic Peladic, PhD, of IRCCS INRCA (Ancona, Italy) and colleagues, conducted a perspective observational study. In addition, the researchers also investigated the influence of dysphagia and nutritional therapies on clinical outcomes, including nutritional status, pressure ulcers, hospitalization, and mortality in dysphagic subjects.
The study, known as the ULISSE project, consisted of 31 Italian nursing homes. The participants included 1490 long-stay nursing home residents, older than 65 years, who were assessed at baseline and reassessed after 6 and 12 months. The participants of the study underwent a standardized comprehensive assessment using the Italian version of the nursing home Minimum Data Set. Further, the researchers evaluated functional status of daily living using a Long-Form scale, and health care professionals assessed dysphagia by clinical evaluation. Finally, nutritional status was assessed using information on weight loss.
According to the findings, the researchers found that the prevalence of dysphagia was 12.8%, and 16% of the subjects were treated with artificial nutrition. Based on this finding, they concluded that mortality rate in subjects with dysphagia was significantly higher compared with that of nondysphagic subjects (27.7% vs 16.8%; P = .0001). Finally, weight loss and pressure ulcer prevalence was higher in dysphagic participants. The researchers noted that dysphagia was not associated with a higher hospitalization risk.
“Dysphagia is common in nursing home residents, and it is associated with higher mortality,” Dr Peladic and colleagues concluded. “Therefore, early diagnosis and optimal management of dysphagia should become a priority issue in nursing homes.”
Peladic NJ, Orlandoni P, Dell’Aquila G, et al. Dysphagia in nursing home residents: management and outcomes. J Am Med Dir Assoc. 2019;20(2):147-151. doi: https://doi.org/10.1016/j.jamda.2018.07.023
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