Frailty measurements and dysphagia in the outpatient setting

Ann Otol Rhinol Laryngol. 2014 Sep;123(9):629-35. doi: 10.1177/0003489414528669. Epub 2014 Apr 4.

Abstract

Objective: Deconditioning and frailty may contribute to dysphagia and aspiration. Early identification of patients at risk of aspiration is important. Aspiration prevention would lead to reduced morbidity and health care costs. We therefore wondered whether objective measurements of frailty could help identify patients at risk for dysphagia and aspiration.

Methods: Consecutive patients (n = 183) were enrolled. Patient characteristics and objective measures of frailty were recorded prospectively. Variables tested included age, body mass index, grip strength, and 5 meter walk pace. Statistical analysis tested for association between these parameters and dysphagia or aspiration, diagnosed by instrumental swallowing examination.

Results: Of variables tested for association with grip strength, only age category (P = .003) and ambulatory status (P < .001) were significantly associated with grip strength in linear regression models. Whereas walk speed was not associated with dysphagia or aspiration, ambulatory status was significantly associated with dysphagia and aspiration in multivariable model building.

Conclusion: Nonambulatory status is a predictor of aspiration and should be included in risk assessments for dysphagia. The relationship between frailty and dysphagia deserves further investigation. Frailty assessments may help identify those at risk for complications of dysphagia.

Keywords: aspiration; frailty; grip strength; oropharyngeal dysphagia.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Deglutition Disorders / complications*
  • Deglutition Disorders / diagnosis
  • Deglutition Disorders / epidemiology
  • Deglutition Disorders / etiology
  • Deglutition Disorders / physiopathology
  • Deglutition*
  • Exercise Test
  • Female
  • Frail Elderly*
  • Hand Strength*
  • Humans
  • Male
  • Middle Aged
  • Outpatients*
  • Pneumonia, Aspiration / prevention & control
  • Predictive Value of Tests
  • Prospective Studies
  • Reproducibility of Results
  • Risk Assessment
  • Risk Factors
  • Sensitivity and Specificity
  • Severity of Illness Index
  • United States / epidemiology
  • Walking*