Cognitive Impairment and Mild to Moderate Dysphagia in Elderly Patients: A Retrospective Controlled Study

Ear Nose Throat J. 2024 Nov;103(11):NP671-NP678. doi: 10.1177/01455613211054631. Epub 2022 Mar 7.

Abstract

Background: To investigate whether cognitive impairment in elderly patients could correlate with the severity of swallowing disorders detectable through the endoscopic fiber optic evaluation. Methods: Elderly patients (≥65 years) performing a swallowing evaluation were included and divided according to the Dysphagia outcome and severity scale (DOSS). Neurological evaluation and Mini-Mental test examination (MMET) were administered to detect cognitive impairment. Results: Significantly worse swallowing function was reported in the cognitive impairment group than the control one (40% vs 19%; P = .001). A different significant distribution of swallowing performance was detected according to the patient's MMET score (P < .001; P < .001; P = .01). At the ANOVA test among dependent variables assessed, only age>65 and MMET<10 were significantly correlated with swallowing function (F = 3.862, P = .028; F = 17.49, P = .000). Conclusions: The elderly patient has an increased risk for unrecognized swallowing disorders, with a prevalence of mild to moderate forms. Assessment of cognitive performance could facilitate the identification of swallowing disorders by providing a higher level of suspicion for silent aspiration in subjects with poor MMET scores.

Keywords: Mini-Mental test; cognitive impairment; deglutition; deglutition disorders; dysphagia; dysphagia outcome severity scale; elderly patient; swallowing disorders.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Cognitive Dysfunction* / diagnosis
  • Deglutition / physiology
  • Deglutition Disorders* / diagnosis
  • Female
  • Humans
  • Male
  • Mental Status and Dementia Tests
  • Retrospective Studies
  • Severity of Illness Index*