Risk Factors for Oropharyngeal Dysphagia in Older Adults - Evidence from Consorci Sanitari Del Maresme and Mataró University Hospital, Catalonia, Spain.

Abstract

Oropharyngeal dysphagia (OD) is a highly prevalent geriatric syndrome that remains underdiagnosed and undertreated, often resulting in severe nutritional and respiratory complications with poor clinical outcomes. Its risk factors are still not well defined, representing a critical gap in efforts to understand its pathophysiology, prevent the condition and reduce its associated complications. To analyze data from comprehensive studies conducted in a single-center setting to ascertain the major risk factors associated with OD as a geriatric syndrome. A retrospective analysis was conducted, encompassing a review of prior studies, including a cohort of 7,272 older patients with OD at Consorci Sanitari del Maresme, Catalonia, Spain, presented as a narrative review. The study presents data using odds ratios (OR) and p-values from univariate and multivariate analyses to show the association of OD with its main risk factors in different phenotypes of older patients with OD (independently living, acute hospitalized, and with pneumonia, dementia, COVID-19, stroke). Quality of studies was assessed with ROBINS-I-V2. Outcome (risk factors) quality was assessed with GRADE. Thirteen studies (2010-2022) were reviewed. OD exhibited significant associations with 8 main groups of risk factors among older patients from diverse phenotypes. The main risk factors were impaired functionality (OR:2.24-12.7), aging (OR:1.05-5.16) and malnutrition (OR:2.46-5.16). Comorbidities, respiratory disease, neurological impairments, geriatric syndromes and pharmacological treatments were also significantly associated with OD (OR:1.02-15.52). The quality of the included studies and variables was mainly moderate. OD is a geriatric syndrome associated with several risk factors across multiple phenotypes of older patients. These findings highlight the critical need for early identification and targeted prevention of key risk factors for OD to improve clinical outcomes and reduce the burden of this underdiagnosed geriatric syndrome.