Impact of dysphagia on early psychosocial consequences after acute ischemic stroke

Abstract

Background

Post-stroke dysphagia is common and known to impair both recovery and overall quality of life of stroke survivors. This study explores whether its impact extends to psychosocial consequences following acute ischemic stroke.

Methods

We prospectively evaluated 1117 consecutive patients with acute ischemic stroke (STROKE-CARD Registry 2020–2023, study center Innsbruck, Austria) for post-stroke dysphagia using standardized clinical and instrumental swallowing examinations during initial hospital stay. Outcomes were dependency in daily activities, changes in living arrangements, and employment status, assessed at hospital admission and three months post-stroke.

Results

Dysphagia was diagnosed in 233 patients (20.9 %) at hospital admission (mean age 70.6 ± 13.4 years, 36.3 % females). At three months post-stroke, patients with dysphagia showed significantly higher rates of adverse psychosocial outcomes compared to those without: dependency in daily activities (23.0 % vs 5.1 %, aOR 2.63 [1.5–4.5]), need for care allowance (34.2 % vs 9.0 %, aOR 2.41 [1.6–3.8]). In working-age patients (≤65 years), those with dysphagia were more likely to have not returned to work (69.4 % vs 29.7 %, aOR 2.61 [1.2–5.8]). These associations remained significant after adjusting for age, sex, stroke severity, and functional disability at discharge.

Conclusions

Post-stroke dysphagia is associated with serious psychosocial consequences including increased dependency in daily living and a higher risk of being unable to return to work. These findings underscore the need for awareness as well as comprehensive rehabilitation strategies addressing both physical and psychosocial consequences of dysphagia.