Risk Factors of Oropharyngeal Dysphagia and Malnutrition in Neurological Patients

IF 2.7 3区医学 Q2 CLINICAL NEUROLOGY

Acta Neurologica Scandinavica Pub Date : 2025-10-02 DOI:10.1155/ane/3715519

Līga Savicka, Baiba Kubile, Guna Bērziņa

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Abstract

Background

Oropharyngeal dysphagia (OD) and malnutrition are prevalent among neurological patients, particularly those with cerebrovascular disease and neurodegenerative conditions. Both conditions can significantly impact the health and recovery of these individuals. The study was aimed at identifying risk factors associated with OD and malnutrition, using the biopsychosocial model to explore the relationships between these outcomes and various risk factors, including body structures, body functions, level of activity and participation, and contextual factors.

Methods

This cross-sectional study included 144 neurological patients, aged 19–93 years. Data were collected on a range of factors, including oral and pharyngeal structures, appetite, cognitive function, and social participation. The prevalence of OD and malnutrition was assessed using the Standardized Swallowing Assessment and Global Leadership Initiative on Malnutrition (GLIM) criteria. Risk factors were evaluated using logistic regression models based on the biopsychosocial model.

Results

The prevalence of OD and malnutrition in the study sample was 27.1% and 35.4%, respectively. Significant risk factors for OD included impaired oral structures (tongue, lips, and soft palate), cognitive dysfunction, and appetite loss. Malnutrition was associated with soft palate impairment, reduced calf circumference, weight loss, and social isolation. Higher scores in the WHO Disability Assessment Schedule (WHODAS 2.0) getting along domain (indicating poor social functioning) and living alone were linked to increased malnutrition risk. No significant relationship was found between environmental factors or health conditions and OD or malnutrition. While most dysphagia patients retained some ability to eat orally, dietary adaptations were frequently required.

Conclusion

This study highlights the high prevalence of OD and malnutrition among neurological patients and identifies key risk factors, including both physical impairments and psychosocial elements. Early screening and targeted interventions, such as dietary modifications and cognitive support, are essential for improving patient outcomes. A biopsychosocial approach is effective in understanding the multifactorial nature of these conditions and informs clinical practice. Future longitudinal studies are necessary to better understand causal relationships and enhance the generalizability of these findings.

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神经系统患者口咽吞咽困难和营养不良的危险因素

口咽吞咽困难（OD）和营养不良在神经系统患者中很普遍，特别是那些患有脑血管疾病和神经退行性疾病的患者。这两种情况都会严重影响这些人的健康和康复。该研究旨在确定与吸毒过量和营养不良相关的风险因素，并使用生物心理社会模型来探索这些结果与各种风险因素之间的关系，包括身体结构、身体功能、活动和参与水平以及环境因素。方法对144例神经系统疾病患者进行横断面研究，年龄19 ~ 93岁。收集了一系列因素的数据，包括口腔和咽结构、食欲、认知功能和社会参与。使用标准化吞咽评估和全球营养不良领导倡议（GLIM）标准评估OD和营养不良的患病率。使用基于生物心理社会模型的逻辑回归模型评估危险因素。结果研究样本中吸毒过量和营养不良的发生率分别为27.1%和35.4%。过量用药的重要危险因素包括口腔结构受损（舌头、嘴唇和软腭）、认知功能障碍和食欲减退。营养不良与软腭损伤、小腿围减小、体重减轻和社会孤立有关。在世卫组织残疾评估表（WHODAS 2.0）中得分较高的相处领域（表明社会功能差）和独居与营养不良风险增加有关。环境因素或健康状况与用药过量或营养不良之间无显著关系。虽然大多数吞咽困难患者仍有一定的口服能力，但经常需要调整饮食。结论：本研究突出了神经系统疾病患者中吸毒过量和营养不良的高患病率，并确定了包括身体损伤和社会心理因素在内的关键危险因素。早期筛查和有针对性的干预措施，如饮食调整和认知支持，对于改善患者预后至关重要。生物心理社会方法是有效的理解这些条件的多因素性质，并告知临床实践。未来的纵向研究是必要的，以更好地了解因果关系和提高这些发现的普遍性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.