Dysphagia in Hospitalised Older Adults: Prevalence, Incidence and Predictors in the Multicentre NUTRIFAG Cohort: Empirical Research Quantitative.

Abstract

Aims: To determine the prevalence, incidence, associated factors and progression of suspected and clinically diagnosed dysphagia in hospitalised adults aged 65 years and over.

Design: A multicentre prospective observational cohort study in nine public hospitals.

Methods: Older adults (≥ 65 years) staying ≥ 48 h were consecutively recruited. Sociodemographic, functional, cognitive, nutritional and clinical data were collected at admission and discharge. Dysphagia was screened using the Eating Assessment Tool-10 and clinically diagnosed with the Volume-Viscosity Swallow Test. Descriptive, bivariate and multivariate analyses included logistic and Cox regression models. The study was approved by participating ethics committees.

Results: The study included 3139 patients with discharge data available for 2817. Suspected dysphagia affected 16.01% at admission and 12.96% at discharge; among clinically assessed patients, diagnosed dysphagia affected 69.66% and 76.57%, respectively. New cases appeared during hospitalisation (2.50% suspected; 8.33% diagnosed). Lower calf circumference, functional dependence and mild cognitive impairment were independently associated with both suspected and confirmed dysphagia. The presence of dysphagia was linked to longer hospital stays.

Conclusion: Dysphagia was common and often persisted or worsened during hospitalisation in older adults. Its association with functional, cognitive and nutritional vulnerability reinforces the need for systematic screening and follow-up.

Implications for the profession and/or patient care: Nurses can integrate dysphagia screening and reassessment into geriatric care, prioritising older inpatients with functional, cognitive or nutritional vulnerability.

Impact: Dysphagia persisted or emerged during hospitalisation; findings support the potential value of nurse-led screening and reassessment in hospitalised older adults.

Reporting method: Reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology statement for cohort studies.

Patient or public contribution: A patient representative contributed to study design and variable selection. The NUTRIFAG Public Advisory Group supported the interpretation of findings and clinical relevance.