Swallowing Muscle Dysfunction and Residual Factor of Dysphagia with Community- Acquired Pneumonia in the Elderly

Objectives: This study aimed to elucidate the characteristics of swallowing function, including swallowing muscle activity, and the residual factors of dysphagia in elderly patients with community-acquired pneumonia (CAP). Study design: A total of 163 subjects were included in the study. The subjects were classified into an oral intake independent group (severe aspiration), which comprises subjects who have a total fiberoptic endoscopic evaluation of swallowing (FEES) score of seven or more, and an oral intake restriction group (no aspiration or mild aspiration), which comprises subjects who have a total FEES score of less than seven. These two groups were compared, and the residual factors of dysphagia were analyzed. Results: Significant differences between the two groups were found in the repetitive saliva swallowing test, geriatric nutritional risk index, pneumonia severity, swallowing muscle activity, and respiratory rate fasting period. Multivariate logistic regression analysis revealed that the duration of swallowing muscle activity (OR 15.7, 95% CI 1.29 to 19.66; P=0.031) and respiratory rate (OR 1.22, 95% CI 1.03 to 1.58; P=0.026) were the residual factors of dysphagia in elderly people with CAP. Conclusions: This study highlighted the importance of an early approach that focuses on swallowing function and respiratory rate in the rehabilitation of elderly people with dysphagia and CAP. The results for the residual factors of dysphagia provide new evidence in the field of rehabilitation and will help reduce hospitalization and readmission for pneumonia.