Factors associated with dysphagia risk among residents in aged care : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand

Abstract

Background: Dysphagia is commonly associated with the ageing process and can lead to decreased food intake with associated health problems. Aim: This study aimed to determine factors associated with dysphagia risk among older adults in residential aged care (RAC). Methods: Residents aged ≥ 65 years and, with severe cognitive or functional decline, or undertaking palliative care were excluded. Pacemaker wearers were excluded from completing the body composition analysis assessment. This cross-sectional study included 91 older adults across three RAC facilities in Auckland. Demographic data were collected from the RAC clinical files. Validated questionnaires were completed during personal interviews. These included: Strength, Assistance with walking, Rising from a chair, Climbing stairs, and experiencing Falls (SARC-F), Mini Nutritional Assessment Short-Form (MNA-SF), Eating Assessment Tool (EAT-10), Geriatric Depression Scale (GDS) and the 12-item short form survey to assess health-related quality of life (SF-12). Physical measures included weight, grip strength, gait speed and body composition. Results: Findings showed the odds of being at dysphagia risk increased in those at risk of sarcopenia OR= 4.7, 95% CI 1.8, 12; malnutrition OR=10, 95% CI 1.2, 82, and depression OR= 5.0 95% CI 1.9, 13. Adjusting for age, sex and number of medications, sarcopenia risk, malnutrition and depression remained associated with dysphagia risk. Adjusting for age, sex, number of medications and all health variables (SARC-F, MNA, and GDS); depression risk was the only remaining significant association with being at dysphagia risk. Conclusion: This study highlights the need to identify and address malnutrition, sarcopenia, and depression to minimise the cyclic impact these conditions have one each other and older adults in RAC.