Brochier et al. (2018), Brazil(1919 Brochier CW, Hugo FN, Rech RS, Baumgarten A, Hilgert JB. Influence of dental factors on oropharyngeal dysphagia among recipients of long-term care. Gerodontology. 2018 Dez;35(4):333-8. http://dx.doi.org/10.1111/ger.12345. PMid:29882353.
http://dx.doi.org/10.1111/ger.12345...
)
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115 in 3 NHs, 67% females, over 81 years old. |
To assess the association of the sociodemographic and behavioral variables and oral conditions with the presence of OD in institutionalized older adults. |
Sensory oral-motor assessment and clinical diagnosis of OD were conducted with indirect swallowing test, oral assessment, and xerostomia inventory (XI). |
Xerostomia was the only sign with a positive association with OD. (p<0.001). |
Cross-sectional |
| Level VI |
Ekberg et al. (2002), Germany, France, Spain, and United Kingdom(2424 Ekberg O, Hamdy S, Woisard V, Wuttge-Hannig A, Ortega P. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002;17(2):139-46. http://dx.doi.org/10.1007/s00455-001-0113-5. PMid:11956839.
http://dx.doi.org/10.1007/s00455-001-011...
)
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360 in 37 NHs, 67% females, mean age 71.6 years. |
To determine the effects of dysphagia on social and psychological aspects related to the quality of life and investigate the relationship between the condition and its diagnosis and treatment. |
The assessment was based on interviews with the modified revision of the questionnaire developed by Gustafsson and Tibbling to elicit problems related to dysphagia (basic information, eating habits, personal feelings, help-seeking, and medical condition). |
The following were found: symptoms of food sticking in the throat (55%), uncomfortable or sore throat (41%), chokes and coughs (46%), and discomfort when eating solid foods (55%), slower mastication and swallowing (32%), a habit of drinking liquids during meals (27%), and weight loss (44%). |
Cross-sectional |
| Level VI |
Gilmore-Bykovskyi et al. (2018), United States(2222 Gilmore-Bykovskyi AL, Rogus-Pulia N. Temporal associations between caregiving approach, behavioral symptoms and observable indicators of aspiration in nursing home residents with dementia. J Nutr Health Aging. 2018;22(3):400-6. http://dx.doi.org/10.1007/s12603-017-0943-y. PMid:29484354.
http://dx.doi.org/10.1007/s12603-017-094...
)
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12 in 1 NH for dementia, 50% females, mean age 84 years. |
To identify temporal associations between the caregiver’s approach, behavioral symptoms, and events of aspiration among NH residents with dementia. |
Two meals were assessed with video observation regarding the actions of the caregiver centered on the person (resident) and on the caregiver’s task and defined indicators of aspiration, such as coughs and chokes during or after swallowing. |
Signs of coughs and chokes during meals were identified, which were observable indicators of events of laryngotracheal aspiration, associated with the actions centered on the caregiver’s tasks (96%). |
Cross-sectional |
| Level VI |
Huppertz et al. (2018), Netherlands(2323 Huppertz VAL, Halfens RJG, van Helvoort A, de Groot LCPGM, Baijens LWJ, Schols JMGA. Association between oropharyngeal dysphagia and malnutrition in dutch nursing home residents: results of the national prevalence measurement of quality of care. J Nutr Health Aging. 2018;22(10):1246-52. http://dx.doi.org/10.1007/s12603-018-1103-8. PMid:30498833.
http://dx.doi.org/10.1007/s12603-018-110...
)
|
6,349 in 65 NHs, 70.2% females, mean age 84.5 years. |
To assess the association between OD and malnutrition in Dutch NH residents. |
A questionnaire, based on the literature and consultation to specialists, was applied; it included questions on relevant symptoms to detect OD: “Do you have trouble swallowing and sneeze or cough when you swallow? Malnutrition was indicated based on the Body Mass Index (BMI). |
It was observed that almost half of those with dysphagia showed signs of coughs when swallowing (46.9%), and almost all these coughing residents had overall swallowing problems (82.2%). |
Cross-sectional |
| Level VI |
| Jukic Peladic et al. (2018) Italy(3333 Jukic Peladic N, Orlandoni P, Dell’Aquila G, Carrieri B, Eusebi P, Landi F, et al. Dysphagia in nursing home residents: management and outcomes. J Am Med Dir Assoc. 2019 Fev;20(2):147-151. PMid:30249360.)
|
1,299 for 6 months and 971 for 12 months, 71.5% females, mean age 83.5 years. |
To estimate the prevalence of dysphagia and associated factors and investigate the influence of dysphagia and nutritional therapies conducted with dysphagic subjects on clinical outcomes. |
Clinical assessment with the collection of information on swallowing problems and review of the medical history. The nutritional status was assessed with the information on weight loss. |
The subjects with dysphagia presented with signs of greater weight loss than the non-dysphagic subjects (14.6%, p<0.001). |
Prospective cohort |
| Level IV |
Kayser-Jones and Pengilly (1999), United States(2525 Kayser-Jones J, Pengilly K. Dysphagia among nursing home residents. Geriatr Nurs. 1999;20(2):77-82, quiz 84. http://dx.doi.org/10.1053/gn.1999.v20.97011. PMid:10382421.
http://dx.doi.org/10.1053/gn.1999.v20.97...
)
|
82 in 2 NHs, without data on sex, mean age 83.4 years. |
To identify the factors that influence nutritional intake in NHs. |
All three meals were observed throughout about 6 months. Each resident was screened for dysphagia at the bedside by a speech-language-hearing therapist. |
Signs of delay finishing the oral phase, weight loss, older adults who spat their food, and frequent coughs when eating or drinking liquids were observed and reported by the residents. |
Cross-sectional |
| Level VI |
Lin et al. (2002), Taiwan(2626 Lin L-C, Wu S-C, Chen HS, Wang T-G, Chen M-Y. Prevalence of impaired swallowing in institutionalized older people in taiwan. J Am Geriatr Soc. 2002 Jun;50(6):1118-23. http://dx.doi.org/10.1046/j.1532-5415.2002.50270.x. PMid:12110075.
http://dx.doi.org/10.1046/j.1532-5415.20...
)
|
1,221 in 18 NHs, 48.1% females, mean age 77.07 years. |
To investigate the prevalence of impaired swallowing in NH residents in Taiwan. |
The assessment was based on self-reported questionnaires on swallowing difficulties and timed liquid-swallowing tests. |
The individuals pointed out signs and symptoms of swallowing difficulties, and the occurrence of coughs and chokes was verified during the timed swallowing test. |
Cross-sectional |
| Level VI |
Namasivayam et al. (2016), Canada(3232 Namasivayam AM, Steele CM, Keller H. The effect of tongue strength on meal consumption in long term care. Clin Nutr. 2016;35(5):1078-83. http://dx.doi.org/10.1016/j.clnu.2015.08.001. PMid:26321499.
http://dx.doi.org/10.1016/j.clnu.2015.08...
)
|
20 in 1 NH, 12.60% females, mean age 85 years. |
To explore the tongue force and its associations with signs of deficient swallowing, based on dysphagia screening and observations made during meals, time taken to eat, and amount of food ingested. |
The modified version of the Screening Tool for Acute Neurological Dysphagia (STAND) was used, as well as the Iowa Oral Performance Instrument (IOPI) to measure the maximum tongue pressures; the meals were also observed to determine their duration and the food intake. |
It was identified that those with reduced maximum tongue force had signs of swallowing difficulties during meals; they took 20 minutes more on average to finish their meals and their daily food intake was reduced (p <0.05). |
Cross-sectional |
| Level VI |
Namasivayam-MacDonald et al. (2017), Canada(2727 Namasivayam-MacDonald AM, Morrison JM, Steele CM, Keller H. How swallow pressures and dysphagia affect malnutrition and mealtime outcomes in long-term care. Dysphagia. 2017;32(6):785-96. http://dx.doi.org/10.1007/s00455-017-9825-z. PMid:28733775.
http://dx.doi.org/10.1007/s00455-017-982...
)
|
639 in 32 NHs, 68.9% females, mean age 87 years. |
To study associations between nutritional status, food intake measures during meals, clinical signs suggestive of dysphagia, and reduced tongue force. |
The older adults’ behavior during meals was observed; the Screening Tool for Acute Neurological Dysphagia (STAND) was used, as well as the Iowa Oral Performance Instrument (IOPI) to measure tongue force, in a subset of 80 residents. |
Signs of coughs and, less frequently, chokes in most residents were recorded. Signs of less tongue pressure were also observed in older adults with suspicion of dysphagia (p<0.05). |
Cross-sectional |
| Level VI |
Nogueira and Rei (2013), Portugal(2828 Nogueira D, Reis E. Swallowing disorders in nursing home residents: how can the problem be explained? Clin Interv Aging. 2013;8:221-7. http://dx.doi.org/10.2147/CIA.S39452. PMid:23449951.
http://dx.doi.org/10.2147/CIA.S39452...
)
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266 in 8 NHs, 75% females, mean age 82 years. |
To determine the prevalence of swallowing disorders in older adults living in NHs and identify its relationship with their cognitive and functional performance and the variables that explain the self-perceived swallowing disorders. |
The swallowing and diet profiles were assessed with the 3-ounce Water Swallow Test (3 oz. WST) and Dysphagia Self-Test (DST) for older adults who managed to answer the questionnaire. |
Based on the 3 oz. WST, signs of coughs and wet voice were recorded, the second one being more prevalent (10.3%). The most frequent symptoms self-reported with the DST were chokes or coughs with solid or liquid foods (49%) and the need for drinking something after swallowing (47%). |
Cross-sectional |
| Level VI |
Nomura et al. (2020), Japan(2121 Nomura Y, Tsutsumi I, Nagasaki M, Tsuda H, Koga F, Kashima N, et al. Supplied food consistency and oral functions of institutionalized elderly. Int J Dent. 2020;3463056. http://dx.doi.org/10.1155/2020/3463056.
http://dx.doi.org/10.1155/2020/3463056...
)
|
69 in 1 NH, 81.15% females, mean age 86.23 years. |
To analyze the relationship between oral functions and the consistency of the food that is served. |
The following were verified: oral moisture, oral hygiene status, maximum occlusal pressure, tongue pressure with the Dental Prescale, tongue and lip function with oral diadochokinesia, mastication with the Gluco GSII sensor, swallowing with an OD symptom-related questionnaire. |
The symptom of waking up due to coughs in sleep had a relatively high association with swallowing difficulties, and many of these older adults presented with signs of tongue and lip dysfunction (p=0.027). |
Cross-sectional |
| Level VI |
Park et al. (2013), South Korea(2929 Park Y-H, Han H-R, Oh B-M, Lee J, Park J, Yu SJ, et al. Prevalence and associated factors of dysphagia in nursing home residents. Geriatr Nurs. 2013;34(3):212-7. http://dx.doi.org/10.1016/j.gerinurse.2013.02.014. PMid:23528180.
http://dx.doi.org/10.1016/j.gerinurse.20...
)
|
395 in 2 NHs, 76.5% females, 76.7% aged 75 years or more. |
To assess the prevalence of dysphagia in NH residents in South Korea and identify the factors associated with dysphagia. |
Information on the warning symptoms, signs of dysphagia, and swallowing problems was collected regarding the swallowing capacity and severity of dysphagia with the Gugging Swallowing Screen (GUSS). |
Among the signs found, wet voice (14,4%), saliva loss (9.1%), slow swallowing (58.2%), coughs (24%), mastication difficulties (63.5%), and weight loss (31.7%) were risk factors significantly associated with dysphagia (p<0.001). |
Cross-sectional |
| Level VI |
Roque et al. (2010), Brazil(1818 Roque FP, Bomfim FMS, Chiari BM. Descrição da dinâmica de alimentação de idosas institucionalizadas. Rev Soc Bras Fonoaudiol. 2010;15(2):256-63. http://dx.doi.org/10.1590/S1516-80342010000200018.
http://dx.doi.org/10.1590/S1516-80342010...
)
|
30 in 1 NH, females, mean age 83.73 years. |
To describe the dynamics of the diet of institutionalized older women regarding the clinical aspects of swallowing, as well as cognitive, behavioral, and environmental aspects related to the diet. |
A meal was observed in real time and audiovisually recorded to verify the older women’s attitudinal and behavioral aspects and required dependence; their oral cavity was also inspected. |
The most recurrent signs were food residues (23.3%) and vice changes (16.7%) after swallowing and coughs (20%) during meals. Poor oral intake (26.7%) and taking longer to eat (53.3%) were also identified. |
Cross-sectional |
| Level VI |
Siebens et al. (1986), United States(2020 Siebens H, Trupe E, Siebens A, Cook F, Anshen S, Hanauer R, et al. Correlates and consequences of eating dependency in institutionalized elderly. J Am Geriatr Soc. 1986 Mar;34(3):192-8. http://dx.doi.org/10.1111/j.1532-5415.1986.tb04202.x. PMid:3950287.
http://dx.doi.org/10.1111/j.1532-5415.19...
)
|
131 in 1 NH, 79% females, mean age 81.7 years. |
To identify the factors associated with the loss of the ability to eat. |
A questionnaire was administered approaching the diet, frequency of self-feeding, dysfunction of the upper limbs, and signs of dysphagia. Their cognition, capacity to swallow liquids and semisolids, and motor functions of the oropharyngeal structures were also assessed. |
Dependent older adults had greater signs in the oral phase, such as spitting the food, chokes (n=28), incapacity to masticate (n=19), saliva loss (n=26), nasal regurgitation (n=3), oral food escape (n=13), and delayed swallowing (n=27). In the pharyngeal phase, signs of coughs when swallowing liquids (n=51), chokes during meals (n=36), and wet voice (n=12) were identified. |
Cross-sectional |
| Level VI |
Steele et al. (1997), Canada(3030 Steele CM, Greenwood C, Ens I, Robertson C, Seidman-Carlson R. Mealtime difficulties in a home for the aged: not just dysphagia. Dysphagia. 1997;12(1):43-50, discussion 51. http://dx.doi.org/10.1007/PL00009517. PMid:8997832.
http://dx.doi.org/10.1007/PL00009517...
)
|
372 in 1 NH, in levels of care, 280 females, mean age 87 years. |
Prevalence of identifiable diet-related difficulties in a multi-care institution for older adults and determine their distribution in various levels of attention. |
A single meal was observed, taking notes of the occurrence and frequency of a list of 12 specific problems related to eating/swallowing or any mastication difficulties. |
A greater prevalence of signs of delay to finish meals (29 minutes), coughs or chokes (28%), saliva loss (71%), absent or slow swallowing (31%), oral residues, and spitting the food (33%) were observed. |
Cross-sectional |
| Level VI |
Yoshida et al. (2006), Japan(3131 Yoshida M, Kikutani T, Tsuga K, Utanohara Y, Hayashi R, Akagawa Y. Decreased tongue pressure reflects symptom of dysphagia. Dysphagia. 2006 Jan;21(1):61-5. http://dx.doi.org/10.1007/s00455-005-9011-6. PMid:16544085.
http://dx.doi.org/10.1007/s00455-005-901...
)
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145 in 5 NHs, 109 females, mean age 83 years. |
To determine the relationship between tongue force and signs of cough and demonstrate the clinical value of the tongue pressure measure in swallowing assessments. |
The swallowing problems were identified based on the report of coughs during meals, classified from mild to intense; to assess tongue pressure, a prototype device that registers tongue pressure was used. |
Most older adults reported symptoms of mild coughs, and those with defined swallowing problems reported intense coughs. Less tongue pressure was identified and was significantly related to coughs during meals (p<0.001). |
Cross-sectional |
| Level VI |
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Subtitle: n = number of studies