How Swallow Pressures and Dysphagia Affect Malnutrition and Mealtime Outcomes in Long-Term Care
AbstractMalnutrition is a major cause of hospitalization for residents of long-term care facilities (LTC). Dysphagia is thought to contribute to malnutrition. Tongue weakness is suggested to predict poor food intake, longer meals, and dysphagia. We explored the relationships between tongue strength, dysphagia, malnutrition and mealtime outcomes in LTC residents. Data were collected from 639 LTC residents (199 male), aged 62 –102 (mean 87). Maximum isometric tongue pressures (MIPs) and saliva swallow pressures (MSPs) were measured using the Iowa Oral Performance Instrument. Participants also completed the Screening Tool for Acute Neuro Dysphagia. Nutrition status was assessed using the Patient-Generated Subjective Glo bal Assessment. A series of repeated meal observations provided measures of meal duration and calories consumed. Mean MIPs were 33 kPa (95% CI 29–37) and MSPs were 26 kPa (95% CI 23–29). The odds of showing signs of dysphagia were 3.7 times greater in those with MSPs less than 26 kPa (p
Conclusions &InferencesPan‐esophageal pressurization and esophageal shortening were associated with symptoms severity but did not predict the cause of this disorder. Further prospective studies are necessary to determine if RDC test could help to select patients who might benefit from treatment. Pan‐esophageal pressurization during rapid drink challenge test was associated with more severe dysphagia but not with specific cause of esophago‐gastric junction obstruction. Esophageal shortening was more likely associated with definitive findings of obstruction.
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