Association between anticholinergic burden and oropharyngeal dysphagia among hospitalized older adults

Oropharyngeal dysphagia is an emerging age-related disorder that affects 23% of inpatients leading to malnutrition, dehydration, or aspiration pneumonia. Anticholinergic drugs can cause reduced peristalsis and dry mouth, both related to dysphagia.

To determine the association between anticholinergic burden and oropharyngeal dysphagia in older inpatients.

Retrospective descriptive observational study. There are 239 patients. Dysphagia diagnosis based on routine volume-viscosity swallow test. Characteristics: age, functional loss (instrumental and basic activities), frailty (Frail-VIG-Index), geriatric syndromes, polypharmacy, and anticholinergic-cognitive-burden scale at admission.

25.5% of elderly patients diagnosed with dysphagia are more dependent and frailer than non-dysphagic patients. 83.6% scored ≥ 3 points on the ACB Scale [odds ratio: 4.46 (2.13-9.33)], which is statistically associated with dysphagia (p < 0.001).

Patients with an ACB of ≥ 3 points at admission are more than four times as likely to develop oropharyngeal dysphagia. Evaluating anticholinergic burden routinely should be considered and, whenever possible, reduce it.