Association Between Oral Health and Swallowing Function in the Elderly

Area of Science:

• Gerontology
• Respiratory Medicine
• Gastroenterology

Background:

• The oral environment significantly influences pneumonia risk, yet its relationship with swallowing function remains understudied.
• Few comparative studies have utilized video endoscopy (VE) and video fluorography (VF) to assess oral intake and food consistency in relation to pneumonia.
• Understanding the interplay between oral health, swallowing, and pneumonia is crucial for elderly patient care.

Purpose of the Study:

• To investigate whether the oral environment or swallowing function is a greater contributor to pneumonia development in elderly individuals.
• To compare the efficacy of VE and VF in assessing swallowing function and its impact on pneumonia risk.
• To identify key factors influencing recurrent pneumonia, even in patients with a seemingly healthy oral environment.

Main Methods:

• A cohort of 24 elderly patients (mean age 86) with various conditions, including pneumonia, were evaluated.
• Assessments included the Oral Health Assessment Tool (OHAT), VE, and VF to evaluate oral health and swallowing.
• Patients' oral intake status (oral intake, tube feeding, or gastric banding) was recorded.

Main Results:

• The OHAT score showed no correlation with VE or VF scores.
• No significant difference in OHAT scores was observed between patients with multiple pneumonia episodes versus those with none or a single episode.
• Patients experiencing multiple pneumonia episodes exhibited significantly lower VE and VF scores, indicating impaired swallowing function.

Conclusions:

• Oral assessment, VE, and VF are essential for evaluating swallowing in patients with suspected dysphagia.
• Swallowing function, particularly as measured by VE and VF, is more critical than the oral environment in assessing the risk of recurrent aspiration pneumonia in the elderly.
• Recurrent pneumonia in the elderly can be multifactorial, involving subclinical aspiration, pharyngeal clearance issues, and delayed gag reflex activation, even with good oral hygiene.