Social Isolation Among Older Adults With Dysphagia Requiring Home Health Care: A Cross-Sectional Study

We hypothesized that community-dwelling older adults with impaired swallowing functions have a higher risk of social isolation than individuals without impaired function. The aim of this study was to identify the association of dysphagia with social isolation in home care patients using daily interaction frequency and laughter frequency as indicators of social interaction.

One hundred ninety home care patients, aged ≥65 years, were included in this cross-sectional questionnaire survey. The patients' basic information, level of care required, and social background as a percentage of public health care costs were obtained. Swallowing function, assessed with the Food Intake Level Scale (FILS), was evaluated from the medical records. Respondents answered how often they interacted with people outside their family, the number of people they interacted with, and how often they laughed in their daily lives. Logistic regression analyses were performed to examine factors associated with social isolation.

Laughter frequency was significantly lower in the dysphagia group (P=0.011). The interaction frequency was lower in those who needed more care (odds ratio (OR) (95% confidence interval (CI)) = 0.16 (0.03, 0.78)) and lower in those with dysphagia (0.40 (0.17, 0.97)). The number of exchanges was lower for those with dysphagia (0.22 (0.09, 0.58)) and needed more care (0.10 (0.02, 0.60)) and higher for those with dementia (2.86 (1.22, 6.66)).

Swallowing function is significantly associated with social interaction between homebound older adults and others. An approach to maintaining and improving swallowing function in older people requiring home healthcare may help maintain social interaction and prevent social isolation.