Frailty Status and Dysphagia Trajectory Among Hospitalized Nursing Home Residents With Advanced Dementia

Area of Science:

• Gerontology
• Neurology
• Clinical Nutrition

Background:

• Dysphagia and frailty are prevalent in persons living with dementia (PLWD) residing in skilled nursing facilities (SNFs).
• Hospitalization is a critical event that can exacerbate health conditions in PLWD.

Purpose of the Study:

• To investigate the association between frailty and dysphagia in PLWD within SNFs before and after hospitalization.

Main Methods:

• Retrospective cohort study of long-stay US nursing home residents with advanced dementia (2012-2018).
• Utilized Minimum Data Set (MDS) assessments to measure dysphagia and FRAIL-NH scale components.
• Adjusted analyses examined dysphagia risk based on pre-hospital frailty status and new dysphagia post-hospitalization.

Main Results:

• 85% of the pre-hospital cohort (n=1,207,345) were classified as frail.
• Frail residents had a higher frequency of dysphagia (6.2%) compared to prefrail (2.4%) and nonfrail (1.1%) residents.
• Frailty was associated with a significantly greater risk of dysphagia (IRR, 3.97) and new-onset dysphagia post-hospitalization (IRR, 1.7).

Conclusions:

• Frailty is a significant risk factor for dysphagia in PLWD in SNFs.
• Frail PLWD who are hospitalized face an increased risk of developing new dysphagia.
• Findings highlight the need for interventions targeting dysphagia in frail PLWD and suggest further validation of MDS for dysphagia assessment.