A decade-long study on dysphagia risk: sex and age differences in older adults with obstructive sleep apnea

With the aging global population, obstructive sleep apnea (OSA) is becoming increasingly prevalent. This study aimed to determine the incidence of dysphagia among patients with OSA and to examine its associations with age, sex, and comorbidities.

A population-based cohort study, which included a total of 20 971 patients with OSA, was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan from 2009 to 2020. The incidence rate of dysphagia was reported as events per 1000 person-years. Furthermore, we applied the Fine-Grey competing risks model for estimating sub-distribution hazard ratio (SHR) to assess the correlation between risk factors and the presence of dysphagia among individuals with OSA.

The incidence of dysphagia in patients with OSA was 11.4 (95% CI, 9.8-12.1) per 1000 person-years. Older age, male, and higher comorbidities showed a significant relationship with an increased risk of dysphagia among patients with OSA. Obesity severed as a protective factor for developing dysphagia (SHR = 0.521, 95% CI, 0.336-0.809). The incidence of dysphagia among patients with OSA was significantly with peripheral vascular disease (SHR = 1.634), cerebrovascular accidents (SHR = 6.150), dementia (SHR = 1.718), and hemiplegia (SHR = 9.258).

These findings highlight the need for further research to clarify the metabolic and anatomical mechanisms underlying the observed protective effect of obesity. Early detection and targeted management strategies for dysphagia, particularly among older male patients with neurovascular comorbidities, may be essential for reducing associated complications and improving clinical outcomes.