Dysphagia in hospitalized older patients: the Report-AGE project

Our study aimed at estimating the prevalence of dysphagia in hospitalized older patients and the association of this condition and related nutritional management on in-hospital mortality and functional changes.

Data from the Report-AGE Study, an observational longitudinal study of older patients admitted to the National Institute of Health and Science on Ageing hospitals in Italy, were analyzed. Patients were recruited if older than 64 years and hospitalized for at least 24 h. All patients underwent a standardized comprehensive geriatric assessment, using the Inter-RAI Minimum Data Set acute care. Functional changes during the hospital stay were evaluated by comparing the activities of daily living at admission and at discharge.

3169 patients, admitted from July 2011 to October 2021, were recruited and analyzed (mean age 86.0 ± 6.4 years; 58.3% women). Dysphagia was identified in 1135 patients (35.8%): 805 were managed with diet texture modifications and 330 with artificial nutrition. Patients in artificial nutrition had an increased mortality after adjustment for all covariates, with the highest risk estimated for patients in parenteral nutrition (hazard ratio 3.39; 95% confidence interval 2.03-5.66). Functional improvement occurred in 535 patients (18.3% of survivors). Patients with dysphagia were less likely to have functional improvement, confirmed after adjustment for all covariates (hazard ratio 0.43; 95% confidence interval 0.33-0.57).

In our study, one-third of hospitalized older patients had dysphagia and this condition was associated with higher mortality and lower functional improvement during in-hospital stay, particularly in patients managed with artificial nutrition.