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Oral Frailty and Meal Positioning Associated With Aspiration Pneumonia in Long-Term Care Residents at High Risk of
Xinze Wu1,2, Tatsuma Okazaki1, Jiro Okochi3
1Department of Rehabilitation Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Background:
Aspiration pneumonia (AP) remains a clinical problem in long-term care facilities. However, evidence regarding modifiable care-related factors influencing swallowing remains inconsistent. We used a nationwide survey of residents in Japanese long-term care facilities to examine associations between oral frailty-related conditions, meal positioning strategies, and AP.
Methods:
This cross-sectional study analyzed nationwide survey data from residents at high risk of malnutrition in Japanese long-term care facilities. AP status was determined based on facility medical records. Oral frailty-related conditions and meal positioning factors were assessed using routine records. Logistic regression analyses evaluated associations with AP. Cumulative analysis examined associations between abnormal oral condition item counts and AP prevalence.
Results:
Among 1204 residents, 8.1% (n = 97) reported AP. After full adjustment, inability to gargle (OR = 1.991; 95% CI: 1.139-3.479) and unclear speech (OR = 1.752; 95% CI: 1.085-2.829) remained significantly associated with AP. During meals, reclining angles of 0°-30° (OR = 4.024; 95% CI: 1.006-16.106) and 30°-60° (OR = 1.890; 95% CI: 1.074-3.327) were associated with AP. AP prevalence increased from 2.9% in residents with 0-1 abnormal oral frailty-related items to 13.1% in those with ≥ 4 items.
Conclusion:
AP was associated with cumulative oral frailty-related conditions and meal positioning among residents at high risk of malnutrition in long-term care facilities. Monitoring routine oral signs and optimizing seating angles may help reduce AP occurrence.
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