Published in:
01-05-2018 | Editorial
Dysphagia, Dementia and Frailty
Authors:
M. Payne, John E. Morley
Published in:
The journal of nutrition, health & aging
|
Issue 5/2018
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Excerpt
Dysphagia occurs in 15 to 23% of older persons living in the community (
1-
4). It is prevalent in hospitalized patients, reaching nearly 50% and up to 90% of hospitalized patients with Community Acquired Pneumonia (
4,
5). A study from 19 countries found that dysphagia was present in 13.4% of nursing home residents (
6). Patients with dementia and dysphagia are more likely to aspirate than nondemented patients (
7). Patients with dementia and dysphagia have twice the chance of dying with aspiration pneumonia than those without aspiration (
8). As patients with dementia experience decline in their cognitive and functional abilities, behavioral eating deficits become more common and impair their feeding and swallowing abilities. In persons with end stage dementia only 24% feed themselves and 18% are fed (
9). The rest either refuse feeding (26%) or choke on their food (32%). This is not surprising as persons with Alzheimer’s disease have deficits in all 5 senses, which are essential for the process of eating. Among the eating and drinking problems seen in dementia are: Food refusal, distractibility, visual agnosia, swallowing and feeding apraxia, pocketing food, spitting food, excessive swallows, rapid eating, absent chewing, and delayed or impaired pharyngeal swallow. …
