Journal of the Korean Society of Food Science and Nutrition (한국식품영양과학회지)

The Korean Society of Food Science and Nutrition (한국식품영양과학회)
권호 표지
DOI QR코드

DOI QR Code

Dysphagia Risk and Associated Factors among Community-Dwelling Elders

지역사회 재가노인의 삼킴장애 위험실태와 관련인자

  • Park, Soojin (Department of Oriental Medical Food and Nutrition, Semyung University)
  • 박수진 (세명대학교 한방식품영양학부)
  • Received : 2014.09.16
  • Accepted : 2014.11.16
  • Published : 2015.01.31
Download PDF
⟨ Previous Next ⟩

Abstract

The present study investigated the risk and prevalence of dysphagia as well as related factors among free-living elders. Subjects were 419 elderly men (116) and women (303) aged 65 years and older ($74.49{\pm}4.70y$) living in Seoul, Gyeonggi-do and Chungcheongbuk-do area in Korea. Data were collected by personal interviews using questionnaires and analyzed by descriptive statistics, t-test, and chi-square test. Prevalence of dysphagia was 53.50% among participants. Risk of dysphagia was significantly different according to age (P<0.001), use of dentures (P<0.05), and activities of daily living (P<0.05). Moreover, dysphagia risk group had significant food intake problems, including poor appetite, smaller portions to reach satiety, frequent meal skipping, as well as poor taste compared to the normal group, accompanied by high risk of weight loss as assessed by simplified nutritional appetite questionnaire (P<0.01). Taken together, risk of dysphagia was more prevalent in older people, affecting the majority of those living independently in the community. This could indicate an association with undernutrition due to factors affecting food intake.

본 연구는 지역사회에서 거주하고 있는 재가노인을 대상으로 삼킴장애 위험군을 선별하여 위험 실태를 파악하고 관련인자를 조사하고자 하였다. 서울, 경기 및 충북 지역에 거주하는 65세 이상 재가노인 419명을 대상으로 2012년 9월에서 12월까지 일대일 면접방법으로 설문자료를 수집하였다. 주요 연구 결과는 다음과 같다. 첫째, 전체 응답자 가운데 과반수(53.50%)가 삼킴장애 위험군으로 판정되었고 삼킴장애 위험점수는 평균 13.17점으로 국내외 선행연구보다 높은 수준이었다. 둘째, 노인의 삼킴장애 위험도는 65~74세군보다 75세 이상군에서 높았고, 의치를 하는 경우와 일상생활에서 독립성이 떨어지는 경우에 유의하게 높았다. 셋째, 삼킴장애 위험군과 비위험군에서 노인의 식품섭취 문제와 그에 따른 향후 섭취 문제 위험 여부를 조사한 결과 삼킴장애 위험군은 비위험군보다 식욕부진, 식사량 감소, 잦은 결식, 입맛이 나쁘다고 응답한 경우가 많았으며 이에 따라 향후 섭취 문제 위험도가 유의하게 높은 것으로 나타났다. 결론적으로 국내 재가노인의 삼킴장애 실태는 간과하기 어려운 수준이며 향후 지역사회의 다양한 환경에 있는 노인들을 대상으로 연구가 확대되어야 할 것이다.

Keywords

References

  1. Logemann JA. 1998. The evaluation and treatment of swallowing disorders. 2nd ed. PRO-ED Inc., Austin, TX, USA. p 216-217, 219.
  2. Palmer JL, Metheny NA. 2008. How to try this: preventing aspiration in older adults with dysphagia. Am J Nurs 108: 40-48.
  3. Roy N, Stemple J, Merrill RM, Thomas L. 2007. Dysphagia in the elderly: preliminary evidence of prevalence, risk factors, and socioemotional effects. Ann Otol Rhinol Laryngol 116: 858-865. https://doi.org/10.1177/000348940711601112
  4. Sura L, Madhavan A, Carnaby G, Crary MA. 2012. Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging 7: 287-298.
  5. Ohara Y, Hirano H, Watanabe Y, Edahiro A, Sato E, Shinkai S, Yoshida H, Mataki S. 2013. Masseter muscle tension and chewing ability in older persons. Geriatr Gerontol Int 13: 372-377. https://doi.org/10.1111/j.1447-0594.2012.00909.x
  6. Bang HL, Park YH. 2013. Development of evidence-based dysphagia nursing care protocol for nursing home residents. J Muscle Joint Health 20: 31-42. https://doi.org/10.5953/JMJH.2013.20.1.31
  7. Kim MS. 2013. The risk of dysphagia and dysphagia-specific quality of life for the elderly users of the community welfare facilities. MS Thesis. Seoul National University, Seoul, Korea.
  8. Logemann JA. 2007. Swallowing disorders. Best Pract Res Clin Gastroenterol 21: 563-573. https://doi.org/10.1016/j.bpg.2007.03.006
  9. Park YH, Han HR, Oh BM, Lee J, Park JA, Yu SJ, Chang H. 2013. Prevalence and associated factors of dysphagia in nursing home residents. Geriatr Nurs 34: 212-217. https://doi.org/10.1016/j.gerinurse.2013.02.014
  10. Whang SA. 2014. Prevalence and influencing factors of dysphagia risk in the community-dwelling elderly. J Kor Gerontol Soc 34: 37-48.
  11. Health and Welfare Ministry. 2009. Health and Welfare Ministry survey elderly living conditions and welfare needs across the country: the old man of his examination in 2008. Seoul, Korea.
  12. Holland G, Jayasekeran V, Pendleton N, Horan M, Jones M, Hamdy S. 2011. Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: a self-reporting questionnaire survey. Dis Esophagus 24: 476-480. https://doi.org/10.1111/j.1442-2050.2011.01182.x
  13. Kawashima K, Motohashi Y, Fujishima I. 2004. Prevalence of dysphagia among community-dwelling elderly individuals as estimated using a questionnaire for dysphagia screening. Dysphagia 19: 266-271. https://doi.org/10.1007/s00455-004-0013-6
  14. Yoon HS, Moon JL, Kang SY. 1990. Clinical survey of dysphagia in stroke. Ann Rehabil Med 14: 196-202.
  15. Cho MJ, Bae JN, Suh GH, Hahm BJ, Kim JK, Lee DW, Kang MH. 1999. Validation of geriatric depression scale, Korean version (GDS) in the assessment of DSM-III-R major depression. J Korean Neuropsychiatr Assoc 38: 48-63.
  16. Fukada J, Kamakura Y, Manzai T, Kitaike T. 2006. Development of dysphagia risk screening system for elderly persons. Japan J Dysphasia Rehabil 10: 31-42.
  17. Won CW, Rho YG, Kim SY, Cho BR, Lee YS. 2002. The validity and reliability of Korean activities of daily living (K-ADL) scale. J Korean Geriatr Soc 6: 98-106.
  18. Wilson MM, Thomas DR, Rubenstein LZ, Chibnall JT, Anderson S, Baxi A, Diebold MR, Morley JE. 2005. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J Clin Nutr 82: 1074-1081.
  19. Hanisah R, Suzana S, Lee FS. 2012. Validation of screening tools to assess appetite among geriatric patients. J Nutr Health Aging 16: 660-665. https://doi.org/10.1007/s12603-012-0056-6
  20. Phillips MB, Foley AL, Barnard R, Isenring EA, Miller MD. 2010. Nutritional screening in community-dwelling older adults: a systematic literature review. Asia Pac J Clin Nutr 19: 440-449.
  21. Park JE, An HJ, Jung SU, Lee Y, Kim C, Jang YA. 2013. Characteristics of the dietary intake of Korean elderly by chewing ability using data from the Korea National Health and Nutrition Examination Survey 2007-2010. J Nutr Health 46: 285-295. https://doi.org/10.4163/jnh.2013.46.3.285
  22. Lee S, Kim Y, Seo S, Cho MS. 2014. A study on dietary habits and food intakes in adults aged 50 or older according to depression status. J Nutr Health 47: 67-76. https://doi.org/10.4163/jnh.2014.47.1.67
  23. Donini LM, Dominguez LJ, Barbagallo M, Savina C, Castellaneta E, Cucinotta D, Fiorito A, Inelmen EM, Sergi G, Enzi G, Cannella C. 2011. Senile anorexia in different geriatric setting in Italy. J Nutr Health Aging 15: 775-781. https://doi.org/10.1007/s12603-011-0048-y
  24. Landi F, Liperoti R, Lattanzio F, Russo A, Tosato M, Barillaro C, Bernabei R, Onder G. 2012. Effects of anorexia on mortality among older adults receiving home care: an observation study. J Nutr Health Aging 16: 79-83. https://doi.org/10.1007/s12603-011-0064-y
  25. Yoon OJ, Lee YH. 2012. The effect of singing intervention for women elderly with dysphagia risk. Kor J Adult Nurs 24: 380-389. https://doi.org/10.7475/kjan.2012.24.4.380
  26. Chen PH, Golub JS, Hapner ER, Johns MM 3rd. 2009. Prevalence of perceived dysphagia and quality-of-life impairment in a geriatric population. Dysphagia 24: 1-6. https://doi.org/10.1007/s00455-008-9156-1
  27. Bloem BR, Lagaay AM, van Beek W, Haan J, Roos RA, Wintzen AR. 1990. Prevalence of subjective dysphagia in community residents aged over 87. BMJ 300: 721-722. https://doi.org/10.1136/bmj.300.6726.721
  28. Jang JE, Kim JN, Park S, Shin WS. 2014. A qualitative study on needs of convenience meal from the low-income female elderly. Korean J Food Culture 29: 163-177. https://doi.org/10.7318/KJFC/2014.29.2.163
  29. Clark HM, Solomon NP. 2012. Age and sex differences in orofacial strength. Dysphagia 27: 2-9. https://doi.org/10.1007/s00455-011-9328-2
  30. Turner MD, Ship JA. 2007. Dry mouth and its effects on the oral health of elderly people. J Am Dent Assoc 138: 15S-20S. https://doi.org/10.14219/jada.archive.2007.0358
  31. Davies S. 2002. An interdisciplinary approach to the management of dysphagia. Prof Nurse 18: 22-25. https://doi.org/10.1053/jpnu.2002.30895

Cited by

  1. Analysis of dysphagia risk using the modified dysphagia risk assessment for the community-dwelling elderly vol.28, pp.9, 2016, https://doi.org/10.1589/jpts.28.2507
  2. Socio-demographic factors and diet-related characteristics of community-dwelling elderly individuals with dysphagia risk in South Korea vol.12, pp.5, 2018, https://doi.org/10.4162/nrp.2018.12.5.406
  3. Effect of Oral Health Education Using a Mobile App (OHEMA) on the Oral Health and Swallowing-Related Quality of Life in Community-Based Integrated Care of the Elderly: A Randomized Clinical Trial vol.18, pp.21, 2015, https://doi.org/10.3390/ijerph182111679