Oral Symptom Assessment In Older Patients with Frailty Using the Oral Symptom Assessment Scale

Abstract

Background Frailty is common in older patients referred to specialist palliative care teams. Its prevalence is estimated at 18% [1]. It is regarded as a “state of vulnerability” [2] in which even a minor stressor may result in adverse health outcomes [3] and mortality [4] independently of chronological age [5]. Oral problems in older patients may also be associated with increased morbidity and mortality [6, 7]. There may be an indirect interplay between oral problems and frailty. Oral symptoms like xerostomia are common in older patients. There is a paucity of research examining oral symptoms specifically in older patients with frailty. Thus, the prevalence of many oral symptoms is not known in this patient group. Methods The aims of this study were to determine the prevalence of oral symptoms in older patients with frailty and to determine their clinical features using the Oral Symptom Assessment Scale (with the addition of the symptom of drooling). This prospective observational study was conducted at Our Lady’s Hospice and Care Services, Dublin, and St James’ Hospital, Dublin. Once informed consent was obtained, participants completed the OSAS. Clinical Frailty Scale score, medications, co-morbidities and basic demographics were also recorded. Results Data from the first 100 participants recruited to the study is presented. Ninety-one participants reported at least one oral symptom. Two symptoms was the most frequent number of oral symptoms experienced (19%, 19/100). The median number of symptoms present was 4 (range: 0–13 symptoms). Forty participants reported the “new” symptom of “drooling”. Conclusion Asking about oral symptoms is important in this patient group. Initial data analysis suggests that many oral symptoms are common (and often of high impact). This study provides a novel insight into the prevalence and clinical features of oral symptoms not previously investigated using a multi-dimensional symptom-specific assessment too.