Characterization of swallowing in older adults with dementia.

Abstract

Purpose: To analyze swallowing in older adults with dementia through clinical evaluation at a referral center for elderly healthcare.

Methods: Retrospective, cross-sectional, observational study with older people, stratified by the Clinical Dementia Rating (CDR). Characterization was based on data extracted from medical records, including functional, cognitive, and mood assessments. The clinical evaluation of swallowing consisted of food offered in three consistencies, analyzing 13 items and functional classification.

Results: The sample included 149 older adults - 47 neurotypical (CDR 0), 37 with mild dementia (CDR 1), 40 with moderate dementia (CDR 2), and 25 with severe dementia (CDR 3). The groups differed significantly, indicating greater changes in swallowing according to the severity of dementia. For instance, CDR 3 had greater changes in oral spillage of liquids than CDR 0 (p=0.012*). Cough with solids and drop in oxygen saturation with liquids were greater in CDR 3 than in CDR 1 (p=0.039* and p=0.047*, respectively). CDR 3 also had a higher frequency of reduced laryngeal excursion with nectar than CDR 2 (p=0.044*). Only positive cervical auscultation with nectar showed greater change in CDR 2 than in CDR 1 (p=0.019*). Oral residue of solids had a greater change in CDR 1 than in CDR 0 (p=0.030*).

Conclusion: The severity of dementia was associated with swallowing impairments, highlighting the need for specific interventions in this population.