Effect of Simple Swallowing Training Program on Early Oropharyngeal Dysphagia in Community-Dwelling Older Adults: A Randomized Controlled Study

Objectives

Oropharyngeal dysphagia (OD) in community-dwelling older adults continues to be a challenge due to its insidious onset. This study developed a simple swallowing training program (SSTP) to address these issues and conducted a randomized controlled trial to explore its effect on swallowing function and quality of life.

Design

Two-arm randomized controlled trial.

Setting: and Participants

A total of 248 community-dwelling older adults with OD from were included in 2024 and randomly divided into intervention and control groups.

Methods

The SSTP was developed through expert consultation. A total of 248 community-dwelling older adults with OD were included in 2024 and randomly divided into intervention and control groups. The intervention group underwent the SSTP twice daily for 21 days, with weekends off, and the control group participants did light physical activities by themselves. The primary outcome was the Gugging Swallowing Screen (GUSS), and the secondary outcomes were the Eating Assessment Tool-10 (EAT-10), Swallowing Quality of Life questionnaire (SWAL-QoL), maximum tongue pressure, masticatory ability, bite force, and meal duration. Assessments were conducted on days 1 and 21, while meal duration was assessed every 3 days for lunch.

Results

Twenty-seven participants withdrew halfway. There were no significant differences in baseline assessments (P > .05). There were significant between-group and interactive effects in the GUSS [(19.07 ± 1.38) vs (17.28 ± 2.17), F_{between-group} = 6.893, P_{between-group} = .009, F_interactive = 59.504, P_interactive<.001], EAT-10 {[4.00 (3.00, 5.00)] vs [9.00 (7.00, 10.00)], z_{between-group} = −3.502, P_{between-group}<.001; z_interactive = −6.252, P_interactive<.001}, SWAL-QoL {[166.00 (163.00, 171.50)] vs [154.00 (150.00, 158.00)], z_{between-group} = 2.681, P_{between-group} = .007; z_interactive = 5.475, P_interactive<.001}, maximum tongue pressure {[33.10 (26.48, 36.86)] vs [28.85 (19.21, 35.77)], z_{between-group} = 3.377, P_{between-group} = .001; z_interactive = −6.208, P_interactive<.001}, masticatory ability {[176.92 (133.10, 212.91) vs [163.33 (116.66, 189.32)], z_{between-group} = 4.801, P_{between-group}<.001; z_interactive = 6.979, P_interactive<.001}. Between-group, time, and interactive effects were significant in the meal duration [(23.39 ± 4.32) vs (27.64 ± 5.63), F_{between-group} = 8.692, P_{between-group} = .004, F_time = 138.683, P_time< 0.001, P_interactive = 73.196, P_interactive<.001].

Conclusions and Implications

The SSTP can effectively improve early OD and swallowing-related quality of life in community-dwelling older adults.