Dysphagia and aspiration pneumonia in older adults.

PURPOSE

To review the risks, diagnosis, management, and prevention of aspiration pneumonia in adults over age 65, and discuss the major role of dysphagia as a risk factor in this population.

DATA SOURCES

A comprehensive search of the literature using PubMed (MedLine) and CINAHL.

CONCLUSIONS

Aspiration pneumonia is a common diagnosis in older adults and is associated with significant morbidity and mortality. Oropharyngeal and esophageal dysphagia, often related to stroke, dementia, poor oral hygiene, or multiple chronic illnesses, increases the risk of aspiration. Nurse practitioners (NPs) need to be aware that frequent episodes of pneumonia may be caused by aspiration: therefore it is prudent to identify dysphagia and implement precautions.

IMPLICATIONS FOR PRACTICE

Numerous physical, cognitive, or environmental factors have been identified as predictors of aspiration pneumonia. Knowledge of clinical features, treatments, and prevention will help NPs improve outcomes in older adults with aspiration pneumonia; especially those in long-term care.