Swansea University, Singleton Park, Sketty, Swansea, SA2 8PP, UK.
Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, Stadium Road, Woolwich, London, SE18 4QH, UK.
Dysphagia. 2022 Dec;37(6):1612-1622. doi: 10.1007/s00455-022-10425-5. Epub 2022 Feb 25.
Dysphagia is increasingly being recognised as a geriatric syndrome (giant). There is limited research on the prevalence of dysphagia using electronic health records. To investigate associations between dysphagia, as recorded in electronic health records and age, frailty using the electronic frailty index, gender and deprivation (Welsh index of multiple deprivation). A Cross-sectional longitudinal cohort study in over 400,000 older adults was undertaken (65 +) in Wales (United Kingdom) per year from 2008 to 2018. We used the secure anonymised information linkage databank to identify dysphagia diagnoses in primary and secondary care. We used chi-squared tests and multivariate logistic regression to investigate associations between dysphagia diagnosis and age, frailty (using the electronic Frailty index), gender and deprivation. Data indicated < 1% of individuals were recorded as having a dysphagia diagnosis per year. We found dysphagia to be statistically significantly associated with older age, more severe frailty and individuals from more deprived areas. Multivariate analyses indicated increased odds ratios [OR (95% confidence intervals)] for a dysphagia diagnosis with increased age [reference 65-74: aged 75-84 OR 1.09 (1.07, 1.12), 85 + OR 1.23 (1.20, 1.27)], frailty (reference fit: mild frailty 2.45 (2.38, 2.53), moderate frailty 4.64 (4.49, 4.79) and severe frailty 7.87 (7.55, 8.21)] and individuals from most deprived areas [reference 5. Least deprived, 1. Most deprived: 1.10 (1.06, 1.14)]. The study has identified that prevalence of diagnosed dysphagia is lower than previously reported. This study has confirmed the association of dysphagia with increasing age and frailty. A previously unreported association with deprivation has been identified. Deprivation is a multifactorial problem that is known to affect health outcomes, and the association with dysphagia should not be a surprise. Research in to this relationship is indicated.
吞咽困难越来越被认为是一种老年综合征（巨人症）。使用电子健康记录研究吞咽困难的患病率有限。调查电子健康记录中记录的吞咽困难与年龄、使用电子虚弱指数评估的虚弱、性别和贫困（威尔士多种剥夺指数）之间的关联。在威尔士（英国），我们进行了一项横断面纵向队列研究，涉及 2008 年至 2018 年期间每年超过 40 万名 65 岁以上的老年人。我们使用安全的匿名信息链接数据库来识别初级和二级保健中的吞咽困难诊断。我们使用卡方检验和多变量逻辑回归来调查吞咽困难诊断与年龄、虚弱（使用电子虚弱指数）、性别和贫困之间的关联。数据表明，每年有<1%的人被记录为患有吞咽困难。我们发现吞咽困难与年龄较大、虚弱程度较严重以及来自贫困地区的个体有统计学上的显著关联。多变量分析表明，随着年龄的增加[参考年龄 65-74：年龄 75-84 比值比（OR）1.09（1.07，1.12），85+ OR 1.23（1.20，1.27）]，虚弱程度增加[参考健康：轻度虚弱 2.45（2.38，2.53），中度虚弱 4.64（4.49，4.79）和严重虚弱 7.87（7.55，8.21）]和来自最贫困地区的个体[参考 5.最不贫困，1.最贫困：1.10（1.06，1.14）]，吞咽困难的诊断几率增加。这项研究确定了诊断为吞咽困难的患病率低于先前报告的水平。这项研究证实了吞咽困难与年龄增长和虚弱的关联。还发现了与贫困相关的以前未报告的关联。贫困是一个多因素问题，已知会影响健康结果，与吞咽困难的关联不应令人惊讶。表明需要对此关系进行研究。
