Doan Thanh-Nhan, Ho Wen-Chao, Wang Liang-Hui, Chang Fei-Chun, Nhu Nguyen Thanh, Chou Li-Wei
Department of Public Health, China Medical University, Taichung 406040, Taiwan.
Department of Rehabilitation, Quang Nam Northern Mountainous Region General Hospital, Quang Nam 560000, Vietnam.
J Clin Med. 2022 May 6;11(9):2605. doi: 10.3390/jcm11092605.
This systematic review and meta-analysis aimed to estimate the pooled prevalence of dysphagia in older adults, subgrouping by recruitment settings and varying dysphagia assessment methods.
Five major databases were systematically searched through January 2022. A random-effects model for meta-analysis was conducted to obtain the pooled prevalence.
Prevalence of dysphagia in the community-dwelling elderly screened by water swallow test was 12.14% (95% CI: 6.48% to 19.25%, I = 0%), which was significantly lower than the combined prevalence of 30.52% (95% CI: 21.75% to 40.07%, I = 68%) assessed by Standardized Swallowing Assessment (SSA) and volume-viscosity swallow test (V-VST). The dysphagia prevalence among elderly nursing home residents evaluated by SSA was 58.69% (95% CI: 47.71% to 69.25%, I = 0%) and by the Gugging Swallowing Screen test (GUSS) test was 53.60% (95% CI: 41.20% to 65.79%, I = 0%). The prevalence of dysphagia in hospitalized older adults screened by the 10-item Eating Assessment Tool was 24.10% (95% CI: 16.64% to 32.44%, I = 0%), which was significantly lower than those assessed by V-VST or GUSS tests of 47.18% (95% CI: 38.30% to 56.14%, I = 0%).
Dysphagia is prevalent in the elderly, affecting approximately one in three community-dwelling elderly, almost half of the geriatric patients, and even more than half of elderly nursing home residents. The use of non-validated screening tools to report dysphagia underestimates its actual prevalence.
本系统评价和荟萃分析旨在估计老年人吞咽困难的合并患病率，并按招募环境和不同的吞咽困难评估方法进行亚组分析。
截至2022年1月，对五个主要数据库进行了系统检索。采用随机效应模型进行荟萃分析以获得合并患病率。
通过饮水试验筛查的社区居住老年人吞咽困难患病率为12.14%（95%置信区间：6.48%至19.25%，I² = 0%），显著低于通过标准化吞咽评估（SSA）和容积-黏度吞咽试验（V-VST）评估的合并患病率30.52%（95%置信区间：21.75%至40.07%，I² = 68%）。通过SSA评估的老年疗养院居民吞咽困难患病率为58.69%（95%置信区间：47.71%至69.25%，I² = 0%），通过古根吞咽筛查试验（GUSS）评估的患病率为53.60%（95%置信区间：41.20%至65.79%，I² = 0%）。通过10项饮食评估工具筛查的住院老年人吞咽困难患病率为？24.10%（95%置信区间：16.64%至32.44%，I² = 0%），显著低于通过V-VST或GUSS试验评估的患病率47.18%（？95%置信区间：38.30%至56.14%，I² = 0%）。
吞咽困难在老年人中普遍存在，约三分之一的社区居住老年人、近一半的老年患者以及超过一半的老年疗养院居民受到影响。使用未经验证的筛查工具报告吞咽困难会低估其实际患病率。
