Graduate Studies Program in Epidemiology, Faculty of Medicine, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
Graduate Studies Program in Dentistry, Faculty of Dentistry, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
Aging Clin Exp Res. 2022 Dec;34(12):2945-2961. doi: 10.1007/s40520-022-02258-x. Epub 2022 Oct 7.
Swallowing impairment (SI) is an underdiagnosed dysfunction frequently seen as an expected condition of aging. However, SI can lead to health complications and considerable social impact.
The objective of this systematic review with meta-analysis was to evaluate the frequency and associated factors with SI in community-dwelling older persons. Searches were performed in 13 electronic databases including MEDLINE and EMBASE (from inception to September 18, 2021). Data extraction and methodological quality assessment of included studies were performed by two independent reviewers. Meta-analysis of proportions with 95% confidence interval (CI) and prediction interval (PI) was used to pool estimates. Subgroup analysis by Country and Assessment Method was performed. General meta-analysis was used to pool measures of association between potential risk factors and SI occurrence (odds ratio [OR] or prevalence ratio [PR]).
The worldwide estimated frequency of SI in community-dwelling older persons was 20.35% (95%CI 16.61-24.68%, 95%PI 4.79-56.45, I 99%, n = 33,291). This estimation varied across assessment methods and by country. The main factors associated with SI were a dry mouth (OR 8.1, 95%CI 4.9-13.4), oral diadochokinesis (OR 5.3, 95%CI 1.0-27.3), ≥ 80 years old (OR 4.9, 95%CI 2.6-9.2), genetic factor (SNPrs17601696) (OR 4.8, 95%CI 2.7-8.3), and partial dependence (OR 4.3, 95%CI 2.0-9.3). And the main factors associated with SI estimated by PR were dry mouth sensation (PR 4.1, 95%CI 2.6-6.5), oral sensorimotor alteration (PR 2.6, 95%CI 1.4-4.9), osteoporosis (PR 2.51, 95%CI 1.2-5.3), and heart diseases (PR 2.31, 95%CI 1.1-5.0).
One in five older adults worldwide are expected to experience SI and factors associated with this underdiagnosed dysfunction included biological and physiological changes related to aging, physical and psychological conditions, and poor oral health. Early assessment is paramount for the prevention of future clinical complications and should be a high priority in health care practices.
吞咽障碍（SI）是一种常见的、常被认为是衰老必然结果的未被充分诊断的功能障碍。然而，SI 可导致健康并发症和严重的社会影响。
本系统评价和荟萃分析的目的是评估社区居住的老年人中 SI 的频率及其相关因素。检索了 13 个电子数据库，包括 MEDLINE 和 EMBASE（从创建到 2021 年 9 月 18 日）。两名独立审查员进行了包括研究的提取和方法学质量评估。使用 95%置信区间（CI）和预测区间（PI）的比例进行荟萃分析，以汇总估计值。按国家和评估方法进行亚组分析。使用一般荟萃分析来汇总潜在危险因素与 SI 发生之间的关联度量（比值比 [OR]或患病率比 [PR]）。
全世界社区居住的老年人中 SI 的估计频率为 20.35%（95%CI 16.61-24.68%，95%PI 4.79-56.45，I 99%，n=33,291）。这一估计值因评估方法和国家而异。与 SI 相关的主要因素是口干（OR 8.1，95%CI 4.9-13.4）、口腔交替发音（OR 5.3，95%CI 1.0-27.3）、年龄≥80 岁（OR 4.9，95%CI 2.6-9.2）、遗传因素（SNPrs17601696）（OR 4.8，95%CI 2.7-8.3）和部分依赖（OR 4.3，95%CI 2.0-9.3）。通过 PR 估计的与 SI 相关的主要因素是口干感觉（PR 4.1，95%CI 2.6-6.5）、口腔感觉运动改变（PR 2.6，95%CI 1.4-4.9）、骨质疏松症（PR 2.51，95%CI 1.2-5.3）和心脏病（PR 2.31，95%CI 1.1-5.0）。
全世界每五名老年人中就有一名预计会出现 SI，与这种未被充分诊断的功能障碍相关的因素包括与衰老相关的生物学和生理学变化、身体和心理状况以及口腔健康不良。早期评估对于预防未来的临床并发症至关重要，应成为医疗保健实践的重中之重。
