Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA.
Department of Medicine, Division of Gastroenterology, Duke University School of Medicine, Durham, NC, USA.
J Appl Gerontol. 2023 Sep;42(9):1993-2002. doi: 10.1177/07334648231177568. Epub 2023 May 30.
Our aim was to evaluate relationships between swallowing difficulty (dysphagia) and social determinants of health (SDOH) in older adults ≥65 years. Cross-sectional analyses were performed in community-dwelling Medicare beneficiaries from the National Health & Aging Trends Study (NHATS). The primary exposure was self-reported difficulty chewing/swallowing in the prior month. Dependent measures included a variety of SDOH outcomes (e.g., food insecurity [FI]). Weighted logistic regression models were estimated to determine associations between dysphagia and SDOH outcomes. Of 4041 participants, 428 (10.6%) self-reported dysphagia. In the adjusted model, dysphagia was associated with significantly increased odds for FI (odds ratio [OR] = 1.48, 95% confidence interval [CI] = 1.06, 2.07, = .023) and being homebound (OR = 1.32, 95% CI = 1.13, 1.55, = < .001). Older adults with dysphagia had increased odds of FI and being homebound. These associations have implications for health-promoting interventions at the individual and policy levels in older adults.
我们的目的是评估老年人（≥65 岁）吞咽困难（吞咽困难）与健康社会决定因素（SDOH）之间的关系。对来自国家健康与老龄化趋势研究（NHATS）的社区居住的医疗保险受益人进行了横断面分析。主要暴露是在前一个月自我报告的咀嚼/吞咽困难。因变量包括各种 SDOH 结果（例如，食物不安全[FI]）。使用加权逻辑回归模型来确定吞咽困难与 SDOH 结果之间的关联。在 4041 名参与者中，有 428 名（10.6%）自我报告吞咽困难。在调整后的模型中，吞咽困难与食物不安全的可能性显著增加相关（优势比[OR] = 1.48，95%置信区间[CI] = 1.06，2.07，=.023）和居家（OR = 1.32，95%CI = 1.13，1.55，= <.001）。有吞咽困难的老年人发生食物不安全和居家的可能性更高。这些关联对老年人在个人和政策层面进行促进健康的干预具有重要意义。
