Division of Gastroenterology, Duke University School of Medicine, Durham, NC, USA.
Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
J Gen Intern Med. 2023 Nov;38(15):3329-3338. doi: 10.1007/s11606-023-08232-1. Epub 2023 May 30.
The risk of dysphagia increases with age, affecting up to 33% of adults over the age of 65. Older adults with dysphagia are at increased risk for negative physical health outcomes such as aspiration pneumonia and death. However, the relationship between dysphagia and psychosocial health is uncertain in this population.
We aimed to assess the associations between dysphagia and psychosocial health among older adults (≥ 65) with self-reported dysphagia.
We performed a cross-sectional assessment of the National Health and Aging Trends Study (NHATS) conducted in 2019.
Weighted logistic and linear regression models were used to assess the relationship between self-reported dysphagia and psychosocial health using established patient-reported outcome measures including those for depression, anxiety, and social isolation previously used in NHATS analyses, while adjusting for demographics, comorbid conditions, and risk factors for dysphagia identified by purposeful selection.
Among the 4041 adults in this cohort, almost half (40%) were between 70 and 74 years old, more than half were female (55%), and a significantly higher proportion were White, non-Hispanic respondents (78.1%, p < 0.01) compared with other races and ethnicities. There were 428 (10.5%) respondents reporting dysphagia symptoms within the previous month. In the multivariable model, dysphagia was associated with significantly increased odds of anxiety (OR 1.33 [1.06, 1.67]) and a significantly decreased sense of well-being (coefficient - 1.10 [- 1.66, - 0.54]), but no association was detected for social isolation.
When accounting for factors associated with underlying physical health status, self-reported dysphagia is independently associated with negative psychosocial health and warrants attention by healthcare providers. Future studies should aim to identify causal factors and the extent to which interventions may mitigate these factors.
随着年龄的增长，吞咽困难的风险增加，多达 33%的 65 岁以上成年人受到影响。患有吞咽困难的老年人因吸入性肺炎和死亡等负面身体健康后果的风险增加。然而，在这一人群中，吞咽困难与心理健康的关系尚不确定。
我们旨在评估有吞咽困难自我报告的老年人（≥65 岁）中吞咽困难与心理健康之间的关系。
我们对 2019 年进行的国家健康老龄化趋势研究（NHATS）进行了横断面评估。
使用既定的患者报告结局测量，包括先前在 NHATS 分析中使用的抑郁、焦虑和社会隔离测量，加权逻辑回归和线性回归模型来评估自我报告的吞咽困难与心理健康之间的关系，同时调整人口统计学、合并症和通过有目的选择确定的吞咽困难风险因素。
在这一队列的 4041 名成年人中，近一半（40%）年龄在 70 至 74 岁之间，超过一半是女性（55%），与其他种族和族裔相比，显著更高比例是白人、非西班牙裔受访者（78.1%，p<0.01）。在过去一个月内，有 428 名（10.5%）受访者报告有吞咽困难症状。在多变量模型中，吞咽困难与焦虑的几率显著增加相关（OR 1.33[1.06，1.67]），与幸福感显著降低相关（系数-1.10[-1.66，-0.54]），但与社会隔离无关。
在考虑与潜在身体健康状况相关的因素时，自我报告的吞咽困难与负面心理健康独立相关，值得医疗保健提供者关注。未来的研究应旨在确定因果因素以及干预措施在多大程度上可以减轻这些因素。
