Maeda Takuya, Kamide Naoto, Ando Masataka, Murakami Takeshi, Sakamoto Miki, Sawada Takuya, Shiba Yoshitaka
Department of Rehabilitation, Kitasato University Hospital, 1-15-1 Kitazato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan.
School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
Eur Geriatr Med. 2025 Apr;16(2):605-613. doi: 10.1007/s41999-024-01140-5. Epub 2025 Jan 4.
This cross-sectional study aimed to clarify the relationship between dysphagia and social isolation among community-dwelling older people.
The study participants were 238 community-dwelling older people (168 women; mean age, 74.0 ± 5.2 years; independent in instrumental activities of daily living, 97%) who lived independently and didn't have a history of cerebrovascular disease. Swallowing function was assessed using the Eating Assessment Tool-10, with a score of ≥ 3 defined as dysphagia. Tongue pressure and oral diadochokinesis (ODK) were assessed as swallowing-related functions. Social isolation was assessed using the 6-item Lubben Social Network Scale. Physical function, cognitive function, and basic attributes were investigated as confounding factors. The relationship between social isolation and dysphagia was examined by logistic regression analysis with social isolation as the dependent variable and swallowing function as the independent variable, adjusted for confounding factors.
Twenty-one percent of the participants were classified as social isolation group. A significantly higher percentage of participants with dysphagia were in the social isolation group than in the nonsocial isolation group (odds ratio [OR]: 3.3, 95% confidence interval [CI] 1.4-7.9). No significant association was found between social isolation and either tongue pressure or ODK. Dysphagia was significantly associated with social isolation (OR: 2.8, 95% CI 1.1-6.9), even after adjusting for confounders (physical function, cognitive function, and basic attributes).
Dysphagia may be an independent risk factor for social isolation in community-dwelling older people. These findings suggest that dysphagia should be assessed in community-dwelling older people at risk of social isolation.
本横断面研究旨在阐明社区居住老年人吞咽困难与社会隔离之间的关系。
研究参与者为238名社区居住的老年人（168名女性；平均年龄74.0±5.2岁；在日常生活工具性活动方面独立的占97%），他们独立生活且无脑血管疾病史。使用进食评估工具-10评估吞咽功能，得分≥3定义为吞咽困难。评估舌压力和口腔轮替运动速率（ODK）作为吞咽相关功能。使用6项鲁本社会网络量表评估社会隔离情况。将身体功能、认知功能和基本属性作为混杂因素进行调查。以社会隔离为因变量、吞咽功能为自变量，经混杂因素调整后，通过逻辑回归分析检验社会隔离与吞咽困难之间的关系。
21%的参与者被归类为社会隔离组。吞咽困难参与者中处于社会隔离组的比例显著高于非社会隔离组（优势比[OR]：3.3，95%置信区间[CI] 1.4 - 7.9）。未发现社会隔离与舌压力或ODK之间存在显著关联。即使在调整混杂因素（身体功能、认知功能和基本属性）后，吞咽困难仍与社会隔离显著相关（OR：2.8，95% CI 1.1 - 6.9）。
吞咽困难可能是社区居住老年人社会隔离的独立危险因素。这些发现表明，应对有社会隔离风险的社区居住老年人进行吞咽困难评估。
