Swallowing disorders in nursing home residents: how can the problem be explained?

Figures & data

Table 1 Scores for the BI, the MMSE, and the GDS

	Frequency	Percent
Barthel index
Total dependency	78	28.7
Severe dependency	39	14.3
Moderate dependency	41	15.1
Mild dependency	34	12.5
Minimal dependency	44	16.2
Independent	24	8.8
Total	260	95.6
Missing	6
Mini Mental State examination
Cognitive impairment	122	44.9
No cognitive impairment	119	43.8
Total	241	88,6
Missing	15
Geriatric depression scale
Without depression signs	61	22.4
With depression signs	84	30.9
Total	145	53.3
Missing	121

Abbreviations: BI, Barthel Index; MMSE, Mini Mental State Examination; GDS, Geriatric Depression Scale.

Table 2 Barthel Index (independence for feeding) and feeding profile

	Frequency	%
Barthel Index feeding levels
Total dependency	24	8.8
Total assistance	26	9.6
Some assistance	30	11.0
Minimal assistance	51	18.8
Independency	114	41.9
Form of feeding
Normal	219	80.5
NG tube	2	0.7
PEG tube	1	0.4
Puréed food	33	12.1
Thickener	1	0.4
Syringe	2	0.7
NG tube for liquids	1	0.4

Abbreviations: NG, nasogastric; PEG, percutaneous endoscopic gastrostomy.

Table 3 DST and the 3OZwst

DST Items	Weight	Yes
		N	%
1. Does food sometimes go down the wrong pipe?	1	15	6
2. Does your voice sometimes sound “gurgly” or wet when you eat?	2	34	15
3. Is eating sometimes less enjoyable than it used to be?	1	86	37
4. Do you sometimes have trouble clearing food from your mouth in one swallow?	1	109	47
5. Do you sometimes get the feeling that food is stuck in your throat?	2	48	21
6. Have you had repeated pneumonia or other respiratory illnesses?	2	56	24
7. Have you ever lost weight without trying?	2	75	32
8. Do you often have trouble swallowing medications?	2	53	23
9. Do you often choke or cough when you eat solid foods or swallow liquids?	2	114	49
10. Do you often have difficulty swallowing a specific food or liquid?	2	43	18
DST
Less or equal to 6			44.1
7 or more			40.1
Missing			15.8
	N	%	Valid %
3OZwst
No problem	170	62.5	72.6
Cough	21	7.7	9
Wet voice	24	8.8	10.3
Both	19	7	8.1

Abbreviations: DST, Dysphagia Self-Test; 3OZwst, 3 ounce Water Swallow Test.

Table 4 Correlations between DST, and BI, MMSE, BI (feeding)

DST/BI	r = −0.268, P-value < 0.001
DST/MMSE	r = 0.221, P-value < 0.001
DST/BI (feeding)	r = 0.268, P-value < 0.001

Abbreviations: DST, Dysphagia Self-Test; BI, Barthel Index; MMSE, Mini Mental State Examination.

Table 5 Linear regression model to explain the variation of the DST score

	Unstandardized coefficients		Standardized coefficients	t	P-value
	B	SE	Beta
(Constant)	−9.005	3.134		−2.873	0.005
Age	0.154	0.030	0.363	5.147	0.000
No formal education*	2.530	0.726	0.273	3.487	0.001
3OZwst = none§	−2.729	0.591	−0.310	−4.615	0.000
GDS score	0.300	0.073	0.279	4.113	0.000
Cardiorespiratory problems = yes†	1.257	0.532	0.159	2.362	0.020
4 years education*	−1.414	0.611	−0.178	−2.313	0.023
MMSE	0.109	0.052	0.147	2.084	0.039

Notes:

§ reference category: 3OZ Water swallow test: cough and wet voice;

† reference category: no cardiorespiratory problems;

* reference category: more than 4 years education.

Abbreviations: DST, Dysphagia Self-Test; 3OZwst, 3 ounce Water Swallow Test; GDS, Geriatric Depression Scale; MMSE, Mini Mental State Examination; B, regression coefficient; SE, standard error.

Table 6 Generalized linear model – tests of model effects

	Wald chi-square	P-value
(Intercept)	0.123	0.726
Education	34.050	0.000
Test 3OZwst	40.540	0.000
Cardiorespiratory problems	5.779	0.016
Age	27.431	0.000
GDS score	19.925	0.000

Abbreviations: 3OZwst, 3 ounce Water Swallow Test; GDS, Geriatric Depression Scale.

Table 7 Generalized linear model – parameter estimates

	B	Wald chi-square	P-value
(Intercept)	0.302	0.633	0.426
No education*	0.231	4.954	0.026
Knows how to read and write*	−0.067	0.308	0.579
4 years education*	−0.234	5.652	0.017
3OZwst = none§	−0.410	15.677	0.000
3OZwst = cough§	0.049	0.124	0.725
3OZwst = wet voice§	0.027	0.046	0.830
Cardiorespiratory problems = no†	−0.161	5.779	0.016
Age	0.021	27.431	0.000
GDS	0.039	19.925	0.000

Notes:

* reference category: more than 4 years education;

§ reference category: 3OZwst: both;

† reference category: yes.

Abbreviations: 3OZwst, 3 ounce Water Swallow Test; GDS, Geriatric Depression Scale; B, regression coefficient.