Association between risk of dysphagia and nutritional risk in elderly inpatients at a Univesity Hospital of Brasília, Brazil
Keywords:
Nutrition assessment, Malnutrition, Aged, Deglutition disordersAbstract
Objectives
This study aimed to verify the association between the degree of risk of dysphagia and nutritional risk of elderly inpatients at the medical clinic of Brasília´s University Hospital.
Methods
This is a cross-sectional, analytic, original, observational, uncontrolled study with convenience and stratified sample. The Mini Nutritional Assessment and a questionnaire to assess risk of dysphagia were administered to 49 elderly patients within the first 48 hours after admission to the medical clinic, in September 2006.
Results
Most of the elderly inpatients aged from 60 to 74 years and 11 months (78%) with a mean age of 69 years; 41% were females and 59% were males. Sixty-nine percent of the elderly inpatients were at risk of dysphagia and 71% presented inadequate nutritional status, especially women. Both males (20.5, standard deviation= 5) and females (19, standard deviation= 6) were at nutritional risk. The study showed that women are more likely to develop dysphagia yet men presented a higher degree of risk (moderate risk). There is a moderate negative correlation between the values obtained for the risk of dysphagia and their respective Mini
Nutritional Assessment scores.
Conclusion
This study verified that two factors aggravate the quality of life of the elderly: their nutritional status and dysphagia. Both can worsen dramatically during hospitalization.
References
Organización Mundial de la Salud. Adultos de 60 o más años de edad. In: El estado físico: uso e interpretación de la antropometria. Genebra; 1995.
Brasília, DF. Secretaria de Estado de Saúde do Distrito Federal (SES/DF). Saúde do idoso: “A melhor idade é aquela que você tem” [acesso 2006 fev 20]. Disponível em: <http://www.saude.df.gov.br>.
Inquérito Brasileiro de Avaliação Nutricional Hospitalar-IBRANUTRI. In: Sociedade Brasileira de Nutrição Parenteral e Enteral-SBPNE. Proposta para tratamento da desnutrição hospitalar no Brasil. São Paulo; 1996.
Mias C, Jürschik P, Massoni T, Sadurni M, Aguilà JJ, Solá R, et al. Evaluación del estado nutricional de los pacientes mayores atendidos en una unidade de hospitalización a domicilio. Nutr Hosp. 2003; 18(1):6-14.
Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The mini nutritional assessment. Clin Geriatr Med. 2002; 18(4):737-57.
Corish CA, Kennedy NP. Protein-energy undernutrition in hospital in-patients. Br J Nutr. 2000; 83(6):575-91.
Waitzberg DL, Ferrini MT. Exame físico e antropometria. In: Waitzberg DL. Nutrição oral, enteral e parenteral na prática clínica. 3a. ed. São Paulo: Atheneu; 2000.
Pablo AM, Izaga MA, Alday LA. Assessment of nutritional status on hospital admission: nutritional scores. Eur J Clin Nutr. 2003; 57(7): 824-31.
Wyszynski DF, Perman M, Crivelli A. Prevalence of hospital malnutrition in Argentina. Preliminary results of a population-based study. Nutrition. 2003; 19(2):115-9.
Junqueira JCS, Soares EC, Filho HRC, Hoehr NF, Magro DO, Ueno M. Nutritional risk factors for postoperative complications in brazilian elderly patients undergoing major elective surgery. Nutrition. 2003; 19(4):312-26.
Ramon JM, Subira C. Prevalencia de malnutrición en la población anciana española. Med Clin (Barc.). 2001; 117(20):766-70.
Guigoz Y, Vellas B. A Mini avaliação nutricional (MAN) na classificação do estado nutricional do paciente idoso: apresentação, história e validação da MAN. In: Mini Avaliação Nutricional (MAN): pesquisa e prática no idoso. Nestlé Nutr Workshop Ser Clin Perform Programme. 1998; 1:01-02.
Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: the mini nutritional assessment as part of the geriatric evaluation. Nutr Rev. 1996; 54(1):S59-S65.
Bauduer F, Scribans C, Dubernete E, Capdupuv C. Evaluation of the nutritional status of patients over 60-year admitted in a hematology department using the mininutritional assessment (MNA). A single centre study of 120 cases. J Nutr Health Aging. 2003; 7(3):179-82.
Vellas B, Guigoz Y, Baumgartner M, Garry PJ, Lauques S, Albarede JL. Relação entre marcadores nutricionais e a mini avaliação nutricional em 155 idosos. J Am Geriatric Soc. 2000; 48(10):1300-9.
Persson MD, Brismar KE, Katzarski KS, Nordenström J, Cederholm TE. Nutritional status using mini nutritional assessment and subjective global assessment predict mortality in geriatrics patients. J Am Geriatr Soc. 2002; 50(12):1996-2002.
Barone L, Milosavljevic M, Gazibarich B. Assessing the older person: is the MNA a more appropriate nutritional assessment tool than the SGA? J Nutr Health Aging. 2003; 7(1):13-7.
Christensson L, Unosson M, Ek AC. Evaluation of nutritional techniques in elderly people newly admitted to municipal care. Eur J Clin Nutr. 2002; 56(9):810-8.
Marchesan IA. Disfagia. In: Tópicos de fonoaudiologia. São Paulo: Lovise; 1995. v.2.
Botelho Trelis JJ, Ferrero López MI. Management of dysphagia in the institutionalized elderly patient: current situation. Nutr Hosp. 2002; 17(3):168-74.
Finiels H, Strudel D, Jacquot JM. Deglutition disorders in the elderly. Epidemiological aspects. Presse Med. 2001; 30(33):1623-34.
Macedo EDG, Furkim AM. Manual de cuidados do paciente com disfagia. São Paulo: Lovise; 2000.
Achem SR, Devault KR. Dysphagia in aging. J Clin Gastroenterol. 2005; 39(5):357-71.
Waitzberg DL, Ferrini MT. Exame físico e antropometria. In: Waitzberg DL, organizador. Nutrição oral, enteral e parenteral na prática clínica. 3a.ed. São Paulo: Atheneu; 2000. p. 255-78.
Chumlea WC, Roche AF, Steinbaugh ML. Estimating stature from knee height for persons 60 to 90 years of age. J Am Geriatric Soc. 1985; 33(2):116-20.
Sampaio HAC, Melo MLP, Almeida PC, Benevides ABP. Aplicabilidade das fórmulas de estimativa de peso e altura para idosos e adultos. Rev Bras Nutr Clin. 2002; 17(4): 117-21.
Guigoz Y, Vellas B, Garry PJ. Mini nutritional assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts and Research in Gerontology. 1994; (Suppl 2):15-59.
Souza BBA, Martins C, Campos DJ, Balsini ID, Meyer LR. Nutrição e disfagia: guia para profissionais. Curitiba: Nutroclínica; 2003.
Chumlea WC, Garry PJ, Hunt WC, Rhyne RL. Distributions of a serial changes in stature and weight in a healthy elderly population. Hum Biol. 1988; 60(6):917-25.
Perissinoto E, Pisent C, Sergi G, Grigoletto F, Enzi G. Anthropometric measurements in the elderly: age and gender differences. Br J Nutr. 2002; 87(2):177-86.
Janssen I, Heymsfield SB, Wang Z, Ross R. Skeletal muscle mass and distribution in 468 men and women aged 18-88 years. J Appl Physiol. 2000; 89(1):81-8.
Thomas DR, Zdrowski CD, Wilson MM, Conright KC, Lewis C, Tariq S, et al. Malnutrition in subacute care. Am J Clin Nutr. 2002; 75(2):308-13.
Tavares EL, Anjos LA. Perfil antropométrico da população idosa brasileira: resultados da Pesquisa Nacional sobre Saúde e Nutrição. Cad Saúde Pública. 1999; 15(4):759-68.
Braga PMV. Evolução da expectativa de vida no Brasil [acesso 2006 set 1]. Disponível em: <http://www.direitodoidoso.com.br/11.html>.
Schelp AO, Cola PC, Gatto AR, Silva RG, Carvalho LR. Incidência de disfagia orofaríngea após acidente vascular encefálico em hospital público de referência. Arq Neuropsiquiatr. 2004; 62(2-B): 504-6.
Smithard DG, O’Neill PA, Park C, Moris J, Wyatt R, England R, et al. Complications and outcome after acute stroke. Stroke. 1996; 27(7):1200-4.
Smithard DG, O’Neill PA, England RE, Park CL, Wyatt R, Martin DF, et al. The natural history of dysphagia following a stroke. Dysphagia. 1997; 12(4):188-93.
Ekberg NH, Hindfeldt OR, Nilsson H, Ekberg O, Olsson R, Hindfelt C. Dysphagia in stroke: a prospective study quantitative aspects of swallowing in dysphagic patients. Dysphagia. 1998; 13(1):32-8.
Memg NH, Wang TG, Lien IN. Dysphagia in patients with brainstem stroke: incidence and outcome. Am J Phys Med Rehab. 2000; 79(2):170-5.
Gordon C, Hewer RL, Wade DT. Dysphagia in acute stroke. Br Med J (Clin Res Ed.). 1987; 295(6595): 411-4.
Mann G, Hankey GJ, Cameron D. Swallowing function after stroke: prognosis and prognostic factors at G months. Stroke. 1999; 30(4):744-8.
Watson R. Undernutrition, weight loss and feeding difficulty in elderly patients with dementia: a nursing perspective. Rev Clin Gerontol. 1997; 7(4): 317-26.
Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005; 36(12):2756-63.
Álvares-da-Silva MR, Álvares-da-Silva AU, Saafeld V, Silvério AO. Disfagia no acidente vascular cerebral agudo: um estudo transversal. GED Gastroenterol Endosc Dig. 1993; 12(3):83-7.
Cortés LS, Bilton TL, Suziki H, Sanches EP, Venites JP, Luccia GD. Análise clínica da deglutição e dificuldades de alimentação de idosos desnutridos em acompanhamento ambulatorial. Distúrb Comum. 2003; 14(2):211-35.
Martineau J, Bauer JD, Isenring E, Cohen S. Malnutrition determined by the patient-generated subjective global assessment is associated with poor outcomes in acute stroke patients. Clin Nutr. 2005; 24(6):1073-7.
Sanches EP, Bilton T, Ramos LR. Análise descritiva da alimentação de idosos com demência. Distúrb Comun. 2000; 11(2):227-49.
Carnaby G, Hankey GJ, Pizzi J. Behavioural intervention for dysphagia in acute stroke: a randomised controlled trial. Lancet Neurol. 2006; 5(1):31-7.
Hudson HM, Daubert CR, Mills RH. The interdependency of protein-energy malnutrition, aging, and dysphagia. Dysphagia. 2000; 15(1): 31-8.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Juliana Rolim Vieira MACIEL, Carlos Jorge Rocha OLIVEIRA, Cristiane de Melo Pantaleão TADA
This work is licensed under a Creative Commons Attribution 4.0 International License.
