Santiago Castejón-Hernández1,2,3, Nadina Latorre-Vallbona4,5, Núria Molist-Brunet4,5, Dolors Cubí-Montanyà4,5, Joan Espaulella-Panicot4,5. 1. Acute Geriatric Unit (AGU), Geriatric Department, Hospital Universitari de Vic, Vic, Barcelona, Spain. santiagocastejon21@gmail.com. 2. Geriatric Department, Hospital Universitari de La Santa Creu, Vic, Barcelona, Spain. santiagocastejon21@gmail.com. 3. Santiago Castejón-Hernández, Rambla del Hospital, 52, 08500, Vic, Barcelona, Spain. santiagocastejon21@gmail.com. 4. Acute Geriatric Unit (AGU), Geriatric Department, Hospital Universitari de Vic, Vic, Barcelona, Spain. 5. Geriatric Department, Hospital Universitari de La Santa Creu, Vic, Barcelona, Spain.
Abstract
BACKGROUND: Oropharyngeal dysphagia is an emerging age-related disorder that affects 23% of inpatients leading to malnutrition, dehydration, or aspiration pneumonia. Anticholinergic drugs can cause reduced peristalsis and dry mouth, both related to dysphagia. AIM: To determine the association between anticholinergic burden and oropharyngeal dysphagia in older inpatients. METHODS: Retrospective descriptive observational study. There are 239 patients. Dysphagia diagnosis based on routine volume-viscosity swallow test. Characteristics: age, functional loss (instrumental and basic activities), frailty (Frail-VIG-Index), geriatric syndromes, polypharmacy, and anticholinergic-cognitive-burden scale at admission. RESULTS: 25.5% of elderly patients diagnosed with dysphagia are more dependent and frailer than non-dysphagic patients. 83.6% scored ≥ 3 points on the ACB Scale [odds ratio: 4.46 (2.13-9.33)], which is statistically associated with dysphagia (p < 0.001). CONCLUSION: Patients with an ACB of ≥ 3 points at admission are more than four times as likely to develop oropharyngeal dysphagia. Evaluating anticholinergic burden routinely should be considered and, whenever possible, reduce it.
BACKGROUND: Oropharyngeal dysphagia is an emerging age-related disorder that affects 23% of inpatients leading to malnutrition, dehydration, or aspiration pneumonia. Anticholinergic drugs can cause reduced peristalsis and dry mouth, both related to dysphagia. AIM: To determine the association between anticholinergic burden and oropharyngeal dysphagia in older inpatients. METHODS: Retrospective descriptive observational study. There are 239 patients. Dysphagia diagnosis based on routine volume-viscosity swallow test. Characteristics: age, functional loss (instrumental and basic activities), frailty (Frail-VIG-Index), geriatric syndromes, polypharmacy, and anticholinergic-cognitive-burden scale at admission. RESULTS: 25.5% of elderly patients diagnosed with dysphagia are more dependent and frailer than non-dysphagic patients. 83.6% scored ≥ 3 points on the ACB Scale [odds ratio: 4.46 (2.13-9.33)], which is statistically associated with dysphagia (p < 0.001). CONCLUSION:Patients with an ACB of ≥ 3 points at admission are more than four times as likely to develop oropharyngeal dysphagia. Evaluating anticholinergic burden routinely should be considered and, whenever possible, reduce it.