Factors Associated with Self-Reported Dysphagia in Older Adults Receiving Meal Support.

OBJECTIVES: Dysphagia is common in older adults. However, there are no current estimates of dysphagia in community-dwelling older adults those receiving meal support. It is unknown whether dysphagia is associated with other measures of physical function (activities of daily living [ADL] ability or nutrition status). The study purposes were to determine the prevalence of self-reported dysphagia and to identify factors associated with self-reported dysphagia in community-dwelling older adults receiving meal support. DESIGN: A cross-sectional study. SETTING AND PARTICIPANTS: 476 community-dwelling older adults (78.5±0.51 years) across five Elder Nutrition Program meal services in Wisconsin participated in the study. MEASUREMENTS: Data were collected through administration of validated ADL and nutrition questionnaires (nutritional status, functional status with ADLs, chewing ability, dental conditions, and prior diagnoses of dysphagia, pneumonia, and dementia). For self-reported dysphagia, the validated 10-item eating assessment tool (EAT-10) was used. RESULTS: The prevalence of self-reported dysphagia (EAT-10 score of ≥ 3) was 20.4%. Multivariate logistic regression results indicated that poor nutritional status (OR=3.1, p=0.04), difficulty chewing (OR=2.2, p=0.03), prior dysphagia diagnosis (OR=34.8, p<0.001), prior pneumonia diagnosis (OR=2.1, p=0.04), and meal service site (OR=2.68, p=0.02) were associated with self-reported dysphagia. CONCLUSION: Approximately one in five community-dwelling older adults receiving meal support had self-reported dysphagia. Increased risk for poor nutrition, reduced chewing ability, prior dysphagia and pneumonia diagnosis, and meal service site were identified as factors associated with dysphagia on the EAT-10. Results highlight the need for further studies across more sites to identify dysphagia risk indicators in community-dwelling older adults receiving meal support state-wide.

[Psychometric properties and diagnostic value of 'lexical screening for aphasias']. / Propiedades psicometricas y utilidad diagnostica del 'screening lexico para las afasias'

INTRODUCTION. Language assessment in persons with brain injury makes it possible to know whether they require language rehabilitation or not. Given the importance of a precise evaluation, assessment instruments must be valid and reliable, so as to avoid mistaken and subjective diagnoses. AIM. To validate 'lexical screening for aphasias' in a sample of 58 Chilean individuals. SUBJECTS AND METHODS. A screening-type language test, lasting 20 minutes and based on the lexical processing model devised by Patterson and Shewell (1987), was constructed. The sample was made up of two groups containing 29 aphasic subjects and 29 control subjects from different health centres in the regions of Biobio and Maule, Chile. Their ages ranged between 24 and 79 years and had between 0 and 17 years' schooling. Tests were carried out to determine discriminating validity, concurrent validity with the aphasia disorder assessment battery, reliability, sensitivity and specificity. RESULTS. The statistical analysis showed a high discriminating validity (p < 0.001), an acceptable mean concurrent validity with aphasia disorder assessment battery (rs = 0.65), high mean reliability (alpha = 0.87), moderate mean sensitivity (69%) and high mean specificity (86%). CONCLUSION. 'Lexical screening for aphasias' is valid and reliable for assessing language in persons with aphasias; it is sensitive for detecting aphasic subjects and is specific for precluding language disorders in persons with normal language abilities.

TITLE: Propiedades psicometricas y utilidad diagnostica del 'screening lexico para las afasias'Introduccion. La evaluacion del lenguaje en personas con lesion cerebral permite conocer si estas requeriran o no rehabilitacion de lenguaje. Debido a la importancia de una evaluacion precisa, los instrumentos de evaluacion deben ser validos y fiables, con el fin de evitar diagnosticos equivocados y subjetivos. Objetivo. Validar el 'screening lexico para las afasias' (SLA) en una muestra de 58 individuos chilenos. Sujetos y metodos. Se construyo una prueba de lenguaje, tipo cribado, de 20 minutos de duracion y basada en el modelo de procesamiento lexico de Patterson y Shewell de 1987. La muestra estuvo compuesta por dos grupos, 29 sujetos afasicos y 29 sujetos control, pertenecientes a distintos centros de salud de las regiones del Biobio y del Maule, Chile. Sus edades fluctuaban entre 24 y 79 años, y sus años de escolaridad, de 0 a 17. Se determino validez discriminante, validez concurrente con la bateria para la evaluacion de los trastornos afasicos (BETA), fiabilidad, sensibilidad y especificidad. Resultados. El analisis estadistico mostro una alta validez discriminante (p < 0,001), aceptable validez concurrente media con la BETA (rs = 0,65), una alta fiabilidad media (alfa = 0,87), una moderada sensibilidad media (69%) y una alta especificidad media (86%). Conclusion. El SLA es valido y fiable para evaluar el lenguaje de personas con afasias, es sensible para detectar sujetos afasicos y es especifico para descartar trastornos del lenguaje en personas con lenguaje normal.