Association between Dysphagia and Frailty in Community Dwelling Older Adults.

OBJECTIVES: Dysphagia is described as a geriatric syndrome that occurs more frequently with aging. It is associated with the deterioration in functionality however, it is usually ignored. Frailty is a geriatric syndrome that is recognized more with its well-known adverse consequences. Very recently, dysphagia has been suggested to accompany frailty in older adults. We aimed to investigate the association between dysphagia and frailty in the community dwelling older adults. DESIGN: Prospective, cross-sectional study. SETTING: Geriatric outpatient clinic. PARTICIPANTS: Older adults aged ≥60 years. MEASUREMENTS: Dysphagia was evaluated by EAT-10 questionnaire and frailty by FRAIL scale. Handgrip strength (HGS) was evaluated by hand-dynamometer. Gait speed was evaluated by 4-meter usual gait speed (UGS). Nutritional status was assessed by mini-nutritional assessment-short form (MNA-SF). RESULTS: 1138 patients were enrolled. Mean age was 74.1±7.3 years. EAT-10 questionnaire was answered by all and FRAIL-scale by 851 subjects. EAT-10 score >15 points was regarded as significant dysphagia risk. The participants with EAT-10>15 points were older when compared to the participants with EAT-10<=15 points (p=0.002). Among participants with EAT-10>15 points, women gender and neurodegenerative diseases were more prevalent (p=0.04, p=0.002; respectively); number of chronic diseases, number of drugs and FRAIL score were higher (p=0.001 for each), and HGS, UGS, MNA-SF scores were lower (p=0.002, p=0.01, p<0.001; respectively). In multivariate analyses, the factors independently associated with presence of EAT-10 score>15 were FRAIL score and the number of drugs. CONCLUSION: Dysphagia is associated with frailty irrespective to age, presence of neurodegenerative diseases, number of chronic diseases and drugs. To our knowledge, this is the largest serie in the literature providing data on independent association of dysphagia with frailty.

Reliability and validity of Turkish version of the Simplified Nutritional Appetite Questionnaire (SNAQ).

OBJECTIVE: We aimed to investigate reliability and validity of the Turkish version of the Simplified Nutritional Appetite Questionnaire (SNAQ) in geriatric outpatients. DESIGN/SETTING: A cross-sectional study was designed through 2013-2016 years. At first, translation and back translation processes of the SNAQ from English to Turkish languages were done consecutively. Then construct validity was performed. PARTICIPANTS: They were recruited among the outpatients aged >=60 years that were consecutively admitted to the geriatric outpatient clinic of the Istanbul University hospital. MEASUREMENTS: Demographic data was recorded. SNAQ, Mini Nutritional Assessment (MNA), six-item Katz activities of daily living (ADL) and eight-item Lawton instrumental activities of daily living (IADL) scales were applied. RESULTS: 442 participants consisted of 305 women and 137 men with a mean age of 77.1 ± 6.8 years. The SNAQ identified 21.5% (n=95) of the participants with poor appetite. Reliability analysis showed good inter-rater reliability (r= 0.693, p< 0.05) and test-retest stability (r= 0.654, p< 0.05). Cronbach's alpha coefficient was 0.522. In terms of construct validity of SNAQ, Cohen's kappa analysis showed fair to moderate agreement between SNAQ and MNA (κ=0,355, p<0.001). Female gender, being illiterate, functional dependency in IADL were significantly associated with poor appetite. The SNAQ score was weakly correlated with scores of MNA-SF and MNA-LF (r=0.392 and r=0.380, respectively, p<0.0001 for both). There was statistically significantbut negligible correlation between the SNAQ and Katz ADL index, Lawton IADL index, and age. CONCLUSION: Turkish version of the SNAQ is a simple measurement with sufficient reliability and validity to screen poor appetite in community-dwelling older adults.