Understanding how frailty and physical function are related to swallowing impairments in older adults

About the Project

Swallowing difficulties (dysphagia) are common in older adults, affecting up to 33% of the population. If these difficulties are not managed, they can lead to malnutrition, dehydration, reduced quality of life, pneumonia, hospitalization and mortality. One recent study has suggested that swallowing difficulties as reported by older adults may be caused by both older age and frailty. To date, no studies have used objective measures of swallowing difficulties to better understand its link to frailty. As such, the current study aims to use objective measures to:

  1. Confirm the relationship between frailty and objectively-measured swallowing difficulties; and
  2. Demonstrate that increased levels of physical activity allows for longer maintenance of swallowing function with age.

We will enroll 108 community-dwelling participants (age range: 60-89 years, 18 female, 18 male per decade) who are living with frailty or at risk, and perform objective, comprehensive assessments of swallowing, frailty, physical function and physical activity. Statistical analyses will then be conducted by a statistician. We expect to demonstrate that frailty and physical function are independently associated with severity of swallowing difficulties. This will in turn serve as preliminary evidence to encourage rehabilitation clinicians, such as speech-language pathologists and physiotherapists, to take a multidisciplinary approach to swallowing interventions to maximize patient outcomes by integrating physical activity to reduce the impact of frailty on swallowing.

Anticipated Findings

We expect to demonstrate that those who are more frail and/or have worse overall physical function, will have worse swallowing difficulties.

Project Team

Principal Investigator:

Ashwini Namasivayam-MacDonald — McMaster University

Co-Investigators:

Rebecca Affoo — Dalhousie University
Jinhui Ma — McMaster University
Ada Tang — McMaster University

Keywords: dysphagia; deglutition; swallowing; frailty; physical activity; physical function; older adults; community

Background & Rationale

Background

Swallowing difficulties (dysphagia) are common in older adults, and if they are not addressed, they can lead to malnutrition, dehydration, reduced quality of life, pneumonia, hospitalization and even death. A recent research study from our lab has suggested that swallowing difficulties as reported by older adults may be caused by old age and frailty (a medical condition of reduced function and health in older individuals). To date, no studies have used clinical measures of swallowing difficulties to better understand how they are related to frailty.

Rationale

Our goal is to confirm the relationships between swallowing difficulties, frailty and physical activity (which has been shown to reduce the risk of frailty in the muscles of the arms and legs) to strengthen our understanding of dysphagia and identify potential interventions.

Research Plan & Hypothesis

Research Plan

We will enroll 108 older adults who live in the community who are living with frailty or at risk, and perform assessments of swallowing, frailty, physical function and physical activity.

Hypothesis

We hypothesize that swallowing difficulties are directly associated with frailty in older adults. We also hypothesize that older adults who are more frail will have more severe swallowing difficulties.