Original Paper
Understanding the Risk of Dysphagia in Daytime Rehabilitation Services and Combination of Assessment Methods Using Screening for Dysphagia
2022 Volume 26 Issue 2 Pages 109-120
Details
2022 Volume 26 Issue 2 Pages 109-120
Purpose: Dealing with dysphagia in elderly people requiring support and care who use daytime rehabilitation services is important in terms of supporting them to continue a stable life at home, and appropriate swallowing assessment is required for this purpose. The aim of this study was to identify the factors that influence the risk of dysphagia among users of daytime rehabilitation services and to clarify the relationship between such factors and the combination of screening that appropriately assesses individual ability, in addition to understanding the risk of dysphagia among the users.
Methods: The results of three types of swallowing assessments, basic information, and related factors were examined in subjects aged 65 years and older who used a facility between January 2016 and April 2021.
Results: There were 81 subjects with a mean age of 82.3 years. The results of the swallowing assessments showed that 29.6% of the subjects had a risk of dysphagia on both the Seirei questionnaire and MMASA, and 42.0% on the RSST. The Seirei questionnaire had the highest percentage of respondents with severe symptoms of nutritional status, and the MMASA had the lowest percentage of gag reflex scores. In addition, the judgments of the three types of swallowing assessments did not always agree, and the fact that there were seven different combinations of patients judged to have a risk of dysphagia suggests that each may have characteristics based on the assessment method.
Discussion: Although a relatively large number of users were in a state of low nutrition, many of them tended not to have symptoms severe enough to cause aspiration or aspiration pneumonia. Regarding the combination of assessment methods, the Seirei questionnaire and RSST were used more frequently in patients without dementia, so these two methods were used preferentially for such patients. On the other hand, for users with dementia, it was thought to be highly necessary to include MMASA in the judgment, thereby facilitating a broader understanding of the risk of dysphagia. In the future, it is necessary to include the results of the videofluoroscopic swallowing study in patients who were at risk, so that more appropriate assessments can be made.
