Prevalence and management of dysphagia in a geriatric rehabilitation unit

Introduction. Dysphagia is a leading cause of morbidity and mortality in the elderly, and its prevalence depends on age, setting and evaluation instruments. Aim of the present study in a geriatric rehabilitation ward is to evaluate the prevalence of dysphagia, and the efficacy of a multiprofessional targeted rehabilitative approach. Methods. On admission, all patients underwent a comprehensive multidimensional assessment, and a screening for dysphagia with the 3-oz swallowing test (3-oz). Patients with positive 3-oz test underwent a second-level dysphagia evaluation using the Dysphagia Outcome and Severity Scale (DOSS). Dysphagic patients started a specific rehabilitative program, diet were modified, relatives and staff were trained. Results. 1434 patients were screened with the 3oz, and 168 (11.7%) resulted dysphagic at second level evaluation (DOSS <5). Patients were old, mainly female, with a moderate cognitive and functional decline; 20% of patients had prevalent delirium. A significative number of patients (24%) increased their DOSS stage). Discussion. Dysphagia is a relevant problem in geriatric rehabilitation. The use of an assessment tool simple and rapid is associated to improved outcomes.