162A Systematic Review of the Prevalence of Oropharyngeal Dysphagia in the Nursing Home Population

Abstract

Background: Oropharyngeal dysphagia (OPD) is an important cause of morbidity and mortality in the nursing home (NH) population. We reviewed the literature systematically to determine an estimate of prevalence of OPD in nursing home populations and to catalogue the methodology employed in identifying its presence. Methods: We undertook a systematic review identifying original research papers that estimated a prevalence of OPD amongst a general NH population. The databases searched were Pubmed and Embase with keywords "dysphagia", "deglutition" and "nursing home". The inclusion criteria comprised of any paper identifying the prevalence of OPD (by any method) in older NH residents. In addition, we tabulated the methods, where described, of screening for OPD, and clarified how many reported engagement of Speech and Language Therapists (SLT) in assessment and/or management. Results: We screened 2562 papers. 33 papers, published between 1996 and 2016, were included in the study with estimates of the prevalence of OPD in the NH population ranging from 12% to 88%. OPD estimates varied with the investigative methodology used with qualitative questionnaires revealing lower estimates to those obtained from objective measures. Referral to SLT was reported in just two papers. Conclusions: The wide range of prevalence estimates found in this systematic review reflects the lack of standardisation in defining, investigating and managing OPD internationally. There is a need for larger local and international studies of the prevalence of OPD in NH residents with the aim of creating a systematic approach to OPD screening and management in this vulnerable population.