Poor Appetite Negatively Affects Recovery of Swallowing Function During Post-Acute Rehabilitation

Abstract

Purpose: Impaired swallowing function is prevalent among older adults, significantly impacting nutritional status and quality of life. Although appetite plays a crucial role in nutrition and clinical recovery, its influence on swallowing function recovery remains unclear. This study aimed to clarify the relationship between poor appetite and swallowing recovery in older adults undergoing rehabilitation. Methods: This retrospective cohort study analyzed data from 309 hospitalized older adults (aged ≥ 65 years) admitted to a post-acute rehabilitation ward with diagnosed impaired swallowing function. Appetite at admission was assessed using the Simplified Nutritional Appetite Questionnaire for Japanese Elderly (SNAQ-JE). Swallowing function was evaluated at discharge using the Food Intake Level Scale (FILS). Multivariable analyses adjusted for age, sex, nutritional status, sarcopenia, cognitive function, functional independence, and clinical characteristics. Results: Among participants (mean age 80.3 ± 7.9 years; 57.6% female), 41.4% had poor appetite. Patients with poor appetite showed significantly lower FILS scores at discharge compared to those with normal appetite (p = 0.002). In adjusted analyses, poor appetite remained negatively associated with FILS scores (Estimate: −0.224, 95% CI: −0.435 to −0.013, p = 0.038). Similarly, poor appetite was associated with impaired swallowing function at discharge (odds ratio: 2.11, 95% confidence interval: 1.16–3.92, p = 0.016). Conclusions: Poor appetite was negatively associated with the recovery of swallowing function among older patients undergoing post-acute rehabilitation. Early evaluation of appetite may assist in identifying barriers to the recovery of swallowing function within this population.