218 Swallowing/Communication Screening in Older Adults Attending the Emergency Department and Association with Clinical Frailty Scale Scores

Abstract

Dysphagia, frailty and negative patient outcomes are interlinked 1. Changes in communication may result from the ageing process, chronic conditions, and/or neurologic conditions presenting in later years 2. However, unlike other cohorts, including stroke, frail older patients are not routinely screened for swallowing/communication difficulties in acute settings. We investigated the proportion of Speech and Language Therapy (SLT) referrals generated for older patients attending our Emergency Department (ED) following use of a swallowing/communication screening tool and their association with Clinical Frailty Scale (CFS) scores. A retrospective analysis of data collected over a four week period was completed. Older patients presenting to ED were screened by the interdisciplinary gerontological ED team using a screening tool, including a locally developed swallow/communication screen. Statistical analyses were performed using STATA Version 12. Of 176 patients screened (mean age 81.8 years, SD 5.9 years), median CFS score was 5 (IQR 3-6). Thirty-seven percent (66/176) of patients were referred for SLT assessment following initial screen. SLT referrals were more commonly required in patients with a CFS score of ≥4 (46.2% vs. 19.3%, P=0.001) and likelihood of requiring SLT referral increased with greater CFS score (P<0.0001). Results suggest that screening for swallowing and communication difficulties in older patients yields a high level of SLT referrals, with a higher frequency of SLT referrals observed with increasing frailty scores. Further research is required to determine the optimum swallowing/communication screening tool in the acute setting. Future research will focus on evaluating outcomes of SLT assessments completed and determining the prevalence of swallowing and/or communication difficulties in this cohort.