Characterization of Geriatric Dysphagia Diagnoses in Age-Based Cohorts
Objective An aging population requires increased focus on geriatric otolaryngology. Patients aged ≥65 years are not a homogenous population, and important physiologic differences have been documented among the young-old (65-74 years), middle-old (75-84), and old-old (≥85). We aim to analyze differen...
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doaj-8fc2321cd0db465c8b68a4f8bcac80f82020-11-25T03:37:54ZengSAGE PublishingOTO Open2473-974X2020-07-01410.1177/2473974X20939543Characterization of Geriatric Dysphagia Diagnoses in Age-Based CohortsJeremy Applebaum MD0Emerson Lee1Aisha Harun MD2Ashley Davis MS3Alexander T. Hillel MD4Simon R. Best MD5Lee M. Akst MD6Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USADepartment of Otolaryngology–Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USADepartment of Otolaryngology–Head and Neck Surgery, School of Medicine, Emory University, Atlanta, Georgia, USADepartment of Otolaryngology–Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USADepartment of Otolaryngology–Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USADepartment of Otolaryngology–Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USADepartment of Otolaryngology–Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USAObjective An aging population requires increased focus on geriatric otolaryngology. Patients aged ≥65 years are not a homogenous population, and important physiologic differences have been documented among the young-old (65-74 years), middle-old (75-84), and old-old (≥85). We aim to analyze differences in dysphagia diagnoses and swallowing-related quality-of-life among these age subgroups. Study Design Retrospective chart review. Setting Tertiary care laryngology clinic. Subjects and Methods We identified chief complaint, diagnosis, and self-reported swallowing handicap (Eating Assessment Tool [EAT-10] score) of all new patients aged ≥65 years presenting to the Johns Hopkins Voice Center between April 2015 and March 2017. Dysphagia diagnoses were classified by physiologic etiology and anatomic source. Diagnostic categories and EAT-10 score were evaluated as functions of patient age and sex. Results Of 839 new patients aged ≥65 years, 109 (13.0%) reported a chief complaint of dysphagia and were included in this study. The most common dysphagia etiologies were neurologic and esophageal. Most common diagnoses were diverticula (15.6%), reflux (13.8%), and radiation induced (8.3%). Diverticula, cricopharyngeal hypertonicity, and radiation-induced changes were associated with higher EAT-10 score ( P < .001). Significant differences by sex were found in anatomic source of dysphagia, as men and women were more likely to present with oropharyngeal and esophageal disease, respectively ( P = .023). Dysphagia etiology and EAT-10 score were similar across age subgroups. Conclusion Important differences among dysphagia diagnosis and EAT-10 score exist among patients aged ≥65 years. Knowledge of these differences may inform diagnostic workup, management, and further investigations in geriatric otolaryngology.https://doi.org/10.1177/2473974X20939543 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jeremy Applebaum MD Emerson Lee Aisha Harun MD Ashley Davis MS Alexander T. Hillel MD Simon R. Best MD Lee M. Akst MD |
spellingShingle |
Jeremy Applebaum MD Emerson Lee Aisha Harun MD Ashley Davis MS Alexander T. Hillel MD Simon R. Best MD Lee M. Akst MD Characterization of Geriatric Dysphagia Diagnoses in Age-Based Cohorts OTO Open |
author_facet |
Jeremy Applebaum MD Emerson Lee Aisha Harun MD Ashley Davis MS Alexander T. Hillel MD Simon R. Best MD Lee M. Akst MD |
author_sort |
Jeremy Applebaum MD |
title |
Characterization of Geriatric Dysphagia Diagnoses in Age-Based Cohorts |
title_short |
Characterization of Geriatric Dysphagia Diagnoses in Age-Based Cohorts |
title_full |
Characterization of Geriatric Dysphagia Diagnoses in Age-Based Cohorts |
title_fullStr |
Characterization of Geriatric Dysphagia Diagnoses in Age-Based Cohorts |
title_full_unstemmed |
Characterization of Geriatric Dysphagia Diagnoses in Age-Based Cohorts |
title_sort |
characterization of geriatric dysphagia diagnoses in age-based cohorts |
publisher |
SAGE Publishing |
series |
OTO Open |
issn |
2473-974X |
publishDate |
2020-07-01 |
description |
Objective An aging population requires increased focus on geriatric otolaryngology. Patients aged ≥65 years are not a homogenous population, and important physiologic differences have been documented among the young-old (65-74 years), middle-old (75-84), and old-old (≥85). We aim to analyze differences in dysphagia diagnoses and swallowing-related quality-of-life among these age subgroups. Study Design Retrospective chart review. Setting Tertiary care laryngology clinic. Subjects and Methods We identified chief complaint, diagnosis, and self-reported swallowing handicap (Eating Assessment Tool [EAT-10] score) of all new patients aged ≥65 years presenting to the Johns Hopkins Voice Center between April 2015 and March 2017. Dysphagia diagnoses were classified by physiologic etiology and anatomic source. Diagnostic categories and EAT-10 score were evaluated as functions of patient age and sex. Results Of 839 new patients aged ≥65 years, 109 (13.0%) reported a chief complaint of dysphagia and were included in this study. The most common dysphagia etiologies were neurologic and esophageal. Most common diagnoses were diverticula (15.6%), reflux (13.8%), and radiation induced (8.3%). Diverticula, cricopharyngeal hypertonicity, and radiation-induced changes were associated with higher EAT-10 score ( P < .001). Significant differences by sex were found in anatomic source of dysphagia, as men and women were more likely to present with oropharyngeal and esophageal disease, respectively ( P = .023). Dysphagia etiology and EAT-10 score were similar across age subgroups. Conclusion Important differences among dysphagia diagnosis and EAT-10 score exist among patients aged ≥65 years. Knowledge of these differences may inform diagnostic workup, management, and further investigations in geriatric otolaryngology. |
url |
https://doi.org/10.1177/2473974X20939543 |
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