Introduction: Oropharyngeal dysphagia (OD) is a serious health condition associated with poor survival and quality of life in adults aged 60 years and older. Comprehensive assessment and management of OD could lead to better and improved health outcomes for older adults. Therefore, we performed the first meta-analysis to determine the pooled prevalence of OD and risk of pneumonia, malnutrition, and mortality. Methods: Databases including Ovid-MEDLINE, Web of Science, Embase, PubMed, Cochrane, and CINAHL were searched up to January 2021. Data analysis was conducted using logistic-normal for prevalence rate and DerSimonian-Lard random-effects models for outcomes and associated factors of OD, providing odds ratio (OR) and corresponding 95% confidence interval (CI). Results: The pooled prevalence of OD in 39 studies with 31,488 participants was 46% associated with higher pooled OR for risk of pneumonia 2.07 (95% CI, 1.58–2.72), malnutrition 2.21 (95% CI, 1.43–3.41), and mortality 2.73 (95% CI, 1.62–4.60). Geriatric syndromes including fecal incontinence 6.84 (4.955–9.44), immobility syndrome 6.06 (5.28–6.96), pressure ulcers 4.02 (2.46–6.56), sarcopenia 3.10 (1.89–5.09), urinary incontinence 2.75 (1.81–4.19), frailty 2.66 (1.16–6.13), delirium 2.23 (1.73–2.87), and falls 1.47 (1.19–1.81) and comorbidities including dementia 3.69 (2.36–5.78) and stroke 1.92 (1.47–2.52) were associated with OD. Conclusion: Early identification and management of OD should consider geriatric syndromes and neurogenic comorbidities to prevent malnutrition and pneumonia and reduce mortality in adults aged 60 years and older.
12 September 2024 in Archives of Gerontology and Geriatrics
Sleep is a biological function necessary for vital functions, including memory, emotion, learning, metabolic regulation, cellular toxin removal, and neural development in humans [1]. It is crucial in maintaining survival, recovery, and energy conservation, which are important for good health and improved quality of life, while poor sleep has severe health implications as it interrupts […]
Ageing process and abnormal protein accumulation in dementia damage neural pathways affecting the swallowing process and leading to swallowing disorder. To estimate the prevalence of swallowing disorder among older adults with different dementia subtypes. We conducted a systematic search across multiple databases, including PubMed, Embase, Scopus, Web of Science and OVID Medline. The meta-analysis employed R (version 4.0.2) and utilised a generalised linear mixed model with a random-effect approach to estimate the pooled prevalence of swallowing disorder among older adults, considering various dementia subtypes. The quality of included studies was assessed using Hoy’s criteria. Heterogeneity was identified through Cochrane’s Q and I2 statistics. To further explore heterogeneity, moderator analysis was performed to identify the contributing variables among the included studies. Eighteen studies with 12,532 older adults with different dementia subtypes were enrolled in our meta-analysis. The pooled prevalence of swallowing disorder among older adults with dementia was 58%, with 46.5% for Alzheimer’s dementia, 34.9% for Parkinson’s dementia, 18.8% for vascular dementia, 16.3% for mixed dementia and 12.2% for Lewy body dementia. According to assessment tools, Alzheimer’s dementia had the highest prevalence, with 58% in instrumental assessments and 39% in clinical assessments. Medical history, Alzheimer’s dementia, moderate-to-severe Clinical Dementia Rating, delayed oral phase, delayed pharyngeal phase and poor tongue motility contributed to the heterogeneity of the included studies. More than half of older adults with dementia demonstrate to have swallowing disorder. Our findings offer valuable insights to healthcare professionals for the identification of swallowing disorder in ageing population with dementia.
21 February 2025 in The Journal Of Prevention of Alzheimer's Disease
Multisensory stimulation defined as engaging multiple senses (visual, olfactory, auditory, gustatory, and tactile), has been demonstrated to improve older adults' general health. However, its effectiveness in mitigating neuropsychiatric symptoms (NPSs) and cognitive deficits in older adults with dementia remains unclear. This meta-analysis evaluated the efficacy of multisensory stimulation in ameliorating NPSs and improving overall cognitive function in older adults with dementia. We searched eight databases to September 2024 without restriction. Older adults with all stages of dementia aged 65 years and above were included. To estimate the pooled effect size, Hedge's g (g) values were calculated using a random-effects model. Heterogeneity was assessed using the Q, I², and τ² statistics. Subgroup and meta-regression analyses were performed to identify moderators. Publication bias was assessed using Begg and Mazumdar's rank correlation and Egger's linear regression tests. This review included 16 studies (974 patients). Multisensory stimulation significantly reduced agitation (g= -0.96; 95 %CI= -1.44, -0.48), apathy (g= -1.27; 95 %CI= -2.08, -0.46), and depression (g= -0.28; 95 %CI= -0.48, -0.07). Moreover, the intervention significantly improved overall cognitive function (g= 0.30; 95 %CI= 0.09, 0.52). However, multisensory stimulation had no significant effect on anxiety (g= -0.81; 95 %CI= -1.79, 0.17). Significant heterogeneity was observed in agitation, apathy, and anxiety. Moreover, meta-regression analyses by educational level (junior high school and above) revealed significant moderators in agitation. Multisensory stimulation shows promise as a non-pharmacological intervention for older adults with dementia. It may effectively mitigate NPSs and improve cognitive function into clinical practice as an alternative therapeutic.
23 April 2024 in International Journal of Mental Health Nursing