Exploring the Associations Between Dysphagia and Health-Related Outcomes in Older Adults: Results from the ilSirente Study

Introduction: Dysphagia, or difficulty swallowing, is a multifactorial condition prevalent in older adults, with estimates ranging from 15% to 30.5% among community-dwellers. Causes include neurological disorders, dementia, and certain medications. Dysphagia can lead to reduced nutrient intake, malnutrition, muscle loss, and, ultimately, sarcopenia, increasing the risk of frailty, falls, hospitalization, and mortality. Additionally, swallowing dysfunction may be linked to cognitive decline, as both share overlapping neural pathways. Despite these risks, few studies have examined the broader health impacts of dysphagia in community settings. Hence, the present study examined cross-sectional and longitudinal associations between dysphagia and a variety of health-related parameters, including physical performance, cognitive function, malnutrition, sarcopenia, disability, frailty, falls, hospitalization, and mortality in a cohort of octogenarians living in the mountainous Sirente region of Central Italy. Methods: Dysphagia was operationalized as the need to modify the diet to facilitate swallowing and/or the exclusive consumption of specific food consistencies due to swallowing difficulties according to self-report and physician examination. Physical performance, cognitive function, malnutrition, disability, falls, and hospitalizations were assessed via the Minimum Data Set for Home Care. Sarcopenia was defined as the coexistence of low muscle mass and dynapenia according to the cutoff points described by the European Working Group on Sarcopenia, while frailty was operationalized according to the Fried’s phenotype. Falls history and incident falls, as well as disability, were tracked over two years, while survival status was followed for up to ten years. Results: Data of 362 older adults were analyzed. Our results indicated that dysphagia was significantly and cross-sectionally associated with poor physical performance and reduced cognitive function. In contrast, no longitudinal associations were observed. Conclusions: Dysphagia appears to be linked to deficits in physical and cognitive domains, underscoring the value of comprehensive geriatric assessment and the development of multidomain intervention strategies.