Predictive Factors for Swallowing Function Decline in Older Adults With Alzheimer's Disease: A 1‐Year Longitudinal Study
Maki Shirobe, Ayako Edahiro, Keiko Motokawa, Shiho Morishita, Yuki Ohara, Yutaka Watanabe, Masanori Iwasaki, Hirohiko HiranoABSTRACT
Background
By 2060, the global burden of dementia, particularly Alzheimer's disease (AD), is expected to increase significantly, necessitating effective palliative care strategies. Dysphagia, a common condition among people with dementia, leads to malnutrition, aspiration pneumonia, and a reduced quality of life.
Objective
This study aimed to identify oral health management factors that could predict a decline in swallowing function in older adults with AD.
Methods
Data from the Akita–Omorimachi study, which included 63 adults diagnosed with AD, were analysed. Swallowing function was assessed using the modified water‐swallowing test (MWST) at baseline and after 1 year.
Results
The results indicated that 25.4% of participants exhibited a decline in swallowing function, as indicated by a decrease from the highest MWST score of 5 at baseline to a lower score at follow‐up. Poisson regression analysis revealed that refusal of oral care (incidence rate ratio (IRR): 7.28), tongue coating (IRR: 4.21), and unclear articulation of /ka/ (IRR: 5.79) were significant predictors of swallowing function decline. The participants with these indicators had a higher risk of developing dysphagia.
Conclusions
These findings suggest that factors related to specific oral health problems may predict poor swallowing function in older adults with AD. Moreover, implementing targeted oral care interventions, including person‐centered care and regular tongue cleaning, may improve the outcomes in this vulnerable population. Despite the limitations of this study, including a small sample size, the results underscore the importance of comprehensive oral health management in preventing dysphagia‐related complications.