Disfagia e sarcopenia em idosos acompanhados da atenção especializada

Abstract

Objective: To investigate the association between dysphagia and/or sarcopenia with clinical, functional, and nutritional factors in elderly individuals receiving specialized care. Methods: This study adopted an observational, analytical, and retrospective design, using a non-probabilistic convenience sample composed of secondary data from medical records of elderly patients treated in the Speech Therapy department of a specialized elderly care clinic located in Belo Horizonte, Minas Gerais, Brazil. Data were extracted from the records of all patients treated from January 1, 2021, to December 31, 2022. For sample selection, individuals aged 60 years or older who were receiving speech therapy follow-up at the Mais 60 Saúde clinic and had accessible data in the electronic medical records of geriatric, speech therapy, and nutritional assessments were included, provided these assessments were conducted within a 30-day interval. Patients evaluated by the Speech Therapy and Nutrition teams only via teleconsultations, those diagnosed with neuromuscular diseases, upper limb osteoarthritis, hemiplegia, or other conditions that could reduce upper limb strength for reasons other than sarcopenia, residents of long-term care facilities, those fed by alternative routes, or those lacking data on grip strength (GS), calf circumference (CC), and gait speed were excluded. A total of 500 medical records of elderly patients were identified within the specified period, of which 199 were eligible. Data were analyzed using descriptive statistics for the frequency distribution of categorical variables and measures of central tendency and variability for continuous variables. Hypothesis tests were applied to verify associations between variables, considering a significance level of 5% and a 95% confidence interval. Results: Of the 199 eligible participants, the majority were women (77.4%) aged between 63 and 101 years. The sample was characterized by frequent use of multiple medications (73.8%), independence in Basic Activities of Daily Living (BADLs) (84.9%), no feeding dependency (81.4%), multiple pathologies (78.4%), and edentulism (49.7%). The prevalence of dysphagia was 57.7% and sarcopenia 62.8%. Bivariate analysis revealed a significant association between dysphagia and sarcopenia, particularly in the reduction of body muscle strength in elderly individuals with mild/moderate dysphagia. The same clinical, functional, and nutritional factors were identified in both health conditions. Edentulism, modifications in food and liquid consistency, restricted functional capacity for oral intake, and frailty risk were associated with both mild/moderate oropharyngeal dysphagia and sarcopenia. Male gender was associated only with sarcopenia. Conclusion: This study found a significant association between dysphagia and sarcopenia in elderly individuals receiving specialized care, indicating interaction between these conditions. Clinical, functional, and nutritional factors influenced this association, with notable impacts from edentulism, modifications in food and liquid consistency, and restricted functional capacity for oral intake.