社区居住老年人自报吞咽困难的患病率及预测因素

文献信息

中文摘要

目的： 老年人吞咽困难与营养不良、误吸及生活质量下降相关。本研究旨在估计以色列社区居住老年人中自报吞咽困难的患病率，并识别人口学、医学和社会经济预测因素。方法：在这项横断面研究中，1064名年龄≥60岁的社区居住成年人（平均75.1±7.5岁；68.1%为女性）完成了一份在线问卷，收集人口学、医学诊断、体力活动、收入和居住地信息，同时完成经过验证的希伯来语和阿拉伯语版进食评估工具-10（EAT-10）。吞咽困难筛查定义为EAT-10≥3，并使用多变量logistic回归检验人口学、医学和社会经济预测因素。结果：吞咽困难筛查阳性的患病率为29.1%。在调整模型中，显著的独立预测因素包括年龄较大（比值比[OR]=1.84）、吞咽困难相关医学诊断（OR=3.10）、缺乏规律体力活动（OR=2.19）、较低收入（OR=1.36）和较低居住地社会经济集群（OR=1.84）。性别（平均年龄75.07岁，标准差=7.52）、体重指数（BMI）和居住地边缘性在调整后不显著；双变量分析中边缘性的效应似乎主要由社会经济因素介导。结论：近三分之一的以色列社区居住老年人吞咽困难筛查呈阳性。除已确定的医学危险因素外，缺乏体力活动和社会经济劣势与筛查阳性独立相关，提示可能是未来研究可干预的目标。研究结果支持将吞咽筛查整合到常规老年护理中，并针对低社会经济和边缘社区制定以公平为重点的筛查举措。

英文摘要

Objectives: Dysphagia in older adults is associated with malnutrition, aspiration, and reduced quality of life. This study aimed to estimate the prevalence of self-reported swallowing difficulties among community-dwelling older adults in Israel and to identify demographic, medical, and socioeconomic predictors. Method: In this cross-sectional study, 1064 community-dwelling adults aged ≥ 60 years (mean 75.1 ± 7.5 years; 68.1% female) completed an online questionnaire capturing demographics, medical diagnoses, physical activity, income, and place of residence, together with the validated Hebrew and Arabic versions of the Eating Assessment Tool-10 (EAT-10). Dysphagia screening was defined as EAT-10 ≥ 3, and demographic, medical, and socioeconomic predictors were examined using multivariable logistic regression. Results: The prevalence of positive dysphagia screening was 29.1%. In the adjusted model, significant independent predictors were older age (odds ratio [OR] = 1.84)), a dysphagia-related medical diagnosis (OR = 3.10), absence of regular physical activity (OR = 2.19), lower income (OR = 1.36), and lower residential socioeconomic cluster (OR = 1.84). Gender, with a mean age of 75.07 years (SD = 7.52), body mass index (BMI), and residential peripherality were not significant after adjustment; the bivariate peripherality effect appeared to be largely mediated by socioeconomic factors. Conclusions: Nearly one in three community-dwelling Israeli older adults screened positive for dysphagia. Beyond established medical risk factors, physical inactivity and socioeconomic disadvantage were independently associated with positive screening, suggesting potentially modifiable targets for future study. Findings support integrating swallowing screening into routine geriatric care and developing equity-focused screening initiatives for lower-socioeconomic and peripheral communities.