gms | German Medical Science

26th Annual Meeting of the German Drug Utilisation Research Group (GAA)

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

21.11. - 22.11.2019, Bonn/Bad Godesberg

Iatrogenic burden and components of so-called presbydysphagia? Health care research in oropharygeal dysphagia in the elderly analysing associated and drug related risk factors

Meeting Abstract

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  • corresponding author presenting/speaker Ursula Wolf - University Hospital, Pharmacotherapy Management, Halle (Saale), Germany
  • author Grit Walter - Diakonie Hospital, Halle (Saale), Germany
  • author Andreas Wienke - Institute of Medical Epidemiology, Biostatistics and Informatics, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
  • Sandra Gregor - University Hospital, Pharmacotherapy Management, Halle (Saale), Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 26. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Bonn/Bad Godesberg, 21.-22.11.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. Doc19gaa12

doi: 10.3205/19gaa12, urn:nbn:de:0183-19gaa124

Published: November 19, 2019

© 2019 Wolf et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Background: Dysphagia resulting from central nervous system diseases (CNS-D) is well established and another increasingly accepted form now is the so-called presbydysphagia. Yet, the detailed data situation on associated risk factors for oropharyngeal dysphagia in the elderly patient is incomplete with regard to multimorbidity and polypharmacy and thus subject of this investigation. The focus of this work is on 1. assessment of the prevalence of oropharyngeal dysphagia in the geriatric patient; 2. consecutive analysis of possible drug-iatrogenic causes and potential associations within multimorbidity in this patient group. Dysphagia guidelines do not consider this aspect in the multimorbid and vulnerable patient group sufficiently.

Materials and methods: In a cross-sectional study based on a random sample of 200 patients admitted to a geriatric hospital comprehensive data were included besides the detailed list of drugs and an intensely clinical investigation of swallowing according to Stanschus as a screening method for oropharyngeal dysphagia performed in each of the 200 patients.

Results: Within the 200 patients, mean age 84±6.5 years, 65% female, prevalence of dysphagia was 29% (n=58). Compared to women (21%), men revealed a higher rate (45%). Dysphagia was more frequent in nursing home residents (36%) compared to own households (27%). From concomitant diseases as diabetes mellitus, different grades of renal dysfunction, COPD and upper gastrointestinal illnesses we did not find associated risks. Patients with dysphagia presented 1.5 fold risk of pneumonia (95% KI=(0.65;3.58)). Central nervous system diseases (CNS-D) posed a 6.9 fold significant risk of dysphagia (95% KI=(3.7;14.8)). Another significant risk was associated with neuroleptics OR=2.5 (95% KI=(1.2;5.04)) – adjusted for CNS-D (adj): OR=1.9 (95% KI=(0.88;4.31)); anti-Parkinson drugs: OR=2.8 (95% KI=(1.19;6.73)) – adj.: OR=1.3 (95% KI=(0.52;3.51)); benzodiazepines: OR=4.4 (95% KI=(1.01;18.93)) – adj.: OR=2 (95% KI=(0.42;9.5)). With antidepressants we found a 2.1 fold risk for dysphagia (95% KI=(0.96;4.72)).

Conclusion: As well as in patients with CNS-D and without we can identify specific drug groups associated with risk of aggravating and/or inducing dysphagia respectively. Restricted indication especially for neuroleptics, benzodiazepines and antidepressants might be a preventative contribution and requires implementation in future dysphagia guidelines.