Oropharyngeal dysphagia frequency in older adults living in nursing homes: an integrative review
Frequência de disfagia orofaríngea em idosos institucionalizados: uma revisão integrativa
Jessica Soares Xavier; Amanda Cibelly Brito Gois; Letícia de Carvalho Palhano Travassos; Leandro Pernambuco
Abstract
Purpose: To synthesize the scientific knowledge on the frequency of oropharyngeal dysphagia in older adults living in nursing homes. Research strategies: The study question followed the PECO strategy and the search was performed in the Pubmed/Medline, Web of Science, Scopus, LILACS and SciELO databases, using keywords and specific free terms. Selection criteria: articles with no time or language restrictions that reported the frequency of oropharyngeal dysphagia in older adults living in nursing homes and the diagnostic criteria. Data analysis: it was analyzed the population characteristics, the concept of “oropharyngeal dysphagia”, the methods for identifying the outcome and the frequency of oropharyngeal dysphagia. The evaluation of the methodological quality of the articles followed the criteria of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Results: Fifteen articles were included. There was great variability in relation to the sample size, with a predominance of longevous old women. The concept of dysphagia, when mentioned, was heterogeneous. Diagnostic criteria were diverse and mostly comprised of questionnaires or clinical trials results. No studies used instrumental tests. The frequency of oropharyngeal dysphagia in the studied population ranged from 5.4% to 83.7%, being higher in studies that used clinical tests, but with greater precision of confidence intervals in studies that used questionnaires and large sample size. Conclusion: The frequency of oropharyngeal dysphagia in older adults living in nursing homes has wide variability. Methodological discrepancies among studies compromise the reliability of frequency estimates and highlight the need for research with better defined and standardized methodological criteria.
Keywords
Resumo
Objetivo: Sintetizar o estado do conhecimento científico sobre a frequência de disfagia orofaríngea em idosos institucionalizados. Estratégia de pesquisa: A pergunta de pesquisa foi formulada de acordo com a estratégia PECO e a busca foi realizada nas bases de dados Pubmed/Medline, Web of Science, Scopus, LILACS e SciELO, utilizando descritores e termos livres específicos. Critérios de seleção: Artigos sem restrição de tempo ou idioma, que relatassem a frequência de disfagia orofaríngea em idosos institucionalizados e o critério utilizado para diagnóstico. Análise dos dados: Foram analisadas as características da população, conceito de “disfagia orofaríngea”, métodos para identificação do desfecho e a frequência de disfagia orofaríngea. A avaliação da qualidade metodológica dos artigos seguiu os critérios do Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Resultados: Foram incluídos quinze artigos. Houve grande variabilidade quanto ao tamanho da amostra, com predomínio de idosos longevos do sexo feminino. O conceito de disfagia, quando mencionado, foi heterogêneo. Os critérios diagnósticos foram diversos e compostos, em sua maioria, por resultados de questionários ou testes clínicos. Nenhum estudo utilizou exames instrumentais. A frequência de disfagia orofaríngea na população estudada oscilou entre 5.4% e 83.7%, sendo mais elevada nos estudos que utilizaram testes clínicos, porém, com intervalos de confiança mais precisos naqueles que usaram questionários e amostras maiores. Conclusão: A frequência de disfagia orofaríngea em idosos institucionalizados possui ampla variabilidade. As discrepâncias metodológicas entre os estudos comprometem a confiabilidade das estimativas de frequência e apontam a necessidade de pesquisas com critérios metodológicos mais bem definidos e padronizados.
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Submetido em:
28/05/2020
Aceito em:
13/07/2020
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