Impact of Mild Frailty on Quantitative Measures of Oropharyngeal Swallow.

Abstract

Frail individuals have diminished muscle strength and may experience swallowing dysfunction. While studies have demonstrated associations between frailty and oropharyngeal dysphagia, few have examined the impact of frailty on instrumental measures of oropharyngeal swallowing. Our objective was to compare quantitative measures of oropharyngeal swallowing during videofluoroscopic swallow study (VFSS) in patients with mild frailty compared to no frailty, based on the Modified Frailty Index-11 (mFI-11). A retrospective study was conducted among adults undergoing VFSS. Hyoid displacement (HD), posterior pharyngeal wall thickness (PPW), and pharyngoesophageal segment (PES) opening were quantified and compared between those with "no frailty" and "mild frailty," defined as an mFI-11 score of 0 and 1, respectively. Forty-four patients were included in this study (no frailty, n = 24 and mild frailty, n = 20), including 28 females, with an overall median age of 47.5 (range 18-85). There was no significant difference in HD on 1-mL bolus (95% CI: -0.53 to 0.66, p = 0.82), 20-mL bolus (95% CI: -0.89 to 0.30, p = 0.33), PPW at rest (95% CI: -0.22 to 0.98, p = 0.22), PPW at maximal constriction (95% CI: -0.12 to 1.09, p = 0.11), and PES (95% CI: -0.95 to 0.25, p = 0.25). HD, PPW, and PES opening appear to be preserved among individuals with mild frailty. Deficits in oropharyngeal swallow, however, may be more apparent in moderate and severe frailty as well as those with comorbid sarcopenia. Future studies may consider including patients with advanced frailty as well as using direct measures of muscle mass/strength such as imaging findings and grip strength to capture the association between frailty and oropharyngeal dysphagia.