Associations of cognitive function with feeding performance and swallowing function in elderly with dementia

Introduction: Feeding difficulty and dysphagia are common problems in elderly patients with dementia. Malnutrition and aspiration pneumonia may result from feeding problem and swallowing dysfunction. There were limited previous reports on the course of cognitive functional decline and the relationship among cognitive function, feeding performance and swallowing function in dementia patients. Objectives: The objectives of the present study were to investigate the association between cognitive function and feeding performance in elderly with dementia, and to investigate the association between cognitive function and severity of dysphagia in elderly with dementia. Method: In this cross-sectional study, we recruited 215 Chinese participants from hospital clinics and old aged homes from March 2014 to July 2014. The participants were over 65-year-old, with diagnosis of dementia and without history of other neurological diseases. Sociodemographic information of the participant was interviewed. Medical records were reviewed for the diagnoses of dementia and associated medical conditions. The Abbreviated Mental Test (AMT) was adopted to assess participants’ cognitive function. The feeding performance was evaluated by the Chinese version of Edinburgh Feeding Evaluation in Dementia (EdFED) Scale. The swallowing function was assessed by the Gugging Swallowing Screen (GUSS) test and Therapy Outcome Measure (TOM) impairment scale. Results: Significant negative correlation was demonstrated between AMT score with EdFED score (rho= -0.571, p<0.001). After adjustment of confounders, AMT score was an independent predictor of EdFED score (p=0.034), with age (p=0.016) and functional status (p=0.001) being two additional independent factors. The AMT score manifested significant associations with the measures of severity of dysphagia from the bivariate analysis of results from GUSS (p<0.001) and TOM (p