Assessment and Early Diagnosis of Dysphagia

Dysphagia is defined as difficulty in swallowing food (semi-solid or solid), liquid, or both. Neurological, muscular, anatomical, and/or psychological factors may predispose a person to difficulty in swallowing. Difficulty in swallowing or dysphagia can lead to serious complications including aspiration pneumonia, malnutrition, and death if not diagnosed early. Health care providers who are knowledgeable in assessing and diagnosing individuals with or at risk for dysphagia can in collaboration with an interdisciplinary team ameliorate the complications of dysphagia and optimize outcomes through focused interventions. In addition, health care costs would be reduced through decreased need for hospitalization, length of stay when hospitalized, and overall health care expenditures. This article provides a review of the epidemiology of dysphagia, the normal swallowing process, pathophysiology, signs and symptoms, and diagnostics. Implications for practice also are discussed. (Geriatr Nurs 2008;29:376-383)