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Clinical Outcomes of Dysphagia in Elderly Patients with Cerebrovascular Accident

Fellow, UCLA Multicampus Fellowship Program in Geriatrics and Gerontology

Rajeswari Kumar

Department: of Physical Medicine and Rehabilitation, V.A. Medical Center, West Los Angeles, and Department of Medicine, UCLA School of Medicine

Oscar U. Scremin

GRECC, V.A. Medical Center, West Los Angeles, and Department of Physiology, UCLA School of Medicine

Dysphagia is a common complication for patients after cerebrovascular accident (CVA). The present study was done to determine the clinical outcome of dysphagia after CVA. The study also correlated the clinical outcome with the initial severity and location of the lesion. Method: A retrospective analysis of the videofluoroscopic study of patients who had clinical suspicion of dysphagia after stroke was performed. Forty-three patients met the inclusion criteria. All the patients included were 60 years of age or older with mean ± SD of 70.09 ± 8.69. The stroke diagnosis and location were documented by neu roimaging. Statistical analysis was done to determine whether initial severity of dys phagia, location of stroke, and age were predictive of dysphagia recovery. Results: The anatomical location of the lesion was predictive of dysphagia improvement. The high est incidence of improvement was noted in cortical stroke (65%), lowest in multiple strokes (12.5%), and intermediate values for subcortical (31%) and brainstem (20%) strokes (²: 8.17; p < 0.0427). Initial severity of dysphagia and age was not predictive of improvement. There was a trend for increased risk of aspiration in patients with multi ple strokes, but this did not reach statistical significance. Conclusion: Improvement of dysphagia secondary to stroke is related to the anatomical location of the lesion, with better recovery in single cortical strokes and worse in multiple strokes. Improvement of dysphagia is not related to age or initial severity of dysphagia.

Key Words: Key Words: Cere brovascular accident—Dysphagia—Videofluoroscopic study.

Neurorehabilitation and Neural Repair, Vol. 10, No. 4, 217-222 (1996)
DOI: 10.1177/154596839601000401


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