Perception of Swallowing-Related Fatigue Among Older Adults

Purpose: Although fatigue is recognized as clinically relevant to swallowing performance, its prevalence and significance in dysphagic and nondysphagic adults have not been sufficiently examined. In this study, an online survey was used to examine swallowing-and eating-related fatigue (SERF) symptoms, the relationship between perceived SERF and other dysphagia-related health out-comes, and whether perceived SERF predicts risk for dysphagia or malnutrition. Method: An online survey of older adults (aged 60 years or older) was con-ducted. A novel 12-item scale was developed to capture perceived SERF. Previously validated scales were used to measure dysphagia risk, sarcopenia, general fatigue, malnutrition risk, and quality of life. Logistic regression was used to examine whether SERF predicted risk for dysphagia and/or malnutrition. Results: Complete responses were collected from 417 community-dwelling adults (Mage = 70.6 years, SD = 4.9; 263 women); 75% (n = 312) reported at least some degree of SERF. SERF was significantly correlated with dysphagia risk, sarcopenia, general fatigue, malnutrition risk, and quality of life. SERF was a significant predictor of dysphagia risk while controlling for age, gender, and other health outcomes (odds ratio [OR] = 1.2, 95% confidence interval [CI; 1.16, 1.27], p < .001). For every unit increase in SERF score, the odds of being at risk for dysphagia were associated with an increase of 22%. Significant predictors for malnutri-tion risk included SERF (OR = 0.94, 95% CI [0.91, 0.98]), general fatigue (OR = 0.95, 95% CI [0.92, 0.99]), and quality of life (OR = 1.04, 95% CI [1.0, 1.1]). Conclusions: Fatigue during swallowing and mealtimes is experienced by community-dwelling older adults and predicted dysphagia risk and malnutrition risk. Further research is needed to refine and validate a patient-reported out-come measure for SERF and examine the effects of fatigue on swallowing function and physiology under imaging.