Differences in the quality of life of patients with oropharyngeal dysphagia according to the place of residence: impact on food selection and type of diet

Background: dysphagia is a disabling, uncomfortable symptom with repercussions on daily basic aspects of well-being. The SWAL-QoL test is validated for checking dysphagia's impact on quality of life (QoL). Methods: a descriptive cross-sectional study. Randomized patients from our in-house Nutrition & Dietetics database. Telephone interviews directly with patients or caregivers. SWAL-QoL test, 11 sections: swallowing, eating, symptoms, food selection, communication, fears, mental health, fatigue, and social function. A 1-5 Likert scale was adjusted and final results were linearly transferred to 0-100 (100 being best positive score). Results as follows: 0-49 severe impact (SI), 50-70 moderate impact (MI), and 71-100 mild impact or no impact (DI/NI). Variables: gender, age, days with treatment, residence: Home (H)/nursing home (NH), indication of commercial thickener (CT) by V/V test: nectar (N), honey (H), pudding (P), days with CT, type of diets; pureed (PD), soft diet (SD), mixed(P&S/D), regular (RD), SWAL-QoL sections. Results: a total of 202 patients with a mean age of 85 years (23-103); IQR: 12. Mostly women, 57.9 %. Dwelling: 43.1 % H/56.9 % NH. SWAL-QoL: SI affects 19.3 %, 59.9 % MI and 20.8 % DI/NI. Using less thickener proved a better QoL; SI in pudding 21.1 % vs nectar 15.3 %, p = 0.04. Diets included 66.3 % PD; 3 % SD; MD, 21.3 %, and RD, 9.4 %. At NH 86.1 % of PD vs 40.2 % at H, p < 0.001. Direct impact of diet on QoL: 30.8 % on DI or no impact of grouped diets vs 15.7 % with PD, p = 0.016. Analysing each section by H/NH, significant difference between fears, higher at H, 57.01 ± 36.41 vs NH, 48.70 ± 27.03, p < 0.001; worse mental health for NH, 66.44 ± 34.30 vs H, 47.48 ± 24.06, p < 0.001; better food selection for H, 75.86 ± 34.12 vs NH, 68.17 ± 33.60, p < 0.01 (AU)