Oropharyngeal dysphagia (OD) is a set of clinical symptoms defined as difficulty effectively transporting a food bolus from the oral cavity to the oesophagus.1 The main risk factors are: age, dysfunction, sarcopenia, frailty, polypharmacy and comorbidities.2 The prevalence of OD among the elderly who live independently in the community is estimated to be between 30% and 40%.3 This increases to around 47.4% among patients hospitalised for an acute condition.4 Highest OD prevalence has been observed in neurological patients, although percentages vary depending on the neurological disease and population studied. Ferrero López et al. reported a dysphagia prevalence of 43% in patients with a history of cerebrovascular accident (CVA) and 75% in patients with Parkinson's disease.5 In other studies6, 7 prevalences in Alzheimer's patients ranged from 32% to 45% if they were clinically assessed and 84%–93% if they were instrumentally evaluated. The study conducted by Cabré et al. found the prevalence in dementia patients to be 50%.8

OD is associated with impaired swallowing efficacy and safety, giving rise to complications such as malnutrition, dehydration, airway penetration and aspiration leading to respiratory infections, aspiration pneumonia and hospital admission.9 These complications significantly impact the health of elderly patients, affecting their nutritional status, functionality, morbidity, mortality and quality of life.10 This results in frailty and greater institutionalisation, increasing the mortality rate in this population.11

A robust relationship between OD and malnutrition (MN) has been established in the literature.1, 5, 10, 12 In the elderly, food and fluid intake decrease due to age-related physiological factors, such as anorexia, chewing difficulty, cognitive impairment, and social, emotional and health-related problems.1 These health problems are often associated with conditions that entail increased nutritional requirements, a hypercatabolic state contributing to the onset of OD in elderly patients.5, 12 The age-related relationship between loss of masticatory and swallowing strength and muscle mass, and changes in swallowing function that lead to the onset of OD (and consequently MN), is well established. While MN is accompanied by generalised loss of muscle mass, it also contributes to the onset of OD.1 MN-OD is a bidirectional relationship.

Both MN and OD reduce patient quality of life10 entail increased health costs13, 14 due to a higher morbidity and mortality rate, and result in an increased length of hospital stay12 and higher institutionalisation rates. Early identification of OD and MN is vital in preventing complications and hospital readmissions. That is why nutritional screening, the detection of OD warning signs, and the application of validated OD diagnostic methods or more specific instrumental techniques are important.15 Treating dysphagia is simple, cost-effective and can prevent many complications if applied in time.2

The primary objective of this study is to determine the prevalence of OD and MN in hospitalised patients at high risk for OD. Its secondary objective is to identify the prevalence and association of these two syndromes with other related factors: the reason for admission, hospital stay, referral to the Dietetics and Clinical Nutrition Department (DCND), number of hospital readmissions and survival during the year following their inclusion in the study.