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Nur Laila Safira  -  Departemen Ilmu Gizi, Fakultas Kedokteran, Universitas Diponegoro, Indonesia
Enny Probosari  -  Departemen Ilmu Gizi, Fakultas Kedokteran, Universitas Diponegoro, Indonesia
Aryu Candra  -  Departemen Ilmu Gizi, Fakultas Kedokteran, Universitas Diponegoro, Indonesia
Fitriyono Ayustaningwarno  -  Departemen Ilmu Gizi, Fakultas Kedokteran, Universitas Diponegoro, Indonesia
*Ayu Rahadiyanti orcid scopus  -  Departemen Ilmu Gizi, Fakultas Kedokteran, Universitas Diponegoro, Indonesia
Received: 3 Jun 2021; Published: 9 Dec 2021.

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Background: Dysphagia can lead to a decrease in nutritional status and increased risk of malnutrition in the elderly. The incidence of dysphagia often undetected, especially among the elderly in the community, causes the prevalence of the elderly at risk of dysphagia in the elderly to increase.

Objective: The aims of this literature study was to review the latest research related to dysphagia with malnutriton in the elderly.

Method: The search for 2011 – 2021 English-language articles was carried out on the PubMed, SpringerLink, ScienceDirect, DOAJ, and ResearchGate databases using the keyword Dysphagia AND (Nutritional Status OR Malnutrition) AND Elderly and it was found  that 16 articles were selected based on inclusion criteria, including articles with elderly subjects aged ≥65 years in the community, a minimum sample of 50 respondents, a cross sectional and prospective cohort study, analyzed the relationship between variables, and data collection using valid instruments by a trained people.

Result: Dysphagia independently had a significant relationship with nutritional status in elderly, could reduce oral food intake and lead to decrease in nutritional status due to nutrient deficiency. It was known that differences in instruments, characteristics and number of samples as well as the timing of malnutrition can affect the relationship between variables. Other factors such as teeth condition, body composition and tongue pressure might also be associated with dysphagia and malnutrition.

Conclusion: The existence of a relationship between the two variables found in most of the studies indicates that dysphagia is an important factor that can lead to malnutrition in elderly

Keywords: Elderly; Dysphagia; Malnutrition

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Keywords: elderly; dysphagia; malnutrition

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  1. Kemenkes RI Pusat Data dan Informasi. Situasi dan analisis lanjut usia. Jakarta: Kemenkes RI Pusat Data dan Informasi; 2014
  2. United Nations Department of Economic and Social Affairs. World Population Ageing 2019 [Internet]. Economic and Social Affairs, Population Division. United Nations; 2019. 1–111 p. Available from:
  3. Badan Pusat Statistik. Statistik penduduk lanjut usia 2019. Jakarta: Badan Pusat Statistik; 2019
  4. Fatmah F. Gizi usia lanjut. Jakarta: Erlangga; 2010
  5. Darmojo B. Buku ajar Boedhi-Darmojo geriatric. Jakarta: Balai Penerbit FK UI; 2009
  6. Nyberg M, Olsson V, Pajalic Z, Örtman G, Andersson HS, Blucher A, et al. Eating difficulties, nutrition, meal preferences and experiences among elderly: a literature overview from a Scandinavian context. J Food Res. 2015;4(1):22–37
  7. Johansson L, Sidenvall B, Malmberg B, Christensson L. Who will become malnourished? A prospective study of factors associated with malnutrition in older persons living at home. J Nutr Health Aging. 2009;13(10):855–66
  8. Rasheed S, Woods RT. Malnutrition and quality of life in older people: A systematic review and meta-analysis. Ageing Res Rev. 2013;12(2):561–6
  9. Kemenkes RI Direktorat Jenderal Bina Gizi dan Kesehatan Ibu dan Anak. Buku pedoman pelayanan gizi lanjut usia. Jakarta: Kemenkes RI; 2011
  10. Brogan KE, Jen KLC. Nutrition in the elderly. In: Lichtenberg P, editor. Handbook of Assessment in Clinical Gerontology. 2nd Editio. San Diego: Elsevier Science Publishing Co Inc; 2010. p. 357–80
  11. Hickson M. Malnutrition and ageing. Postgr Med J. 2006;82:2–8
  12. Takeuchi K, Aida J, Ito K, Furuta M, Yamashita Y, Osaka K. Nutritional status and dysphagia risk among community-dwelling frail older adults. J Nutr Heal Aging. 2014;18(4):352–7
  13. World Health Organization (WHO). Evidence profile: malnutrition. 2017;1–35. Available from: malnutrition.pdf?ua=1
  14. Krishnamoorthy Y, Vijayageetha M, Kumar SG, Rajaa S, Rehman T. Prevalence of malnutrition and its associated factors among elderly population in rural Puducherry using mini-nutritional assessment questionnaire. J Fam Med Prim care. 2018;7(6):1429–33
  15. Kalaiselvi S, Arjumand Y, Jayalakshmy R, Gomathi R, Pruthu T, Palanivel C. Prevalence of under-nutrition, associated factors and perceived nutritional status among elderly in a rural area of Puducherry, South India. Arch Gerontol Geriatr. 2016;65:156–60
  16. Damayanthi HDWT, Moy FM, Abdullah KL, Dharmaratne SD. Prevalence of malnutrition and associated factors among community-dwelling older persons in Sri Lanka: A cross-sectional study. BMC Geriatr. 2018;18(1):1–10
  17. Mathew AC, Das D, Sampath S, Vijayakumar M, Ramakrishnan N, Ravishankar SL. Prevalence and correlates of malnutrition among elderly in an urban area in Coimbatore. Indian J Public Health. 2016;60(2):112–7
  18. Tamang MK, Yadav UN, Hosseinzadeh H, Kafle B, Paudel G, Khatiwada S, et al. Nutritional assessment and factors associated with malnutrition among the elderly population of Nepal: A cross-sectional study. BMC Res Notes [Internet]. 2019;12(1):1–5. Available from:
  19. Wei JM, Li S, Claytor L, Partridge J, Goates S. Prevalence and predictors of malnutrition in elderly Chinese adults: Results from the China Health and Retirement Longitudinal Study. Public Health Nutr. 2018;21(17):3129–34
  20. Hirose T, Hasegawa J, Izawa S, Enoki H, Suzuki Y, Kuzuya M. Accumulation of geriatric conditions is associated with poor nutritional status in dependent older people living in the community and in nursing homes. Geriatr Gerontol Int. 2014;14(1):198–205
  21. Furuta M, Komiya-Nonaka M, Akifusa S, Shimazaki Y, Adachi M, Kinoshita T, et al. Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people. Community Dent Oral Epidemiol. 2013;41(2):173–81
  22. Leij-Halfwerk S, Verwijs MH, van Houdt S, Borkent JW, Guaitoli PR, Pelgrim T, et al. Prevalence of protein-energy malnutrition risk in European older adults in community, residential and hospital settings, according to 22 malnutrition screening tools validated for use in adults ≥65 years: A systematic review and meta-analysis. Maturitas. 2019;126(February):80–9
  23. Feldblum I, German L, Castel H, Harman-Boehm I, Bilenko N, Eisinger M, et al. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status. Nutr J. 2007;6(1):1-9
  24. Pirlich M, Lochs H. Nutrition in the elderly. Bailliere’s Best Pract Res Clin Gastroenterol. 2001;15(6):869–84
  25. Bartali B, Salvini S, Turrini A, Lauretani F, Russo CR, Corsi AM, et al. Age and disability affect dietary intake. J Nutr. 2003;133(9):2868–73
  26. Donini LM, Savina C, Cannella C. Eating habits and appetite control in the elderly: The anorexia of aging. Int Psychogeriatrics. 2003;15(1):73–87
  27. Mann T, Heuberger R, Wong H. The association between chewing and swallowing difficulties and nutritional status in older adults. Aust Dent J. 2013;58(2):200–6
  28. Taylor C. Dysphagia and malnutrition in older adults. Br J Community Nursing,. 2019;24(7):26–8
  29. Silva LM de L, Lima CR de, Cunha DA da, Orange LG de. Dysphagia and its relation with nutritional status and calorie/protein intake in the elderly. Rev CEFAC. 2019;21(3):1–9
  30. Madhavan A, Carnaby GD, Crary MA. Dysphagia in the elderly : management and nutritional considerations. Clin Interv Aging. 2012;7:287–98
  31. Lindroos E, Saarela RKT, Soini H, Muurinen S, Suominen MH, Pitkala KH. Caregiver-reported swallowing difficulties, malnutrition, and mortality among older people in assisted living facilities. J Nutr Health Aging. 2014;18(7):718–22
  32. Okabe Y, Furuta M, Akifusa S, Takeuchi K, Adachi M, Kinoshita T, et al. Swallowing function and nutritional status in Japanese elderly people receiving home-care services: A 1-year longitudinal study. J Nutr Heal Aging. 2016;20(7):697–704
  33. Lindroos E, Jyväkorpi S, Soini H, Muurinen S, Saarela RKT, Pitkala KH, et al. Swallowing difficulty and nutrient intakes among residents in assisted living facilities in Helsinki. Eur Geriatr Med. 2017;8(3):228–33
  34. Madhavan A, Lagorio LA, Crary MA, Dahl WJ, Carnaby GD. Prevalence of and risk factors for dysphagia in the community dwelling elderly: A systematic review. J Nutr Heal Aging. 2016;20(8):806–15
  35. Abdul Khader F, Somayaji K. S. G, . M. Swallowing difficulties among healthy elderly: prevalence and aetiology. Int J Otorhinolaryngol Head Neck Surg. 2018;4(2):494
  36. Yang EJ, Kim MH, Lim JY, Paik NJ. Oropharyngeal dysphagia in a community-based elderly cohort: The Korean longitudinal study on health and aging. J Korean Med Sci. 2013;28(10):1534–9
  37. Igarashi K, Kikutani T, Tamura F. Survey of suspected dysphagia prevalence in home-dwelling older people using the 10-Item Eating Assessment Tool (EAT-10). PLoS One. 2019;14(1):1–13
  38. Serra-Prat M, Hinojosa G, Lopez D, Juan M, Fabre E, Voss D, et al. Prevalence of oropharyngeal dysphagia and impaired safety and efficacy of swallow in independently living older persons. J Am Geriatr Soc. 2011;59(1):186–7
  39. Abu-Ghanem S, Chen S, Amin MR. Oropharyngeal Dysphagia in the Elderly: Evaluation and Prevalence. Curr Otorhinolaryngol Rep. 2020;8(1):34–42
  40. Holland G, Jayasekeran V, Pendleton N, Horan M, Jones M, Hamdy S. Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: A self-reporting questionnaire survey. Dis Esophagus. 2011;24(7):476–80
  41. Jardine M, Miles A, Allen J. Self-reported Swallowing and Nutrition Status in Community-Living Older Adults. Dysphagia [Internet]. 2020;(0123456789). Available from:
  42. Nugroho W. Keperawatan gerontik dan geriatrik. Edisi 3. Jakarta: EGC; 2008
  43. Nishida T, Yamabe K, Honda S. The influence of dysphagia on nutritional and frailty status among community-dwelling older adults. Nutrients. 2021;13(2):1–8
  44. Bayram HM, Ilgaz F, Serel-arslan S, Demir N. Nutritional status in dysphagic and nondysphagic elderly persons in Turkey : A comparison study. Prog Nutr. 2020;22(3):1–9
  45. Tsuji T, Yamamoto K, Yamasaki K, Hayashi F, Momoki C, Yasui Y, et al. Lower dietary variety is a relevant factor for malnutrition in older Japanese home-care recipients: A cross-sectional study. BMC Geriatr. 2019;19(1):1–8
  46. Hägglund P, Fält A, Hägg M, Wester P, Levring Jäghagen E. Swallowing dysfunction as risk factor for undernutrition in older people admitted to Swedish short-term care: a cross-sectional study. Aging Clin Exp Res [Internet]. 2019;31(1):85–94. Available from:
  47. Chatindiara I, Williams V, Sycamore E, Richter M, Allen J, Wham C. Associations between nutrition risk status, body composition and physical performance among community-dwelling older adults. Aust N Z J Public Health. 2019;43(1):56–62
  48. Furuta M, Takeuchi K, Adachi M, Kinoshita T, Eshima N, Akifusa S, et al. Tooth loss, swallowing dysfunction and mortality in Japanese older adults receiving home care services. Geriatr Gerontol Int. 2018;18(6):873–80
  49. Tagliaferri S, Lauretani F, Pelá G, Meschi T, Maggio M. The risk of dysphagia is associated with malnutrition and poor functional outcomes in a large population of outpatient older individuals. Clin Nutr. 2019;38(6):2684–9
  50. Wakabayashi H, Matsushima M, Ichikawa H, Murayama S, Yoshida S, Kaneko M, et al. Occlusal Support, Dysphagia, Malnutrition, and Activities of Daily Living in Aged Individuals Needing Long-Term Care: A Path Analysis. J Nutr Heal Aging. 2018;22(1):53–8
  51. Huppertz VAL, Halfens RJG, van Helvoort A, de Groot LCPGM, Baijens LWJ, Schols JMGA. Association between oropharyngeal dysphagia and malnutrition in Dutch nursing home residents: Results of the National Prevalence Measurement of Quality of Care. J Nutr Heal Aging. 2018;22(10):1246–52
  52. Lim Y, Kim C, Park H, Kwon S, Kim O, Kim H, et al. Socio-demographic factors and diet-related characteristics of community-dwelling elderly individuals with dysphagia risk in South Korea. Nutr Res Pract. 2018;12(5):406–14
  53. Namasivayam-MacDonald AM, Morrison JM, Steele CM, Keller H. How swallow pressures and dysphagia affect malnutrition and mealtime outcomes in Long-term care. Dysphagia. 2017;32(6):785–96
  54. Wakabayashi H. MM. Dysphagia Assessed by the 10-Item Eating Assessment Tool Is Associated with Nutritional Status and Activities of Daily Living in Elderly Individuals Requiring Long-Term Care. J Nutr Heal &Aging. 2016;20(1):22–7
  55. Goes VF, Hack J, Magro M, Bonini JS. Evaluation of dysphagia risk , nutritional status and caloric intake in elderly patients with Alzheimer ’ s. Rev Latino-Am Enferm. 2014;22(2):317–24
  56. Park YH, Bang HL, Han HR, Chang HK. Dysphagia screening measures for use in nursing homes: A systematic review. J Korean Acad Nurs. 2015;45(1):1–13
  57. Gallegos C, Brito-de la Fuente E, Clavé P, Costa A, Assegehegn G. Nutritional Aspects of Dysphagia Management. In: Advances in Food and Nutrition Research [Internet]. 1st ed. Elsevier Inc.; 2017. p. 271–318. Available from:
  58. Sura L, Madhavan A, Carnaby G, Crary MA. Dysphagia in the elderly: Management and nutritional considerations. Clin Interv Aging. 2012;7:287–98
  59. Cichero JAY. Age-related changes to eating and swallowing impact frailty: Aspiration, choking risk, modified food texture and autonomy of choice. Geriatr. 2018;3(4)
  60. Whitney E, Rolfes SR. Life cycle nutrition: Adulthood and the later years. In: Understanding Nutrition. 12e ed. Belmont, CA: Wadsworth, Cengage Learning; 2011. p. 575–603
  61. Wellman NS, Kamp BJ. Nutrition in aging. In: Mahan LK, Escott-Stump S, editors. Krause’s food and nutrition therapy. 12e ed. St. Louis, CA: Elsevier; 2008. p. 286–308
  62. Homem SG, Moreira EAM, da Silva AF, Barni GC, da Rosa JS, Oliveira D de L, et al. Relationship between oropharyngeal dysphagia, nutritional status, antioxidant vitamins and the inflammatory response in adults and elderly: A cross-sectional study. Clin Nutr ESPEN. 2020;38(xxxx):211–7

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