About this trial
The purpose of this study is to learn about oral and swallowing function in older adults presenting to the emergency department. The hypothesis is that older adults often have problems with oral and swallowing function and these problems relate to other conditions. Study activities are done during the emergency department visit and include providing saliva samples, completing a bedside water swallow test, completing oral function assessments, completing respiratory function tests, and answering survey questions.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age ≥ 60
Clinically stable and able (not NPO) to safely drink water and eat a saltine cracker per ED provider
Disqualifiers
Prisoner
Non-English speaking
Trial population
Older adults presenting to the emergency department
Trial design
Cohort
Prospective
Treatments tested in this trial
3-ounce water swallow test
Diagnostic testBedside water swallow dysphagia screen where vocal quality of the participant is assessed before and after swallowing 3 ounces of water
Kayser-Jones Brief Oral Health Status Examination (BOHSE)
Diagnostic testScored assessment of the lymph nodes, lips, tongue, tissue inside of cheek, floor and roof of mouth, gums between teeth and/or under artificial teeth, saliva, condition of natural/artificial teeth, chewing position of teeth, and oral cleanliness
Tongue pressure
Diagnostic testMaximum isometric lingual pressure at the front and back of tongue will be measured by placing an air-filled pressure bulb on the surface of the oral tongue and having participants press the bulb "as hard as possible" against the hard palate
Test of Masticating and Swallowing Solids (TOMASS)
Diagnostic testMeasurement of bites, masticatory cycles, swallows, and time taken to consume a cracker
Respiratory function tests
Diagnostic testParticipants will take a maximum inhalation and forcefully exhale into a spirometer to measure maximum expiratory pressure (MEP), fully exhale their air and take a maximal inhalation into the spirometer to measure maximum inspiratory pressure (MIP), and produce a single strong cough into to spirometer to measure peak expiratory flow (PEF) and forced expiratory volume (FEV1)
Treatment groups
Trial outcomes
Primary outcomes
Positive oropharyngeal dysphagia screen prevalence
Number of participants with positive oropharyngeal dysphagia screen identified through bedside dysphagia screen and patient reported swallowing function
Secondary outcomes
Mean brief oral health status examination (BOHSE) score
Score 0 - 20 with 20 indicating the worst oral health
Oral dryness prevalence
Number of participants with stimulated salivary flow rate (volume saliva/collection time) less than two standard deviations below published norms
Decreased tongue pressure prevalence
Number of participants with maximum isometric lingual pressures at front or back tongue location less than fifth percentile for published age-matched norms
Decreased masticatory function prevalence
Number of participants with test of masticating and swallowing solids (TOMASS) greater than two standard deviations above published age- and sex-matched norms for any of four components: number of bites, number of masticatory cycles, number of swallows, total time
Sponsors and contacts
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