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<p>Dysphagia is increasingly recognized in older adults and is known to have significant implications for quality of life. Prior research has suggested a complicated interplay between social isolation, mental health, and cognitive decline, with dysphagia potentially serving as a mediator within this cycle. In this study, we used two nationally representative datasets: Wave 1 (2008–2011) of the Hispanic Community Health Study/Study of Latinos (HCHS) and the 1999–2000 cycle of the National Health and Nutrition Examination Survey (NHANES), to evaluate associations between dysphagia and depression, anxiety, social isolation, and cognitive function in adults aged 65 and older. Among the 1,463 participants included (1,018 from HCHS and 445 from NHANES; 57% women), 12% reported swallowing difficulty. After adjusting for demographic, socioeconomic, and medical confounders, dysphagia was significantly associated with symptoms of depression and anxiety in the HCHS cohort (CESD-10: coefficient 9.56, 95% CI 3.26 to 28.00, p &lt; 0.001; STAI-10: coefficient 5.54, 95% CI 1.98 to 15.50, p = 0.001). In the NHANES cohort, participants with dysphagia had 2.87 times the odds of reporting a need for more emotional support in the past year (95% CI 1.33 to 5.96, p = 0.006). However, dysphagia was not associated with other measures of social isolation in the HCHS cohort, nor was it significantly associated with cognitive performance in either cohort. These findings underscore the mental health burden and perceived emotional support needs associated with dysphagia in older adults. Further research using longitudinal designs and objective swallowing metrics is needed to better characterize the psychosocial effects of dysphagia.</p>

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The Association of Dysphagia with Social Isolation, Mental Health, and Cognition in Older Adults

  • 期刊论文

  • 发表日期：

    2026年4月1日

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  • Elliot Morse,
  • Lauren H. Tucker,
  • Rachel B. Kutler,
  • Maggie Barilka,
  • Justin S. Golub,
  • Hayley Born

摘要

Dysphagia is increasingly recognized in older adults and is known to have significant implications for quality of life. Prior research has suggested a complicated interplay between social isolation, mental health, and cognitive decline, with dysphagia potentially serving as a mediator within this cycle. In this study, we used two nationally representative datasets: Wave 1 (2008–2011) of the Hispanic Community Health Study/Study of Latinos (HCHS) and the 1999–2000 cycle of the National Health and Nutrition Examination Survey (NHANES), to evaluate associations between dysphagia and depression, anxiety, social isolation, and cognitive function in adults aged 65 and older. Among the 1,463 participants included (1,018 from HCHS and 445 from NHANES; 57% women), 12% reported swallowing difficulty. After adjusting for demographic, socioeconomic, and medical confounders, dysphagia was significantly associated with symptoms of depression and anxiety in the HCHS cohort (CESD-10: coefficient 9.56, 95% CI 3.26 to 28.00, p < 0.001; STAI-10: coefficient 5.54, 95% CI 1.98 to 15.50, p = 0.001). In the NHANES cohort, participants with dysphagia had 2.87 times the odds of reporting a need for more emotional support in the past year (95% CI 1.33 to 5.96, p = 0.006). However, dysphagia was not associated with other measures of social isolation in the HCHS cohort, nor was it significantly associated with cognitive performance in either cohort. These findings underscore the mental health burden and perceived emotional support needs associated with dysphagia in older adults. Further research using longitudinal designs and objective swallowing metrics is needed to better characterize the psychosocial effects of dysphagia.