Negative association of dementia comorbidity with improvement of swallowing function and activities of daily living in patients with sarcopenic dysphagia: A multicenter retrospective cohort study

Background: Sarcopenic dysphagia (SD) is a swallowing disorder due to sarcopenia involving the whole-body skeletal muscles and the swallowing muscles. Objectives: The aim of this study was to investigate the effects of comorbid dementia on rehabilitation outcomes in patients with SD. Methods: This retrospective cohort study used data from the Japanese SD Database. Patients with dysphagia aged 20 years or older with a food intake level scale (FILS) of 8 or less diagnosed with SD were included. Baseline data were collected for all patients. Follow-up data were collected after 3 months. For patients who had been in hospital for <3 months, follow-up data were collected at discharge. The effect of comorbid dementia with SD on improvement in activities of daily living (ADL) and swallowing function was examined using multivariate analysis. Results: Of 285 participants with SD, 98 (34.4%) had dementia and 187 (65.6%) did not. Ordered logistic regression revealed dementia as a significant predictor of lower FILS scores at follow-up (odds ratio: 1.89, 95% CI: 1.15–3.10, P = 0.012). Multiple regression analysis indicated dementia significantly predicted lower Barthel Index (BI) scores at follow-up (β = −0.106, P = 0.024), after adjusting for baseline characteristics including age, sex, hospital type, and baseline BI. Conclusion: In patients with SD, comorbid dementia was associated with poorer rehabilitation outcomes in swallowing function and ADL. These findings highlight the necessity of personalized rehabilitation strategies that account for individual cognitive impairments.