Dysphagia
DOI 10.1007/s00455-014-9584-z
ORIGINAL ARTICLE
Prevalence of Oropharyngeal Dysphagia in the Netherlands:
A Telephone Survey
Berit Kertscher • Renée Speyer • Eric Fong •
Anastasios M. Georgiou • Moira Smith
Received: 27 April 2014 / Accepted: 20 October 2014
Ó Springer Science+Business Media New York 2014
Abstract Recent and specific data on the prevalence and/
or incidence of oropharyngeal dysphagia in the general
population are scarce. This study focuses on obtaining this
data by means of a literature review and telephone survey.
A literature review was performed to obtain data on the
prevalence of dysphagia in the general population. Sec-
ondly, a quasi-random telephone survey using the func-
tional health status questionnaire EAT-10 was conducted
with the aim of establishing prevalence data on oropha-
ryngeal dysphagia in the Netherlands. The literature review
revealed six articles which met the inclusion criteria. The
prevalence data on oropharyngeal dysphagia in the general
population varied between 2.3 and 16 %. For the telephone
survey, a total of 6,700 individuals were contacted by
B. Kertscher
RehaA Winterthur, RehaClinic, Zurzach, Switzerland
B. Kertscher (&)
RehaA Winterthur, RehaClinic, Rudolfstrasse 13,
8400 Winterthur, Switzerland
e-mail: b.kertscher@rehaclinic.ch
R. Speyer  E. Fong  M. Smith
School of Public Health, Tropical Medicine and Rehabilitation
Sciences, James Cook University, Townsville, QLD, Australia
R. Speyer
Department of Otorhinolaryngology and Head and Neck
Surgery, Leiden University Medical Center, Leiden,
The Netherlands
E. Fong
Flinders Medical Centre, Bedford Park, SA, Australia
A. M. Georgiou
School of Health & Social Welfare Professionals, Higher
Technological Educational Institute of Peloponnese, Kalamata,
Greece
telephone, of which, 2,600 (39 %) participated in the study.
Of the 2,600 participants, as many as 315 (12.1 %) were
identified as having swallowing abnormalities and showed
increased risk of oropharyngeal dysphagia with age.
Prevalence data on oropharyngeal dysphagia in the Dutch
general population were as high as 12.1 %. This data are in
line with the retrieved prevalence data from the literature.
Keywords Oropharyngeal dysphagia  Deglutition 
Deglutition disorders  Prevalence  General population
Introduction
Swallowing is a complex motor reflex requiring coordination
among the neurological system, the oropharynx, and the
esophagus [1]. Dysphagia is a disruption of bolus flow through
the mouth, pharynx, and esophagus [2], and oropharyngeal
dysphagia refers to any abnormality in swallowing physiology
of the upper aerodigestive tract [3]. Oropharyngeal dysphagia
(OD) is a common problem and comorbidity among various
patient groups. Dysphagia can lead not only to dehydration,
malnutrition, and higher risk for pulmonary complications [4,
5] but also to death [6]. Early diagnosis and intervention to
minimize the risks of oropharyngeal dysphagia are considered
to be essential in dysphagia management.
In the literature, prevalence and incidence data on oro-
pharyngeal dysphagia are scarce and may vary consider-
ably: for example, 81 % in stroke patients at the time of
initial clinical swallowing evaluation [7], 51 % in patients
with acute first-ever stroke [8] to 51 % in head and neck
cancer patients [9]. Obviously, these data cannot be gen-
eralized to the general population as all above-mentioned
studies focus on specified patient populations at risk for
swallowing problems.
123

Table 1 Search strategies and number of abstracts retrieved in
PubMed and Embase
Database Literature search strategies NAbstracts
PubMed ((‘‘Deglutition’’[Mesh] OR ‘‘Deglutition 2,118
Disorders’’[Mesh]) AND
(‘‘Population’’[Mesh] OR ‘‘Population
Characteristics’’[Mesh] OR ‘‘Community
Health Planning’’[Mesh] OR
‘‘Registries’’[Mesh]) AND
(‘‘Incidence’’[Mesh] OR
‘‘Epidemiology’’[Mesh] OR
‘‘epidemiology’’[Subheading] OR
‘‘Prevalence’’[Mesh])) OR ((swallow* OR
dysphag* OR deglut*) AND (prevalence* OR
incidence*)) AND ‘‘humans’’[MeSH Terms]
AND English[lang]) AND (‘‘2012/01/
0100 [PDAT] : ‘‘2013/07/3100 [PDAT]))
Embase ((swallow* or dysphag* or deglut*) and 899
(prevalence* or incidence*)).mp. [mp = title,
abstract, subject headings, heading word, drug
trade name, original title, device manufacturer,
drug manufacturer, device trade name,
keyword] limit to (human and English
language and yr = ’’2012 -Current’’)
The outcome of prevalence studies highly depends on
the selected subject populations and the definition of oro-
pharyngeal dysphagia as determined by the use of different
assessment tools and outcome variables. In the assessment
of oropharyngeal dysphagia, fiberoptic endoscopy or vid-
eofluoroscopy of the swallowing act (respectively FEES or
VFS) are considered to be the gold standard. However, in
prevalence studies screening tools are more likely to be
used. The Eating Assessment Tool (EAT-10) by Belafsky
et al. [17] is an example of a self-report screening inven-
tory on functional health status to identify patients at risk
with oropharyngeal dysphagia.
In order to get a better understanding of the magnitude
of the prevalence of OD in the general population, the aim
of this study is twofold: (1) a literature review is performed
to extract prevalence data on oropharyngeal dysphagia in
the general population and (2) a telephone survey is con-
ducted using the EAT-10 as measuring tool to establish the
prevalence of OD in the Dutch general population.
Literature Review
Method
A systematic literature search of two relevant databases,
PubMed and Embase, was performed. Subject headings
(MeSH and Thesaurus) and free-text terms were used to
search both databases. For inclusion, the manuscript nee-
ded to be published in English and describe the prevalence
123
B. Kertscher et al.: Prevalence of Oropharyngeal Dysphagia
and/or incidence of OD in the general population. Only
randomized controlled trials or well-designed clinical trials
were considered, thus excluding for example multiple case
studies. The methodological study quality was assessed, by
taking the number of participants into account, making sure
the used questionnaires were either validated or well
described to insure reproducibility, and the definition of
OD was clearly formulated. All encountered hits until July
2013 were included in this review. Table 1 shows the
search strategies used in PubMed and Embase plus the
retrieved number of abstracts.
The literature search retrieved 3,017 abstracts: 2,118
abstracts from PubMed and 899 abstracts from Embase.
The search in PubMed and Embase combined, produced
173 double abstracts, which were excluded and brought the
total of original abstracts to 2,844. Two independent
reviewers, EF and TG, carried out the abstract selection
and differences of opinion during that process were dis-
cussed until a consensus was reached. During the process
of abstract selection, 2,825 original abstracts were exclu-
ded because studies were not published in English; had no
data on prevalence and/or incidence of OD; included
populations other than patients with OD; or were (multiple)
case study design. Nineteen original articles were consid-
ered for the full-text review, of which 14 articles were later
excluded. The reasons for article exclusion varied from
paucity of data on OD, poster presentation instead of an
original manuscript, and to lack of information on OD in
the general population. After the reference check for rele-
vant references and citations, one article was added, raising
the total of included articles to six. Figure 1 shows the
complete flow diagram of the abstract reduction process in
both PubMed and Embase.
Results
Six articles met all inclusion criteria [10–15]. Chiocca et al.
[10] assessed the prevalence of gastro-oesophageal reflux
symptoms in association with atypical symptoms, such as
asthma, dyspepsia, dysphagia, and globus, in Argentina.
837 adults participated in this self-reported survey using
the Gastro-oesophageal Reflux Questionnaire (GERQ).
Chiocca et al. found the overall prevalence of dysphagia to
be 12.9 % and the prevalence of frequent dysphagia to be
6.5 %. Dysphagia occurred more often in women (17.1 %)
compared to men (3.5 %). 6.7 % of the participants,
affected by dysphagia, reported the symptoms to be severe
or very severe. Furthermore, subjects who reported dys-
phagic symptoms stated to also have odynophagia
(27.9 %), to have dysphagia to solids (57.3 %), to have
dysphagia to liquids (8.7 %) or to have dysphagia to liquids
and solids (34 %) [10].
B. Kertscher et al.: Prevalence of Oropharyngeal Dysphagia
Fig. 1 Flow diagram of the
abstract reduction process in
PubMed and Embase
1 article included
from reference check
Cho et al. [11] evaluated the prevalence of symptoms of
gastroesophageal reflux disease (GERD), including (non-
obstructive) dysphagia, in a general population. 1,417
Korean adults were randomly selected to participate in a
cross-sectional survey (face-to-face interview). The ques-
tionnaire included 60 questions of which 29 items focused
on gastroesophageal reflux symptoms over the past year.
The frequency of dysphagia in the general population was
2.3 % [11].
Eslick and Talley [12] aimed to determine the magni-
tude and impact of dysphagia in the general population.
The authors described a randomly selected sample of 672
adults using the Chest Pain Questionnaire (CPQ). The CPQ
was developed to study the epidemiology of chest pain and
related disorders, including dysphagia [12]. The partici-
pants were asked if they ‘ever’ experienced dysphagia
during the past twelve months. The prevalence of dys-
phagia in the general population was 16 % and the severity
of dysphagia was most often reported as mild (65 %) fol-
lowed by a moderate severity (30 %). The frequency of
dysphagia symptoms was reported by the participants as:
65 % occurring less than once a month, 15 % occurring
once a month, 8 % once a week, 9 % several times a week,
and 1 % as daily. Of the respondents with dysphagia, 29 %
reported pain on swallowing. 8 % of the respondents who
reported dysphagic symptoms indicated problems with
liquid only, 54 % respondents indicated problems with
solid food, and 38 % reported problems with both solid
food and liquids [12]. All three above-mentioned studies
[10–12] defined dysphagia as the feeling that food sticks in
the throat or chest.
Ruth et al. [13] aimed to determine the prevalence and
the severity of symptoms suggestive of esophageal disor-
ders, with particular emphasis on gastroesophageal reflux
(GER), in a general population. The used questionnaire
2118 abstracts from PubMed
899 abstracts from Embase
- 173 excluded double abstracts
2844 abstracts PubMed + Embase
2825 abstracts excluded at abstract level
• No English publication
• No prevalence data on oropharyngeal
dysphagia
• Patient population without
oropharyngeal dysphagia
• (Multiple) case studies
19 articles included
14 articles excluded at full-text level
• 1 study with paucity of data relating
to oropharyngeal dysphagia
• 6 original manuscripts not retrieved
(only abstracts available)
• 7 studies on specific rather than
general population
6 articles in final inclusion
focused on symptoms suggestive of GER and esophageal
motility disorder. A total of 337 adults participated and
10 % reported having dysphagia. 4 % reported having
social dysphagia which was defined as having difficulty
eating in company [13].
Watson and Lally [14] aimed to determine the preva-
lence of gastroesophageal reflux symptoms, the prevalence
of side effects of anti-reflux surgery, and the consumption
of reflux medication in the wider community. 2,973 ran-
domly selected adolescents and adults participated in the
survey. Face-to-face interviews revealed the prevalence of
dysphagia to be 11 % in the general population. 3.5 % of
adults with dysphagia experienced swallowing problems at
least once per month, whereas 2.1 % experienced dys-
phagic symptoms at least two to three times per week [14].
Ziółkowski et al. [15] assessed the prevalence of
digestive tract alarm symptoms, and the readiness levels to
undergo endoscopic screening for colorectal and other
gastrointestinal cancers in the general Polish population.
Possible alarm symptoms were, for example, persistent
vomiting or dysphagia. 850 randomly selected adults par-
ticipated in this study. The prevalence of dysphagia in the
general population was found to be 2.5 % [15].
All three aforementioned studies [13–15] included ran-
domly selected subjects from the general population.
However, none of these three studies defined dysphagia.
Therefore, it is not clear whether the term dysphagia is
defined as oropharyngeal dysphagia, esophageal dysphagia
or both types of dysphagia.
Analysis of the literature on oropharyngeal dysphagia
indicates that the prevalence varies between 2.3 and 16 %
in the general population. There are however limitations in
the literature, the prime limitation being the lack of defi-
nition of dysphagia. Table 2 presents a complete overview
of the included articles and their outcomes.
123
 B. Kertscher et al.: Prevalence of Oropharyngeal Dysphagia

Table 2 Overview of included studies: study characteristics and outcomes

Authors, Country Sample size general Measurement tool Data Prevalence
Publication year population sampling process collection

Chiocca et al. [10] Argentina N = 839 (M = 373, F = 466) Gastro-oesophageal 1998 12.9 % (95 % CI
Age range 18-80 years questionnaire (GERQ) 10.6–15.2 %)
Consecutive enrollment dysphagia; 3.5 %
(95 % CI 2.2–4.7 %)
frequent dysphagia
Cho et al. [11] South Korea, Asan- N = 1,417 (M = 762, Questionnaire on GERD 2000–2001 2.30 % (95 % CI
si area F = 655) Random selection (14 months) 2.8–14.7 %)
Chungcheongnam- dysphagia
do Province
Eslick and Australia, Nepean N = 672 (M = 323, F = 349) Chest pain questionnaire 10 weeks 16 % (95 % CI
Talley [12] catchment area Random selection (CPQ) 14–20 %) dysphagia
(during the past 12
months)
Ruth et al. [13] Sweden, Gothenburg N = 337 (M = 168, F = 169) Questionnaire on GER 1986 10 % dysphagia; 4 %
Age range 20–79 years and esophageal motility social dysphagia
Random selection disorder
Watson and Australia, Adelaide N = 2,973 (M = 1,277, South Australian spring 2006 10.9 % dysphagia to
Lally [14] F = 1,696) health omnibus survey (4 months) solids; 6.9 %
Random stratified sampling dysphagia to liquids
technique
Ziółkowski Poland, Otwock N = 850 (M = 340, F = 510) Questionnaire on 2002–2009 2.5 % dysphagia
et al. [15] Age range 21–76 years digestive tract
Random selection

Telephone Survey
Method
A telephone survey was conducted to acquire additional
information on the actual prevalence of oropharyngeal
dysphagia in the Dutch general population. All participants
had to be 18 years or older and registered in the telephone
directory of either the city of Groningen, Nijmegen or
Rotterdam. Groningen is located in the north of the Neth-
erlands with about 190,000 inhabitants and Nijmegen
counts approximately 165,000 inhabitants in the east of the
Netherlands. Rotterdam is a major harbor city in the west
of the Netherlands with about 616,500 inhabitants. These
three cities are a gross representation for the general Dutch
population. This study protocol was approved by the HAN
University of Applied Sciences.
Measurement Tool
The Eating Assessment Tool (EAT-10) by Belafsky et al.
[17] was used as screening inventory to identify patients at
risk for OD during the telephone survey. The EAT-10 is a
self-reporting functional health status questionnaire [16]
about weight loss, the ability to go out for meals, difficulties
in swallowing liquid or solid consistencies, pain or stressful
swallowing, difficulties in taking pills, food getting stuck in
the throat, and coughing while eating. The EAT-10 holds
ten items and is scored by means of a five-point scale with
scores ranging from 0 (no problem) to 4 (severe problem).
The score 0 implicates no difficulties in swallowing and the
score 4 implicates a severe swallowing problem. The
maximum total score is 40 points and an EAT-10 score of 3
or higher is considered to be abnormal, thus indicating at the
swallowing problems [17]. Recent literature, however,
assessed the accuracy of the EAT-10 for detecting OD by
determining diagnostic performance with videofluoroscopy
as reference standard. Rofes et al. [18] showed that reducing
the EAT-10 cut-off point from 3 to 2 increases the sensi-
tivity of the EAT-10 by nearly 5 % without affecting the
specificity, resulting in fewer false-negative cases. Because
an EAT-10 cut-off score of 2 or higher may be a more
accurate measure to indicate at swallowing problems, this
study will provide data using both the cut-off points. For the
purpose of this telephone survey, the EAT-10 was translated
into Dutch by consensus using three dysphagia experts. The
Dutch version of the EAT-10 is not yet validated, but the
psychometric measurement properties of the Dutch version
of the EAT-10 are currently under study.
Procedure
Five fourth-year speech and language pathology students
were trained to conduct the telephone survey using a

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B. Kertscher et al.: Prevalence of Oropharyngeal Dysphagia

a N = 280 N = 542 N = 756 N = 728 N = 294

After the purpose of the telephone call was stated, the
request for participation was accepted and the age of the
participant verified as 18 years or older, further instructions
were given on the EAT-10. Participants were asked to choose
the answer that fitted their situation best by assigning a score
Participants (%)

78.1
to each question. If a participant showed difficulties in
understanding an item, the item was read out again. All
90.2
94.6 95.9 93.5 answers were comprised in a data spreadsheet using SPSS
Dysphagia -
Dysphagia +
version 22.0. Data were only included if the participant fin-
ished the questionnaire and provided answers to all ten items.

21.9
9.8
Results
5.4 4.1 6.5
18-30 31-45 46-60 61-75 > 76
Age groups (Years)
In total, 6,700 persons were contacted by telephone. 2,633
persons (39 %) agreed to participate of which 33 partici-
b N = 280 N = 542 N = 756 N =728 N = 294 pants (1.2 %) were excluded after initial participation due
to the inability to finish the questionnaire. Finally, a total of
2,600 (38.8 %) participants were included in the data ana-
lysis. The age of the participants ranged from 18 years to
97 years with a median age of 55 years (25 % = 42 years;
Participants (%)

73.8 75 % = 67 years). Of the 2,600 people participating in the

89.5 87.6
88.2 93.4
Dysphagia -
Dysphagia +
26.2
11.8 6.6 10.5 12.4
18-30 31-45 46-60 61-75 > 76
Age groups (Years)
Fig. 2 a Prevalence data (EAT-10 score C3) on oropharyngeal
dysphagia per age group. Number (in percentage) of participants of
the telephone survey with dysphagia (EAT-10 score C3; NTo-
tal = 219) and without dysphagia (EAT-10 score \3; NTotal = 2,381)
per age group. b Prevalence data (EAT-10 score C2) on oropharyn-
geal dysphagia per age group. Number (in percentage) of participants
of the telephone survey with dysphagia (EAT-10 score C2;
NTotal = 315) and without dysphagia (EAT-10 score \2; NTo-
tal = 2,285) per age group
standardized protocol. The telephone survey was con-
ducted from September 2012 until December 2012 on
weekdays between 5 PM and 8 PM. This particular time
was chosen because it was thought to be the most likely
time to reach people at home by telephone. The resource
for this telephone survey was the officially printed tele-
phone directories of Groningen, Nijmegen, and Rotterdam.
The telephone directories were systematically and alpha-
betically used to call potential participants. The letters Q,
X, and Y were excluded prior to the start of the survey,
because these letters are the least likely to be found as first
letter of a Dutch last name, and therefore least represen-
tative for the Dutch general population.
telephone survey, 219 (8.4 %) participants scored a three or
higher on the EAT-10 questionnaire indicating at swal-
lowing abnormalities according to Belafsky et al. [17]. The
age of the individuals with a total EAT-10 score of 3 or
higher ranged from 18 to 90 years with a median age of
65 years (25 % = 53 years; 75 % = 76 years). However,
using the more conservative cut-off point of 2 or higher by
Rofes et al. [18], 315 (12.1 %) of the 2,600 people partic-
ipating in the telephone survey should be considered for
further clinical bedside assessment. The age of the indi-
viduals with a total EAT-10 score of two or higher also
ranged from 18 to 90 years with a median age of 62 years
(25 % = 46 years; 75 % = 75 years). Therefore, the
prevalence of OD in the general Dutch population, using the
EAT-10 as screening tool, was noted to be as high as 12.1 %
(315/2,600 participants).
Figure 2 provides a comparison per age group of par-
ticipants with and without OD (Table 3).
Figures 3a, b present scores per EAT-10 item for par-
ticipants with OD using a cut-off score of 3 and 2,
respectively. The following four EAT-10 items were most
frequently rated as abnormal: ‘Swallowing pills takes extra
effort’ (33 vs. 48 %); ‘When I swallow food sticks in my
throat’ (19 vs. 24 %); ‘I cough when I eat’ (13 vs. 26 %);
‘Swallowing solids takes extra efforts’ (11 vs. 19 %).
Discussion and Conclusions
The literature review on the prevalence of OD in the general
population identified six relevant articles. In all of these

123
 B. Kertscher et al.: Prevalence of Oropharyngeal Dysphagia

Table 3 Prevalence data of oropharyngeal dysphagia

Participants (N) Prevalence OD (95 % Confidence interval)
Cut-off point EAT-10 C 3a Cut-off point EAT-10 C 2b
Pr (N) 95 % CI Pr (N) 95 % CI

Total group (2,600) 8.42 % (219) 7.35–9.49 12.12 % (315) 10.87–13.37

Age group 18–30 years (280) 5.36 % (15) 4.46–6.26 11.79 % (33) 10.47–13.11
Age group 31–45 years (542) 4.06 % (22) 3.27–4.85 6.64 % (36) 5.62–7.66
Age group 46–60 years (756) 6.48 % (49) 5.49–7.47 10.45 % (79) 9.20–11.70
Age group 61–75 years (728) 9.75 % (71) 8.56–10.94 12.36 % (90) 11.01–13.71
Age group [76 years (294) 21.09 % (62) 19.45–22.73 26.19 % (77) 24.39–27.99
a
Belafsky et al. (2008)
b
Rofes et al. (2014)

a 100%
90%
research. Furthermore, the sample sizes in the included
80% studies vary, ranging from 337 participants [13] to 2,973
70% participants [14], and different measuring tools were used of
Score (%)

60% Score 4 (severe) which only three questionnaires are validated [10, 12, 14]. In
50% Score 3 order to make conclusions about the general population,
40% Score 2 large sample sizes are required and validated measuring tools
30% Score 1 (mild) are necessary to avoid bias in the prevalence data retrieved.
20%
None The telephone survey was executed to compliment the
10%
limited data found in the literature review and to gather
0%
1 2 3 4 5 6 7 8 9 10 actual data on the prevalence of OD in the Dutch general
EAT-10 Items population. The sample size of the telephone survey in this
b 100%
study was 2,600 participants, close to the highest end of the
90% given range as found in the literature. The telephone survey
80% was chosen as the method because it is an easily available
70% and low-cost means of reaching the target population.
Score (%)

60% Score 4 (severe) However, a telephone survey may also hold sources of bias
50% Score 3 that need to be taken into consideration when interpreting
40% Score 2 the data. Firstly, the telephone survey was conducted
30% Score 1 (mild) between 5 PM and 8 PM. If the telephone survey had taken
20%
None place in the morning or early afternoon the results may
10%
0% have varied, because people participating in the workforce
1 2 3 4 5 6 7 8 9 10
are less likely to be home at that time. Secondly, some of
EAT-10 Items
the elderly population may be unable to answer the phone
Fig. 3 a Scores (C3) [17] per EAT-10 item (%) for participants with
or may have moved to a nursing home, and therefore their
oropharyngeal dysphagia (NTotal = 219). b Scores (C2) [18] per entry in the telephone directory could be outdated. Thirdly,
EAT-10 item (%) for participants with oropharyngeal dysphagia the younger generations are more likely to use cell phones
(NTotal = 315). EAT-10 items: 1 My swallowing problem has caused instead of landlines, and therefore may not have an entry in
me to lose weight; 2 My swallowing problem interferes with my
ability to go out for meals; 3 Swallowing liquids takes extra effort; 4
the telephone directory.
Swallowing solids takes extra effort; 5 Swallowing pills takes extra For the telephone survey, the EAT-10 questionnaire by
effort; 6 Swallowing is painful; 7 The pleasure of eating is affected by Belafsky et al. was used, because it is an efficient and
my swallowing; 8 When I swallow food sticks in my throat; 9 I cough validated screening tool for identification of individuals at
when I eat; and 10 Swallowing is stressful
risk of swallowing problems. The choice to include data
articles, it is unclear whether the term dysphagia is defined as based on the EAT-10 cut-off score provided by Rofes et al.,
oropharyngeal dysphagia, esophageal dysphagia or both was based on the fact that a gold standard for detecting OD
types of dysphagia. Future studies need less ambiguous ter- (VFS) was used in the validation process as a reference
minology in order to allow more effective comparison of test. The use of a gold standard provides a strong argument

123
B. Kertscher et al.: Prevalence of Oropharyngeal Dysphagia
for reducing the cut-off from 3 to 2, which increased the
sensitivity of the EAT-10 by nearly 5 % without affecting
the specificity.
In conclusion, the prevalence data on oropharyngeal
dysphagia in the general population as identified in the
systematic literature review varied between 2.3 and 16 %.
The prevalence of swallowing problems in a quasi-random
selection of the general Dutch population based on the
telephone survey using the EAT-10 was up to 12.1 %. This
data is in line with the data obtained from the literature. As
confirmed by this study, dysphagia most commonly affects
the elderly population. The risk of OD increases with age,
because this population can be associated with muscle
atrophy, cognitive decline, and increased aspiration risk in
as many as 35 % of the elderly population older than
75 years [19].
The knowledge that approximately 12 % of the general
population suffers from a swallowing disorder is relevant,
for example, for the estimation of health care costs. Early
detection of swallowing problems and prompt installment
of treatment can avoid further complications and costs.
Furthermore, swallowing problems have a major effect on
the health-related quality of life (HRQoL) of a patient, and
therefore need to be taken in consideration [20]. However,
as only limited information is available, it seems apparent
that more research is needed on the prevalence of OD in the
general population.
Conflict of interest None.
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Berit Kertscher MSc
Renée Speyer PhD
Eric Fong MBBS
Anastasios M. Georgiou LSc
Moira Smith MSc
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