A Conceptual Model of Dysphagia in Older Adults

A conceptual model was developed to create a basis for understanding the risk factors and outcomes associated with dysphagia and to hypothesize the nature of the relationship between certain factors. The conceptual model was developed by two academic speech-language pathologists with ≥10 years research and clinical experience in swallowing and dysphagia in older adults. A comprehensive review of English-language literature was conducted, and relevant, evidence-informed factors associated with dysphagia in older adults were identified. The synthesis of clinical expertise and theoretical underpinnings complemented the literature review, incorporating the socio-ecological model. Discussion and brainstorming of the identified factors and their potential and/or proven relationships with dysphagia were conducted. All the factors identified were initially organized using a thematic approach, then were further structured into overarching categories, guided by the inherent relationships between the factors. The arrangement of the conceptual model framework was undertaken once these categories had been optimized, and consensus had been achieved among the authors with support from the literature. Factors were identified to increase the risk of dysphagia, be an outcome of dysphagia, or both. The conceptual model illustrates the complex multifactorial relationship between dysphagia and individual, relationship, community, and societal factors. The proposed conceptual model improves our understanding of the risk factors and outcomes associated with dysphagia in older adults. Future work should focus on empirically testing the relationships among the factors presented, so the model can ultimately be used by members of the dysphagia community to target modifiable risk factors for dysphagia, as well as identify effective treatments that optimize overall patient well-being.