Association Between Dysphagia and Depressive Symptoms: Propensity Score Matching Approaches

The co-occurrence of depression and dysphagia is obvious to clinicians and has been the focus of several research investigations. Dysphagia not only leads to physical complications but also exerts a negative emotional impact, resulting in a decline in quality of life. The purpose of the study was to investigate the association between dysphagia and depressive symptoms at the population level while accounting for various demographics and health conditions. This study was a cross-sectional design using the 2022 National Health Interview Survey. The study subjects were American adults who completed the survey questionnaires about depressive symptoms, swallowing problems, and health conditions. Regression models and three different propensity score matching approaches were utilized to estimate associations between dysphagia and depressive symptom. Data analyzed in the study showed that among 25,651 U.S. adults, 1,664 (6.48%) reported dysphagia. Among patients with dysphagia, 976 (58.65%) were women, and the average age was 55.48 years. The differences in demographics and health conditions between individuals with and without dysphagia were balanced by three propensity score matching approaches (p >.05). After adjustments using population-weighted multivariable logistic regression, the inverse probability of treatment weighting (IPTW) with both normalized weights, IPTW with stabilized weights, and Greedy algorithms with 1:1 matching method, the risks of having depressive symptom in those with dysphagia were significantly higher than those without dysphagia (odds ratios ranged from 1.763 to 2.402, p <.0001). The study supports that dysphagia and depressive symptoms frequently co-occur in U.S. adults, highlighting the need for comprehensive care that addresses both physical and mental health aspects of swallowing impairments.