Introduction
Background
Rationale for the Study
Methods
Study Design
Data Sources
Setting and Participants
Variables
Statistical Methods
Results
Study Size
Recording of Dysphagia and Differences in Demographic Information
Year | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 |
---|---|---|---|---|---|---|---|---|---|---|---|
Individuals | |||||||||||
Count (N) | 400,921 | 407,983 | 417,824 | 424,317 | 437,693 | 450,160 | 464,122 | 475,882 | 486,620 | 495,186 | 502,791 |
Dysphagia identified | |||||||||||
All prior records | 3.6% | 3.8% | 4.0% | 4.3% | 4.5% | 4.7% | 4.9% | 5.1% | 5.4% | 5.6% | 5.8% |
Previous year | 0.6% | 0.6% | 0.6% | 0.6% | 0.6% | 0.7% | 0.7% | 0.7% | 0.8% | 0.7% | 0.8% |
General practice—all prior records | 2.6% | 2.8% | 2.9% | 3.1% | 3.3% | 3.4% | 3.5% | 3.7% | 3.8% | 3.9% | 4.0% |
General practice—previous year | 0.4% | 0.4% | 0.4% | 0.4% | 0.4% | 0.4% | 0.4% | 0.4% | 0.4% | 0.4% | 0.4% |
Hospital—all prior records | 1.4% | 1.5% | 1.6% | 1.8% | 1.9% | 2.0% | 2.1% | 2.2% | 2.4% | 2.6% | 2.8% |
Hospital—previous year | 0.3% | 0.3% | 0.3% | 0.3% | 0.3% | 0.3% | 0.3% | 0.4% | 0.4% | 0.4% | 0.4% |
Age | |||||||||||
65–74 | 52.8% | 53.1% | 53.4% | 53.5% | 54.0% | 54.7% | 55.0% | 55.2% | 55.6% | 55.7% | 55.4% |
75–84 | 34.4% | 33.9% | 33.5% | 33.3% | 32.8% | 32.3% | 32.1% | 32.0% | 31.8% | 31.7% | 32.1% |
85+ | 12.9% | 13.0% | 13.1% | 13.2% | 13.2% | 13.0% | 12.9% | 12.8% | 12.6% | 12.5% | 12.5% |
Frailty (eFI) | |||||||||||
Fit | 50.2% | 48.3% | 46.6% | 45.4% | 44.8% | 44.9% | 45.3% | 46.2% | 47.0% | 48.0% | 48.9% |
Mild | 36.2% | 36.6% | 36.9% | 37.3% | 37.3% | 37.2% | 37.0% | 36.8% | 36.7% | 36.4% | 36.1% |
Moderate | 11.4% | 12.4% | 13.3% | 13.9% | 14.2% | 14.2% | 14.0% | 13.5% | 13.1% | 12.6% | 12.2% |
Severe | 2.3% | 2.7% | 3.1% | 3.4% | 3.7% | 3.8% | 3.7% | 3.5% | 3.2% | 3.0% | 2.8% |
Gender | |||||||||||
Female | 55.8% | 55.5% | 55.3% | 55.1% | 54.9% | 54.7% | 54.5% | 54.3% | 54.1% | 54.0% | 53.8% |
Male | 44.2% | 44.5% | 44.7% | 44.9% | 45.1% | 45.3% | 45.5% | 45.7% | 45.9% | 46.0% | 46.2% |
WIMD 2014 | |||||||||||
1. Most deprived | 17.3% | 17.1% | 16.9% | 16.8% | 16.7% | 16.6% | 16.4% | 16.3% | 16.5% | 16.3% | 16.2% |
2 | 20.5% | 20.3% | 20.3% | 20.1% | 20.1% | 19.8% | 19.7% | 19.6% | 19.5% | 19.5% | 19.5% |
3 | 20.8% | 20.8% | 20.9% | 20.9% | 20.9% | 20.9% | 21.0% | 21.2% | 21.2% | 21.2% | 21.2% |
4 | 19.4% | 19.6% | 19.6% | 19.6% | 19.7% | 19.8% | 19.9% | 19.9% | 19.8% | 19.8% | 19.8% |
5. Least deprived | 22.0% | 22.2% | 22.4% | 22.6% | 22.6% | 22.9% | 22.9% | 23.0% | 23.1% | 23.2% | 23.3% |
Year | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 |
---|---|---|---|---|---|---|---|---|---|---|---|
Individuals | |||||||||||
N | 398,409 | 405,496 | 415,266 | 421,588 | 434,882 | 447,104 | 460,896 | 472,593 | 482,893 | 491,508 | 498,970 |
Age | |||||||||||
65–74 | 52.8% | 53.2% | 53.5% | 53.6% | 54.1% | 54.8% | 55.2% | 55.3% | 55.7% | 55.8% | 55.5% |
75–84 | 34.3% | 33.9% | 33.5% | 33.3% | 32.8% | 32.3% | 32.1% | 32.0% | 31.8% | 31.7% | 32.1% |
85+ | 12.8% | 12.9% | 13.0% | 13.1% | 13.2% | 12.9% | 12.8% | 12.7% | 12.6% | 12.5% | 12.4% |
Frailty (eFI) | |||||||||||
Fit | 50.3% | 48.4% | 46.8% | 45.6% | 45.0% | 45.0% | 45.5% | 46.4% | 47.2% | 48.2% | 49.1% |
Mild | 36.1% | 36.6% | 36.9% | 37.3% | 37.3% | 37.2% | 37.0% | 36.8% | 36.6% | 36.4% | 36.1% |
Moderate | 11.3% | 12.3% | 13.3% | 13.8% | 14.1% | 14.1% | 13.9% | 13.4% | 13.0% | 12.5% | 12.0% |
Severe | 2.2% | 2.6% | 3.1% | 3.4% | 3.6% | 3.7% | 3.6% | 3.4% | 3.2% | 2.9% | 2.8% |
Gender | |||||||||||
Female | 55.8% | 55.5% | 55.3% | 55.1% | 54.9% | 54.6% | 54.5% | 54.3% | 54.1% | 54.0% | 53.9% |
Male | 44.2% | 44.5% | 44.7% | 44.9% | 45.1% | 45.4% | 45.5% | 45.7% | 45.9% | 46.0% | 46.1% |
WIMD 2014 | |||||||||||
1. Most deprived | 17.3% | 17.1% | 16.8% | 16.8% | 16.7% | 16.5% | 16.4% | 16.3% | 16.4% | 16.3% | 16.2% |
2 | 20.5% | 20.3% | 20.3% | 20.1% | 20.1% | 19.8% | 19.7% | 19.6% | 19.5% | 19.5% | 19.5% |
3 | 20.8% | 20.8% | 20.9% | 20.9% | 20.9% | 20.9% | 21.0% | 21.2% | 21.2% | 21.2% | 21.2% |
4 | 19.5% | 19.6% | 19.6% | 19.6% | 19.7% | 19.8% | 19.9% | 19.9% | 19.8% | 19.8% | 19.8% |
5. Least deprived | 22.0% | 22.2% | 22.4% | 22.6% | 22.7% | 22.9% | 23.0% | 23.1% | 23.1% | 23.2% | 23.3% |
Year | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 |
---|---|---|---|---|---|---|---|---|---|---|---|
Individuals | |||||||||||
N | 2,512 | 2,487 | 2,558 | 2,729 | 2,811 | 3,056 | 3,226 | 3,289 | 3,727 | 3,678 | 3,821 |
Age | |||||||||||
65–74 | 41.4% | 40.5% | 37.6% | 39.7% | 40.4% | 41.2% | 39.6% | 40.6% | 43.1% | 42.3% | 42.3% |
75–84 | 38.7% | 38.4% | 39.7% | 37.7% | 36.9% | 36.7% | 37.8% | 37.8% | 36.7% | 37.0% | 37.2% |
85+ | 19.9% | 21.0% | 22.7% | 22.6% | 22.7% | 22.1% | 22.6% | 21.6% | 20.3% | 20.8% | 20.4% |
Frailty (eFI) | |||||||||||
Fit | 24.0% | 21.5% | 21.0% | 20.1% | 19.6% | 19.3% | 19.9% | 18.5% | 20.6% | 21.0% | 20.5% |
Mild | 40.4% | 41.2% | 40.9% | 39.0% | 39.8% | 38.0% | 38.3% | 41.2% | 41.1% | 40.1% | 41.5% |
Moderate | 27.6% | 27.5% | 26.6% | 28.4% | 28.0% | 28.5% | 29.4% | 27.6% | 26.8% | 27.6% | 27.5% |
Severe | 8.0% | 9.8% | 11.4% | 12.5% | 12.5% | 14.2% | 12.4% | 12.7% | 11.5% | 11.3% | 10.4% |
Gender | |||||||||||
Female | 56.7% | 58.5% | 55.8% | 56.5% | 56.2% | 56.4% | 55.4% | 52.6% | 55.9% | 54.4% | 52.6% |
Male | 43.3% | 41.5% | 44.2% | 43.5% | 43.8% | 43.6% | 44.6% | 47.4% | 44.1% | 45.6% | 47.4% |
WIMD 2014 | |||||||||||
1. Most deprived | 20.5% | 19.1% | 20.4% | 18.8% | 19.4% | 19.9% | 19.5% | 19.4% | 19.0% | 19.3% | 19.1% |
2 | 19.7% | 22.0% | 21.1% | 20.7% | 21.4% | 20.4% | 20.3% | 20.4% | 20.1% | 19.8% | 20.9% |
3 | 19.8% | 20.6% | 20.9% | 21.4% | 20.5% | 20.2% | 19.3% | 21.5% | 20.0% | 21.3% | 20.0% |
4 | 18.6% | 18.0% | 18.2% | 18.8% | 17.3% | 18.8% | 19.4% | 17.9% | 18.5% | 18.5% | 18.1% |
5. Least deprived | 21.3% | 20.3% | 19.5% | 20.3% | 21.5% | 20.7% | 21.5% | 20.8% | 22.4% | 21.1% | 21.9% |
Multilevel Logistic Regression Results
Odds ratios (95% confidence interval) | Null | Age | Frailty | Gender | WIMD | Multivariate |
---|---|---|---|---|---|---|
Age (reference: 65–74) | ||||||
75–84 | – | 1.541 (1.504, 1.579) | – | – | – | 1.093 (1.066, 1.120) |
85+ | – | 2.240 (2.177, 2.305) | – | – | – | 1.234 (1.196, 1.272) |
Frailty (electronic frailty index, reference: fit) | ||||||
Mild | – | – | 2.515 (2.443, 2.589) | – | – | 2.453 (2.382, 2.527) |
Moderate | – | – | 4.897 (4.747, 5.053) | – | – | 4.637 (4.487, 4.793) |
Severe | – | – | 8.478 (8.149, 8.821) | – | – | 7.872 (7.548, 8.210) |
Gender (reference: female) | ||||||
Male | – | – | – | 0.971 (0.951, 0.992) | – | 1.135 (1.111, 1.160) |
Welsh index of multiple deprivation 2014 (Reference: 5. least deprived) | ||||||
1. Most deprived | – | – | – | – | 1.269 (1.227,1.312) | 1.100 (1.063, 1.138) |
2 | – | – | – | – | 1.121 (1.085, 1.159) | 1.010 (0.977, 1.044) |
3 | – | – | – | – | 1.053 (1.019, 1.089) | 0.973 (0.941, 1.006) |
4 | – | – | – | – | 1.005 (0.972, 1.040) | 0.955 (0.923, 0.989) |
Intercept | 0.007 (0.007, 0.007) | 0.005 (0.005, 0.005) | 0.003 (0.003, 0.003) | 0.007 (0.007, 0.007) | 0.006 (0.006, 0.007) | 0.003 (0.003, 0.003) |
Random effects | ||||||
Level 2 variance (annum) | 0.006 (0.001, 0.012) | 0.007 (0.001, 0.013) | 0.008 (0.001, 0.014) | 0.006 (0.001, 0.012) | 0.006 (0.001, 0.012) | 0.007 (0.001, 0.014) |
– | – | – | – | – | – | – |
Observations | 4,963,499 | 4,963,499 | 4,963,499 | 4,963,499 | 4,963,499 | 4,963,499 |
Level 2 groups (years) | 11 | 11 | 11 | 11 | 11 | 11 |