How self-reported risk of dysphagia relates to anxiety symptoms in older adults: a propensity score-matched study

Functional impairment and psychological problems are mutually affected. Swallowing disorders and anxiety symptoms are common among community-dwelling older adults. This study aimed to explore the association between these two issues and report the comorbidity rate. The current cross-sectional, face-to-face investigation was performed in China in 2023. Individuals aged ≥ 65 years were randomly selected in community settings through cluster random sampling. self-reported risk of dysphagia and anxiety symptoms were assessed using the 10-item Eating Assessment Tool and 7-item Generalized Anxiety Disorder scale, respectively. Covariates included basic demographic information, lifestyle, leisure activities, and health conditions. Confounding variables were identified using multiple logistic regressions and Directed Acyclic Graphs. Propensity Score Matching (PSM) was used to reduce potential bias and explore the net effects of self-reported risk of dysphagia and anxiety symptoms. A total of 13,544 older adults were included. The prevalence of anxiety symptoms and self-reported risk of dysphagia was 18.10% (95%CI: 17.46%-18.75%, n = 2452) and 21.37% (95%CI: 20.68%-22.07%, n = 2895), respectively. The comorbidity rate was 5.16% ( n = 699) After adjusting for covariates, significant association was identified between anxiety symptoms and self-reported risk of dysphagia (aOR = 1.567, 95%CI: 1.386–1.772, P < 0.001). 5790 participants were captured by 1:1 PSM, with no significant differences in any covariate. In both pre- and post-matching samples, participants with self-reported risk of dysphagia showed significantly higher ratios of anxiety symptoms than their counterparts without self-reported risk of dysphagia (pre-matching: 24.15% versus 16.46%, P < 0.001; post-matching: 24.15% versus 17.93%, P < 0.001). Self-reported risk of dysphagia and anxiety symptoms each affect approximately one-fifth of community-dwelling older adults in Central China. Older adults with self-reported risk of dysphagia had a significantly higher prevalence of anxiety symptoms than those without.