Understanding the Domains of Health-Related Quality of Life in Older Adults With Dysphagia: A Scoping Review.

Purpose: Dysphagia is common in older adults and significantly impacts health-related quality of life (HRQoL). This scoping review maps dysphagia on to the revised Wilson-Cleary model to identify key domains of HRQoL represented in current research. Method: A systematic search of MEDLINE and EMBASE was conducted following the guidelines set by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews statement. Studies were included if they assessed HRQoL in older adults (> 65 years) with oropharyngeal dysphagia. Data were extracted and mapped onto the following health concepts of the revised Wilson-Cleary model: biological factors, symptoms, functional status, general health perceptions, overall quality of life (QOl), and two modifiers-- characteristics of the individual and characteristics of the environment. Results: Six studies met the inclusion criteria, encompassing 1,527 participants. Most studies assessed symptoms and functional status, but few explored general health perceptions or overall QOL. Only two studies incorporated objective dyspha-gia assessments, and few considered characteristics of the individual and environment, such as social support, health care access, or socioeconomic status. Conclusions: Dysphagia negatively affects HRQoL in older adults, yet current research primarily focuses on functional limitations rather than broader psychosocial and contextual factors. Future research should adopt a holistic, patient-centered approach integrating objective swallowing assessments with QOL measures to personalize dysphagia management and enhance overall well-being in aging populations.