Background: Although a recent study reported an association between cachexia, as defined by the Asian Working Group for Cachexia (AWGC), and lower functional recovery at discharge among post-stroke patients capable of oral intake during the convalescent rehabilitation phase, its impact on functional recovery in patients with dysphagia remains unclear. This study aimed to evaluate the association between cachexia, according to AWGC criteria, and both functional status and discharge destinations among inpatients with dysphagia. Methods: This prospective cohort study enrolled 198 inpatients with dysphagia from eight convalescent rehabilitation hospitals. Cachexia was defined using the AWGC criteria at baseline. The primary outcome was the total Functional Independence Measure (FIM) at discharge, while the secondary outcomes were the Food Intake LEVEL Scale (FILS) score and discharge destinations. We applied generalized linear models to evaluate the association between cachexia and total FIM score at discharge, adjusting for age, sex, baseline FILS score, comorbidities, and use of enteral nutrition. Results: Of 198 patients, the median age was 83.0 years (interquartile range, 77.0–88.0); 111 (56.1%) were women, and 33 (16.7%) had cachexia. After adjusting for covariates, cachexia was not significantly associated with total FIM score at discharge (β=0.03, 95% confidence interval [CI] -0.10 to 0.15, p=0.66), FILS (β=0.23, 95% CI -0.53 to 1.00, p=0.55), or discharge destinations including discharge to home (β=0.25, 95% CI -0.75 to 1.35, p=0.63). Conclusion Cachexia, as defined by the AWGC, was not significantly associated with either functional status at discharge or discharge destinations among inpatients with dysphagia undergoing convalescent rehabilitation.

Purpose: This study aimed to a geographic accessibility, including patient coverage, of facilities providing specialized palliative care in Hokkaido. Methods: Vital statistics and digitized geographic information were used as data. We estimated the number of patients in need of palliative care, including both cancer and non-cancer patients, based on estimated by Murtagh et al. and the mortality statistics for Hokkaido. We analyzed the coverage rate within a 16 km radius of specialized palliative care facilities, as well as the distances and travel times to these facilities. Results: Cancer patient coverage within the 16 km radius, with hospitals providing specialized palliative care as the main purpose of coverage, was 77.2%. Patient coverage, including noncancer patients, in home-based palliative care facilities was 83.2%. The average time for cancer patients to arrive at the nearest hospital providing specialized palliative care varied from 9.7 to 197.0 minutes, with regional differences. Discussion: We assessed geographic accessibility to specialized palliative care in Hokkaido. In the future, we suggest the need for optimal allocation of medical facilities and collaboration between hospitals and home care to improve equity of specialized palliative care provision.

Background: Although the relationship between medication status, symptomatology, and outcomes has been evaluated, data on the prevalence of polypharmacy and potentially inappropriate medications (PIMs) and the association of polypharmacy and PIMs with swallowing function during follow-up are limited among hospitalized patients aged ≥65 years with dysphagia. Methods: In this 19‐center cohort study, we registered 467 inpatients aged ≥65 years and evaluated those with the Food Intake LEVEL Scale (FILS) scores ≤8 between November 2019 and March 2021. Polypharmacy was defined as prescribing ≥5 medications and PIMs were identified based on the 2023 Updated Beers Criteria. We applied a generalized linear regression model to examine the association of polypharmacy and PIMs with FILS score at discharge. Results: We analyzed 399 participants (median age, 83.0 years; males, 49.8%). The median follow‐up was 51.0 days (interquartile range, 22.0–84.0 days). Polypharmacy and PIMs were present in 67.7% of and 56.1% of patients, respectively. After adjusting for covariates, neither polypharmacy (β = 0.05; 95% confidence interval [CI], -0.04–0.13, p=0.30) nor non‐steroidal anti‐inflammatory medications (β = 0.09; 95% CI, -0.02–0.19; p=0.10) were significantly associated with FILS score at discharge. Conclusions The results of this study indicated a high proportion of polypharmacy and PIMs among inpatients aged ≥65 years with dysphagia. Although these prescribed conditions were not significantly associated with swallowing function at discharge, our findings suggest the importance of regularly reviewing medications to ensure the appropriateness of prescriptions when managing older inpatients.