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Introduction: The prevalence of swallowing disorders widely varies depending on age and comorbidity. Objectives: To determine the prevalence of dysphagia and feeding disorders in elderly people living in nursing homes from the province of Seville and assess the effectiveness of dietary counselling. Methods: We carried out a cross-sectional descriptive study on a population of 3921 residents distributed among 86 nursing homes. At the first phase of the study, we pretended to estimate the prevalence of dysphagia so that we selected 373 residents in 23 nursing homes. At the second phase, a sample of residents with dysphagia was selected, being reassessed a month later after receiving dietary counselling and basic measures for managing dysphagia. Results: The median age was 80 (73.86) years, 60 (17.3%) had dysphagia and 50 (13.4%) had feeding difficulties. Both conditions were significantly (p <0.05) associated with neurological diseases. Forty (11.3%) presented cerebrovascular accident and 123 (34.8%) dementia. Twelve patients with dysphagia were studied at the second phase, the mean age being 80.6±11.9 years, MNA 19±3, Barthel 24±27, and dysphagia Karnell level of 3-4 in 75% of the cases. These patients, receiving dietary counselling and basic measures for managing dysphagia, did not improve their intake level, dysphagia or dependency. Conclusions: The prevalence of dysphagia and feeding difficulties is high among nursing homes residents. The standard measures for controlling dysphagia are little effective in patients with severe dependence or advanced dementia. [ABSTRACT FROM AUTHOR]