Dysphagia, mealtime behaviors, and eating ability of persons living with dementia: A systematic review of psychometric properties of instruments

Abstract

AbstractBackgroundIt is critical to use validated instruments to assess dysphagia, mealtime behaviors, and eating ability of persons living with dementia to evaluate the efficacy of mealtime care interventions. However, the characteristics and psychometric quality of such instruments are unknown. This systematic review aims to synthesize the quantity and quality of instruments that assess dysphagia, mealtime behaviors, and eating ability of persons living with dementia.MethodWe searched Pubmed, CINAHL, AgeLine, PsychINFO, and Cochrane Library for records published from January 1980 to July 30th, 2021. Records were eligible if they included any instrument that measures concepts of interest (i.e., dysphagia, mealtime behaviors, eating ability). Instruments were excluded if they assessed nutritional status only. Eligible instruments originally developed or later modified to measure concepts of interest were identified from eligible records. Eight characteristics of eligible instruments will be extracted: 1) development process, 2) concept/construct being operationalized, 3) sample and setting, 4) administration method, 5) description of items, 6) scoring format/interpretation, 7) reliability, and 8) validity. The Psychometric Assessment for Self‐report and Observational Tools (PAT), a newly developed psychometric quality assessment tool, will be used to evaluate the psychometric quality of eligible instruments.ResultIn total, 11,074 records were reviewed. Seventy‐nine eligible instruments were identified from 174 records. Fifteen instruments assessed swallowing ability; 5 assessed mastication ability; 6 assessed dysphagia; 24 assessed mealtime behaviors; 7 assessed eating ability; 22 assessed two or more concepts of interest.ConclusionA large number of instruments were developed and/or used to assess dysphagia, mealtime behaviors, and eating ability of persons living with dementia. All instruments’ psychometric properties will be further evaluated to inform the application and adaption of appropriate instruments for practice and research.