Eating Assessment Tool Research Articles

Cross-Cultural Adaptation and Psychometric Evaluation of the Neonatal Eating Assessment Tool–Breastfeeding Into Tamil

ObjectiveTo adapt the Neonatal Eating Assessment Tool–Breastfeeding (NeoEAT-Breastfeeding) into Tamil, a language spoken in several South Asian countries, to identify the tool’s factor structure, and to assess its psychometric properties. DesignCross-sectional. SettingTertiary care hospital in South India. ParticipantsA cohort of 323 mothers of infants ages 1 week to 7 months, including infants with and without feeding difficulties. MethodTo adapt the English tool to Tamil, we followed standard procedures specified by the tool developers and international guidelines for tool translation and adaptation, including pilot testing and personal interviews with participants who had infants younger than 7 months. Participants completed the NeoEAT-Breastfeeding (Tamil) after assessment of breastfeeding by professionals. The 62-item tool involves rating each item on a 6-point scale, and higher scores indicate increased feeding difficulties. ResultsAfter exploratory factor analysis, we divided the tool into five subscales in the Tamil version compared to the seven subscales in the original English version. The Tamil version demonstrated high internal consistency reliability (Cronbach’s α = 0.97) and test–retest reliability (intraclass correlation = 0.99) for the total scores. Infants with feeding concerns demonstrated significantly higher total and subscale scores on the NeoEAT-Breastfeeding (Tamil) than infants without feeding concerns (p = .000; construct validity). ConclusionThe NeoEAT-Breastfeeding (Tamil) holds promise as a culturally appropriate, clinically useful parent-report tool with evidence for initial reliability and validity for identifying feeding-related concerns among infants younger than 7 months in the Tamil-speaking population.

Prevalence and Methods for Assessment of Oropharyngeal Dysphagia in Older Adults: A Systematic Review and Meta-Analysis.

Background: This systematic review and meta-analysis aimed to estimate the pooled prevalence of dysphagia in older adults, subgrouping by recruitment settings and varying dysphagia assessment methods. Methods: Five major databases were systematically searched through January 2022. A random-effects model for meta-analysis was conducted to obtain the pooled prevalence. Results: Prevalence of dysphagia in the community-dwelling elderly screened by water swallow test was 12.14% (95% CI: 6.48% to 19.25%, I2 = 0%), which was significantly lower than the combined prevalence of 30.52% (95% CI: 21.75% to 40.07%, I2 = 68%) assessed by Standardized Swallowing Assessment (SSA) and volume-viscosity swallow test (V−VST). The dysphagia prevalence among elderly nursing home residents evaluated by SSA was 58.69% (95% CI: 47.71% to 69.25%, I2 = 0%) and by the Gugging Swallowing Screen test (GUSS) test was 53.60% (95% CI: 41.20% to 65.79%, I2 = 0%). The prevalence of dysphagia in hospitalized older adults screened by the 10-item Eating Assessment Tool was 24.10% (95% CI: 16.64% to 32.44%, I2 = 0%), which was significantly lower than those assessed by V-VST or GUSS tests of 47.18% (95% CI: 38.30% to 56.14%, I2 = 0%). Conclusions: Dysphagia is prevalent in the elderly, affecting approximately one in three community-dwelling elderly, almost half of the geriatric patients, and even more than half of elderly nursing home residents. The use of non-validated screening tools to report dysphagia underestimates its actual prevalence.

Discrepancy between subjective and objective postoperative oral dysfunction assessment after oral cancer treatment: A single-center cross-sectional study

ObjectivesIt has been reported that in many cancer types, the evaluation of complications and side effects of treatment differs between subjective and objective evaluations. The purpose of this study is to verify whether the evaluation of postoperative oral dysfunction following oral cancer treatment was consistent subjective and objective evaluations. Materials and MethodsThis cross-sectional study collected background data and evaluated the oral function (microorganisms, oral dryness, occlusal force, tongue pressure, masticatory function and eating assessment tool [EAT-10]) of 75 patients from September 2019 to December 2021. The postoperative oral dysfunction-10 (POD-10) was used for the subjective assessment of dysfunction in oral cancer patients. Also, Matsuda-Kanno classification was used for the objective assessment. The kappa coefficient between POD-10 and oral dysfunction was calculated for the degree of agreement. The relationship between oral function measurements and POD-10 was examined by multiple regression analysis. ResultsThe patients’ median age was 72.0 (25–75 percentile: 64.0–78.0) and 69.3% were male. The kappa coefficients indicating the degree of agreement with POD-10 were 0.41 (P < 0.01) for occlusal force, 0.27 (P = 0.01) for masticatory function, and 0.59 (P < 0.01) for EAT-10. Multiple regression analysis showed a significant association of occlusal force (β = −0.33, P = 0.03) and EAT-10 (β = 0.80, P < 0.01) with POD-10. ConclusionsFor postoperative oral dysfunction type III (occlusal type), the evaluations of subjective and objective evaluations tended to be consistent. However, for type I (transport type) and II (oral hygiene type), these evaluations may be prone to overestimation or underestimation by either the medical professional or the patient.

Endoscopic evaluation of dysphagia incorporating eating assessment tool-10 and dysphagia outcome and severity scales-a cross-sectional study

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: Dysphagia is associated with significant morbidity and mortality. A careful history may determine the cause of dysphagia in over 80% of patients. The intention of my study is to assess the patients of dysphagia using fiberoptic nasopharyngolaryngoscope and to study their clinicopathological profile and assess the severity using dysphagia outcome and severity scale (DOSS) scale and eating assessment tool (EAT)-10 score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;: A descriptive cross-sectional study of patients with symptoms of dysphagia who presented to the ENT department were included. The study was conducted from January 2018 to June 2019. A total of 120 patients were taken for the study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Dysphagia was more common among males than females and more prevalent in the age group of 61-70 years. Patients with tracheostomy had an EAT-10 score above 6 and DOSS level 5 and below. EAT-10 score was helpful to assess dysphagia with the majority of patients having a score of 6 to 10 and the scores correlated with DOSS levels. Indirect laryngoscopy (IDL) was helpful to diagnose in 68.5% of cases and fibre optic laryngoscopy (FOL) was helpful in diagnosis in 75.8% of cases. Malignancy was the most common cause of dysphagia (25%) followed by laryngopharyngeal reflux (24.2%). Mortality rate in the present study was 15 %&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Dysphagia is a complex symptom, the description of which varies from person to person and is common among the elderly population and in those with co-morbidities and needs to be evaluated early to diagnose and treat the underlying cause.&lt;/p&gt;

Quality of Life in Patients With Recurrent and Second Primary Head and Neck Cancer.

In the setting of similar outcomes, quality of life (QOL) measures can be utilized to compare treatment modalities in head and neck squamous cell carcinoma (HNSCC). We evaluate QOL and symptoms in patients treated for primary, second primary, and recurrent HNSCC. Retrospective cohort study. Head and neck cancer survivorship clinic. We identified patients seen between 2016 and 2019. QOL and symptoms were assessed with the University of Washington Quality of Life (UW-QOL) questionnaire, 10-item Eating Assessment Tool, 8-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder, and Neck Disability Index. Regression analysis was utilized to explore associations and compare QOL outcomes. Our cohort comprised 662 patients: 546 with primary HNSCC, 34 with second primary HNSCC, and 82 with recurrent HNSCC. Multimodality therapy was associated with lower UW-QOL Physical Subscale (UW-QOL-PS) vs single modality: chemoradiation therapy (-12.17 [95% CI, -16.57 to -7.78]) and surgery + postadjuvant treatment (-12.11 [-16.06 to -8.16]). Multimodality therapy was also associated with lower UW-QOL Social-Emotional Subscale (UW-QOL-SS): chemoradiation therapy (-6.70 [-11.41 to -1.99]) and surgery + postadjuvant treatment (-7.41 [-11.63 to -3.19]). Recurrence (-14.42 [-18.80 to -10.04]) and second primary (-11.15 [-17.71 to -4.59]) demonstrated lower UW-QOL-PS vs primary. Radiation for recurrence or second primary had worse UW-QOL-PS (-10.43 [-19.27 to -1.59]) and UW-QOL-SS (-10.58 [-18.76 to -1.54]) and higher Eating Assessment Tool (6.08 [1.39-10.77]) than surgery alone. Surgery + postadjuvant treatment showed worse UW-QOL-PS (-12.65 [-23.76 to -1.54]) and UW-QOL-SS (-12.20 [-22.38 to -2.03]). Multimodality therapy, particularly with recurrent and second primary HNSCC, is more likely to contribute to diminished QOL and symptoms. This important consideration should play a role in framing informed discussions with patients regarding treatment.

Differences in the oral health status in hospitalised stroke patients according to swallowing function: A cross-sectional study.

Dysphagia is one of the common complications caused by stroke, leading to poor oral health. Oral health is often neglected after stroke by clinical care providers and the patients. Identifying the status of oral health in hospitalised stroke patients with swallowing disorders will facilitate the attention of clinical care providers. To investigate the differences in the oral health status between hospitalised post-stroke patients with dysphagia and non-dysphagia. A cross-sectional study. A purposive sampling method was used to recruit participants. Participants included hospitalised post-stroke patients with dysphagia and without dysphagia. Stroke patients were recruited from the Department of Neurology, Guizhou Provincial People's Hospital in China. A total of 120stroke patients completed the survey. The data collected included their demographics, the scores on the Oral Health Assessment Tool (OHAT), Geriatric Oral Health Assessment Index (GOHAI), and the Eating Assessment Tool-10 (EAT-10). The study was compliant with the STROBE checklist. The average age of the dysphagia group was 67 (64~76) vs the participants without dysphagia group 67 (65~76), (p=.610). The mean standard deviation (SD) OHAT score of participants with dysphagia was 5.28 (2.33) compared to participants without dysphagia 8.89 (3.07), (p<.05). This result indicates post-stroke dysphagia (PSD) patientshad worse oral health than stroke patients without dysphagia. Binary logistic regression analysis showed that oral health status was the independent influencing factor of swallowing function (p<.01). The participants with dysphagia had worse oral health status compared to those without dysphagia, illustrating the critical importance of improving attention to oral health management in patients with post-stroke swallowing disorders. Oral health was often omitted when comparing to other functional impairments resulting from stroke. Health caregivers of post-stroke patients with dysphagia should be aware of the importance of evaluating patient's oral condition and implementing oral care.

The effect of hyperemesis gravidarum on voice and dysphagia: a comparative study.

This study aims to determine the voice and gastrointestinal system changes of patients with hyperemesis gravidarum in the first trimester and to compare them with healthy pregnant women. This study was conducted prospectively. Two groups were defined as hyperemesis and healthy pregnant women. All the participants in the groups are between 20-42 years old and 6-12 weeks pregnant. Voice evaluation of all participants was made with the voice handicap index-10 (VHI-10). The Eating Assessment Tool-10 (EAT-10) was used for Dysphagia evaluation. The groups were compared, and the significance level was determined as p<.05. In terms of mean age and week of gestation, both groups were matched. There was a statistically significant difference in total VHI-10 between the control and HG group. In terms of the EAT-10 on the other hand subjective swallowing problem, higher scores (more problematic) were observed in the HG group. There was no statistically significant correlation between age and VHI-10, VHI-10 sub-scores, or EAT-10. Compared to healthy pregnant women, hyperemesis gravidarum affects the voice quality negatively and increases gastrointestinal complaints. Although these are shown with subjective parameters in this study, there is a need for studies that will make an objective evaluation.

Fiberoptic endoscopic evaluation of swallowing and the Brazilian version of the Eating Assessment Tool-10 in resistant hypertensive patients with obstructive sleep apnea

ObjectiveThe aim of this study was to describe the prevalence and characteristics of OD through Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and the Eating Assessment Tool-10 (EAT-10) in hypertensive patients with OSA, as well as to describe the sensitivity of EAT-10 for the detection of OD in this population. MethodsThis study included a convenience sample in which 85 resistant hypertensive patients diagnosed with OSA in an university hospital participated. Participants were subjected to the EAT-10 (index test) and FEES (reference standard). ResultsThe median EAT-10 score was 2 (0–5.5). According to the FEES, 27 participants did not have dysphagia, 42 had mild dysphagia and 16 had mild to moderate dysphagia. The sensitivity of the EAT-10 was 70.7% (95% CI: 57.3–81.9) at a cutoff score ≥1, with a discriminatory power of 67.4% (p = 0.005). The most prevalent symptom in this population was “food stuck in the throat”, while the most prevalent signs were delayed initiation of the pharyngeal phase of swallowing, premature bolus spillage and pharyngeal residue. ConclusionIn our study, the cutoff score for the EAT-10 for screening for OD in this population was ≥ 1. In conclusion, this population presented a high prevalence of dysphagia detected in FEES and its severity is associated with higher EAT-10 scores.

Discriminant Ability of the Eating Assessment Tool-10 to Detect Swallowing Safety and Efficiency Impairments.

Quick, sensitive dysphagia screening tools are necessary to identify high-risk patients for further evaluation in busy multidisciplinary amyotrophic lateral sclerosis (ALS) clinics. We examined the relationship between self-perceived dysphagia using the validated Eating Assessment Tool-10 (EAT-10) and videofluoroscopic analysis of swallowing safety and efficiency. Prospective, observational, longitudinal study. Individuals with ALS completed the EAT-10 and a videofluoroscopic swallowing study. Duplicate, independent, blinded analyses of the validated Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale were performed to index swallowing safety and efficiency (mild dysphagia: DIGEST ≥ 1, moderate dysphagia: DIGEST ≥ 2). A between-groups analysis of variance with Games-Howell test for post-hoc pairwise comparisons was performed to examine EAT-10 scores across dysphagia severity levels. Receiver operator characteristic curve analysis, area under the curve (AUC), sensitivity, specificity, positive-negative predictive values (PPV, NPV), and odds ratios (OR) were derived. Four hundred and thirty five paired EAT-10 and DIGEST scores were analyzed. Mean EAT-10 score was 8.48 (95% confidence interval [CI]: 7.63-9.33). Individuals with dysphagia demonstrated higher EAT-10 scores (mild: 4.1 vs. 11.3, moderate: 6.0 vs. 17.5, P < .001). Mean EAT-10 scores increased across DIGEST levels (D0: 4.1, D1: 7.9, D2: 15.1, D3: 20.4, D4: 39.0). For mild dysphagia, an EAT-10 cut score of 3 was optimal: AUC 0.74 (95% CI: 0.69-0.78; sensitivity: 77%; specificity: 53%; PPV: 71%; NPV: 60%; OR: 3.5). An EAT-10 cut score of 7 optimized detection of moderate dysphagia: AUC 0.83 (95% CI: 0.78-0.87; sensitivity: 81%; specificity: 66%; PPV: 39%; NPV: 93%; OR: 8.1). The EAT-10 is an easy-to-administer dysphagia screening tool with good discriminant ability for use in ALS clinics. 2 Laryngoscope, 132:2319-2326, 2022.

Cross-cultural Adaption, Validation and Factor Analysis of the Persian Version of the Eating Assessment Tool: EAT-10.

The eating assessment tool (EAT-10) is a self-reported questionnaire to assess the patient's perception of swallowing difficulties. The aim of this study was to cross-culturally adapt and determine validity and reliability of the Persian version of the EAT-10 (P-EAT-10) in patients with oropharyngeal dysphagia. The EAT-10 was translated into Persian language and cross-culturally adapted. One hundred patients with dysphagia (mean age ± SD = 44.44 ± 14.69years) participated. The test-retest reliability (time interval = 7days) was assessed in 50 patients. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and smallest detectable change (SDC) were analyzed. The Persian version of functional oral intake scale (FOIS-P) was also recorded to assess construct validity. One hundred healthy subjects completed the P-EAT-10 for clinical validity. Factor analysis was performed to determine the P-EAT-10 structure. There were no missing responses and floor or ceiling effects. Internal consistency was high (Cronbach's α 0.91). Item-total correlations exceeded acceptable standard of 0.3 for the all items (0.62-0.83). The test-retest reliability was excellent [(ICC)agreement 0.96]. The SEM and SDC were 2.61 and 7.23, respectively. Construct validity was confirmed by a significant correlation between the P-EAT-10 and FOIS-P scores (r = 0.84). Clinical validity was supported by a significant discrimination between patients and healthy subjects (t = 29.97, P < 0.001). Factor analysis indicated 2 components for the P-EAT-10. The P-EAT-10 is a valid and reliable tool and can be used in clinic and research for the assessment of oropharyngeal dysphagia in Persian-speaking patients.

A Novel Balloon Catheter-based Dilation Intervention for Patients with Cricopharyngeus Achalasia After Stroke: A Randomized Study

This study aimed to investigate the efficacy and safety of a novel balloon catheter in dilation intervention for patients with cricopharyngeus achalasia after stroke. Thirty-four patients with cricopharyngeus achalasia after stroke received routine swallowing rehabilitation training and were randomly assigned to an experimental group (Exp, n = 17) that received dilation therapy using the novel balloon catheter once daily for 5 days per week or a control group (Con, n = 17) that received dilation therapy with a 14-Fr ordinary urinary catheter once daily for 5 days per week. The intervention duration, Eating Assessment Tool (EAT)-10 scores, and Functional Oral Intake Scale (FOIS) scores were recorded at baseline and each day during intervention. The time for a patient’s FOIS score to be ≥ 3 as well as the recovery time for oral intake of water, liquid food, mushy food, and solid food were recorded or estimated. Complications were also recorded during intervention. The intervention duration was shorter in the Exp group than in the Con group (p = 0.005). The Exp group patients improved faster than the Con group patients, with a shorter recovery time for oral intake of liquid food (p = 0.002), mushy food (p = 0.001), and solid food (p = 0.001). At the time of intervention termination, EAT-10 scores were lower in the Exp group than in the Con group (p = 0.005). The Exp group had a similar incidence of complications as the Con group but with better tolerability (p = 0.028). Compared with the urinary catheter, the novel balloon catheter for dilation in patients with cricopharyngeus achalasia after stroke may lead to a better and more rapid recovery.

Dysphagia and Quality of Life, Participation, and Inclusion Experiences and Outcomes for Adults and Children With Dysphagia: A Scoping Review

Purpose: Research shows that dysphagia impacts quality of life negatively, but the nature of these impacts is not well understood. This review article aims to examine the impacts of dysphagia and its interventions on mealtime-related quality of life, participation, and inclusion for people with dysphagia. Method: The protocol for this scoping review was published in July 2019 and involved a search of five scientific databases using dysphagia and quality of life–related terms. Results: In total, 106 studies were included in this review article. A qualitative metasynthesis demonstrated that dysphagia had various negative impacts on quality of life, particularly in populations with severe dysphagia. Dysphagia interventions had a range of positive impacts on quality of life; however, modifying food texture also had negative impacts. Most studies ( n = 95) included adults with acquired dysphagia. Only seven studies included people with lifelong conditions, including cerebral palsy or intellectual disability, and only four studies included children. Almost half of the studies ( n = 44) used quantitative instruments, including the Swallowing Quality of Life questionnaire or the Eating Assessment Tool, to measure the impact of dysphagia on quality of life, and few studies used qualitative approaches. Conclusions: There are both positive and negative impacts of dysphagia and dysphagia-related interventions on quality of life, participation, and inclusion. Most research is quantitative and limited to adults with acquired dysphagia. Qualitative and longitudinal studies that include populations with lifelong disability and children are needed to determine how dysphagia and its interventions impact quality of life across conditions and over the life span. Supplemental Material: https://doi.org/10.23641/asha.18862292

Jaw-Opening Force as a Useful Index for Dysphagia: A Cross-Sectional and Multi-Institutional Study

Introduction: Jaw-opening force (JOF) can be a potential screening tool for dysphagia. However, confounding variables such as comorbidities or physical and oral functions that are associated with the physiology of swallowing have not previously been examined. Adjusting for these variables could reveal the relationship between JOF and dysphagia and indicate whether JOF is an independent factor associated with dysphagia. We therefore aimed to assess the efficacy of using JOF for dysphagia screening in this multi-institutional study. Methods: Community-dwelling older adults over the age of 65 years (N = 403) who visited the university dental hospitals and participated in health surveys (mean age ± standard deviation, 77.1 ± 7.0 years; range, 65–96 years) between November 2018 and January 2020 were included in this study. The JOFs of all participants were measured. The measured JOF was compared with the presence of dysphagia, which was defined using the Functional Oral Intake Scale and the Eating Assessment Tool-10. Results: Multiple logistic regression analysis revealed that the presence of dysphagia was independently associated with JOF, calf circumference, and dependence after adjusting for age and sex. Discussion/Conclusion: Decreased JOF can be a risk factor for dysphagia in older adults.

Validation and Cultural Adaptation of an Arabic Version of Pediatric Eating Assessment Tool (Pedi-EAT-10Arabic)

Pediatric eating assessment tool (Pedi-EAT-10Arabic) is a validated and reliable caregiver administered outcome instrument designed for detection of children at high risk of penetration/aspiration. The objective of this study is to translate and validate the Arabic version of Pedi-EAT-10 and to correlate its results with pharyngeal residue and aspiration on fiber optic endoscopic examination of swallowing (FEES). A cross-sectional study including 202 children selected randomly from those attending the swallowing clinic in phoniatrics unit, Otorhinolaryngology department (ORL) at main university hospital between February 2019 and October 2020 complaining of dysphagia. For test–retest reliability, one hundred caregivers refilled the Pedi-EAT-10Arabic after a 2-week period following their first visit. Validity was established by comparing the scores of dysphagia patients to healthy controls. Internal consistency of Pedi-EAT-10Arabic was high (Cronbach's alpha 0.986). Intra class correlation showed excellent test–retest reliability (r = 0.968). The median Pedi-EAT 10Arabic score was significantly higher in dysphagia group compared to healthy controls. (Median 27 IQR 21–34 for cases compared to median zero IQR 0–2 points for healthy controls, P less than 0.001). A strong correlation was found between Pedi-EAT 10Arabic scores and PAS scores with Spearman's correlation coefficient r = 0.803 and P < 0.001. The ROC for evaluating the discriminatory capacity of Pedi-EAT 10 for aspiration showed an AUC of 0.92 (95% CI of 0.89 to 0.96). Conclusion: Pedi-EAT 10Arabic was found to be a valid and reliable screening tool for further instrumental assessment of risk of dysphagia in pediatric population.

Changes in voice quality, swallowing, and pulmonary function after parathyroidectomy for secondary hyperparathyroidism

ObjectiveTo find changes in voice quality, airway invasion during swallowing, pharyngeal residue after swallowing, acoustic and aerodynamic measurements and pulmonary function tests after total parathyroidectomy plus auto-transplantation for secondary hyperparathyroidism. MethodsWe recruited 38 patients who underwent successful surgery for secondary hyperparathyroidism in this study. Voice quality was evaluated using voice handicap index (VHI-10), eating assessment tool (EAT-10), voice impairment, and the grade, roughness, breathiness, asthenia, strain (GRBAS) scale. Acoustic and aerodynamic measurements included fundamental frequency (F0), maximal phonation time, high pitch, jitter, s/z, shimmer and noise-to-harmonic ratio. Vocal cord mobility, vocal cord closure, premature spillage, the penetration–aspiration scale and the Yale pharyngeal residue severity rating scale (PRSRS) after swallowing were examined using fiber-optic endoscopy. Pulmonary function tests included forced vital capacity, forced expiratory volume in 1 s, bronchodilator test, total lung capacity, diffusion capacity of the lung for carbon monoxide, alveolar volume, and distance and O2 desaturation of the 6 min walking test (6MWT). ResultsFour months after successful parathyroidectomy, VHI-10 improved significantly (p < 0.01); incomplete vocal cord closure decreased significantly (p < 0.01); the Yale PRSRS for vallecula and pyriform sinus improved significantly (p = 0.02 and p = 0.02); F0 and high pitch increased significantly (p < 0.01 and p = 0.01); O2 desaturation (<4%) of 6MWT improved significantly (p = 0.04). ConclusionsParathyroidectomy for secondary hyperparathyroidism can improve the voice quality, vocal cord closure, the Yale PRSRS for vallecular and pyriform sinus and O2 desaturation of 6MWT, and increase F0 and high pitch.

A risk prediction model for dysphagia in older patients: a single-center prospective study

Surveys based on western populations have identified many risk factors for dysphagia in older people, but the potential risk factors consistent with the demographic characteristics of older, hospitalized Chinese patients require further study. This single-center prospective study aimed to determine the incidence of dysphagia in western China, and to develop and validate a model to predict the risk of dysphagia among older patients. A total of 343 inpatients (aged ≥ 65 years without dysphagia and cognitive impairment) were included. A score ≥ 2 on the Eating Assessment Tool-10 was defined as dysphagia. After a six-month follow-up, 70 (20.4%) patients were found to have dysphagia. The final model included age, wearing dentures, activities of daily living, cerebral vascular disease, coronary heart disease, and malignancy. The developed model has high predictive accuracy and can be easily implemented in daily practice.

Association Between Patient-Reported Symptoms of Dysphagia and Psychological Distress in Head and Neck Cancer Survivors.

To describe the prevalence of and the association between patient-reported dysphagia and psychological distress (anxiety and depression) in head and neck cancer (HNC) survivors. 228 HNC survivors seen at an interprofessional survivorship clinic in Pittsburgh, PA, between October 2018 and January 2020. Dysphagia was evaluated using the Eating Assessment Tool. Anxiety and depression were measured using the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-8, respectively. Descriptive statistics and multiple linear regression were performed. 70% (n = 159) of survivors reported problems with swallowing safely and efficiently. Twenty-seven survivors reported symptoms of major depression, 34 reported mild symptoms of anxiety, and 19 reported moderate to severe symptoms of anxiety and depression. After controlling for treatment modality, age, and stage, dysphagia was associated with increased symptoms of anxiety and depression. Oncology nurses can inform their daily practice by implementing regular assessments for anxiety and depression in HNC survivors reporting symptoms of dysphagia.

Reflux, dysphonia, and dysphagia symptoms in patients with diabetes and their association with diabetic complications.

Diabetes mellitus (DM) could influence various organs, especially the eyes, kidneys, nerves, heart, and blood vessels, and finally results in many irreversible disease-related complications. In this paper, the association between reflux, swallowing, and voice symptoms in patients with DM and the possible effect of diabetic complications on these symptoms were investigated. A total of 179 patients with diabetes were included to the study. Three self-reported questionnaires; Reflux Symptom Index (RSI), Eating Assessment Tool-10 (EAT-10), and Voice Handicap Index-10 (VHI-10) were administrated to the patients and, their association with DM-related neuropathy and nephropathy were examined. The scores of each questionnaire were significantly correlated with each other (p < 0.001). There was not any statistically significant association between the score of T-RSI and the diabetic complications (p = 0.077), while a statistically significant association was found between the T-EAT-10 score and neuropathy (p < 0.001). Neither neuropathy nor nephropathy alone had an association with the T-VHI-10 score. However, the presence of nephropathy and neuropathy together was found to be associated with the T-VHI-10 score (p = 0.027). It is possible to conclude that gastrointestinal symptoms such as reflux, dysphonia, and dysphagia are associated with each other and they may possibly be related to the microvascular complications of DM. The clinicians should be aware of the possible reflux, voice, and swallowing complaints and also inquire about the presence of neuropathy and nephropathy in the diabetic population.

Association between clinical evaluation and self perception of deglutition with motor disability scale in patients with multiple sclerosis.

To investigate the association between the clinical evaluation and self-perception of deglutition with the motor disability scale in patients with Multiple Sclerosis. It is a cross-sectional, prospective study that was conducted with individuals with Multiple Sclerosis treated by the Neuroimmunology outpatient clinic of a hospital in southern Brazil. We reviewed the electronic medical records of patients to extract the score from the last Expanded Disability Status Scale. After the analysis of the inclusion criteria, and in clinical consultation, two protocols were applied: one of self-perception for the risk of dysphagia, through the Brazilian equivalence instrument of the Eating Assessment Tool; and the clinical evaluation of swallowing, with food, through the scale Gugging Swallowing Screen. The data were analyzed through tables, descriptive statistics and the tests: Fisher's Exact Association Test and Chi-square Test to assess the association between the results of the applied scales. We considered a maximum significance level of 5% (p <0.05). It was possible to observe that there was a significant association between the scores of the Gugging Swallowing Screen scales with the Expanded Disability Status Scale of the patients. In addition, there was also a relation between the results of both protocols with the Expanded Disability Status Scale. The patients with Multiple Sclerosis in this study presented oropharyngeal dysphagia, what was confirmed by the association between the clinical evaluation of swallowing and the results of the instrument of self-perception of swallowing and the motor disability scale.

Dysphagia Weakly Correlates With Other Patient-Reported Outcomes After Anterior Cervical Discectomy and Fusion.

IntroductionDysphagia is a common complication after anterior cervical discectomy and fusion (ACDF), but it is not a routinely asked question in legacy patient-reported outcome measures (PROMs). This study analyzes whether there are associations between dysphagia and legacy outcome measures.MethodsWe retrospectively reviewed 168 patients who underwent ACDF surgery from 2017 to 2019 at a single institution. Demographics, anthropometric data, Neck Disability Index (NDI), Visual Analog Scale (VAS)-Arm and VAS-Neck Pain scores, Patient-Reported Outcomes Measurement Information System (PROMIS)-Physical and PROMIS-Mental scores, Charlson Comorbidity Index (CCI), and Eating Assessment Tool-10 (EAT-10) were obtained for each patient preoperatively and at one, three, six, and 12 months postoperatively. Pearson’s correlation coefficients were used to evaluate the bivariate correlations between legacy, PROMIS, and EAT-10 measures.ResultsSignificant but weak correlations existed between NDI and EAT-10 at one, three, and six months postoperatively (correlation coefficient (R) = 0.31, 0.42, and 0.34 at one, three, and six months, p < 0.001) and VAS-Neck Pain and EAT-10 scores at one, three, and six months postoperatively (R = 0.27, 0.30, and 0.28 at one, three, and six months, p ≤ 0.004). Both PROMIS-Physical and PROMIS-Mental scores showed significant but weak correlations with EAT-10 scores at three and six months postoperatively (R = -0.29 and -0.25, p ≤ 0.01, at three months and R = -0.25 and -0.28, p < 0.01, at six months). In all comparisons of EAT-10 scores with legacy outcome measures, the significance of correlations disappeared by 12 months postoperatively. In addition, there was a positive association between CCI and EAT-10 score (β = 0.37, p < 0.05).ConclusionWeak correlations exist between self-reported dysphagia scores and legacy patient-reported outcome measures in patients undergoing ACDF. The correlation strength decreases over time; therefore, dysphagia scores should be reported separately when looking at outcomes after ACDF. Patients with more comorbidities are also at increased risk for dysphagia.