Comparison of Self-Report of Dysphagia Using the Eating Assessment Tool and the Sydney Swallowing Questionnaire in Community Dwelling Older Adults

Author(s):  
Aarthi Madhavan ◽  
Nicole Shuman ◽  
Claire Snyder ◽  
Nicole Etter

Purpose Patient-reported outcomes (PROs) are an important feature in clinical evaluation of swallowing. The Eating Assessment Tool (EAT-10) and the Sydney Swallow Questionnaire (SSQ) are two validated dysphagia PROs commonly used in healthy older adult populations as screening tools for swallowing problems. The purpose of this study is to compare the consistency of the EAT-10 and SSQ scores for self-reported swallowing difficulties in a group of community-dwelling older adults (CDOA) completing both questionnaires. Method A total of 316 individuals over the age of 60 years completed the EAT-10, SSQ, and provided demographic data, including a self-report of any medical diagnoses. Participants were excluded if they had any diagnoses known to cause dysphagia. Questionnaire responses were analyzed for frequencies of responses across all participants. Results Seventy-five participants were identified as having dysphagia by the EAT-10 (23.7%), while 30 participants were identified by the SSQ (9.49%). When comparing the results of the two assessments, the scales agreed on 289 out of 316 participants (91%). There was a disagreement on the results in 27 of the 316 participants, with 26 of these self-reporting dysphagia symptoms on the EAT-10 but not on the SSQ. Conclusions Two commonly used dysphagia PROs resulted in different prevalence rates of self-reported dysphagia in a group of CDOA. CDOAs may need questionnaires specifically validated for them with special consideration for specific age-related risk factors, to ensure accurate early identification.

Geriatrics ◽  
2018 ◽  
Vol 3 (4) ◽  
pp. 90 ◽  
Author(s):  
Aarthi Madhavan ◽  
Giselle Carnaby ◽  
Karishma Chhabria ◽  
Michael Crary

Evidence suggests that community dwelling older adults (CDOA) are at risk for dysphagia (swallowing difficulties). Dysphagia is often unidentified until related morbidities like under nutrition or pneumonia occur. These cases of unidentified dysphagia, prior to any clinical intervention, may be termed ‘pre-clinical dysphagia’. Identifying pre-clinical dysphagia is challenged by the lack of validated tools appropriate for CDOA. This study addresses preliminary development of a novel patient reported outcome (PRO) screening tool for pre-clinical dysphagia. Initially, 34 questions were developed from literature review and expert opinion. Following pilot testing (n = 53), the questionnaire was revised and tested on 335 additional CDOA. Face validity, content validity, item analysis, reliability (internal consistency), and construct validity (exploratory factor analysis) measures were completed. Psychometric validation resulted in a 17-question PRO tool. Construct analysis identified a three-factor model that explained 67.345% of the variance. Emergent factors represented swallowing effort, physical function, and cognitive function. The results revealed strong construct validity and internal consistency (Cronbach’s α = 0.90). A novel, simple PRO incorporating multiple function domains associated with aging demonstrated strong preliminary psychometric properties. This tool is more comprehensive and aging-focused than existing dysphagia screening tools. Inclusion of multiple domains may be key in early identification of pre-clinical dysphagia.


2017 ◽  
Vol 20 (15) ◽  
pp. 2685-2693 ◽  
Author(s):  
Ilse Bloom ◽  
Wendy Lawrence ◽  
Mary Barker ◽  
Janis Baird ◽  
Elaine Dennison ◽  
...  

AbstractObjectiveTo explore influences on diet in a group of community-dwelling older adults in the UK.DesignData were collected through focus group discussions with older people; discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically.SettingHertfordshire, UK.SubjectsParticipants were sampled purposively from the Hertfordshire Cohort Study, focusing on those whose diets had been assessed at two time points: 1998–2001 and 2011.ResultsNinety-two adults participated (47 % women; 74–83 years) and eleven focus groups were held. A number of age-related factors were identified that were linked to food choices, including lifelong food experiences, retirement, bereavement and medical conditions, as well as environmental factors (such as transport). There appeared to be variability in how individuals responded to these influences, indicating that other underlying factors may mediate the effects of age-related factors on diet. Discussions about ‘keeping going’, being motivated to ‘not give up’, not wanting to be perceived as ‘old’, as well as examples of resilience and coping strategies, suggest the importance of mediating psychological factors. In addition, discussion about social activities and isolation, community spirit and loneliness, indicated the importance of social engagement as an influence on diet.ConclusionsInterventions to promote healthier diets in older age should take account of underlying psychological and social factors that influence diet, which may mediate the effects of age-related factors.


Biology ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 111
Author(s):  
Jort Veen ◽  
Diego Montiel-Rojas ◽  
Fawzi Kadi ◽  
Andreas Nilsson

The role of daily time spent sedentary and in different intensities of physical activity (PA) for the maintenance of muscle health currently remains unclear. Therefore, we investigated the impact of reallocating time spent in different PA intensities on sarcopenia risk in older adults, while considering PA type (muscle strengthening activities, MSA) and protein intake. In a sample of 235 community-dwelling older adults (65–70 years), a sarcopenia risk score (SRS) was created based on muscle mass assessed by bioimpedance, together with handgrip strength and performance on the five times sit-to-stand (5-STS) test assessed by standardized procedures. Time spent in light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and being sedentary was assessed by accelerometry, and PA type (MSA) by self-report. Linear regression models based on isotemporal substitution were employed. Reallocating sedentary time to at least LPA was significantly (p < 0.05) related to a lower SRS, which remained evident after adjustment by PA type (MSA) and protein intake. Similarly, reallocating time in LPA by MVPA was related to a significantly (p < 0.05) lower SRS. Our results emphasize the importance of displacing sedentary behaviours for more active pursuits, where PA of even light intensities may alleviate age-related deteriorations of muscle health in older adults.


2018 ◽  
Vol 74 (4) ◽  
pp. 556-559 ◽  
Author(s):  
Marla K Beauchamp ◽  
Rachel E Ward ◽  
Alan M Jette ◽  
Jonathan F Bean

Abstract Background The Late-Life Function and Disability Instrument (LLFDI) is a well-validated and frequently used patient-reported outcome for older adults. The aim of this study was to estimate the minimal clinically important difference (MCID) of the LLFDI-Function Component (LLFDI-FC) and its subscales among community-dwelling older adults with mobility limitations. Methods We performed a secondary analysis of the Boston Rehabilitative Impairment Study of the Elderly, a longitudinal cohort study of older adults with mobility limitations residing in the community. The MCID for each LLFDI-FC scale over 1 year of follow-up was estimated using both anchor- and distribution-based methods, including mean change scores on a patient-reported global rating of change in function scale, the standard error of measurement (SEM), and the minimal detectable change with 90% confidence (MDC90). Results Data from 320 older adults were used in the analysis (mean age 76 years, 69% female, mean of four chronic conditions). Meaningful change estimates for “small change” based on the global rating of change and SEM were 2, 3, 4, and 4 points for the LLFDI-FC overall function scale and basic lower-extremity, advanced lower-extremity, and upper-extremity subscales, respectively. Estimates for “substantial change” based on the global rating of change and minimal detectable change with 90% confidence were 5, 6, 9, and 10 points for the overall function scale and basic lower-extremity, advanced lower-extremity, and upper-extremity subscales, respectively. Conclusion This study provides the first MCID estimates for the LLFDI-FC, a widely used patient-reported measure of function. These values can be used to interpret the outcomes of longitudinal investigations of functional status in similar populations of community-dwelling older adults.


2019 ◽  
Vol 31 (12) ◽  
pp. 1699-1707 ◽  
Author(s):  
Toshinori Nishizawa ◽  
Ayako Morita ◽  
Takeo Fujiwara ◽  
Katsunori Kondo

ABSTRACTBackground:Subjective memory complaints (SMC) have been suggested as an early marker of mild cognitive impairment and dementia. However, there is a paucity of evidence on the effects of early life conditions on the development of SMC in old age. This study is aimed at investigating the association between childhood socioeconomic status (SES) and SMC in community-dwelling older adults.Methods:We used the data of the Japan Gerontological Evaluation Study, a population-based cohort study of people aged 65 years or older enrolled from 28 municipalities across Japan. Childhood SES and SMC in everyday life were assessed from the self-report questionnaire administered in 2010 (n = 16,184). Poisson regression was performed to determine their association, adjusted for potential confounders and life-course mediators and examined cohort effects.Results:We identified SMC in 47.4% of the participants. After adjusting for sex, age, and number of siblings, low and middle childhood SES were associated with 29% (prevalence ratio [PR]: 1.29, 95% confidence interval [CI]: 1.22, 1.36) and 10% higher prevalence of SMC (PR: 1.10, 95%CI: 1.04, 1.17), respectively, compared with high childhood SES (p for trend <.001). The interaction terms between childhood SES and age groups were not statistically significant.Conclusion:Childhood SES is significantly associated with SMC among community-dwelling older adults. Efforts to minimize childhood poverty may diminish or delay the onset of SMC and dementia in later life.


2014 ◽  
Vol 68 (6) ◽  
pp. 711 ◽  
Author(s):  
Machiko R. Tomita ◽  
Sumandeep Saharan ◽  
Sheela Rajendran ◽  
Susan M. Nochajski ◽  
Jo A. Schweitzer

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