Development of a simplified dysphagia assessment by dentists in older persons

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Abstract

Objective

This study aimed to evaluate the diagnostic accuracy of a simplified clinical examination of swallowing by dentists and the Eating Assessment Tool (EAT-10), when compared with the diagnosis provided by a speech pathologist (gold standard).

Methods

Three dentists and 1 speech pathologist clinically evaluated 265 older persons in southern Brazil, 123 were residents in long-term care and 142 were community-dwelling, all able to respond to the research protocol independently. Accuracy, sensitivity, specificity, positive and negative predictive values (+PV and −PV), and positive and negative likelihood ratios (+LR and −LR) were calculated according to standard methods. This study was approved by the Ethics Committee of the Federal University of Rio Grande do Sul.

Results

Mean age of the participants was 73.5 (±8.9) years and most of them were women (N = 157, 59.2%). The prevalence of dysphagia as diagnosed by a speech pathologist was 45.3%. The accuracy of diagnosis was 0.84 for the clinical examination of swallowing by dentists. Furthermore, sensitivity was 0.77, specificity was 0.89, +PV was 0.85, −PV was 0.83, +LR was 7.02 and −LR was 0.25. The accuracy of EAT-10 was 0.72, the sensitivity was 0.45, specificity was 0.94, +PV was 0.87, −PV was 0.67, +LR was 8.31 and −LR was 0.57.

Conclusions

Simplified clinical examination of swallowing by dentists was found to be an accurate method to screen dysphagia in older persons.

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