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Open AccessArticle

Preliminary Development of a Screening Tool for Pre-Clinical Dysphagia in Community Dwelling Older Adults

Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, PA 16802, USA
Swallowing Research Laboratory, School of Communication Sciences and Disorders, University of Central Florida, Orlando, FL 32816, USA
Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
Author to whom correspondence should be addressed.
Geriatrics 2018, 3(4), 90;
Received: 31 October 2018 / Revised: 3 December 2018 / Accepted: 5 December 2018 / Published: 7 December 2018
(This article belongs to the Special Issue Dysphagia in Older and Frail Adults)
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. View Full-Text
Keywords: pre-clinical dysphagia; screening; patient reported outcomes; tool development pre-clinical dysphagia; screening; patient reported outcomes; tool development
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Madhavan, A.; Carnaby, G.D.; Chhabria, K.; Crary, M.A. Preliminary Development of a Screening Tool for Pre-Clinical Dysphagia in Community Dwelling Older Adults. Geriatrics 2018, 3, 90.

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