Self-perception and clinical presentation of eating and swallowing difficulties within elderly care.
Caitlin S Bell, Esedra Krüger, Rouxjeanne Vermeulen and 2 others
PMID 40035121WHAT IT FOUND
Many residents reported swallowing concerns, especially extra effort for pills and food sticking in the throat, but most clinical swallow scores showed no established aspiration or dysphagia risk.
Ask about self-reported symptoms and do not dismiss them as normal ageing.
Key findings
01Twenty-one participants (48%) reported an overall mild-to-severe swallowing concern. The most common concerns were extra effort swallowing pills (22 participants, 50%) and food sticking in the throat (20 participants, 45%).
02Forty-one of 44 participants (95%) scored above 177 on the MASA for solids and semi-solids, which the study took as no established dysphagia or aspiration risk.
03Twenty of 44 participants (45%) used multiple swallows instead of sequential swallows during the three-ounce water challenge.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was small: 44 residents from private Johannesburg care facilities, so results may not apply to public facilities or other South African communities. People with moderate-to-severe cognitive impairment were excluded, so the findings do not cover residents who may have communication or cognition-related swallowing concerns. All assessments were done in one session, not during usual mealtimes, so self-chosen swallowing adjustments may have changed what the tests showed. The study compared self-report and clinical presentation; it did not test whether asking about self-perceptions improves referral or treatment.
Declared interests
The study received no specific grant from any public, commercial, or not-for-profit funding agency.
The easy way to misread this
Do not read the high MASA scores and the water challenge results as proof that most residents swallow safely. Many residents reported swallowing concerns, and some used their own multiple swallows during the water test.