Skip to main content
SpringerLink
Log in

Dysphagia assessed by the 10-item eating assessment tool is associated with nutritional status and activities of daily living in elderly individuals requiring long-term care

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

The 10-item Eating Assessment Tool (EAT-10) is a self-administered questionnaire for dysphagia screening, with each item scored from 0 to 4. We assessed the associations among the EAT- 10 score, nutritional status and activities of daily living (ADL) in elderly individuals requiring long-term care.

Design

Cross-sectional study.

Setting

Geriatric health services facilities, acute hospitals, and the community.

Participants

Elderly individuals ≥65 years of age with dysphagia or possible dysphagia (N=237).

Measurements

The EAT-10, the Mini Nutritional Assessment Short Form (MNA-SF) and the Barthel Index.

Results

There were 90 males and 147 females. Mean age was 82 ± 8 years. Eighty-nine were in geriatric health services facilities, 28 were in acute hospitals, and 120 were community-dwelling. The median Barthel Index score was 55 (interquartile range: 25, 80). The median EAT-10 score was 1 (interquartile range: 0, 9), and 101 respondents a score > 3, indicating the presence of dysphagia. The MNA-SF revealed that 81 were malnourished, 117 were at risk of malnutrition, and 39 had a normal nutritional status. The Barthel Index score and MNA-SF score were significantly lower in those with an EAT-10 score between 3 and 40, compared to those with an EAT-10 score between 0 and 2. The EAT-10 has an independent effect on the Barthel Index and the MNA-SF by adjusting for covariates such as age, gender, and setting in multiple regression analysis.

Conclusions

Dysphagia assessed by the EAT-10 is associated with nutritional status and ADL in elderly individuals requiring long-term care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Tamura BK, Bell CL, Masaki KH, Amella EJ. Factors associated with weight loss, low BMI, and malnutrition among nursing home patients: a systematic review of the literature. J Am Med Dir Assoc 2013;14:649–655. doi: 10.1016/j.jamda.2013.02.022

    Article  PubMed  Google Scholar 

  2. Foley NC, Martin RE, Salter KL, Teasell RW. A review of the relationship between dysphagia and malnutrition following stroke. J Rehabil Med 2009;41:707–713. doi: 10.2340/16501977-0415

    Article  PubMed  Google Scholar 

  3. Crary MA, Humphrey JL, Carnaby-Mann G, Sambandam R, Miller L, Silliman S. Dysphagia, nutrition, and hydration in ischemic stroke patients at admission and discharge from acute care. Dysphagia 2013;28:69–76. doi: 10.1007/s00455-012-9414-0

    Article  PubMed  Google Scholar 

  4. Takeuchi K, Aida J, Ito K, Furuta M, Yamashita Y, Osaka K. Nutritional status and dysphagia risk among community-dwelling frail older adults. J Nutr Health Aging 2014;18:352–357. doi: 10.1007/s12603-014-0025-3

    Article  PubMed  CAS  Google Scholar 

  5. Furuta M, Komiya-Nonaka M, Akifusa S, Shimazaki Y, Adachi M, Kinoshita T, Kikutani T, Yamashita Y. Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities. Community Dent Oral Epidemiol 2013;41:173–181. doi: 10.1111/cdoe.12000

    Article  PubMed  Google Scholar 

  6. Cabre M, Serra-Prat M, Palomera E, Almirall J, Pallares R, Clavé P. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing 2010;39:39–45. doi: 10.1093/ageing/afp100

    Article  PubMed  Google Scholar 

  7. Serra-Prat M, Palomera M, Gomez C, Sar-Shalom D, Saiz A, Montoya JG, Navajas M, Palomera E, Clavé P. Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study. Age Ageing 2012;41:376–381. doi: 10.1093/ageing/afs006

    Article  PubMed  Google Scholar 

  8. Poisson P, Laffond T, Campos S, Dupuis V, Bourdel-Marchasson I. Relationships between oral health, dysphagia and undernutrition in hospitalised elderly patients. Gerodontology 2014;doi: 10.1111/ger.12123

    Google Scholar 

  9. Carrión S, Cabré M, Monteis R, Roca M, Palomera E, Serra-Prat M, Rofes L, Clavé P. Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital. Clin Nutr 2014; doi: 10.1016/j.clnu.2014.04.014

    Google Scholar 

  10. Kimyagarov S, Turgeman D, Fleissig Y, Klid R, Kopel B, Adunsky A. Percutaneous endoscopic gastrostomy (PEG) tube feeding of nursing home residents is not associated with improved body composition parameters. J Nutr Health Aging 2013;17:162–165. doi: 10.1007/s12603-012-0075-3

    Article  PubMed  CAS  Google Scholar 

  11. Lindroos E, Saarela RK, Soini H, Muurinen S, Suominen MH, Pitkälä KH. Caregiver-reported swallowing difficulties, malnutrition, and mortality among older people in assisted living facilities. J Nutr Health Aging 2014;18:718–722. doi: 10.1007/s12603-014-0467-7

    Article  PubMed  CAS  Google Scholar 

  12. Kuroda Y, Kuroda R. Relationship between thinness and swallowing function in Japanese older adults: implications for sarcopenic dysphagia. J Am Geriatr Soc 2012;60:1785–1786. doi: 10.1111/j.1532-5415.2012.04123.x

    Article  PubMed  Google Scholar 

  13. Kuroda Y. Relationship between swallowing function, and functional and nutritional status in hospitalized elderly individuals. Int J Speech Lang Pathol Audiol 2014;2:20–26. doi: 10.12970/2311-1917.2014.02.01.3

    Article  Google Scholar 

  14. Kojima A, Imoto Y, Osawa Y, Fujieda S. Predictor of rehabilitation outcome for dysphagia. Auris Nasus Larynx 2014;41:294–298. doi: 10.1016/j.anl.2013.12.009

    Article  PubMed  Google Scholar 

  15. Falsetti P, Acciai C, Palilla R, Bosi M, Carpinteri F, Zingarelli A, Pedace C, Lenzi L. Oropharyngeal dysphagia after stroke: incidence, diagnosis, and clinical predictors in patients admitted to a neurorehabilitation unit. J Stroke Cerebrovasc Dis 2009;18:329–335. doi: 10.1016/j.jstrokecerebrovasdis.2009.01.009

    Article  PubMed  Google Scholar 

  16. Maeshima S, Osawa A, Hayashi T, Tanahashi N. Factors associated with prognosis of eating and swallowing disability after stroke: a study from a community-based stroke care system. J Stroke Cerebrovasc Dis 2013;22:926–930.e1. doi: 10.1016/j. jstrokecerebrovasdis.2013.04.003

    Article  PubMed  Google Scholar 

  17. Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol 2008;117:919–924.

    Article  PubMed  Google Scholar 

  18. Wakabayashi H, Kayashita J. Translation, reliability, and validity of the Japanese version of the 10-item Eating Assessment Tool (EAT-10) for the screening of dysphagia. JJSPEN 2014;29:871–876. doi: 10.11244/jjspen.29.871 [Article in Japanese]

    Google Scholar 

  19. Burgos R, Sarto B, Segurola H, Romagosa A, Puiggrós C, Vázquez C, Cárdenas G, Barcons N, Araujo K, Pérez-Portabella C. Translation and validation of the Spanish version of the EAT-10 (Eating Assessment Tool-10) for the screening of dysphagia. Nutr Hosp 2012;27:2048–2054. doi: 10.3305/nh.2012.27.6.6100 [Article in Spanish]

    PubMed  CAS  Google Scholar 

  20. Schindler A, Mozzanica F, Monzani A, Ceriani E, Atac M, Jukic-Peladic N, Venturini C, Orlandoni P. Reliability and validity of the Italian Eating Assessment Tool. Ann Otol Rhinol Laryngol 2013;122:717–724.

    Article  PubMed  Google Scholar 

  21. Gonçalves MI, Remaili CB, Behlau M. Cross-cultural adaptation of the Brazilian version of the Eating Assessment Tool-EAT-10. Codas 2013;25:601–604.

    Article  PubMed  Google Scholar 

  22. Galán Sánchez-Heredero MJ, Santander Vaquero C, Cortázar Sáez M, de la Morena López F, Susi García R, Martínez Rincón Mdel C. Relationship between dysphagia and malnutritition in patients over 65 years of age. Enferm Clin 2014;24:183–190. doi: 10.1016/j.enfcli.2013.12.009. [Article in Spanish]

    Article  PubMed  Google Scholar 

  23. Mahoney FI, Barthel D. Functional evaluation: the Barthel Index. Md State Med J 1965;14:61–65.

    PubMed  CAS  Google Scholar 

  24. Rofes L, Arreola V, Mukherjee R, Clavé P. Sensitivity and specificity of the Eating Assessment Tool and the Volume-Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil 2014;26:1256–1265. doi: 10.1111/nmo.12382.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  25. Vellas B, Villars H, Abellan G, Soto ME, Rolland Y, Guigoz Y, Morley JE, Chumlea W, Salva A, Rubenstein LZ, Garry P. Overview of the MNA®-its history and challenges. J Nutr Health Aging 2006;10:456–465.

    PubMed  CAS  Google Scholar 

  26. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the Short-Form Mini Nutritional Assessment (MNA-SF). J Geront 2001;56A:M366–M372.

    Article  Google Scholar 

  27. Guigoz Y. The Mini-Nutritional Assessment (MNA®) review of the literature-what does it tell us? J Nutr Health Aging 2006;10:466–487.

    PubMed  CAS  Google Scholar 

  28. White JV, Guenter P, Jensen G, Malone A, Schofield M; Academy Malnutrition Work Group; A.S.P.E.N. Malnutrition Task Force; A.S.P.E.N. Board of Directors. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). J Parenter Enteral Nutr 2012;36:275–283. doi: 10.1177/0148607112440285.

    Article  Google Scholar 

  29. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010;39:412–423. doi: 10.1093/ageing/afq034

    Article  PubMed  PubMed Central  Google Scholar 

  30. Wakabayashi H. Presbyphagia and sarcopenic dysphagia: association between aging, sarcopenia, and deglutition disorders. J Frailty Aging 2014;3:97–103.

    Google Scholar 

  31. Wakabayashi H, Sakuma K. Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management. J Cachexia Sarcopenia Muscle 2014;5:269–277. doi: 10.1007/s13539-014-0162-x

    Article  PubMed  PubMed Central  Google Scholar 

  32. Veldee MS, Peth LD. Can protein-calorie malnutrition cause dysphagia? Dysphagia 1992;7:86–101.

    Article  PubMed  CAS  Google Scholar 

  33. Hudson HM, Daubert CR, Mills RH. The interdependency of protein-energy malnutrition, aging, and dysphagia. Dysphagia 2000;15:31–38.

    Article  PubMed  CAS  Google Scholar 

  34. Yang EJ, Kim MH, Lim JY, Paik NJ. Oropharyngeal dysphagia in a communitybased elderly cohort: the Korean longitudinal study on health and aging. J Korean Med Sci. 2013;28:1534–1539. doi: 10.3346/jkms.2013.28.10.1534.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Rehabilitation Medicine, Yokohama City University Medical Center, Yokohama City, Japan

    Hidetaka Wakabayashi

  2. Division of Clinical Epidemiology, Jikei University School of Medicine, Yokohama City, Japan

    Hidetaka Wakabayashi & M. Matsushima

Authors
  1. Hidetaka Wakabayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Matsushima
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hidetaka Wakabayashi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wakabayashi, H., Matsushima, M. Dysphagia assessed by the 10-item eating assessment tool is associated with nutritional status and activities of daily living in elderly individuals requiring long-term care. J Nutr Health Aging 20, 22–27 (2016). https://doi.org/10.1007/s12603-016-0671-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-016-0671-8

Keywords

Search

Navigation