The GUSS test as a good indicator to evaluate dysphagia in healthy older people: a multicenter reliability and validity study
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Key summary points
We aimed to evaluate whether the Gugging Swallowing Screen (GUSS) test is an effective method for evaluating swallowing difficulty in healthy older people.
Total GUSS score sensitivity was 95.5% and its specificity was 94.4%.
The GUSS test is a valid and reliable test to identify possible oropharyngeal dysphagia risk in healthy older person who had no secondary dysphagia. It is suitable as a screen test for clinical practice.
Dysphagia is known to be a disorder of the swallowing function, and is a growing health problem in aging populations. Swallowing screening tests have mostly been studied in comorbidities such as stroke associated with old age. There is no simple, quick and easy screening test to best determine the risk of oropharyngeal dysphagia in geriatric guidelines. We aimed to evaluate whether the Gugging Swallowing Screen (GUSS) test is an effective method for evaluating swallowing difficulty in healthy older people.
This cross-sectional and multicenter study was conducted at 13 hospitals between September 2017 and February 2019. The study included 1163 participants aged ≥65 years and who had no secondary dysphagia. Reliability was evaluated for data quality, scaling assumptions, acceptability, reliability, and validity as well as cutoff points, specificity and sensitivity.
The age distribution of 773 (66.5%) patients was between 65 and 74 years and 347 (29.8%) of them were male and 767 (66%) patients were female. The average total GUSS score was 18.57 ± 1.41. The Cronbach’s alpha was 0.968. There was a moderate statistically significant negative correlation between the total GUSS and 10-item Eating Assessment Tool scores as well as between the total GUSS score and quality of life. The cutoff point of the total GUSS score was 18.50, sensitivity was 95.5% and specificity was 94.4%.
The GUSS test is a valid and reliable test to identify possible oropharyngeal dysphagia risk in healthy older people who had no secondary dysphagia. It is suitable as a screen test for clinical practice.
KeywordsDysphagia Older people Screen test GUSS
There is no funding source in this study.
Compliance with ethical standards
Conflict of interest
There is no conflict of interest among the authors.
All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee ((Ethics committee of University of Health Sciences, Ankara Diskapi Training and Research Hospital) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
All participants or the relatives of illiterate participants were informed about the study and their written informed consents were obtained at the beginning of the study.
- 16.Baijens LW, Clavé P, Cras P, Ekberg O, Forster A, Kolb GF, Leners JC, Masiero S, Mateos-Nozal J, Ortega O, Smithard DG, Speyer R, Walshe M (2016) European Society for Swallowing Disorders —European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Interv Aging 7(11):1403–1428CrossRefGoogle Scholar
- 21.Umay E, Eyigor S, Karahan AY et al (2019) Which swallowing difficulty of food consistency is best predictor for oropharyngeal dysphagia risk in older person. EGM 10(4):609–617Google Scholar
- 23.Umay EK, Gurcay E, Bahceci K, Ozturk E, Yilmaz V, Gundogdu I, Ceylan T, Eren Y, Cakcı A (2018) Validity and reliability of Turkish version of the Gugging Swallowing Screen test in the early period of hemispheric stroke. Neurol Sci Neurophysiol 35:6–13Google Scholar
- 27.Xiao S, Chang H, Wu J, Shuai D, Ma J, Huang W, Liu J (2013) Chinese version of GUSS swallowing function assessment scale for reliability and validity. Chin J Mod Nurs 19(34):4189–4191Google Scholar
- 28.Lee KW, Kim SB, Lee JH, Kim MA, Kim BH, Lee GC (2009) Clinical validity of Gugging Swallowing Screen for acute stroke patients. J Korean Acad Rehabil Med 33(4):458–462Google Scholar
- 32.Nunnally JC, Bernstein IH (2010) Psychometric theory. Tata McGraw-Hill Education, New YorkGoogle Scholar
- 33.Bowling A (2009) Research methods in health: Investigating health and health services. Open University Press, BuckinghamGoogle Scholar
- 38.Orlandoni P, Peladic NJ (2016) Health-related quality of life and functional health status questionnaires in oropharyngeal dysphagia. J Aging Res Clin Pract 5(1):31–37Google Scholar