ArticlePloS one2022
A simplified method for evaluating swallowing ability and estimating malnutrition risk: A pilot study in older adults.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Association between oral hypofunction and general health: a systematic review.BMC oral health · 2023Pooled it
- Review
- Association between clinical and functional factors and masticatory function of edentulous individuals aged 70 years and older: a cross-sectional study.BMC geriatrics · 2025Article
- Chewing difficulty, swallowing problems, xerostomia and cause-specific mortality among older adults: A 7-year follow-up JAGES cohort study.Geriatrics & gerontology international · 2025Article
- Cross-cultural adaptation, reliability, and validity of a Chinese version of the swallowing impairment score.Frontiers in psychology · 2025Article
- Observational
- Tongue Strength of Older Adults Requiring Long-Term Care Varies throughout the Day.Geriatrics (Basel, Switzerland) · 2023Article
- Cross-cultural translation and modification of the revised oral assessment guide for oral health assessment by non-dentists.BDJ open · 2023Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of this pilot study was to develop a Thai-version of a simple swallowing questionnaire, called the T-SSQ, and to evaluate the association between malnutrition risk and swallowing ability, determined objectively by tongue strength and subjectively by the T-SSQ. Sensitivity analysis was also performed to determine which swallowing indices better estimate malnutrition in older adults.
methodsThis cross-sectional study comprised two phases: Phase I, development and cross-cultural translation of the T-SSQ; and Phase II, application of the T-SSQ in 60 older adults. In Phase I, content and face validity of the T-SSQ was evaluated by 10 experts and 15 older adults. In Phase II, the convergent validity of the T-SSQ was evaluated by determining its association with objective tongue strength. Nutritional status was evaluated using the Thai-version of the Mini-Nutritional Assessment. Covariates included sociodemographic characteristics, and oral and health-related status. Adjusting for covariates, the associations between the two swallowing indices and malnutrition risk were determined using multivariable regression analyses. A cut-off value for low tongue strength was determined using a receiver operating characteristic (ROC) curve, and sensitivity analysis between the swallowing indices and malnutrition risk was performed.
resultsThe T-SSQ comprised 4-items of common signs and symptoms of a swallowing problem. Its content and face validity were verified. Older adults were considered as having a swallowing problem when at least one item was reported. Convergent validity of the subjective index was shown by significantly different tongue strength values between the participants with and without a swallowing problem (p for independent t-test = 0.014). Based on the highest area under the ROC curve, an 18-kPa cut-off value was chosen to classify low tongue strength. Having a swallowing problem and low tongue strength was significantly associated with malnutrition risk. The positive predictive value of the subjective swallowing index was 1.8-fold higher than objective tongue strength.
conclusionsSelf-reported swallowing problems determined by the T-SSQ can be used as a subjective index for evaluating swallowing ability in older adults. Subjective swallowing problems and objective tongue strength were associated with malnutrition risk. However, the T-SSQ estimated malnutrition risk better than the objective index.
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