(A716) Eating Assessment Tool - 10 Scores in Older Adults: A Systematic Review and Meta-Analysis

Introduction: Swallowing abnormalities occur with increasing frequency as we age, but there has been insufficient work differentiating pathologic changes in swallowing from those that are a normal part of aging. While the Eating Assessment Tool 10 (EAT-10) is a commonly-used tool to screen for dysphagia in older adults, its threshold for abnormality was established in a younger population and therefore may not apply to older adults.

Methods: We performed a systematic review and meta-analysis of EAT-10 scores in adults aged 60 and older. We included studies examining EAT-10 in community-dwelling older adults without a previous history of dysphagia, head and neck cancer, neurologic diagnoses, or head/ neck/ spinal surgery. Data extraction from eligible full text publications was conducted by two authors in duplicate. Discrepancies were resolved in a consensus meeting.

Results: Our initial search yielded 658 abstracts, with 89 considered for full text review. Of these, 15 papers were eligible for data extraction and featured a total of 6633 older adults. In papers providing a mean, the mean EAT-10 score was 2.44 +/- 4.07, compared to a mean EAT-10 score of 0.40 +/- 1.01 in the original paper validating the EAT-10 (mean difference 2.04, 95% CI 1.67 to 2.41, p< 0.001). In studies of older community-dwelling adults not providing a mean, the overall proportions of patients with an EAT-10>3 was 9.8%. Results were similar following sensitivity analyses.

Conclusions: In the existing literature, EAT-10 scores are significantly higher in populations of older adults without a history of dysphagia compared to a younger normative sample. This warrants a systematic investigation for an appropriate higher threshold value to screen for dysphagia in this population.