title: Evaluation of a dysphagia screening system based on the Mann Assessment of Swallowing Ability for use in dependent older adults.
abstract: OBJECTIVE
  Dysphagia is common in dependent older adults. Thus, a method of evaluating eating and swallowing functions that can be used to diagnose and manage dysphagia in a simple and robust manner is required. In 2002, the Mann Assessment of Swallowing Ability (MASA) was introduced to identify dysphagia in acute-stage stroke patients. As the MASA enables easy screening, it might also be applicable to dependent older adults if appropriate MASA cut-off values and the most useful assessment items could be determined. In the present study, we attempted to determine suitable MASA cut-off values, and the most useful assessment items for predicting aspiration and pharyngeal retention in dependent older adults.
  
  
  METHODS
  Using the MASA, we evaluated the eating and swallowing functions of 50 dependent older adults with dysphagia. All of the patients also underwent videoendoscopic-based swallowing evaluations to detect aspiration and pharyngeal retention. The participants' characteristics and the utility of each assessment item were compared between various groups. Using the patients' videoendoscopic findings as a reference, receiver operating characteristic curve analysis was carried out to determine appropriate cut-off values for predicting aspiration and pharyngeal retention in dependent older adults.
  
  
  RESULTS
  The optimal MASA cut-off values for predicting aspiration and pharyngeal retention were 122 points and 151 points, respectively. A total of 17 of the 24 clinical items assessed by the MASA were found to be associated with aspiration in dependent older adults.
  
  
  CONCLUSIONS
  The MASA is a useful screening tool for evaluating eating and swallowing functions in dependent older adults. Geriatr Gerontol Int 2017; 17: 561-567.
authors.affiliation: Tokyo Dental College Department of Dysphagia Rehabilitation and Community Dental Care, Chiba, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Ohira
authors.affiliation: Tokyo Dental College Department of Dysphagia Rehabilitation and Community Dental Care, Chiba, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Ishida
authors.affiliation: Tokyo Dental College Department of Social Dentistry, Chiba, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Maki
authors.affiliation: Tokyo Dental College Department of Dysphagia Rehabilitation and Community Dental Care, Chiba, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Ohkubo
authors.affiliation: Tokyo Dental College Department of Dysphagia Rehabilitation and Community Dental Care, Chiba, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sugiyama
authors.affiliation: Tokyo Dental College Department of Social Dentistry, Chiba, Japan.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Sakayori
authors.affiliation: Tokyo Dental College Department of Crown & Bridge Prosthodontics, Tokyo Dental College, Chiba, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Sato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000150:complications / Q000175:diagnosis*; D004724:Endoscopy; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008403:Mass Screening; D011237:Predictive Value of Tests; D012372:ROC Curve; D053120:Respiratory Aspiration / Q000175:diagnosis / Q000209:etiology; D020535:Video-Assisted Surgery
keywords: dysphagia; elderly; endoscopy; receiver operating characteristic curve; screening