Background: Alzheimer's disease (AD) is a progressive neurodegenerative disorder frequently associated with dysphagia, leading to malnutrition, dehydration, and aspiration pneumonia. The Eating Assessment Tool-10 (EAT-10) is widely used for dysphagia screening; however, its reliability in advanced AD, where cognitive impairments hinder self-reporting, remains uncertain. Objective: This study aimed to evaluate the diagnostic accuracy of EAT-10 in detecting dysphagia and aspiration across different AD stages. Methods: The study included 30 AD patients classified into mild, moderate, and advanced stages based on Clinical Dementia Rating (CDR) scores. Dysphagia was assessed using EAT-10 and validated through Videofluoroscopic Swallowing Study (VFSS) and the Penetration-Aspiration Scale (PAS). Statistical analyses included the Mann-Whitney U test, Spearman correlation, and receiver operating characteristic (ROC) curve analysis (p < 0.05). Results: EAT-10 scores significantly differed across AD stages (p = 0.001), with mean scores of 3.11 ± 1.17 (mild), 11.70 ± 4.64 (moderate), and 18.00 ± 6.90 (advanced). Unsafe swallowing and aspiration were observed in 43.3% and 23.3% of patients, respectively, with higher prevalence in advanced AD. ROC analysis determined an EAT-10 cut-off score of 15 for unsafe swallowing (AUC: 0.96, sensitivity: 88%, specificity: 77%) and 18 for aspiration (AUC: 0.81, sensitivity: 81.2%, specificity: 75%). Strong correlations were found between EAT-10 and PAS scores (r = 0.812, p < 0.001). Conclusions: EAT-10 is an effective screening tool for dysphagia and aspiration risk in early and moderate AD stages. However, in advanced AD, objective assessments like VFSS remain essential to complement EAT-10 results. Integrating EAT-10 into routine evaluations may enhance early detection, enabling timely interventions and improved clinical outcomes.

Bilingualism may lead to differences in narrative micro- and macrostructural features. Creating a normative data set on the narrative characteristics of healthy Turkish-Kurdish bilinguals may allow for a more effective assessment of language disorders that may occur in bilinguals with acquired brain injury. This study aims to determine how narrative micro- and macrostructural features differ in Turkish-Kurdish bilinguals in single picture and story narratives. A total of 23 bilingual (Turkish-Kurdish) and 23 monolingual (Turkish) healthy individuals were included in the study. Narrative samples were obtained using single pictures and a story. Micro- and macrostructural features were compared between bilinguals and monolinguals matched for age, education, and gender. Mean length utterance-morpheme and clausal density variables, considered as indicators of grammatical complexity, were higher in monolinguals in both single picture and story narratives. Morphemic errors were higher for bilinguals. Effort behaviors, which can interrupt verbal efficiency, were higher in bilinguals in single picture narratives. While there was no difference between the groups in verbal fluency (phonemic and categorical), the lexical diversty in storytelling was higher in monolinguals. In terms of macrostructural features, cognitive inferences in the story context and emotional discourse in the single picture context were higher in monolinguals, while enrichment expressions in the single picture narrative were higher in bilinguals. In both groups, macrostructural features such as cognitive inferences and expressions of uncertainty in discourse were negatively correlated with grammatical complexity variables. Turkish-Kurdish bilinguals’ single picture and story narratives in Turkish may show semantic, morphosyntactic and pragmatic differences compared to Turkish-speaking monolinguals.

Aims: This study aimed to investigate the impact of the presence or absence of verbal communication skills in pediatric intensive care unit (PICU) patients who are unable to eat orally and are fed via enteral or parenteral methods, on the stress levels perceived by their parents. Methods: The study included 49 children hospitalized in the PICU with dysphagia and feeding difficulties. The participants’ information regarding tracheostomy, intubation, ability/inability to engage in verbal communication, and type of enteral feeding was recorded. Patients were retrospectively assessed using PRISM (pediatric risk of mortality) scores, and the Turkish version of the Parental Stress Scale was administered to one parent per patient. The participants were grouped based on their child’s verbal communication ability and feeding method (enteral vs. parenteral), and statistical comparisons were made using the Mann-Whitney U test. ROC (receiver operating characteristic) analysis was conducted to identify which of the recorded clinical variables had the most significant effect on parental stress. Results: The mean age of the children was 7.69 years, with 59.2% being male. Of the 49 children included, 31 (63.3%) were classified as non-verbal and 18 (36.7%) as verbal, according to their ability to communicate. While 81.6% were non-intubated, 42.9% had tracheostomies. Feeding methods included nasogastric tube (46.9%), total parenteral nutrition (38.8%), and percutaneous endoscopic gastrostomy (10.2%). The mean PRISM score was 4.0, and the average parental stress score was 69.1. Parents of non-verbal children reported significantly higher stress levels than those of verbal children (p=0.002). Although parental stress appeared higher in the parenteral nutrition group, the difference was not statistically significant (p=0.077). PRISM scores showed no significant differences between groups based on communication or feeding method. According to the ROC analysis [area under the curve (AUC)=0.728], the most significant indicator of parenteral stress was found to be the inability to engage in verbal communication. Conclusion: The findings demonstrate that the inability of children in PICU to verbally communicate significantly increases parental stress levels, independent of illness severity. Although feeding method did not significantly impact parental stress, a trend toward higher stress in parents of parenterally fed children was observed. These results emphasize the importance of preserving or supporting communication abilities in PICU patients. Implementing augmentative and alternative communication strategies (e.g., speaking valves, communication boards) and integrating psychosocial support for caregivers may contribute to improved family-centered care in pediatric critical care settings.

Objective: Children with allergic rhinitis are known to exhibit atypical developmental patterns and may face difficulties in language, speech, cognitive, and academic skills. This study aims to compare children newly diagnosed with allergic rhinitis (ages 6-9) with their typically developing peers in terms of language development, cognitive performance, and mathematical skills. Methods: A total of 70 participants were included in the study, comprising 35 children with newly diagnosed allergic rhinitis and 35 healthy controls. Following the collection of sociodemographic data, participants were assessed using the Test of Language Development Primary-Fourth Edition: Turkish Version (TOLDP-4:T), the Wechsler Intelligence Scale for Children-Revised (WISC-R), and a set of age-appropriate non-routine mathematical problems. Results: According to the TOLDP-4:T results, children in the allergic rhinitis group demonstrated below-average performance in listening, organizing, grammar, and over all language skills, whereas their healthy peers performed at an average level. In the WISC-R assessment, the allergic rhinitis group had significantly lower mean scores compared to the control group. While a significant correlation between verbal IQ scoress and mathematical performance was initially found, this relationship was no longer statistically significant after applying the Bonferroni correction. Conclusion: Allergic rhinitis appears to have a negative impact on children’s language development, cognitive abilities, and mathematical performance. These findings highlight the importance of early identification and intervention for children with allergic rhinitis to support their developmental outcomes.

Background: Post-stroke dysphagia is a frequent complication associated with aspiration, malnutrition, and prolonged dependence on enteral feeding. Systemic inflammation and impaired nutritional status may adversely affect neuromuscular recovery; however, their relative and combined associations with swallowing recovery and transition from enteral to oral feeding remain insufficiently characterized. Objective: This study aimed to examine the independent associations of inflammatory and nutritional indices with swallowing function recovery and to evaluate their relationship with enteral-to-oral feeding transition in patients with post-stroke dysphagia. Methods: In this retrospective observational study, patients with dysphagia following ischemic stroke were evaluated before (T0) and after (T1) routine dysphagia rehabilitation. Inflammatory indices including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune–inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune–inflammation value (PIV), as well as the prognostic nutritional index (PNI), were calculated at both time points. Changes in indices (Δ = T1 − T0) were analyzed in relation to changes in swallowing function assessed by the Functional Oral Intake Scale (FOIS) and the Penetration–Aspiration Scale (PAS). Results: Changes in PNI were independently associated with greater improvement in functional oral intake (ΔFOIS) and reductions in aspiration severity for both liquid and soft consistencies (ΔPAS; all p < 0.01). In contrast, changes in inflammatory indices (ΔSIRI, ΔSII, ΔPLR, and ΔPIV) were consistently associated with less favorable swallowing outcomes. In multivariable logistic regression analysis, baseline stroke severity (NIHSS) was the only independent determinant of transition from enteral to oral feeding (OR = 0.72, p = 0.002). The model demonstrated good discrimination (AUC = 0.81). Conclusions: Changes in nutritional status, as reflected by ΔPNI over time, were the biomarker most consistently associated with functional swallowing recovery and reduced aspiration severity in patients with post-stroke dysphagia. While inflammatory burden was associated with less favorable swallowing physiology, transition from enteral to oral feeding appeared to be primarily driven by neurological severity rather than inflammatory or nutritional indices alone. These findings may support the clinical value of monitoring nutritional reserve alongside inflammatory burden during dysphagia rehabilitation.