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.

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.

Background and Objectives: Central facial paralysis following stroke may affect oral motor control and swallowing function; however, its role in dysphagia-related impairments remains unclear. This study aimed to investigate the relationship between facial motor impairment, swallowing function, and oral motor dysfunction in patients with post-stroke central facial paralysis. Methods : This cross-sectional observational study included 80 patients with ischemic or hemorrhagic stroke accompanied by central facial paralysis. Facial motor function was evaluated using the Sunnybrook Facial Grading System. Swallowing function was assessed using the Eating Assessment Tool-10 (EAT-10), Repetitive Saliva Swallowing Test (RSST), and Functional Oral Intake Scale (FOIS). Oral motor dysfunction was evaluated using a clinician-based oral motor assessment form. Correlation and exploratory regression analyses were performed. Results: Significant associations were identified between facial motor function, swallowing measures, and oral motor parameters (all p < 0.001). Sunnybrook scores showed strong negative correlations with EAT-10 scores (r = −0.954) and positive correlations with RSST (r = 0.914) and FOIS scores (r = 0.915). In exploratory regression analyses, NIHSS emerged as an important contributor to swallowing-related outcomes. Labial and tongue functions were independently associated with RSST performance, whereas labial, velar, and buccal functions were independently associated with EAT-10 scores. Velar function was the only oral motor variable independently associated with FOIS levels. Conclusions: Facial motor function, oral motor dysfunction, and swallowing-related measures were significantly associated in individuals with post-stroke central facial paralysis. Overall, neurological severity also contributed substantially to swallowing-related outcomes. These findings may suggest a potential association between oral motor dysfunction and swallowing-related outcomes and may warrant consideration in comprehensive dysphagia evaluation. However, the observed relationships should be interpreted as exploratory and require confirmation in future studies using validated assessment tools and instrumental swallowing measures.

Amaç: Trakeostomi işlemi hastaların duygu durumunu, iletişim becerilerini ve yaşam kalitesini ciddi derecede bozmaktadır. Bu çalışma trakeostomili yetişkin hastalarda konuşma valfi sonrası yaşam kalitesi skorlarındaki farklılıkları ve bakım verenlerin yaşadığı stres düzeylerindeki değişimi Zarit Bakıcı Yükü Ölçeği (ZBYÖ) ile değerlendirmeyi amaçladı. Gereç ve Yöntemler: Bu retrospektif çalışmaya konuşma valfi takılmış 36 hasta dahil edildi. Konuşma valfi takılmadan önce ve takıldıktan 2 hafta sonra yaşam kalitelerini değerlendirmeye yönelik hastanın kendi yaşam kalitesini değerlendirdiği Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği-Kısa Formu Türkçe Versiyonu (WHOQOL-BREF-TR) ve hastaların bakım verenlerine ZBYÖ skorları retrospektif olarak toplandı. Bulgular: Çalışmaya dahil edilen katılımcıların ortalama yaşı 56,3 ± 17,0 yıl (aralık: 21-82 yıl) olup, %55,6’sı (n = 20) erkekti. Konuşma valfi sonrası Easy Breath durumuna kıyasla ortalama WHOQOL-BREF-TR puanı artış gösterirken (Easy Breath: 46,4 ± 7,8 vs. Konuşma valfi sonrası: 72,2 ± 14,8; p < 0,001), ortalama ZBYÖ puanı ise azalma gösterdi (Easy Breath: 52,8 ± 12,8 vs. Konuşma valfi sonrası: 33,2 ± 5,4; p < 0,001). Bu bağlamda konuşma valfi sonrası trakeostomi hastalarının ve bakım verenlerinin yaşam kalitesi ölçeği puanı Easy Breath durumuna kıyasla daha yüksekti. Sonuç: Trakeostomili hastalarda konuşma valfi kullanımı, artan yaşam kalitesinin yanısıra azalan bakım verenlerin stres düzeyleri ile ilişkilidir.

Background and Objectives: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease frequently associated with dysphagia and aspiration risk. This study aimed to investigate the relationship between clinical dysphagia assessment tools (EAT-10, GUSS, RSST, and sialorrhea severity) and videofluoroscopic swallowing study (VFSS) findings in patients with ALS. Materials and Methods: This retrospective observational study included 60 patients with ALS classified as spinal-onset (n = 38) or bulbar-onset (n = 22). Relationships between clinical assessments and VFSS findings were analysed using Spearman correlation analysis. Exploratory multivariable regression and receiver operating characteristic (ROC) analyses were performed to evaluate associations and aspiration risk discrimination. Results: Strong negative correlations were observed between PAS–Liquid and RSST and GUSS scores, whereas EAT-10 showed a strong positive correlation (all p < 0.001). ROC analyses demonstrated good discriminative ability for aspiration risk for GUSS (AUC = 0.89), RSST (AUC = 0.88), and EAT-10 (AUC = 0.82). Patients with bulbar-onset ALS demonstrated higher penetration–aspiration severity and lower functional oral intake. Conclusions: Clinical dysphagia assessment tools showed significant associations with instrumental swallowing findings in ALS. GUSS and RSST demonstrated good discriminative ability for aspiration risk and may be clinically useful bedside screening tools. However, instrumental swallowing assessment remains essential whenever feasible.