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The discriminant ability of the Eating Assessment Tool-10 to detect dysphagia and aspiration according to the stage of Alzheimer's disease
Serkan Bengisu, Merve Savaş, Demet Aygün, Senanur Kahraman Beğen, Burak Manay. Journal of Alzheimer s Disease, 2025-07-24
Topic: Amyloid, tau and blood-test diagnosis
Plain-language summary
BackgroundAlzheimer'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.ObjectiveThis study aimed to evaluate the diagnostic accuracy of EAT-10 in detecting dysphagia and aspiration across different AD stages.MethodsThe 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).ResultsEAT-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).ConclusionsEAT-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.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Bengisu, S., Savaş, M., Aygün, D., Beğen, S. K., & Manay, B. (2025). The discriminant ability of the Eating Assessment Tool-10 to detect dysphagia and aspiration according to the stage of Alzheimer's disease. Journal of Alzheimer s Disease. https://doi.org/10.1177/13872877251362229
Vancouver
Bengisu S, Savaş M, Aygün D, Beğen SK, Manay B. The discriminant ability of the Eating Assessment Tool-10 to detect dysphagia and aspiration according to the stage of Alzheimer's disease. Journal of Alzheimer s Disease. 2025. doi:10.1177/13872877251362229. PMID: 40702813.
BibTeX
@article{bengisu2025-40702813,
author = {Bengisu, Serkan and Savaş, Merve and Aygün, Demet and Beğen, Senanur Kahraman and Manay, Burak},
title = {{The discriminant ability of the Eating Assessment Tool-10 to detect dysphagia and aspiration according to the stage of Alzheimer's disease}},
journal = {Journal of Alzheimer s Disease},
year = {2025},
doi = {10.1177/13872877251362229},
pmid = {40702813},
url = {https://doi.org/10.1177/13872877251362229}
}
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Key findings
- BackgroundAlzheimer's disease (AD) is a progressive neurodegenerative disorder frequently associated with dysphagia, leading to malnutrition, dehydration, and aspiration pneumonia.
- Statistical analyses included the Mann-Whitney U test, Spearman correlation, and receiver operating characteristic (ROC) curve analysis (p < 0.05).ResultsEAT-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).
- However, in advanced AD, objective assessments like VFSS remain essential to complement EAT-10 results.
Why it matters
In this study of 30 patients with Alzheimer's disease, the Eating Assessment Tool-10 detected unsafe swallowing and aspiration with different cut-off scores across disease stages, though its reliability in advanced disease where self-reporting is difficult remains uncertain. It is about screening for swallowing problems in people who already have Alzheimer's disease, not about treating, curing or preventing the disease.
Study details
- Participants30
- Effect size43.3%; 23.3%; AUC: 0.96
- Evidence strengthLow
How this study scored 39/100
Published in a peer-reviewed journal. Scored zero for study design and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Alzheimer s Disease) |
| Journal's citation record | 2 / 4 | Journal of Alzheimer s Disease: journal h-index 218 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 30 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 3 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 4.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 0 / 4 | Last-listed author Burak Manay: h-index 2 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Atlas Üniversitesi: institution h-index 29 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40702813) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 39 / 100 | — |
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