Is the modified Mann Assessment of Swallowing Ability useful for assessing dysphagia in patients with mild to moderate dementia?

Abstract

Dysphagia is an important causative factor of aspiration pneumonia among the elderly, particularly in patients with dementia. The modified Mann Assessment of Swallowing Ability (mMASA) is commonly used as a physician-administered screening protocol for assessing dysphagia due to its merits as a clinical test that does not involve special equipment or radiation exposure. The present study investigated whether the mMASA would reflect the dysphagia state as estimated by videofluoroscopic swallowing study (VFSS) findings and cognitive function in patients with dementia. This study included 25 subjects with mild to moderate dementia. In all subjects, swallowing function was evaluated with the mMASA and VFSS and cognitive function was evaluated using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Global Deterioration Scale (GDS), and Clinical Dementia Rating (CDR) scales. The Spearman correlation and linear regression tests were conducted with the mMASA values and other tests for swallowing and cognition. The mMASA values were correlated with the Penetration-Aspiration Scale (PAS) of the VFSS as well as scores on the MMSE, MoCA, GDS, and CDR. In addition, the Judgment and Problem Solving and Community Affairs subscales of the CDR were correlated with mMASA values. The assessments of dysphagia using the mMASA were consistent with the VFSS findings and were reflected by cognitive function. Taken together, the present findings suggest that the mMASA would be useful for the routine evaluation of swallowing function in patients with mild to moderate dementia for the detection of dysphagia.

Keywords: Cognition; Dementia; Dysphagia; Mann Assessment of Swallowing Ability; Swallowing; VFSS.