Evaluation of chewing and swallowing disorders among frail community-dwelling elderly individuals.

The purpose of the present study was to develop a new assessment scale to evaluate the risk of chewing and swallowing disorders among frail community-dwelling elderly individuals. Subjects were 85 frail elderly individuals (29 men and 56 women) living in southern Japan. First, we pooled 18 subjectively evaluated variables identified by previous studies as being related to chewing and swallowing disorders. Secondly, using factor analysis, we extracted 12 variables as the 'dysphagia risk assessment for the community-dwelling elderly' (DRACE) and examined its reliability using Cronbach's alpha coefficient. Thirdly, we examined the validity of the DRACE by comparing it with an existing method for evaluating dysphagia. Cronbach's alpha coefficient of the DRACE was 0.88, indicating satisfactory reliability. Dysphagia risk assessment for the community-dwelling elderly scores were significantly related to the results of the 3-oz water test (P < 0.01). Furthermore, DRACE scores were closely associated with activities of daily living as evaluated by the Barthel index, a tendency that was consistent with previous studies. These findings suggest that the DRACE is a useful tool with sufficient reliability and validity to detect latent risk of chewing and swallowing disorders among frail community-dwelling elderly individuals.