Expert Consensus Statement on Acoustic Metrics for Swallowing Dysfunction Screening in Older Adults: A Delphi Study

Area of Science:

• Gerontology
• Biomedical Engineering
• Speech-Language Pathology

Background:

• Swallowing dysfunction in older adults leads to serious health issues like aspiration pneumonia.
• Early detection of dysphagia is critical for timely intervention and preventing complications.
• Acoustic analysis offers a noninvasive method for screening swallowing problems.

Purpose of the Study:

• To establish an Expert Consensus Statement (ECS) on using acoustic metrics for bedside screening of swallowing dysfunction in adults over 65.
• To guide clinical investigators in utilizing voice, speech, and cough analysis for early dysphagia detection.

Main Methods:

• A multidisciplinary panel of 17 experts utilized a modified Delphi method.
• Consensus discussions were informed by established definitions of swallowing dysfunction and related conditions.
• Iterative survey rounds and conference calls facilitated agreement on key statements.

Main Results:

• Consensus was reached on nine key statements regarding acoustic screening for dysphagia.
• "Wet voice" was identified as a relevant indicator of airway invasion.
• Screening tasks must be feasible for alert older adults, with instrumental validation as a reference standard.
• The potential of artificial intelligence in screening was recognized, alongside concerns about bias and access.

Conclusions:

• Auditory-perceptual assessment and acoustic metrics show promise for screening swallowing dysfunction in older adults.
• Expert insights are provided for clinical research on acoustic indicators of laryngeal function.
• Improved early detection and intervention can enhance patient outcomes in geriatric populations.