Dysphagia Screening in an Aging Population: A Scoping Review of Structural Gaps Between Triage and Comprehensive...

This scoping review aimed to map the characteristics of dysphagia screening implementation in published studies and to compare operational differences between non-Japanese and Japanese practices, focusing on screening personnel, screening tools, and post-screening management pathways. Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, PubMed, Cochrane Library, CINAHL, and Ichushi-Web were searched for studies published between 2016 and 2025 that described the clinical implementation of dysphagia screening. Twenty-nine studies from 12 countries were included. In all 21 non-Japanese studies, nurses performed screening using a single validated tool, with referral to speech-language therapists for comprehensive evaluation. Japanese studies (n = 8) demonstrated variability, with screening conducted by nurses (n = 3), speech-language therapists (n = 3), and physicians (n = 2), who frequently use multiple test combinations. Only 2 of 8 Japanese studies documented referral pathways for comprehensive evaluation following positive screening. Non-Japanese studies consistently implemented structured screening-to-evaluation pathways, whereas Japanese studies demonstrated variability in screening personnel and limited documentation of post-screening referral processes, resulting in blurring of the conceptual distinction between triage and diagnostic evaluation. As Japan's broader screening approach extends beyond the high-risk populations targeted internationally, establishing standardized post-screening pathways with clear role delineation becomes essential to maintain screening quality and optimize resource allocation in aging populations.