Prevalence and Predictors of Self-Reported Swallowing Difficulty in Community-Dwelling Older Adults

Objectives: Dysphagia in older adults is associated with malnutrition, aspiration, and reduced quality of life. This study aimed to estimate the prevalence of self-reported swallowing difficulties among community-dwelling older adults in Israel and to identify demographic, medical, and socioeconomic predictors. Method: In this cross-sectional study, 1064 community-dwelling adults aged ≥ 60 years (mean 75.1 ± 7.5 years; 68.1% female) completed an online questionnaire capturing demographics, medical diagnoses, physical activity, income, and place of residence, together with the validated Hebrew and Arabic versions of the Eating Assessment Tool-10 (EAT-10). Dysphagia screening was defined as EAT-10 ≥ 3, and demographic, medical, and socioeconomic predictors were examined using multivariable logistic regression. Results: The prevalence of positive dysphagia screening was 29.1%. In the adjusted model, significant independent predictors were older age (odds ratio [OR] = 1.84)), a dysphagia-related medical diagnosis (OR = 3.10), absence of regular physical activity (OR = 2.19), lower income (OR = 1.36), and lower residential socioeconomic cluster (OR = 1.84). Gender, with a mean age of 75.07 years (SD = 7.52), body mass index (BMI), and residential peripherality were not significant after adjustment; the bivariate peripherality effect appeared to be largely mediated by socioeconomic factors. Conclusions: Nearly one in three community-dwelling Israeli older adults screened positive for dysphagia. Beyond established medical risk factors, physical inactivity and socioeconomic disadvantage were independently associated with positive screening, suggesting potentially modifiable targets for future study. Findings support integrating swallowing screening into routine geriatric care and developing equity-focused screening initiatives for lower-socioeconomic and peripheral communities.