Adaptation and evaluation of a food preference assessment tool for older adults in geriatric care: the DYSPHAGING...

Undernutrition is a major concern in older adults due to its multifactorial origins and its impact on morbidity and mortality. Oropharyngeal dysphagia is common in frail geriatric patients and contributes to undernutrition by prompting individuals to progressively withdraw foods from their diet, leading to dietary imbalance and potential complications. Although texture adaptation and nutritional strategies are widely implemented in clinical practice, little is known about the actual food preferences of hospitalised older adults with dysphagia. Existing tools to assess food preferences are scarce and poorly adapted to the heterogeneity and sensory impairments of this population. The DYSPHAGING Preferences study aims to develop a food-preference assessment tool specifically tailored to hospitalised older adults, assess its test-retest reliability and describe food preferences measured using this adapted instrument.

The DYSPHAGING Preferences study is designed as a prospective, multicentre, non-comparative protocol consisting of three steps. Step 1 will adapt a forced-choice questionnaire-initially developed for paediatric populations-to adults aged≥70 years hospitalised in geriatric wards, by assessing visual and lexical recognition of pre-selected food items. Step 2 will evaluate the test-retest reliability and practical feasibility of administering the preference questionnaire in a new cohort of older adults. Step 3 will be a cross-sectional study describing food preferences and comparing Preference Indexes between participants screening positive and screening negative for dysphagia using the Eating Assessment Tool-10. The questionnaire will include six categories of food (acidic, textured, sweet, in sauce, dairy and cooked). A total of 209 participants will be included across acute geriatric, rehabilitation and long-term care units (35 participants in step 1, 35 participants in step 2 and 174 participants in step 3, with the 35 participants from step 2 included in the step 3 population). Descriptive and comparative analyses will be performed according to a predefined statistical analysis plan.

The study protocol was approved by the Comité de Protection des Personnes (CPP) Île-de-France III on 11 September 2025 (approval number: 25.02467.000911-2025-A00795-44), in accordance with French legislation. All participants will provide informed non-opposition in accordance with national regulations. The results of the primary and secondary objectives will be disseminated through peer-reviewed publications, conference presentations and communication with clinical stakeholders.

NCT05734586.