Sensitivity and Specificity of the Geriatric Bedside Swallowing Screen (GEBS): A Diagnostic Accuracy Pilot Study / Sensitivität und Spezifität des Geriatric Bedside Swallowing Screen (GEBS): Eine Diagnostische Pilotstudie

Abstract Purpose The projected increase in older adults in the EU to 28.5% by 2050 highlights the need for improved geriatric care. Oropharyngeal dysphagia is common in older adults; it is linked to frailty and neurodegenerative diseases, and can cause malnutrition, dehydration, and aspiration pneumonia. Though screening reduces pneumonia cases in stroke patients, it also risks overdiagnosis in geriatric patients due to age-related swallowing changes that are often misinterpreted by existing tools. Objectives To address this gap, the Geriatric Bedside Swallowing Screen (GEBS) was developed. The goal was to validate the GEBS against an objective instrumental assessment, the Flexible Endoscopic Evaluation of Swallowing (FEES). Methods Between November 2022 and June 2024, a total of 30 participants aged 75 years or more (mean age 79.13 SD ± 5.7) from an acute geriatric ward in Salzburg, Austria, were recruited for this prospective observational cohort study. Participants completed both GEBS and FEES within seven consecutive days, with the FEES investigators being blinded for the results of the GEBS. Results The GEBS demonstrated a sensitivity of 67% and a specificity of 83%, as well as positive and negative predictive values of 73% and 80%, respectively. There were no adverse effects. Conclusions The results indicate the GEBS’s potential as a promising dysphagia screening tool specifically for geriatric patients. Swallowing function should be assessed as part of geriatric assessments, as recommended by the guidelines of several societies.