ICF Application and Assessment Tool Analysis for Dysphagia Evaluation in Patients with Dementia: A Scoping Review

Objective: To analyze dysphagia assessment tools for dementia patients using the International Classification of Functioning, Disability and Health (ICF) framework and suggest future clinical directions.Methods: A scoping review of literature published between 2015 and 2025 identified 44 studies.Thirty assessment tools were mapped to the four ICF components: Body functions, activities, participation, and environmental factors.Results: Instrumental assessments (Videofluoroscopic Swallowing Study [VFSS], Fiberoptic Endoscopic Evaluation of Swallowing [FEES]) and the Water Swallow Test were most frequently used.ICF mapping revealed that 96.7% of tools focused on body functions, while only approximately 20% addressed participation and environmental factors.Self/caregiver-report questionnaires covered multidimensional domains but were limited by subjectivity, whereas instrumental assessments were objective but restricted to body functions.Conclusion: Current assessments prioritize physiological safety, often overlooking actual eating activities and environmental contexts.Future research should focus on developing ICF-based standardized observational tools to objectively assess eating behaviors, environmental factors, and body functions.This approach will support occupational therapist-led integrated rehabilitation to improve the quality of life of patients.(