Association between the Eating Assessment Tool-10 and electrokinesiographic study of swallowing in dementia

In dementia, swallowing abnormalities are common and may remain clinically silent. The Eating Assessment Tool-10 (EAT-10) is a screening tool for swallowing impairment, whereas the electrokinesiographic study of swallowing provides a non-invasive assessment of the oropharyngeal phase of swallowing. However, the relationship between these measures in dementia remains unclear. We enrolled 21 patients with Alzheimer disease (AD), 15 with behavioral variant frontotemporal dementia (bvFTD), and 11 controls. Assessments included the EAT-10, Mini Nutritional Assessment (MNA), Appetite and Eating Habits Questionnaire (AEHQ), and suprahyoid electromyography (SHEMG), from which the SHEMG E/T-shape index and similarity index (SI) were derived. Associations were examined using Spearman correlations and robust regression adjusted for diagnosis and age. Potential swallowing impairment (EAT-10 ≥ 3) was present in 19.0% of AD and 26.7% of bvFTD. Higher EAT-10 scores were associated with higher SHEMG E/T-shape index (β = 3.89, p < 0.001) and lower SI (β=−3.39, p = 0.01), indicating more intense and less reproducible submental activation. The EAT-10 was also associated with Clinical Dementia Rating stage (β = 1.45, p = 0.04), MNA score (β=−0.22, p = 0.05), and AEHQ total score (ρ = 0.42, p = 0.01). In dementia, the EAT-10 is associated with specific electrophysiological and clinical profiles. Electrophysiology may provide complementary information to dysphagia screening to identify patients warranting further instrumental evaluation, although this requires confirmation.