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Dysphagia affects more than half of older adults with dementia and is associated with a 10-fold increase in mortality. The development of accessible, objective, and reliable screening tools is crucial for early detection and management. This systematic scoping review aimed to (1) examine the current state of the art in artificial intelligence (AI) and sensor-based technologies for dysphagia screening, (2) evaluate the performance of these AI-based screening tools, and (3) assess the methodological quality and rigor of studies on AI-based dysphagia screening tools. We conducted a systematic literature search across CINAHL, Embase, PubMed, and Web of Science from inception to July 4, 2024, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework. In total, 2 independent researchers conducted the search, screening, and data extraction. Eligibility criteria included original studies using sensor-based instruments with AI to identify individuals with dysphagia or unsafe swallow events. We excluded studies on pediatric, infant, or postextubation dysphagia, as well as those using non-sensor-based assessments or diagnostic tools. We used a modified Quality Assessment of Diagnostic Accuracy Studies-2 tool to assess methodological quality, adding a \"model\" domain for AI-specific evaluation. Data were synthesized narratively. This review included 24 studies involving 2979 participants (1717 with dysphagia and 1262 controls). In total, 75% (18/24) of the studies focused solely on per-individual classification rather than per-swallow event classification. Acoustic (13/24, 54%) and vibratory (9/24, 38%) signals were the primary modality sources. In total, 25% (6/24) of the studies used multimodal approaches, whereas 75% (18/24) used a single modality. Support vector machine was the most common AI model (15/24, 62%), with deep learning approaches emerging in recent years (3/24, 12%). Performance varied widely-accuracy ranged from 71.2% to 99%, area under the receiver operating characteristic curve ranged from 0.77 to 0.977, and sensitivity ranged from 63.6% to 100%. Multimodal systems generally outperformed unimodal systems. The methodological quality assessment revealed a risk of bias, particularly in patient selection (unclear in 18/24, 75% of the studies), index test (unclear in 23/24, 96% of the studies), and modeling (high risk in 13/24, 54% of the studies). Notably, no studies conducted external validation or domain adaptation testing, raising concerns about real-world applicability. This review provides a comprehensive overview of technological advancements in AI and sensor-based dysphagia screening. While these developments show promise for continuous long-term tele-swallowing assessments, significant methodological limitations were identified. Future studies can explore how each modality can target specific anatomical regions and manifestations of dysphagia. This detailed understanding of how different modalities address various aspects of dysphagia can significantly benefit multimodal systems, enabling them to better handle the multifaceted nature of dysphagia conditions.

Objective: The study aimed to assess the impact of a single session of transcranial direct current stimulation (tDCS) on people with both cognitive and visual impairments. Methods: Sixteen individuals with visual and cognitive impairments were recruited and randomized to either the experimental or sham group. While the sham group only received 30 seconds of initial stimulation, participants in the experimental group received an active tDCS intervention for 20 minutes. The Cantonese Mini-Mental State Examination (CMMSE), the Digit Span Forward Test, the Chinese Verbal Learning Test (CVVLT), and the memory subtest from the Neurobehavioral Cognitive Status Examination (NCSE) were the neuropsychological assessments. To ascertain whether there are statistical differences between groups, repeated measures ANOVA was used to analyze data gathered prior to and following the intervention. Results: Age, educational attainment, and baseline CMMSE scores did not significantly differ between the groups. The type of stimulation and CVVLT total scores showed a significant interaction effect, with improvements in scores seen after active tDCS treatment. Other measured variables did not show any additional effects that were statistically significant. Conclusion: These findings provided preliminary support for the potential efficacy of tDCS in improving immediate memory functions among individuals with both cognitive and visual deficits.

Background/Objectives: This pilot study explored the applicability and preliminary clinical outcomes of cognitive stimulation therapy (CST), an evidence-based cognitive intervention for people with mild and moderate dementia, in elderly individuals with concurrent dementia and visual impairment. Methods: Seven participants received 14 group CST sessions. Their cognitive and language functions were measured and compared pre-/post-therapy. Results: The treatment adherence was satisfactory. Significant improvements in various cognitive domains and language measures were observed after therapy. Conclusions: The findings suggest that CST can be applied to visually impaired individuals with dementia with seemingly positive outcomes in various cognitive domains. Further studies with a larger sample with an emphasis on multisensory stimulation to facilitate therapy delivery are warranted.

Visual impairment has been strongly associated with the incidence of dementia. Appropriate cognitive screening for the elderly with visual impairment is crucial for early identification of dementia and its management. Due to challenges in processing visually presented stimuli among participants, the cut-off score of the Hong Kong version of the Montreal Cognitive Assessment for the Visually Impaired (HKMoCA-VI), also known as MoCA-BLIND or MoCA-22, was unknown. Besides, the cognitive status of elderly with visual impairment residing in care homes is rarely investigated. The current study aimed to 1) establish the cut-off score for HKMoCA-VI and 2) examine the general cognitive functioning of elderly with visual impairment living in residential homes in Hong Kong in terms of MoCA-VI percentile scores. HKMoCA-VI and the Cantonese version of the Mini-Mental State Examination (CMMSE) were administered to 123 visually impaired elderly residents in care homes in Hong Kong. Percentile scores of HKMoCA-VI by age and education level were determined, and the concurrent validity, sensitivity, and specificity of HKMoCA-VI were assessed. A cut-off score 12 was suggested for HKMoCA-VI, which yielded a sensitivity and specificity of 89.29% and 83.58%, respectively. Moreover, it strongly correlated with CMMSE, indicating satisfactory concurrent validity. HKMoCA-VI is suggested to be a viable cognitive screening tool for elderly individuals with visual impairment in residential homes. Further modifications to enhance the sensitivity and specificity of the measure are proposed.

Visual impairment has been strongly associated with the incidence of dementia. Appropriate cognitive screening for the elderly with visual impairment is crucial for early identification of dementia and its management. Due to challenges in processing visually presented stimuli among participants, the cut-off score of the Hong Kong version of the Montreal Cognitive Assessment for the Visually Impaired (HKMoCA-VI), also known as MoCA-BLIND or MoCA-22, was unknown. Besides, the cognitive status of elderly with visual impairment residing in care homes is rarely investigated. The current study aimed to 1) establish the cut-off score for HKMoCA-VI and 2) examine the general cognitive functioning of elderly with visual impairment living in residential homes in Hong Kong in terms of MoCA-VI percentile scores. HKMoCA-VI and the Cantonese version of the Mini-Mental State Examination (CMMSE) were administered to 123 visually impaired elderly residents in care homes in Hong Kong. Percentile scores of HKMoCA-VI by age and education level were determined, and the concurrent validity, sensitivity, and specificity of HKMoCA-VI were assessed. A cut-off score 12 was suggested for HKMoCA-VI, which yielded a sensitivity and specificity of 89.29% and 83.58%, respectively. Moreover, it strongly correlated with CMMSE, indicating satisfactory concurrent validity. HKMoCA-VI is suggested to be a viable cognitive screening tool for elderly individuals with visual impairment in residential homes. Further modifications to enhance the sensitivity and specificity of the measure are proposed.