The McGill Ingestive Skills Assessment Predicts Time to Death in an Elderly Population with Neurogenic Dysphagia: Preliminary Evidence

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Abstract
The McGill Ingestive Skills Assessment (MISA) is a new assessment tool which quantifies the ingestive process by scoring a meal observation. The reliability and the construct validity of the MISA have been documented. However, establishment of the ability of the MISA to predict health outcomes related to feeding difficulties would support its applicability in research and in clinical settings. Seventy-three participants of a large-scale reliability and validity study were followed for up to 563 days following evaluation with the MISA. The date of the first pulmonary infection and the date and cause of death where applicable were obtained from medical records. Individuals with no incident of pulmonary infection and who were not deceased were “censored” at the date of followup. Survival analyses revealed that the MISA scores are predictive of death using a Cox proportional hazards model, and of time to pulmonary infection using a flexible model. Scores on the Solid Ingestion and Self-feeding scales are predictive of death using the Cox model, and the Texture Management scale is predictive of death using the flexible model. This effect remains statistically significant even when MISA scores are adjusted for the participant’s age. These findings support the validity of the MISA for use with elderly individuals with neurogenic ingestive skill loss residing in long-term care facilities.

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