Dysphagia Screening Questionnaire

Preliminary self-test

Many people ignore the problem of dysphagia, but serious cases of this disease can lead to aspiration pneumonia! Answer 10 questions to help you initially screen for dysphagia and its extent.

1. Swallowing problems caused me to lose weight. (0 means no problem, 4 means serious situation)

Please choose an answer
1 / 10

2. Swallowing problems make it difficult for me to eat out. (0 means no problem, 4 means serious situation)

Please choose an answer
2 / 10

3. Swallowing liquid food is very difficult. (0 means no problem, 4 means serious situation)

Please choose an answer
3 / 10

4. Swallowing solid food is very difficult. (0 means no problem, 4 means serious situation)

Please choose an answer
4 / 10

5. Swallowing pills is very difficult. (0 means no problem, 4 means serious situation)

Please choose an answer
5 / 10

6. You will feel pain when swallowing. (0 means no problem, 4 means serious situation)

Please choose an answer
6 / 10

7. Swallowing problems reduce my enjoyment of food. (0 means no problem, 4 means serious situation)

Please choose an answer
7 / 10

8. Food sticks to the throat when swallowing. (0 means no problem, 4 means serious situation)

Please choose an answer
8 / 10

9. Choking and coughing when swallowing food. (0 means no problem, 4 means serious situation)

Please choose an answer
9 / 10

10. I feel pressure whenever I swallow. (0 means no problem, 4 means serious situation)

Please choose an answer
10 / 10

Your results:

4-40 points:

You may have difficulty swallowing. Note: This questionnaire is not a substitute for professional diagnosis and evaluation. If you want to diagnose dysphagia and explore treatment options, you should seek help from a specialist and a speech therapist for professional evaluation.

Your results:

Less than 4 points:

congratulations! It is unlikely that you will have difficulty swallowing. Note: This questionnaire is not a substitute for professional diagnosis and evaluation. If you want to diagnose dysphagia and explore treatment options, you should seek help from a specialist and a speech therapist for professional evaluation.

Note: The results of this questionnaire can only be used for preliminary cognitive assessment and cannot be used as a formal clinical diagnosis. If you have any questions about the results, please contact the relevant specialist for consultation and detailed diagnosis.
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