OBJECTIVES To assess the prevalence of swallowing complaint, and risk factors associated with dysphagia in adults presenting to hospital for any indication (> 75 years), using the Eating Assessment Tool (EAT-10) self-reported questionnaire. METHOD This prospective quasi-experimental, non-controlled cross-sectional cohort study recruited a total of 628 participants over the age of 75. EAT-10 was completed upon admission to either ED or longer-stay acute wards, regardless of reason for admission. EAT-10 scores were analysed in relation to demographic data, and participants' clinical outcomes over the next 30 days. RESULTS 98 of 628 adults revealed an EAT-10 score >8 (15.6%) which triggered a referral to speech language pathology (SLP). The mean EAT-10 score was 3.5 out of 40 (SD=6.2), with statistically significant positive association with number of comorbidities (p=<0.001) and polypharmacy (more than five medications) (p=0.007), but not with increasing age (p=0.092). Higher EAT-10 scores were associated with increasing incidence of pneumonia, readmission, and mortality at 30 days post-discharge (p<0.05). CONCLUSIONS Swallow difficulties were prevalent among older adults in acute hospital settings and its presence was associated with adverse clinical outcomes, especially for patients with multiple comorbidities and polypharmacy. Screening with EAT-10 can identify individuals in whom further assessment is warranted. This underscores the need for routine dysphagia screening for older adults at hospital admission, to enable timely intervention to mitigate risks. Further research should optimize dysphagia care protocols in acute care environments to improve patient outcomes.