**Background:** Dysphagia is increasingly common in older populations, with an average prevalence of approximately 15% in community-dwelling older adults globally and a high prevalence of 39.4% in people aged over 65 in China. Despite this burden, systematic management strategies for dysphagia in older people are lacking in China. Existing Chinese consensus documents focus primarily on post-stroke dysphagia or nutritional management, but no comprehensive standard strategy covering screening, assessment, training, intervention, and administration had been established.
**Methods:** A two-round modified Delphi method was used. An initial set of 74 items was developed based on a literature review of 2,576 retrieved articles (2010–2019), of which 105 articles with strong evidence were included after quality evaluation using the Johns Hopkins Evidence Based Practice framework. A panel of 21 experts (six doctors, 12 nurse managers, three speech therapists) from 12 cities across nine Chinese provinces was recruited via convenience sampling from a dysphagia communication group. Inclusion criteria were bachelor's degree or above, ≥10 years of dysphagia-related work, and familiarity with the study content. Experts rated each item on importance and operability using a 5-point Likert scale. Items were deleted if mean <4 or coefficient of variation (CV) >0.30. The positive coefficient of experts was 85.71% in round 1 (18/21 questionnaires recovered) and 83.33% in round 2 (15 valid of 18 distributed).
**Key Results:** After round 1, 22 items were deleted and two new items were added (S-5: identifying swallowing disorder by complete medical history assessment; I-41: placing intermittent oro-oesophageal tube), resulting in 54 items. After round 2, one additional item (A-5: monitored sip test) was excluded due to CV >0.30. The final consensus included 53 items organized into five sections: Screening (6 items), Assessment (6 items), Training (5 items), Intervention (27 items), and Administration (9 items). The CV of importance for all final items ranged from 0.00 to 0.24, and CV of operability ranged from 0.05 to 0.28. The Kendall coordination coefficient W for importance was 0.332 in round 1 (χ² = 395.343, p < 0.001) and 0.170 in round 2 (χ² = 118.885, p < 0.001). The expert panel had a mean age of 42.28 years (range 30–59) and mean 14.27 years of experience in dysphagia research or geriatric care; 95.24% came from tertiary hospitals.
**Clinical Implications:** The SATIA strategies provide a systematic, evidence-informed framework for managing dysphagia in older people across the full care continuum—from early screening to multidisciplinary management. Key recommendations include using EAT-10 combined with water test for screening (mean importance 4.73 ± 0.59 in round 2), conducting standardized bedside assessment within 24 hours of admission, providing professional training for all staff involved in dysphagia care (mean importance 5.00 ± 0.00), implementing compensatory strategies and sensory stimulation, and establishing multidisciplinary teams including doctors, nurses, speech therapists, and nutritionists. The strategies emphasize risk notification, informed consent, and bedside warning signs for high-risk patients. This is the first study to report systematic dysphagia management strategies for older people using a Delphi process in China. Limitations include a relatively small expert panel (21 invited, 18 participated in round 1, 15 in round 2), exclusion of patient and caregiver perspectives, and lack of clinical validation. Further studies are needed to verify clinical value.