Decreased Tongue Pressure is Associated with Sarcopenia and Sarcopenic Dysphagia in the Elderly

Abstract

The aim of this study was to clarify the association between tongue pressure and factors related to sarcopenia such as aging, activities of daily living, nutritional state, and dysphagia. One-hundred-and-four patients without a history of treatment of stroke and without a diagnosis of neurodegenerative disease (36 men and 68 women), with a mean age of 84.1 ± 5.6 years, hospitalized from May 2013 to June 2013 were included in this study. Maximum voluntary tongue pressure against the palate (MTP) was measured by a device consisting of a disposable oral balloon probe. Nutritional and anthropometric parameters such as serum albumin concentration, Mini-Nutritional Assessment short form (MNA-SF), body mass index, arm muscle area (AMA), and others and presence of sarcopenia and dysphagia were analyzed to evaluate their relationships. Correlation analysis and univariate or multivariate analysis were performed. Simple correlation analysis showed that MTP correlated with Barthel index (BI), MNA-SF, serum albumin concentration, body mass index, and AMA. Univariate and multivariate analysis showed that sarcopenia, BI, MNA-SF, and age were the independent explanatory factors for decreased MTP, and the propensity score for dysphagia, including causes of primary or secondary sarcopenia, and the presence of sarcopenia were significantly associated with the presence of dysphagia. Decreased MTP and dysphagia were related to sarcopenia or the causes of sarcopenia in the studied population. Furthermore, the clinical condition of sarcopenic dysphagia may be partially interpreted as the presence of sarcopenia and causal factors for sarcopenia.

Predictive Accuracy of Calf Circumference Measurements to Detect Decreased Skeletal Muscle Mass and European Society for Clinical Nutrition and Metabolism-Defined Malnutrition in Hospitalized Older Patients

“…CC measures not only muscle mass but also bone, subcutaneous adipose, and skin. It is not surprising that the cut-off values in this study were lower because compared with healthy adults, hospitalized patients tend to have an increased malnutrition risk [10,17,18,19] and elderly patients are likely to have thin subcutaneous adipose layers and skin. Therefore, we propose that the CC cut-off values determined in this study would be most useful clinically in hospitalized elderly patients.…”

Cognitive Dysfunction and Malnutrition Are Independent Predictor of Dysphagia in Patients with Acute Exacerbation of Congestive Heart Failure

“…These latter scale levels consider both diet modifications and patient compensations [9]. Clinically significant dysphagia was defined as requirement for modification of an oral diet (FOIS grades 1–5) [7, 10]. According to previous studies, dysphagia was defined as having a FOIS level of 5 or less in the present study [7, 10].…”

“…In addition, a recent investigation demonstrated that dysphagia was related to sarcopenia or the causes of sarcopenia in hospitalized elderly patients without a history of treatment for stroke, and without diagnosis of neurodegenerative disease [7]. CHF patients with cardiac cachexia, caused by malnutrition, have mortality 2–3 times higher compared with non-cachectic CHF patients [8].…”

Schluckstörungen im Alter

“…So beeinträchtigt der im Alter zu beobachtende Muskelabbau, die Sarkopenie, generell die motorische Komponente des Schluckens [8]. Zudem wird der Schluckakt durch Veränderungen des Bindegewebes, das im Alter an Elastizität verliert, modifiziert [9].…”

“…Dieser Begriff wird definiert als ungewollter Verlust von Skelettmuskelmasse und daraus resultierend auch der Muskelstärke [27]. Grundsätzlich scheinen Patienten mit einer Sarkopenie häufiger eine Beeinträchti-gung des Schluckaktes aufzuweisen [8]. Es finden sich Hinweise darauf, dass die Schluckmuskulatur bei diesen Patienten von der Sarkopenie mit erfasst wird und so zu einer Verschlechterung der Schluckfunktion beiträgt.…”