Suboptimal Tongue Pressure Is Associated with Risk of Malnutrition in Community-Dwelling Older Individuals

Abstract

The tongue plays an important role in swallowing, and its dysfunction theoretically leads to inadequate oral intake and subsequent malnutrition. This study aimed to explore how different levels of tongue pressure are related to malnutrition among community-dwelling older individuals. The target population was community-dwelling adults aged ≥ 65 years. Tongue pressure was measured using the Iowa Oral Performance Instrument, whereas the mini nutrition assessment (MNA) test was administered to determine the nutritional status. A full MNA score of less than 24 points was defined as risk of malnutrition. Multivariate logistic regression analyses were conducted to calculate the odds ratio (OR) of risk of malnutrition among different quartiles of tongue pressure. Among the 362 participants, 26 (7.1%) were classified as having risk of malnutrition. Body weight, body mass index, handgrip strength, skeletal muscle mass index, sum MNA score, and serum levels of albumin were lower in the malnutrition risk groups than in the normal nutrition status group. A positive correlation was identified between tongue pressure and the MNA score (r = 0.143, p < 0.01). Treating the subgroup of the highest quartile of tongue pressure as the reference, the crude odds ratio (OR) of having risk of malnutrition was 5.37 (95% CI, 1.14–25.28) in the subgroup at the third quartile, 3.10 (95% CI, 0.60–15.84) in the subgroup at the second quartile, and 3.95 (95% CI, 0.81–19.15) in the subgroup at the lowest quartile. After adjustment for age and sex, the subgroup in the third quartile still presented with a significantly higher risk (OR, 4.85; 95% CI, 1.02–22.99) of risk of malnutrition. Compared with the subgroup at the highest quartile of tongue pressure, the crude OR for all the subgroups in the lower three quartiles was 4.17 (95% CI, 0.96–18.04), showing borderline significance (p = 0.05). In conclusion, we found hints for an association between decreased tongue pressure and an increased risk of malnutrition in community-dwelling older individuals. Older people with suboptimal tongue pressure should undergo a thorough assessment of their nutritional status and swallowing function for the early identification of subclinical malnutrition and dysphagia.

Sarcopenic Dysphagia: A Narrative Review from Diagnosis to Intervention

“…A recent meta-analysis incorporating ten studies also confirmed the significant association between declined MTP and sarcopenia [58]. Chang et al [57] in 2021. A recent meta-analysis incorporating ten studies also confirmed the significant association between declined MTP and sarcopenia [58].…”

“…In 2019, Kobuchi et al [56] assessed 54 elderly residents in a nursing home and found that MTP was positively correlated with grip strength, skeletal muscle mass, and cross-sectional area of the geniohyoid muscle. Furthermore, the association between decreased MTP and malnutrition in community-dwelling elder subjects was identified by Chang et al [57] in 2021. A recent meta-analysis incorporating ten studies also confirmed the significant association between declined MTP and sarcopenia [58].…”

Effect of Oral Health Education Using a Mobile App (OHEMA) on the Oral Health and Swallowing-Related Quality of Life in Community-Based Integrated Care of the Elderly: A Randomized Clinical Trial

“…According to a related earlier study, the muscular strength of the anterior tongue improved after oral exercise intervention [ 50 ], supporting the results of this study and verifying the positive effect of oral exercise on tongue pressure in the elderly. A decrease in tongue pressure is one of the oral health problems in the elderly and is deeply correlated with reduced swallowing function and nutritional imbalance, with a potential impact on the physical health of the whole body [ 42 , 51 ]. Thus, oral exercise education is essential in maintaining the basic physical health of the elderly.…”

A Missing Voice: The Lingual Complex and Osteopathic Manual Medicine in the Context of Five Osteopathic Models

“…During swallowing, the tongue (lower lingual portion) moves the hyoid bone in horizontal and vertical actions; in the pharyngeal phase, the hyoid is pushed forward and upward [45]. Lingual dysfunctions, attributable to advancing age (very frequent) or to the presence of disorders and pathologies, cause dysphagia which decreases the patient's optimal nutrition [47,48]. Another fundamental aspect of the tongue for the model is related to taste.…”