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

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An Erratum to this article was published on 08 November 2014

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.

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References

  1. Logemann JA. Evaluation and treatment of swallowing disorders. San Diego: College-Hill Press Inc; 1983.

    Google Scholar 

  2. Dodds WJ. The physiology of swallowing. Dysphagia. 1989;3(4):171–8.

    Article  CAS  PubMed  Google Scholar 

  3. Mcconnel F. Analysis of pressure generation and bolus transit during pharyngeal swallowing. Laryngoscope. 1988;98(1):71–8.

    Article  CAS  PubMed  Google Scholar 

  4. Robbins J. Normal swallowing and aging. Semin Neurol. 1996;16(4):309–17.

    Article  CAS  PubMed  Google Scholar 

  5. Robbins JA, Levine R, Wood J, Roecker EB, Luschei E. Age effects on lingual pressure generation as a risk factor for dysphagia. J Gerontol A. 1995;50(5):M257–62.

    Article  CAS  Google Scholar 

  6. Sheth N, Diner WC. Swallowing problems in the elderly. Dysphagia. 1988;2(4):209–15.

    Article  CAS  PubMed  Google Scholar 

  7. Nicosia MA, Hind JA, Roecker EB, Carnes M, Doyle J, Dengel GA, Robbins J. Age effects on the temporal evolution of isometric and swallowing pressure. J Gerontol A. 2000;55(11):M634–40.

    Article  CAS  Google Scholar 

  8. Youmans SR, Stierwalt JA. Measures of tongue function related to normal swallowing. Dysphagia. 2006;21(2):102–11.

    Article  PubMed  Google Scholar 

  9. Kikutani T, Tamura F, Nishiwaki K, Kodama M, Suda M, Fukui T, Takahashi N, Yoshida M, Akagawa Y, Kimura M. Oral motor function and masticatory performance in the community-dwelling elderly. Odontology. 2009;97(1):38–42.

    Article  PubMed  Google Scholar 

  10. Utanohara Y, Hayashi R, Yoshikawa M, Yoshida M, Tsuga K, Akagawa Y. Standard values of maximum tongue pressure taken using newly developed disposable tongue pressure measurement device. Dysphagia. 2008;23(3):286–90.

    Article  PubMed  Google Scholar 

  11. Clark HM, Solomon NP. Age and sex differences in orofacial strength. Dysphagia. 2012;27(1):2–9.

    Article  PubMed  Google Scholar 

  12. Youmans SR, Youmans GL, Stierwalt JA. Differences in tongue strength across age and gender: is there a diminished strength reserve? Dysphagia. 2009;24(1):57–65.

    Article  PubMed  Google Scholar 

  13. Tsuga K, Yoshikawa M, Oue H, Okazaki Y, Tsuchioka H, Maruyama M, Yoshida M, Akagawa Y. Maximal voluntary tongue pressure is decreased in Japanese frail elderly persons. Gerodontology. 2012;29(2):e1078–85.

    Article  PubMed  Google Scholar 

  14. Tamura F, Kikutani T, Tohara T, Yoshida M, Yaegaki K. Tongue thickness relates to nutritional status in the elderly. Dysphagia. 2012;27(4):556–61.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Kuroda Y, Kuroda R. Relationship between thinness and swallowing function in Japanese older adults: implications for sarcopenic dysphagia. J Am Geriatr Soc. 2012;60(9):1785–6.

    Article  PubMed  Google Scholar 

  16. Delmonico MJ, Harris TB, Lee JS, Visser M, Nevitt M, Kritchevsky SB, Tylavsky FA, Newman AB. Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women. J Am Geriatr Soc. 2007;55(5):769–74.

    Article  PubMed  Google Scholar 

  17. Goodpaster BH, Park SW, Harris TB, Kritchevsky SB, Nevitt M, Schwartz AV, Simonsick EM, Tylavsky FA, Visser M, Newman AB. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A. 2006;61(10):1059–64.

    Article  Google Scholar 

  18. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel J-P, Rolland Y, Schneider SM. Sarcopenia: European consensus on definition and diagnosis report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412–23.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Wakabayashi H. Presbyphagia and sarcopenic dysphagia: association between aging, sarcopenia, and deglutition disorders. J Frailty Aging. 2014;3:97–103.

  20. Humbert IA, Robbins J. Dysphagia in the elderly. Phys Med Rehabil Clin N Am. 2008;19(4):853–66.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Kendall KA, Leonard RJ. Pharyngeal constriction in elderly dysphagic patients compared with young and elderly nondysphagic controls. Dysphagia. 2001;16(4):272–8.

    Article  CAS  PubMed  Google Scholar 

  22. Palmer JB. Electromyography of the muscles of oropharyngeal swallowing: basic concepts. Dysphagia. 1989;3(4):192–8.

    Article  CAS  PubMed  Google Scholar 

  23. Kondrup J, Allison S, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003;22(4):415–21.

    Article  CAS  PubMed  Google Scholar 

  24. Ulibarri J, González-Madroño A, De Villar N, González P, González B, Mancha A, Rodríguez F, Fernández G. CONUT: a tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp. 2005;20(1):38–45.

    Google Scholar 

  25. Mahoney FI. Functional evaluation: the Barthel index. Md State Med J. 1965;14:61–5.

    CAS  PubMed  Google Scholar 

  26. Crary MA, Mann GDC, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86(8):1516–20.

    Article  PubMed  Google Scholar 

  27. Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489–95.

    Article  PubMed  Google Scholar 

  28. Moriwaki H, Aoyagi S, Ishizuka Y (2002) Japanese anthropc referenometrice data; JARD. Jpn J Nutr Assess 2001;19:45–81 (In Japanese).

  29. Rosenbaum PR, Rubin DB. Reducing bias in observational studies using subclassification on the propensity score. J Am Stat Assoc. 1984;79(387):516–24.

    Article  Google Scholar 

  30. Yoshida M, Kikutani T, Tsuga K, Utanohara Y, Hayashi R, Akagawa Y. Decreased tongue pressure reflects symptom of dysphagia. Dysphagia. 2006;21(1):61–5.

    Article  PubMed  Google Scholar 

  31. Buehring B, Hind J, Fidler E, Krueger D, Binkley N, Robbins J. Tongue strength is associated with jumping mechanography performance and handgrip strength but not with classic functional tests in older adults. J Am Geriatr Soc. 2013;61(3):418–22.

    Article  PubMed  Google Scholar 

  32. Kodaira Y, Ueda T, Takagi I. Influence of palatal plate on tongue pressure during swallowing prosthodont. Res Pract. 2008;7:40–3.

    Google Scholar 

  33. Singh S, Mulley GP, Losowsky MS. Why are Alzheimer patients thin? Age Ageing. 1988;17(1):21–8.

    Article  CAS  PubMed  Google Scholar 

  34. Guyonnet S, Nourhashemi F, Ousset PJ. Factors associated with weight loss in Alzheimer’s disease. J Nutr Health Aging. 1998;2:107–9.

    CAS  PubMed  Google Scholar 

  35. Wang SY, Fukagawa N, Hossain M, Ooi WL. Longitudinal weight changes, length of survival, and energy requirements of long-term care residents with dementia. J Am Geriatr Soc. 1997;45(10):1189–95.

    CAS  PubMed  Google Scholar 

  36. Hebert LE, Scherr PA, McCann JJ, Bienias JL, Evans DA. Change in direct measures of physical performance among persons with Alzheimer’s disease. Aging Mental Health. 2008;12(6):729–34.

    Article  PubMed  Google Scholar 

  37. Steeman E, Abraham IL, Godderis J. Risk profiles for institutionalization in a cohort of elderly people with dementia or depression. Arch Psychiatr Nurs. 1997;11(6):295–303.

    Article  CAS  PubMed  Google Scholar 

  38. Burge E, Kuhne N, Berchtold A, Maupetit C, von Gunten A. Impact of physical activity on activity of daily living in moderate to severe dementia: a critical review. Eur Rev Aging Phys Act. 2012;9(1):27–39.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Green CR, Mohs RC, Schmeidler J, Aryan M. Functional decline in Alzheimer’s disease: a longitudinal study. J Am Geriatr Soc. 1993;41(6):654–61.

    CAS  PubMed  Google Scholar 

  40. Hudson HM, Daubert CR, Mills RH. The interdependency of protein-energy malnutrition, aging, and dysphagia. Dysphagia. 2000;15(1):31–8.

    Article  CAS  PubMed  Google Scholar 

  41. Veldee MS, Peth LD. Can protein-calorie malnutrition cause dysphagia? Dysphagia. 1992;7(2):86–101.

    Article  CAS  PubMed  Google Scholar 

  42. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G. Frailty in older adults evidence for a phenotype. J Gerontol A. 2001;56(3):M146–57.

    Article  CAS  Google Scholar 

  43. Lang T, Cauley JA, Tylavsky F, Bauer D, Cummings S, Harris TB. Computed tomographic measurements of thigh muscle cross-sectional area and attenuation coefficient predict hip fracture: the health, aging, and body composition study. J Bone Miner Res. 2010;25(3):513–9.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Kuroda Y. Relationship between swallowing function, and functional and nutritional status in hospitalized elderly individuals. Int J Speech Lang Pathol. 2014;2(1):20–6.

    Article  Google Scholar 

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The authors report no conflicts of interest. The research described in this manuscript was not supported by any grant.

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Authors and Affiliations

  1. Department of Internal Medicine, Tamana Regional Health Medical Center, 2172 Tamana, Taman City, Kumamoto Prefecture, 865-0005, Japan

    Keisuke Maeda

  2. Department of Surgery, Tamana Regional Health Medical Center, Tamana, Japan

    Junji Akagi

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  1. Keisuke Maeda
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  2. Junji Akagi
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Correspondence to Keisuke Maeda.

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Maeda, K., Akagi, J. Decreased Tongue Pressure is Associated with Sarcopenia and Sarcopenic Dysphagia in the Elderly. Dysphagia 30, 80–87 (2015). https://doi.org/10.1007/s00455-014-9577-y

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  • DOI: https://doi.org/10.1007/s00455-014-9577-y

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