Maeda Keisuke, Akagi Junji
Department of Internal Medicine, Tamana Regional Health Medical Center, Tamana, Japan.
Department of Surgery, Tamana Regional Health Medical Center, Tamana, Japan.
Geriatr Gerontol Int. 2016 Apr;16(4):515-21. doi: 10.1111/ggi.12486. Epub 2015 Mar 21.
Sarcopenia can cause varying physical function disorders, including dysphagia. Malnutrition, a potential result of dysphagia, can also cause sarcopenia. However, the association between sarcopenia and dysphagia is not fully understood, despite evidence suggesting correlations between deglutition disorders and degenerative loss of muscle mass. The present study investigated the prevalence of dysphagia among patients with sarcopenia, and the association between the two conditions.
We included 224 older adults (mean age 82.5 ± 8.4 years; 37.9% men). Individuals who had a stroke or other diseases that could directly cause dysphagia were excluded. Logistic regression analyses were carried out after adjusting for potential causes of sarcopenia, including malnutrition, a low activity of daily living levels and aging, to investigate the relationship between the skeletal muscle index (SMI), prevalence of sarcopenia diagnosed based on a low SMI and grip strength, and swallowing functions. The Mini-Nutritional Assessment short form was used to assess their nutritional status, and the Barthel Index was used to evaluate their activities of daily living.
The prevalences of sarcopenia and dysphagia were 76.8% and 30.0%, respectively. Multivariate analysis showed that Barthel Index, SMI and presence of sarcopenia were significant independent factors for the prevalence of dysphagia, after adjusting for sex, age and nutritional status. Furthermore, subgroup analysis showed that SMI in males, and both hand-grip strength and SMI in females were lower in dysphagic subjects than in non-dysphagic subjects (P ≤ 0.01).
Sarcopenia was an independent risk factor for dysphagia among older individuals. However, further studies are required to define causality.
肌肉减少症可导致多种身体功能障碍,包括吞咽困难。吞咽困难可能导致的营养不良也会引起肌肉减少症。然而,尽管有证据表明吞咽障碍与肌肉量的退行性减少之间存在关联,但肌肉减少症与吞咽困难之间的关联尚未完全明确。本研究调查了肌肉减少症患者中吞咽困难的患病率以及这两种情况之间的关联。
我们纳入了224名老年人(平均年龄82.5±8.4岁;男性占37.9%)。排除患有中风或其他可能直接导致吞咽困难疾病的个体。在对肌肉减少症的潜在原因进行调整后进行逻辑回归分析,这些潜在原因包括营养不良、日常生活活动水平低和衰老,以研究骨骼肌指数(SMI)、基于低SMI诊断的肌肉减少症患病率和握力与吞咽功能之间的关系。采用微型营养评定简表评估他们的营养状况,采用巴氏指数评估他们的日常生活活动能力。
肌肉减少症和吞咽困难的患病率分别为76.8%和30.0%。多变量分析显示,在对性别、年龄和营养状况进行调整后,巴氏指数、SMI和肌肉减少症的存在是吞咽困难患病率的显著独立因素。此外,亚组分析显示,吞咽困难患者中男性的SMI以及女性的握力和SMI均低于非吞咽困难患者(P≤0.01)。
肌肉减少症是老年人吞咽困难的独立危险因素。然而,需要进一步研究来确定因果关系。