Department of Gerontology and Gerodontology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
Department of Oral and Maxillofacial Surgery, Southern Tohoku General Hospital, Koriyama-shi, Fukushima, Japan.
J Am Med Dir Assoc. 2018 Jun;19(6):516-522. doi: 10.1016/j.jamda.2017.11.007. Epub 2017 Dec 26.
Sarcopenic dysphagia is characterized by difficulty swallowing due to a loss of whole-body skeletal and swallowing muscle mass and function. However, no study has reported on swallowing muscle mass and quality in patients with sarcopenic dysphagia.
To compare the differences in swallowing muscle mass and quality between sarcopenic and nonsarcopenic dysphagia.
A cross-sectional study was performed in 55 older patients, who had been recommended to undergo dysphagia assessment and/or rehabilitation. Sarcopenic dysphagia was diagnosed using a diagnostic algorithm for sarcopenic dysphagia. The thickness and area of tongue muscle and geniohyoid muscle (coronal plane and sagittal plane), and the echo-intensity of the tongue and geniohyoid muscles were examined by ultrasound.
The study participants included 31 males and 24 females (mean age of 82 ± 7 years), with 14 having possible sarcopenic dysphagia, 22 probable sarcopenic dysphagia, and 19 without sarcopenic dysphagia. The group with sarcopenic dysphagia had a significantly lower cross-sectional area and area of brightness of the tongue muscle than that observed in the group without sarcopenic dysphagia. The most specific factor for identifying the presence of sarcopenic dysphagia was tongue muscle area (sensitivity, 0.389; specificity, 0.947; cut-off value, 1536.0), while the factor with the highest sensitivity was geniohyoid muscle area brightness in sagittal sections (sensitivity, 0.806; specificity, 0.632; cut-off value, 20.1). Multivariate logistic regression analysis showed that the area of the tongue muscle and its area of brightness were independent risk factors for sarcopenic dysphagia. However, geniohyoid sagittal muscle area and area of brightness showed no significant independent association with sarcopenic dysphagia.
Tongue muscle mass in patients with sarcopenic dysphagia was smaller than that in patients without the condition. Sarcopenic dysphagia was also associated with increased intensity of the tongue muscle.
失弛缓症的特点是由于全身骨骼和吞咽肌肉质量和功能的丧失而导致吞咽困难。然而，目前尚无研究报道失弛缓症患者的吞咽肌肉质量和功能。
比较失弛缓症和非失弛缓症患者吞咽肌肉质量和功能的差异。
对 55 名老年患者进行横断面研究，这些患者被建议进行吞咽评估和/或康复。使用失弛缓症的诊断算法诊断失弛缓症。通过超声检查舌肌和颏舌骨肌的厚度和面积（冠状面和矢状面）以及舌和颏舌骨肌的回声强度。
研究参与者包括 31 名男性和 24 名女性（平均年龄 82 ± 7 岁），其中 14 例可能患有失弛缓症，22 例可能患有失弛缓症，19 例没有失弛缓症。失弛缓症组的舌肌横截面积和亮度面积明显低于非失弛缓症组。用于识别失弛缓症的最特异的因素是舌肌面积（敏感性 0.389；特异性 0.947；临界值 1536.0），而最敏感的因素是矢状位颏舌骨肌亮度面积（敏感性 0.806；特异性 0.632；临界值 20.1）。多变量逻辑回归分析显示，舌肌面积及其亮度面积是失弛缓症的独立危险因素。然而，颏舌骨肌矢状位面积和亮度面积与失弛缓症无显著独立相关性。
失弛缓症患者的舌肌质量小于无该疾病的患者。失弛缓症还与舌肌强度增加有关。
