Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No.1, Changde Street, Zhongzheng District, Taipei City, 10048, Taiwan, Republic of China.
Physical Medicine & Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, No.87, Neijiang Street, Wanhua District, Taipei City, Taiwan.
BMC Geriatr. 2020 Oct 21;20(1):419. doi: 10.1186/s12877-020-01832-0.
Sarcopenia and dysphagia are prevalent health issues as the elderly population continues to grow. However, whether sarcopenia, defined by either reduced handgrip strength or gait speed, would lead to pathological effects on swallowing function is still a matter of debate. Studies focusing on subclinical changes in the swallowing function in the sarcopenic elderly are lacking. This study evaluates the swallowing function in the sarcopenic elderly without dysphagia.
A cross-sectional study was conducted including subjects recruited from the community. Ninety-four individuals aged 65 and older without dysphagia were divided into two groups: sarcopenia and nonsarcopenia. The swallowing assessment included tongue pressure measurement, hyoid displacement (HD), hyoid velocity (HV) measurement with submental ultrasonography, 100-ml water-swallowing test, and the 10-item Eating Assessment Tool (EAT-10).
The average tongue pressure was 47.0 ± 13.7 and 48.6 ± 11.5 kPa in the sarcopenia and nonsarcopenia groups, respectively (p = 0.55), whereas the average HD during swallowing was 15.3 ± 4.4 and 13.0 ± 4.2 mm in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05). The median of HV during swallowing was 19.5 (6.41-45.86) and 15.9 (3.7-39.7) mm/s in the sarcopenia and nonsarcopenia group (p < 0.05). The median of time needed for consuming 100 ml water was 12.43 (3.56-49.34) and 5.66 (2.07-19.13) seconds in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05). The median of the EAT-10 score was 0 (0-2) and 0 (0-1) in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05).
In elderly individuals, swallowing function was significantly impaired with sarcopenia before clinical symptoms become clear. However, tongue muscles exhibited resistance to sarcopenia. We observed compensative strategies in patients with sarcopenia, such as reduced swallowing speed and increased hyoid bone movement.
随着老年人口的不断增长，肌少症和吞咽困难是普遍存在的健康问题。然而，肌少症（定义为握力或步态速度降低）是否会对吞咽功能产生病理影响仍存在争议。目前缺乏针对肌少症老年人亚临床吞咽功能变化的研究。本研究旨在评估无吞咽困难的肌少症老年人的吞咽功能。
这是一项横断面研究，纳入了来自社区的受试者。94 名年龄在 65 岁及以上、无吞咽困难的老年人分为肌少症组和非肌少症组。吞咽评估包括舌压测量、舌骨位移（HD）、颏下超声测量的舌骨速度（HV）、100 毫升水吞咽试验和 10 项饮食评估工具（EAT-10）。
肌少症组和非肌少症组的平均舌压分别为 47.0±13.7kPa 和 48.6±11.5kPa（p=0.55），吞咽时的平均 HD 分别为 15.3±4.4mm 和 13.0±4.2mm（p<0.05）。吞咽时 HV 的中位数分别为 19.5（6.41-45.86）和 15.9（3.7-39.7）mm/s（p<0.05）。100 毫升水的中位消耗时间分别为 12.43（3.56-49.34）和 5.66（2.07-19.13）秒（p<0.05）。EAT-10 评分的中位数分别为 0（0-2）和 0（0-1）（p<0.05）。
在老年人中，吞咽功能在明显出现临床症状之前就因肌少症而受损。然而，舌肌对肌少症有抵抗作用。我们观察到肌少症患者存在代偿策略，如吞咽速度减慢和舌骨运动增加。
