Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, Tokyo, Japan.
J Am Med Dir Assoc. 2021 Apr;22(4):766-772. doi: 10.1016/j.jamda.2020.10.012. Epub 2020 Nov 15.
To investigate age and other factors related to the deterioration of the muscles used for swallowing, including the tongue and suprahyoid muscles.
Cross-sectional study.
This study included 146 participants: 47 younger adults (23 men and 24 women; age range 23-44 years) recruited from a dental hospital and 99 community-dwelling older adults (37 men and 62 women, age range 65-86 years).
Age (<65 years or ≥65 years), body mass index (BMI), skeletal muscle mass index (SMI), and tooth loss (Eichner classification) were measured. The cross-sectional areas (CSAs) of the tongue, geniohyoid muscle, and anterior belly of the digastric muscle were measured using an ultrasonic diagnostic apparatus. The correlation between each muscle's CSA and strength was examined. Multiple regression analyses were performed separately for each sex using each muscle CSA as the dependent variable and age, BMI, SMI, and the Eichner classification as explanatory variables.
Older men had a significant positive correlation between tongue pressure and CSA (r = 0.35, P = .031). Jaw opening force was positively correlated with geniohyoid muscle CSA (r = 0.41, P = .001) in older women. In the multiple regression analysis, age, BMI, and SMI were significantly associated with tongue CSA in men. Age was significantly and inversely associated with suprahyoid muscle CSA in both men and women. No explanatory variables were significantly associated with geniohyoid muscle CSA except age.
The tongue increased in volume, and the suprahyoid muscles underwent atrophy with age. The study results suggest that interventions to prevent dysphagia associated with aging should be tailored toward specific muscles. Direct muscle training is required for the suprahyoid muscles, whereas the maintenance of tongue muscle mass and function, as well as training for the tongue, requires attention to ensure optimal nutritional status and whole-body skeletal muscle mass.
研究与吞咽肌肉（包括舌肌和舌骨上肌群）恶化相关的年龄及其他因素。
横断面研究。
本研究纳入了 146 名参与者：47 名年轻成年人（23 名男性，24 名女性；年龄 23-44 岁），来自一家牙科医院；99 名社区居住的老年人（37 名男性，62 名女性；年龄 65-86 岁）。
测量年龄（＜65 岁或≥65 岁）、体重指数（BMI）、骨骼肌质量指数（SMI）和牙齿缺失（Eichner 分级）。使用超声诊断仪测量舌、颏舌肌和二腹肌前腹的横截面积（CSA）。检查了各肌肉 CSA 与力量之间的相关性。分别对男性和女性，使用每个肌肉 CSA 作为因变量，年龄、BMI、SMI 和 Eichner 分级作为解释变量，对每个性别进行多元回归分析。
老年男性的舌压与 CSA 呈显著正相关（r=0.35，P=0.031）。老年女性的张口力与颏舌肌 CSA 呈正相关（r=0.41，P=0.001）。多元回归分析显示，年龄、BMI 和 SMI 与男性的舌 CSA 显著相关。年龄与男女的舌骨上肌群 CSA 呈显著负相关。除年龄外，其他解释变量与颏舌肌 CSA 无显著相关性。
随着年龄的增长，舌体积增加，舌骨上肌群萎缩。研究结果表明，预防与衰老相关的吞咽困难的干预措施应针对特定的肌肉。需要对舌骨上肌群进行直接的肌肉训练，而维持舌肌的质量和功能，以及对舌的训练，需要注意保持最佳的营养状态和全身骨骼肌质量。
