低舌力与老年住院患者的口腔和咳嗽相关异常有关。

Low tongue strength is associated with oral and cough-related abnormalities in older inpatients.

机构信息

Department of Nutrition Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan.

Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan; Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan.

出版信息

Nutrition. 2021 Mar;83:111062. doi: 10.1016/j.nut.2020.111062. Epub 2020 Nov 11.

DOI:10.1016/j.nut.2020.111062

PMID:33348111

Abstract

OBJECTIVES

Sarcopenic dysphagia is partly characterized by a decline in the strength of the swallowing muscles. However, its associated characteristics and symptoms are unclear. The aim of this study was to clarify the characteristics and symptoms of swallowing ability associated with low tongue muscle strength, which is one of the swallowing muscles in older adults.

METHODS

This was a cross-sectional study of 197 older patients admitted to the hospital for orthopedic conditions. We measured the maximum tongue pressure (MTP) against the palate. Swallowing-related characteristics were assessed with the Mann assessment of swallowing ability. Sarcopenia was diagnosed using the 2019 Asian Working Group for Sarcopenia.

RESULTS

The mean age of patients was 81.3 ± 7.6 y, and 80.2% of patients were women. Forty-two patients (21.3%) showed low MTP, defined as <20 kPa. Approximately 50% of participants had sarcopenia. Patients in the low MTP group had a significantly higher incidence of sarcopenia compared with the normal MTP group (71.4% vs. 48.4%; P = .008). After adjusting for potential confounders in the multivariate analyses, low MTP was found to be independently associated with abnormalities in tongue coordination (odds ratio [OR]: 5.251; 95% confidence interval [CI], 2.336-11.807; P < .001), oral transit (OR: 5.248; 95% CI, 1.424-19.345; P = .013), cough reflex (OR: 2.709; 95% CI, 1.280-5.733; P = .009), and voluntary cough (OR: 7.786; 95% CI, 3.329-18.208; P < .001).

CONCLUSIONS

Patients with low tongue strength are characterized by abnormal oral and cough-related characteristics.

摘要

目的

肌少性吞咽困难的部分特征是吞咽肌肉力量下降。然而，其相关特征和症状尚不清楚。本研究旨在阐明与老年人吞咽肌肉之一舌肌无力相关的吞咽能力特征和症状。

方法

这是一项针对因骨科疾病住院的 197 名老年人的横断面研究。我们测量了舌压 against palate 的最大值（MTP）。使用曼恩吞咽能力评估（Mann assessment of swallowing ability）评估吞咽相关特征。使用 2019 年亚洲肌少症工作组（Asian Working Group for Sarcopenia）诊断肌少症。

结果

患者的平均年龄为 81.3 ± 7.6 岁，80.2%的患者为女性。42 名患者（21.3%）的 MTP 较低，定义为 <20 kPa。约 50%的参与者患有肌少症。与正常 MTP 组相比，低 MTP 组患者肌少症的发生率明显更高（71.4% vs. 48.4%；P =.008）。在多变量分析中调整潜在混杂因素后，发现低 MTP 与舌协调异常（比值比 [OR]：5.251；95%置信区间 [CI]：2.336-11.807；P <.001）、口腔转运异常（OR：5.248；95% CI：1.424-19.345；P =.013）、咳嗽反射异常（OR：2.709；95% CI：1.280-5.733；P =.009）和自主咳嗽异常（OR：7.786；95% CI：3.329-18.208；P <.001）独立相关。