Ko Chih-Hung, Chao Chia-Ling, Hung Chih-Hsing, Du Je-Kang, Feng Ming-Chu
Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
Doctoral Degree Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
J Clin Med. 2024 Dec 26;14(1):62. doi: 10.3390/jcm14010062.
: Swallowing dysfunction is a prevalent but often overlooked problem in long-term care facilities. This study investigated the relationships between nutritional deficits, frailty, oral health, and swallowing dysfunction. Additionally, we explored the associations between oral muscle weakness, frailty markers, and swallowing dysfunction. : We recruited 373 participants from seven long-term care facilities across Taiwan. Swallowing function, frailty, nutrition status, and oral health were assessed by research staff. Oral muscle function was evaluated through tongue strength measurements, cheek bulging function tests, the Repetitive Saliva Swallowing Test (RSST), and a diadochokinetic task. Frailty was assessed through grip strength as well as mid-upper arm and calf circumference measurements. : The Functional Oral Intake Scale revealed that 97 participants (26%) had swallowing dysfunction. Participants with swallowing dysfunction had poorer nutritional status, higher frailty levels, and worsened oral health. Frailty was the factor most strongly associated with swallowing dysfunction. Participants with swallowing dysfunction also exhibited lower tongue pressure, decreased cheek-bulging ability, fewer repetitions in the diadochokinetic task, lower scores on the RSST, lower calf circumferences, and lower grip strength. Logistic regression demonstrated that cheek bulging was most strongly associated with swallowing dysfunction. Furthermore, lower grip strength was significantly associated with swallowing dysfunction. : Frailty was most strongly associated with swallowing dysfunction, followed by poorer nutritional status and worsened oral health. These factors should be thoroughly assessed in long-term care residents. Participants with swallowing dysfunction also experienced oral muscle weakness, particularly in cheek bulging. Grip strength, which represents frailty, was directly associated with swallowing dysfunction and could serve as a crucial indicator of swallowing dysfunction.
吞咽功能障碍是长期护理机构中普遍存在但常被忽视的问题。本研究调查了营养缺乏、身体虚弱、口腔健康与吞咽功能障碍之间的关系。此外，我们还探讨了口腔肌肉无力、身体虚弱标志物与吞咽功能障碍之间的关联。
我们从台湾的七家长期护理机构招募了373名参与者。研究人员对吞咽功能、身体虚弱、营养状况和口腔健康进行了评估。通过测量舌力、脸颊鼓起功能测试、重复唾液吞咽测试（RSST）和一项连续运动言语任务来评估口腔肌肉功能。通过握力以及上臂中部和小腿围度测量来评估身体虚弱程度。
功能性口腔摄入量表显示，97名参与者（26%）存在吞咽功能障碍。有吞咽功能障碍的参与者营养状况较差、身体虚弱程度较高且口腔健康状况较差。身体虚弱是与吞咽功能障碍关联最密切的因素。有吞咽功能障碍的参与者还表现出较低的舌压、脸颊鼓起能力下降、连续运动言语任务中的重复次数减少、RSST得分较低、小腿围度较小和握力较低。逻辑回归表明，脸颊鼓起与吞咽功能障碍关联最为密切。此外，较低的握力与吞咽功能障碍显著相关。
身体虚弱与吞咽功能障碍关联最为密切，其次是营养状况较差和口腔健康状况较差。这些因素应在长期护理居民中进行全面评估。有吞咽功能障碍的参与者还存在口腔肌肉无力，尤其是在脸颊鼓起方面。代表身体虚弱的握力与吞咽功能障碍直接相关，可作为吞咽功能障碍的关键指标。
