Weng En-Chih, Hasegawa Yoko, Yoshimoto Tasuku, Maria Ma Therese Sta, Nagai Koutatsu, Sato Naoko, Tokumoto Kana, Hori Kazuhiro, Kusunoki Hiroshi, Kishimoto Hiromitsu, Shinmura Ken
Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, 5274, Gakkocho-dori 2-bancho, Chuo-ku, Niigata, 951-8514, Japan.
Department of Oral and Maxillofacial Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
BMC Geriatr. 2025 Jun 24;25(1):429. doi: 10.1186/s12877-025-05896-8.
Deterioration of swallowing function (DSF) is common among aging adults and can lead to negative health outcomes such as increased risk of malnutrition. However, the longitudinal relationship between the DSF and frailty status remains unclear. This study aimed to investigate whether declining swallowing function is linked to frailty progression in independent older adults.
This study included 795 community-dwelling Japanese individuals aged ≥ 65 years who participated in two surveys: one at baseline and one after two years. Swallowing function was evaluated using the repetitive saliva swallowing test, tongue pressure test, and questionnaire. DSF was identified by meeting more than one of three criteria: Repeated Saliva Swallow Test below 3, tongue pressure under 27.4 kPa for men and 26.5 kPa for women, and a "yes" response to the questionnaire. Frailty status was assessed using the Kihon Checklist, with participants showing a decline categorized into the "aggravation group." Oral function (number of teeth, occlusal force, masticatory performance, and oral dryness) and physical function (body mass index, gait speed, grip strength, and skeletal muscle mass index) were evaluated. Comparisons between the two groups were made using the Student's t-test or the χ2 test. Differences among the three groups were assessed using the one-way analysis of variance or the χ2 test. Significant differences in continuous variables were analyzed using the Least Significant Difference method, with P-values adjusted using the Bonferroni correction.
Initially, 87 (10.9%) participants were frail. By follow-up, 149 participants (37.9%) had progressed to frailty, 83 of whom (55.7%) exhibited impaired swallowing function at baseline. At baseline, frailty was significantly associated with age, gait speed, decreased swallowing function, number of functional teeth, occlusal force, and masticatory performance. None of the three swallowing function assessment methods were significantly associated with the progression of frailty. In contrast, logistic regression analysis of frailty progression showed that impaired swallowing function was a significant explanatory variable (OR, 1.53; 95% CI: 1.04-2.21).
This study found a significant association between frailty and multiple factors, particularly oral function. Specifically, diminished swallowing function has emerged as a notable independent predictor of frailty progression.
吞咽功能恶化（DSF）在老年人中很常见，并可能导致营养不良风险增加等负面健康结果。然而，DSF与衰弱状态之间的纵向关系仍不清楚。本研究旨在调查独立生活的老年人吞咽功能下降是否与衰弱进展有关。
本研究纳入了795名年龄≥65岁的日本社区居民，他们参与了两项调查：一项在基线时进行，另一项在两年后进行。使用重复唾液吞咽试验、舌压试验和问卷调查来评估吞咽功能。满足以下三项标准中的一项以上即可确定为DSF：重复唾液吞咽试验低于3次、男性舌压低于27.4kPa且女性低于26.5kPa、问卷回答为“是”。使用简易身体功能检查表评估衰弱状态，参与者出现下降则归类为“加重组”。评估口腔功能（牙齿数量、咬合力、咀嚼性能和口腔干燥情况）和身体功能（体重指数、步速、握力和骨骼肌质量指数）。两组之间的比较采用Student's t检验或χ2检验。三组之间的差异采用单因素方差分析或χ2检验进行评估。连续变量的显著差异采用最小显著差异法进行分析，P值采用Bonferroni校正进行调整。
最初，87名（10.9%）参与者衰弱。到随访时，149名参与者（37.9%）进展为衰弱，其中83名（55.7%）在基线时吞咽功能受损。在基线时，衰弱与年龄、步速、吞咽功能下降、功能性牙齿数量、咬合力和咀嚼性能显著相关。三种吞咽功能评估方法均与衰弱进展无显著关联。相比之下，对衰弱进展的逻辑回归分析表明，吞咽功能受损是一个显著的解释变量（OR，1.53；95%CI：1.04-2.21）。
本研究发现衰弱与多种因素之间存在显著关联，尤其是口腔功能。具体而言,吞咽功能下降已成为衰弱进展的一个显著独立预测因素。
