Evaluation of dysphagia in patients with sarcopenia in a rehabilitation setting: insights from the vicious cycle.

Abstract

Nutritional deficits are known to cause sarcopenia. There is also evidence that sarcopenia itself may cause dysphagia, and swallowing problems are among the reasons for patients to have nutritional deficits. This study aims to evaluate the prevalence of nutritional deficits and dysphagia in patients with or without sarcopenia. 128 patients residing in a rehabilitation clinic are evaluated with EAT-10, MD Anderson Dysphagia Inventory, Functional Oral Intake Status scale, Mini Nutritional Assessment (MNA) and Beck Depression Index. All patients were then classified according to the latest sarcopenia classification proposed by the European Working Group on Sarcopenia in Older People in 2018. Muscle strength and mass were assessed using a hand dynamometer and measuring calf circumference, respectively. Walking velocity was assessed using the 4-m gait speed test. Patients belonging to sarcopenia, probable sarcopenia, and non-sarcopenia groups were then compared using relevant statistical methods to show whether there are differences in outcomes mentioned as well as demographical and clinical status. The presence of oropharyngeal dysphagia risk was only found between sarcopenic [85 (48-100)] and non-sarcopenic [91 (62-100)] individuals (p = 0.026) while other comparisons were insignificant. EAT-10 scores were found to be worse for probably sarcopenic [0 (0-13)] and sarcopenic [0 (0-35)] individuals compared to non-sarcopenics [0 (0-6)], and it was also shown sarcopenics were worse than probable sarcopenics (p = 0.001). While gait velocity only differed between individuals with sarcopenia and not sarcopenic ones, grip strength was deteriorated for both sarcopenic and probably sarcopenic individuals when compared to non-sarcopenics. MNA scores were still significantly worse for probable sarcopenics [10 (3-14)] and sarcopenics [9 (0-13)], when compared to non-sarcopenics [13 (3-14)] latter being even worse than the other two, respectively) (p = 0.0001). Dysphagia and nutritional impairments may be seen in the course of sarcopenia, and this also applies to the condition of probable sarcopenia.