Abstract
ObjectivesThe aim of the present study was (a) to determine the relationship of videofluoroscopic swallowing study (VFSS) findings of the swallowing musculature with the diagnostic criteria for sarcopenic dysphagia and (b) to examine the usefulness of VFSS for diagnosing sarcopenic dysphagia.MethodsThe participants were 132 patients (mean age, 80.4 ± 8.8 years). Their skeletal muscle mass, nutritional status and swallowing functions as assessed by VFSS findings were measured. Also, the relationship between the VFSS findings and sarcopenia was examined.ResultsOf all the participants, 20 men (mean age, 83.2 ± 6.9 years) and 27 women (mean age, 85.3 ± 6.9 years) were diagnosed with sarcopenia. In men, the amount of laryngeal upward movement (ALUM) was significantly lower and the pharyngeal area was significantly wider in the sarcopenia group than in the non‐sarcopenia group. In women, the pharyngeal area was significantly wider in the sarcopenia group than in the non‐sarcopenia group. In a logistic regression model, ALUM (odds ratio [OR] 1.135, 95% confidence interval [CI] 1.037‐1.241, P = .006) and pharyngeal area (OR 0.028, 95% CI 0.001‐0.670, P = .027) was a significant independent factor for the presence or absence of sarcopenia.ConclusionsThe decline in swallowing function of sarcopenia patients was characterised by lower laryngeal movement and enlargement of the pharyngeal cavity due to decreased skeletal muscle mass and decreased muscle strength. The present study suggested the usefulness of measuring ALUM during swallowing and measuring the pharyngeal area with VFSS as indicators of decreased swallowing muscle function in sarcopenia.
Highlights
Sarcopenia, which occurs with ageing, disrupts the vital functions of older people
Some people with decreased systemic muscle mass show a decline in swallowing function, a concept described as sarcopenic dysphagia.[1]
The analysis showed that Barthel index date (BI), Mini Nutritional Assessment-Short Form (MNA-SF), amount of laryngeal upward movement (ALUM) and pharyngeal area were significantly related to the presence or absence of sarcopenia (Table 3)
Summary
Sarcopenia, which occurs with ageing, disrupts the vital functions of older people. Some people with decreased systemic muscle mass show a decline in swallowing function, a concept described as sarcopenic dysphagia.[1]. When a patient presents clinically with dysphagia without a distinct underlying illness such as cerebrovascular disease, the cause of dysphagia could be sarcopenia. The concept of sarcopenic dysphagia is considered to be “dysphagia due to sarcopenia of the whole body and swallowing muscles, and includes as a cause secondary sarcopenia due to age, decreased activity, malnutrition and disease (invasive and cachexia).”[2] Sarcopenia is a serious cause of dysphagia elders. Sarcopenic dysphagia is often observed after aspiration pneumonia.[3]. The relationship between aspiration pneumonia, one of the most common causes of death in older people, and sarcopenic dysphagia implies that sarcopenia is linked to a fatal outcome
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