Sarcopenia is an independent risk factor of dysphagia in hospitalized older people

K. Maeda and J. Akagi

Geriatr Gerontol Int. 2016;16(4):515-21

Sarcopenia can cause varying physical function disorders, including dysphagia. Malnutrition, a potential result of dysphagia, can also cause sarcopenia. However, the association between sarcopenia and dysphagia is not fully understood, despite evidence suggesting correlations between deglutition disorders and degenerative loss of muscle mass. The present study investigated the prevalence of dysphagia among patients with sarcopenia, and the association between the two conditions.

224 older adults (mean age 82.5 ± 8.4 years; 37.9% men) aged ≥65 years who were admitted to acute phase wards in Tamana Regional Health Medical Center, Tamana, Japan, from April 2014 to July 2014 were included. Individuals who had a stroke or other diseases that could directly cause dysphagia were excluded. Logistic regression analyses were carried out after adjusting for potential causes of sarcopenia, including malnutrition, a low activity of daily living levels and aging, to investigate the relationship between the skeletal muscle index (SMI), prevalence of sarcopenia diagnosed based on a low SMI and grip strength, and swallowing functions. The Mini-Nutritional Assessment short form was used to assess their nutritional status, and the Barthel Index was used to evaluate their activities of daily living.

The prevalences of sarcopenia and dysphagia were 76.8% and 30.0%, respectively. Multivariate analysis showed that Barthel Index, SMI and presence of sarcopenia were significant independent factors for the prevalence of dysphagia, after adjusting for sex, age and nutritional status. Furthermore, subgroup analysis showed that SMI in males, and both hand-grip strength and SMI in females were lower in dysphagic subjects than in non-dysphagic subjects (P ≤ 0.01).

Comment: These findings suggest that sarcopenia is an independent risk factor for dysphagia among older individuals. Additionally, it was shown a strong association between sarcopenia and dysphagia among men and women who did not have a stroke, neurodegenerative disease or head and neck cancer, and a relation between physical function and dysphagia. The decreased physical function and the loss of skeletal muscle volume and strength impact the ability to swallow. Low SMI and low hand-grip strength are associated with sarcopenic dysphagia.