In the ageing society, sarcopenia, in which muscle strength and motor function decline with age, has attracted attention, and many researchers have investigated different testing and treatment methods. 1-6 Aspiration resulting from reduced swallowing function is a problem in the elderly, and aspiration pneumonia significantly deteriorates the life prognosis and QOL. 7 These disorders associated with reduced swallowing function were dysphagia. As sarcopenia is involved in the onset of dysphagia, 8,9 the relationship between sarcopenia and dysphagia has attracted attention. AbstractBackground: Sarcopenia in the oral region, including the tongue, leads to declined swallowing function and dysphagia. Muscle mass and strength, and motor function in the oral region have not been examined together, and the relationship between generalised and oral sarcopenia remains unclear. Objective(s):The purpose of this study is to clarify the relationship between generalised sarcopenia and oral sarcopenia in the elderly in order to facilitate the establishment of a method for assessing oral sarcopenia. Methods:A total of 54 elderly persons participated in this study. We examined the skeletal muscle mass index (SMI), grip strength (GS) and walking speed (WS) as the index of generalised sarcopenia, and the cross-sectional area of the geniohyoid muscle (CSG), tongue pressure (TP) and oral diadochokinesis (ODK) as the index of oral sarcopenia. Results:We found a moderate correlation between CSG and SMI, a weak correlation between GS and TP, and a moderate correlation between WS and ODK. CSG, TP and ODK were significantly smaller in the sarcopenia group than in the non-sarcopenia group. By multiple regression analysis, SMI and TP were significantly associated with CSG. ODK, BMI and CSG were significantly associated with TP. WS and SMI were significantly associated with ODK.Conclusion: CSG, TP and ODK were confirmed as endpoints of oral sarcopenia. All endpoints of oral sarcopenia were influenced by those of generalised sarcopenia. K E Y W O R D Sgeniohyoid muscle, oral diadochokinesis, oral sarcopenia, sarcopenia, tongue pressure | 637 KOBUCHI et al.

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Oral appliances (OAs) have demonstrated efficacy in treating obstructive sleep apnea (OSA), but many different OA devices are available. The Japanese Academy of Dental Sleep Medicine supported the use of OAs that advanced the mandible forward and limited mouth opening and suggested an evaluation of their effects in comparison with untreated or CPAP. A systematic search was undertaken in 16 April 2012. The outcome measures of interest were as follows: Apnea Hypopnea Index (AHI), lowest SpO2 , arousal index, Epworth Sleepiness Scale (ESS), the SF-36 Health Survey. We performed this meta-analysis using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Five studies remained eligible after applying the exclusion criteria. Comparing OA and control appliance, OA significantly reduced the weighted mean difference (WMD) in both AHI and the arousal index (favouring OA, AHI: -7.05 events h(-1) ; 95% CI, -12.07 to -2.03; P = 0.006, arousal index: -6.95 events h(-1) ; 95% CI, -11.75 to -2.15; P = 0.005). OAs were significantly less effective at reducing the WMD in AHI and improving lowest SpO2 and SF-36 than CPAP, (favouring OA, AHI: 6.11 events h(-1) ; 95% CI, 3.24 to 8.98; P = 0.0001, lowest SpO2 : -2.52%; 95% CI, -4.81 to -0.23; P = 0.03, SF-36: -1.80; 95% CI, -3.17 to -042; P = 0.01). Apnea Hypopnea Index and arousal index were significantly improved by OA relative to the untreated disease. Apnea Hypopnea Index, lowest SpO2 and SF-36 were significantly better with CPAP than with OA. The results of this study suggested that OAs improve OSA compared with untreated. CPAP appears to be more effective in improving OSA than OAs.

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