Decreased Tongue Pressure Associated with Aging, Chewing and Swallowing Difficulties of Community-Dwelling Older Adults in Taiwan

Abstract

Personalized tongue pressure (TP) training focuses on improving swallowing. This study aims to establish the TP values of different age levels and compare changes between different swallowing status among community-dwelling elders. In this cross-sectional study, 1000 participants, aged 60 years old and above, were recruited from community care centers. All participants were classified into non chewing and/or swallowing difficulties (NCSD) and with chewing and/or swallowing difficulties (CSD) groups and their diseases and dieting status were recorded using a structured questionnaire. A disposable oral probe was used to measure TP by asking participants to compress it against the hard palate with maximum voluntary effort. Among 1000 elders, 63.10% had CSD and their TP (from 31.76 to 18.20 kPa) was lower than the NCSD group (from 33.56 to 24.51 kPa). Both groups showed the same tendency for TP decline with increasing age. Decline of TP makes CSD elderly have a poor appetite, eat a soft or liquid diet, and take longer to eat a meal (all p < 0.050). The secondary risk factor dominating TP decline for NCSD and CSD elders is having an education level less than primary school and an abnormal eating assessment, respectively. Our results demonstrated that TP decline has a significant relationship with age changes. Education level and an abnormal eating assessment score are closely associated with TP decline. A series of TP values can be used as a reference indicator of personalized medicine during the aging process among community-dwelling older adults.

Population-based reference values for tongue pressure in Japanese older adults: A pooled analysis of over 5,000 participants

“…In contrast, we did not set exclusion criteria based on dentition status or swallowing function. Although occlusal status was not associated with TP in a previous study [21], swallowing difficulties were suggested to be associated with low TP [22]. Therefore, excluding those with poor swallowing function might have led to an increase in TP in Utanohara et al [7].…”

Features of Masticatory Behaviors in Older Adults with Oral Hypofunction: A Cross-Sectional Study

“…There have been prior reports of the relationships of decreased tongue pressure to activities of daily living (ADL) [ 37 ] and dysphagia [ 38 ]. It has also been reported that decreased tongue pressure is associated with longer mealtimes [ 39 ] and the intake of formula diet [ 40 ], suggesting that decreased tongue pressure also affects the form of food that can be ingested. In the present study as well, elderly people with decreased tongue pressure showed an increased number of chews and longer total chewing time in order to form a bolus adequately, suggesting that decreased tongue pressure affects bolus formation.…”

Frequency and associated factors for swallowing impairment in community-dwelling older persons: a systematic review and meta-analysis

“…Despite the broad search conducted, only few of the studies identified were population-based and designed to measure the prevalence of SI, with a representative sample [41,43,[46][47][48]. This limited our analysis, as we could not estimate the actual prevalence of SI.…”