Prevalence of Hoarseness and Its Association with Severity of Dysphagia in Patients with Sarcopenic Dysphagia

Abstract

Objectives To investigate the prevalence of hoarseness and its association with the severity of dysphagia in patients with sarcopenic dysphagia. Design Cross-sectional study using the Japanese sarcopenic dysphagia database. Setting 19 hospitals including 9 acute care hospitals, 8 rehabilitation hospitals, 2 long-term care hospitals, and 1 home visit rehabilitation team. Participants 287 patients with sarcopenic dysphagia, aged 20 years and older. Measurements Sarcopenic dysphagia was diagnosed using a reliable and validated diagnostic algorithm for the condition. The presence and characteristics of hoarseness classified as breathy, rough, asthenic, and strained were assessed. The prevalence of hoarseness and the relationship between hoarseness and Food Intake LEVEL Scale (FILS) were examined. Order logistic regression analysis adjusted for age, sex, naso-gastric tube, and handgrip strength was used to examine the relationship between hoarseness and FILS at baseline and at follow-up. Results The mean age was 83 ± 10 years. Seventy-four (26%) patients had hoarseness, while 32 (11%), 20 (7%), 22 (8%), and 0 (0%) patients had breathy, rough, asthenic, and strained hoarseness, respectively. Median FILS at the initial evaluation was 7 (interquartile range, 5–8). Hoarseness (β=0.747, 95% confidence intervals= 0.229, 1.265, p=0.005), age, sex, naso-gastric tube, and handgrip strength were associated independently with baseline FILS, while hoarseness (β=0.213, 95% confidence intervals= −0.324, 0.750, p=0.438) was not associated independently with the FILS at follow-up. Conclusions Hoarseness was associated with the severity of dysphagia at baseline, however not a prognostic factor for sarcopenic dysphagia. Resistance training of swallowing and respiratory muscles and voice training as part of rehabilitation nutrition might be useful for treating sarcopenic dysphagia.

Sensitivity and Specificity of Body Mass Index for Sarcopenic Dysphagia Diagnosis among Patients with Dysphagia: A Multi-Center Cross-Sectional Study

“…Data were derived from a multi-center prospective cohort study using the Japanese Sarcopenic Dysphagia Database, the details of which are described elsewhere [ 18 , 19 ], with a web-based electronic data-capturing system (REDCap) [ 20 ]. In the database, we registered dysphagic patients aged ≥ 20 years with a score of ≤8 by the food intake level scale (FILS) [ 21 ] at nine acute-care hospitals, eight rehabilitation hospitals, two long-term care hospitals, and one home-visit rehabilitation team between November 2019 and March 2021.…”

“…We included non-consecutive dysphagic in patients aged ≥20 years with a FILS score ≤ 8 [ 21 ] between November 2019 and March 2021 in the database. The inclusion criteria was registration in the database [ 16 , 18 , 19 , 22 ], while the exclusion criteria were (1) outpatients and (2) missing values for BMI and other components of the diagnostic algorithm for sarcopenic dysphagia, such as muscle strength, physical performance, or muscle mass. The reason for choosing these criteria was that BMI was intended to be used to screen for sarcopenic dysphagia at the time of admission.…”

Nutritional Biomarkers as Predictors of Dysphonia Severity in Patients with Ischemic Stroke

“…Vocal fold muscles are also skeletal muscles and may be affected by malnutrition. Due to the comparable histological architecture of the tongue and thyroarytenoid muscles, sarcopenia may arise in the vocal fold muscles [ 41 , 42 ]. Weakness and wasting of the vocal fold muscles can cause changes in voice quality [ 41 ].…”

“…Due to the comparable histological architecture of the tongue and thyroarytenoid muscles, sarcopenia may arise in the vocal fold muscles [ 41 , 42 ]. Weakness and wasting of the vocal fold muscles can cause changes in voice quality [ 41 ]. In addition, sarcopenia of the respiratory muscles may cause changes in voice quality and dysphonia due to a decrease in expiratory function [ 43 ].…”