Relationship between tongue strength, lip strength, and nutrition-related sarcopenia in older rehabilitation inpatients: a cross-sectional study

Abstract

ObjectiveThe objective of this study was to clarify the relationship between tongue strength, lip strength, and nutrition-related sarcopenia (NRS).Patients and methodsA total of 201 older inpatients aged ≥65 years (70 men, median age: 84 years, interquartile range: 79–89 years) consecutively admitted for rehabilitation were included in this cross-sectional study. The main factors evaluated were the presence of NRS diagnosed by malnutrition using the Mini-Nutrition Assessment – Short Form, sarcopenia based on the criteria of the Asian Working Group for Sarcopenia, tongue strength, and lip strength. Other factors such as age, sex, comorbidity, physical function, cognitive function, and oral intake level were also assessed.ResultsIn all, 78 (38.8%) patients were allocated to the NRS group, and 123 (61.2%) patients were allocated to the non-NRS group. The median tongue strength and lip strength (interquartile range) were significantly lower in the NRS group (tongue: 22.9 kPa [17.7–27.7 kPa] and lip: 7.2 N [5.6–9.8 N]) compared with the non-NRS group (tongue: 29.7 kPa [24.8–35.1 kPa] and lip: 9.9 N [8.4–12.3 N], P<0.001 for both). Multivariable logistic regression analysis showed that NRS was independently associated with tongue strength (odds ratio [OR] =0.93, 95% confidence interval [CI] 0.87–0.98, P=0.012) and lip strength (OR =0.76, 95% CI 0.66–0.88, P<0.001), even after adjusting for age, sex, comorbidity, physical function, cognitive function, and oral intake level.ConclusionThe likelihood of occurrence of NRS decreased when tongue strength or lip strength increased. Tongue strength and lip strength may be important factors for preventing and improving NRS, regardless of the presence of low oral intake level in older rehabilitation inpatients.

Nutritional status and functionality in geriatric rehabilitation patients: a systematic review and meta-analysis

“…The prevalence of reduced muscle mass was described only by one study which reported a reduced SMMI (women < 5.4 kg/m 2 , men < 7.0 kg/m 2 ) in 42.3% of women and 57.7% of men [63]. The prevalence of sarcopenia was reported in two studies and was 76.1% [62] according to the consensus definition of the Asian working group for sarcopenia and 40% (34% men, 46% women) [73] according to reduced fat-free mass index and quadriceps strength. Prevalence of frailty according to Fried was reported in one study [39]; 14.8% were frail and 55.6% prefrail.…”

Poor Oral Health as a Determinant of Malnutrition and Sarcopenia

“…Several authors also reported a decline in the strength of the swallowing muscles with aging or sarcopenia [116]. Maximal tongue strength decreases with aging [116][117][118][119], and there is some evidence that aging leads to a decreased jaw-opening force in older men. Several authors also reported an association between tongue strength and handgrip strength [120,121].…”

Dysphagia, Dementia and Frailty

“…Grip strength and walking speed are associated with tongue pressure and to a lesser extent jaw opening force in men (62)(63)(64)(65)(66)(67)(68). Similarly, head lifting strength is associated with dysphagia and malnutrition in older persons (69).…”