Tongue pressure during swallowing is an independent risk factor for aspiration pneumonia in middle‐aged and older hospitalized patients: An observational study

Abstract

AimTo evaluate oral frailty features present in hospitalized older patients with aspiration pneumonia.MethodsWe enrolled hospitalized patients aged ≥50 years and classified them into three groups: the community‐acquired, aspiration, and non‐community‐acquired pneumonia groups. Oral frailty was defined as meeting three or more criteria from the following: choking, and decreased occlusal force, masticatory function, tongue–lip motor function, tongue pressure, and tongue pressure during swallowing.ResultsOf 168 patients enrolled, the incidence of aspiration pneumonia was 23.9% (17/71) in patients admitted with pneumonia as the primary diagnosis. The occlusal force and masticatory function were significantly poorer and tongue pressure and tongue pressure during swallowing were significantly lower in the aspiration pneumonia group than in the other two groups. A higher number of chronic comorbidities, poor oral health, and lower tongue pressure during swallowing were significantly associated with aspiration pneumonia. A tongue pressure during swallowing of <10.32 kPa might be a cutoff point for predicting the risk of aspiration pneumonia.ConclusionsHospitalized patients aged ≥50 years with multiple comorbidities, poor oral hygiene, and oral frailty during swallowing are at a higher risk of developing aspiration pneumonia, especially when their tongue pressure during swallowing is <10.32 kPa. Aspiration pneumonia is a preventable disease. Healthcare professionals should incorporate tongue pressure measurements or other screening tools into routine clinical practice to facilitate the early detection of this condition and intervention. Geriatr Gerontol Int 2023; ••: ••–••.

Decrease in Tongue Pressure in Frail Patients in the Sitting Position and Its Alleviation by Plantar Grounding

“…Low tongue pressure, which is one of the objective items of oral frailty [4], is associated with frailty [5] and aspiration risk [6]. Therefore, it is reasonable and beneficial for admitted patients to undergo tongue pressure measurement screening before oral intake in order to prevent aspiration.…”

In Frail Patients, Tongue Pressure Decreases in the Sitting Position, but This Decrease Is Alleviated by Plantar Grounding

“…Low tongue pressure, which is one of the objective items of oral frailty [3], is associated with frailty [4] and aspiration risk [5]. Therefore, it is reasonable and beneficial for admitted patients to receive tongue pressure measurement screening before oral intake in order to prevent aspiration.…”