Mikel González-Fernández1, Jose M Arbones-Mainar2,3,4, Eduardo Ferrer-Lahuerta5, Javier Perez-Nogueras6, Antonio Serrano-Oliver7, Elena Torres-Anoro8, Alejandro Sanz-Paris1,9. 1. Department of Nutrition, University Hospital Miguel Servet, Zaragoza, Spain. 2. Instituto de Investigacion Sanitaria Aragon (IIS-Aragon), Zaragoza, Spain. jmarbones.iacs@aragon.es. 3. Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, University Hospital Miguel Servet, Instituto Aragones de Ciencias de la Salud (IACS), 50009, Zaragoza, Spain. jmarbones.iacs@aragon.es. 4. Centro de Investigacion Biomedica en Red Fisiopatología Obesidad Y Nutricion (CIBERObn), Instituto Salud Carlos III, Madrid, Spain. jmarbones.iacs@aragon.es. 5. Department of Radiology and Ultrasound, University Hospital Miguel Servet, Zaragoza, Spain. 6. Geriatric Unit, Elias Martinez Nursing Home, Zaragoza, Spain. 7. Geriatric Unit, Casa Amparo Nursing Home, Zaragoza, Spain. 8. Geriatric Unit, Romareda Nursing Home, Zaragoza, Spain. 9. Instituto de Investigacion Sanitaria Aragon (IIS-Aragon), Zaragoza, Spain.
Abstract
BACKGROUND & AIMS: Oral phase dysphagia is dependent on ability to chew. As people age, general muscle atrophy contributes to decreased masseter strength. The main objective of this study was to assess the relationship between the thickness of the masseter muscle measured by ultrasonography and the presence of dysphagia in a group of institutionalized elderly people. As a secondary objective, we aimed to establish cutoff points of masseters muscle thickness (MMT) to identify elderly individuals at risk of oral dysphagia. METHODS: Cross-sectional study of all residents from 3 nursing homes. All individuals underwent ultrasonographic measurements of left and right MMT and were classified according to the presence of dysphagia assessed by both the EAT-10 screening questionnaire and the volume-viscosity swallow test (V-VST). RESULTS: 469 patients (69% women, mean age 84.7 yrs) were recruited. Dysphagia was present in 41.6% and 26% of individuals according the EAT-10 and V-VST, respectively. Multivariate logistic regression showed that 1 mm increase in MMT reduced the risk of dysphagia by 21% according to the EAT-10 tool and by 30% using the V-VST after adjusting for age, sex, mini-nutritional assessment score, and body mass index. We used receiver operative characteristic (ROC) curves to identify cutoff points of MMT to detect dysphagic individuals according to either EAT-10 or V-VST. CONCLUSIONS: The MMT measured by ultrasonography is reduced in elderly individuals with dysphagia. Based on MMT, clinicians may be better informed about the patients'´ ability to masticate solid foods and identify potential nutrient deficiencies in geriatric settings.
BACKGROUND & AIMS: Oral phase dysphagia is dependent on ability to chew. As people age, general muscle atrophy contributes to decreased masseter strength. The main objective of this study was to assess the relationship between the thickness of the masseter muscle measured by ultrasonography and the presence of dysphagia in a group of institutionalized elderly people. As a secondary objective, we aimed to establish cutoff points of masseters muscle thickness (MMT) to identify elderly individuals at risk of oral dysphagia. METHODS: Cross-sectional study of all residents from 3 nursing homes. All individuals underwent ultrasonographic measurements of left and right MMT and were classified according to the presence of dysphagia assessed by both the EAT-10 screening questionnaire and the volume-viscosity swallow test (V-VST). RESULTS: 469 patients (69% women, mean age 84.7 yrs) were recruited. Dysphagia was present in 41.6% and 26% of individuals according the EAT-10 and V-VST, respectively. Multivariate logistic regression showed that 1 mm increase in MMT reduced the risk of dysphagia by 21% according to the EAT-10 tool and by 30% using the V-VST after adjusting for age, sex, mini-nutritional assessment score, and body mass index. We used receiver operative characteristic (ROC) curves to identify cutoff points of MMT to detect dysphagic individuals according to either EAT-10 or V-VST. CONCLUSIONS: The MMT measured by ultrasonography is reduced in elderly individuals with dysphagia. Based on MMT, clinicians may be better informed about the patients'´ ability to masticate solid foods and identify potential nutrient deficiencies in geriatric settings.
Authors: Charlène Cool; Philippe Cestac; Charlotte Laborde; Cécile Lebaudy; Laure Rouch; Benoit Lepage; Bruno Vellas; Philipe de Souto Barreto; Yves Rolland; Maryse Lapeyre-Mestre Journal: J Am Med Dir Assoc Date: 2014-10-03 Impact factor: 4.669