title: The relationship of aspiration status with tongue and handgrip strength in healthy older adults.
abstract: BACKGROUND
  Recently, subclinical aspiration has been identified in approximately 30% of community-dwelling older adults. Given that the tongue is a key component of the safe swallow, we hypothesized healthy older adults who aspirate will generate less tongue strength than adults who do not aspirate. Furthermore, as muscle weakness may reflect a global effect of aging, we further investigated whether tongue strength is correlated with handgrip strength.
  
  
  METHODS
  We assessed 78 healthy community-dwelling older adults (M = 77.3 years, SD = 7.26) for aspiration status (37% aspirators) via flexible endoscopic evaluation of swallowing. Maximal isometric anterior and posterior tongue strength, anterior and posterior swallowing tongue strength, and maximum handgrip strength were measured.
  
  
  RESULTS
  Isometric tongue strength was significantly lower in aspirators versus nonaspirators (p = .03) at both the anterior (463 vs 548 mmHg, respectively) and posterior lingual locations (285 vs 370 mmHg, respectively). Likewise, swallowing tongue strength was significantly lower in aspirators versus nonaspirators at both the anterior (270 vs 317 mmHg, respectively) and posterior lingual locations (220 vs 267 mmHg, respectively). There was no difference between aspirators and nonaspirators' handgrip strength (p > .05), although handgrip strength was correlated with posterior tongue strength (r = .34, p = .005).
  
  
  CONCLUSIONS
  Lower anterior and posterior isometric and swallowing tongue strength were dependent on aspiration status. Lower lingual strength in healthy adults may predispose them to aspiration. The correlation between tongue and handgrip strength is consistent with the hypothesis that impaired oropharyngeal strength reflects global age-related declines in muscle strength.
authors.affiliation: Department of Otolaryngology, Claude D. Pepper Older Americans Independence Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. sbutler@wfubmc.edu
authors.forename: Susan G
authors.initials: SG
authors.lastname: Butler
authors.forename: Andrew
authors.initials: A
authors.lastname: Stuart
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Leng
authors.forename: Erika
authors.initials: E
authors.lastname: Wilhelm
authors.forename: Catherine
authors.initials: C
authors.lastname: Rees
authors.forename: Jeff
authors.initials: J
authors.lastname: Williamson
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kritchevsky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003680:Deglutition Disorders / Q000453:epidemiology*; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D018908:Muscle Weakness / Q000503:physiopathology; D053120:Respiratory Aspiration / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology; D014059:Tongue / Q000503:physiopathology*