title: Neck Circumference Is Not Associated with Dysphagia but with Undernutrition in Elderly Individuals Requiring Long-term Care.
abstract: OBJECTIVE
  The purpose was to assess the association between neck circumference, dysphagia, and undernutrition in elderly individuals requiring long-term care.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Geriatric health services facilities, acute hospitals, and the community.
  
  
  METHODS
  Elderly individuals ≥65 years of age with dysphagia or possible dysphagia (N=385).
  
  
  METHODS
  Neck circumference, the Dysphagia Severity Scale (DSS) and the Mini Nutritional Assessment Short Form (MNA-SF).
  
  
  RESULTS
  Participants included 130 males and 255 females with a mean age (± standard deviation) of 83 ± 8.0 years. Sixty-six were in acute hospitals, 195 were in geriatric health services facilities, and 124 were community-dwelling. The mean neck circumference in males and females was 37.1 ± 3.0 cm and 33.3 ± 3.3 cm, respectively. Based on the DSS, 81 participants were within normal limits, 137 had dysphagia without aspiration, and 167 had dysphagia with aspiration. The MNA-SF revealed that 173 were malnourished, 172 were at risk of malnutrition, and 40 had a normal nutritional status. Neck circumference was not significantly correlated with the DSS (r=-0.080) but was significantly correlated with the MNA-SF (r=0.183) in the Spearman rank correlation analysis. In the logistic regression, neck circumference was not independently associated with the DSS after adjusting for the MNA-SF, the Barthel Index, age, sex, setting, and cerebrovascular disorders. However, the multiple regression analysis showed that neck circumference had an independent effect on the MNA-SF after adjusting for the Barthel Index, age, sex, setting and cerebrovascular disorders.
  
  
  CONCLUSIONS
  Neck circumference is not associated with dysphagia but with undernutrition in elderly individuals requiring long-term care.
authors.affiliation: Hidetaka Wakabayashi, Department of Rehabilitation Medicine, Yokohama City University Medical Center, 4-57 Urafune-chou, Minami ward, Yokohama City, Japan 232-0024, E-mail: noventurenoglory@gmail.com, Tel: +81-45-261-5656; Fax: +81-45-253-9955.
authors.forename: H
authors.initials: H
authors.lastname: Wakabayashi
authors.forename: M
authors.initials: M
authors.lastname: Matsushima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D009333:Neck / Q000033:anatomy & histology*; D015596:Nutrition Assessment; D009752:Nutritional Status