title: Relationship between skeletal muscle mass and swallowing function in patients with Alzheimer's disease.
abstract: OBJECTIVE
  The present study verified the hypothesis that decreased skeletal muscle in older adults with Alzheimer's disease is related to Alzheimer's disease progression and decreased oral or swallowing function.
  
  
  METHODS
  We investigated 232 patients with Alzheimer's disease (31 men, 201 women, average age 85.4 ± 5.9 years) in two regions in Japan. The patients provided basic information (sex and age), and were assessed for skeletal muscle index, dementia severity (clinical dementia rating), activities of daily living, nutritional status, oral status and swallowing function.
  
  
  RESULTS
  Stratification by clinical dementia rating was as follows: clinical dementia rating 0.5:21 patients (9.0%), clinical dementia rating 1:85 patients (36.6%), clinical dementia rating 2:88 patients (37.9%) and clinical dementia rating 3:38 patients (16.3%). Alzheimer's disease severity was significantly related to skeletal muscle index. Logistic regression analysis showed that clinical dementia rating 3 (odds ratio 11.68, 95% confidence interval 4.52-30.20), body mass index < 18.5 (odds ratio 3.18, 95% confidence interval 1.27-8.00), calf circumference <30.5 cm (odds ratio 9.33, 95% confidence interval 2.01-43.27) and poor swallowing function (odds ratio 4.93, 95% confidence interval 1.10-22.04) had a significant effect on decreased skeletal muscle index.
  
  
  CONCLUSIONS
  Therefore, decreased skeletal muscle mass in patients with Alzheimer's disease requires strategies to manage swallowing dysfunction. Geriatr Gerontol Int 2016; 17: 402-409.
authors.affiliation: Department of Special Needs Dentistry Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takagi
authors.affiliation: Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Hirano
authors.affiliation: Department of Oral Diseases Research, National Center for Geriatrics and Gerontology, Aichi, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Edahiro
authors.affiliation: Department of Oral Health Care Education Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ohara
authors.affiliation: Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Hideyo
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Hunkyung
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Special Needs Dentistry Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan.
authors.forename: Kohji
authors.initials: K
authors.lastname: Murakami
authors.affiliation: Department of Special Needs Dentistry Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan.
authors.forename: Shouji
authors.initials: S
authors.lastname: Hironaka
mesh_terms: D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000503:physiopathology*; D015992:Body Mass Index; D015331:Cohort Studies; D016001:Confidence Intervals; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000502:physiology*; D009752:Nutritional Status; D016017:Odds Ratio; D009929:Organ Size; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
keywords: Alzheimer's disease; dysphagia; sarcopenia; skeletal muscle mass; swallowing function