Alternating Motion Rate to Distinguish Elderly People With History of Pneumonia.
BACKGROUND
Under the hypothesis that elderly people in the community may have deficient oropharyngeal dysfunction, the purpose of this case-control study was to compare oral and physical characteristics in elderly people with and without a history of pneumonia and to identify factors distinguishing them.


METHODS
In 2014, we examined 1,311 elderly people who agreed to participate in a longitudinal and intervention study for the community-dwelling elderly. We looked at such physical characteristics as body composition, grip power, gait, and balance and at oropharyngeal characteristics, such as alternating motion rate (AMR) in speech and the repetitive saliva-swallowing test (RSST). The subjects were also asked about past history of pneumonia and other morbid conditions. From that information, we extracted 24 subjects reporting to have had pneumonia within the previous 5 y as well as 172 other subjects who matched the pneumonia subjects with respect to age, sex, and number of other morbidities to form 2 groups for comparisons. We also subjected the data to a logistic regression analysis, with having or not having pneumonia as the dependent variable, oral and physical characteristics as independent variables, and age and sex as covariates.


RESULTS
No significant differences were seen in physical characteristics between the 2 groups. Among the oropharyngeal characteristics, AMR was significantly lower in the pneumonia subjects (P = .005, effect size = 0.20), whereas RSST exhibited no significant difference between the 2 groups. Logistic regression revealed AMR to be the only factor related to pneumonia (P = .002, odds ratio 0.169, 95% CI 0.056-0.508).


CONCLUSIONS
In community-dwelling elderly people, association of pneumonia with skilled tongue control (AMR) rather than with swallowing (RSST) prompts a reexamination of what constitutes being at risk for pneumonia.
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology (Tokyo Metropolitan Institute of Gerontology), Tokyo, Japan. kera@tmig.or.jp.|Japanese Red Cross Ogawa Hospital, Department of Rehabilitation, Saitama, Japan.
Takeshi
T
Kera
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology (Tokyo Metropolitan Institute of Gerontology), Tokyo, Japan.
Ayako
A
Edahiro
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology (Tokyo Metropolitan Institute of Gerontology), Tokyo, Japan.
Hirohiko
H
Hirano
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology (Tokyo Metropolitan Institute of Gerontology), Tokyo, Japan.
Hisashi
H
Kawai
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology (Tokyo Metropolitan Institute of Gerontology), Tokyo, Japan.
Hideyo
H
Yoshida
Department of Physical Therapy, Faculty of Medical Health Sciences, University of Tokyo Health Sciences, Tokyo, Japan.
Motonaga
M
Kojima
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology (Tokyo Metropolitan Institute of Gerontology), Tokyo, Japan.
Yoshinori
Y
Fujiwara
Department of Public Health, Toho University School of Medicine, Tokyo, Japan.
Kazushige
K
Ihara
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology (Tokyo Metropolitan Institute of Gerontology), Tokyo, Japan.
Shuichi
S
Obuchi
D000368:Aged; D001823:Body Composition; D016022:Case-Control Studies; D003679:Deglutition / Q000502:physiology; D005260:Female; D005684:Gait; D018737:Hand Strength; D006801:Humans; D057187:Independent Living; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009960:Oropharynx / Q000503:physiopathology*; D010608:Pharyngeal Diseases / Q000209:etiology; D011014:Pneumonia / Q000150:complications / Q000503:physiopathology*; D004856:Postural Balance; D013060:Speech / Q000502:physiology; D013997:Time Factors; D014059:Tongue / Q000503:physiopathology
alternating motion rate; community-dwelling elderly; pneumonia; repeated phonation; repeated swallowing