title: Decreased Skeletal Muscle Mass and Risk Factors of Sarcopenic Dysphagia: A Prospective Observational Cohort Study.
abstract: BACKGROUND
  Dysphagia is a known risk factor for malnutrition and pneumonia. Although sarcopenia is hypothesized to cause dysphagia, its causality remains unclear. Thus, this study aimed to investigate causality and the risk factors for sarcopenic dysphagia.
  
  
  METHODS
  We enrolled 95 hospitalized patients aged 65 years or older who had restricted oral intake without dysphagia. The skeletal muscle index and Functional Oral Intake Scale were used to evaluate muscle mass and swallowing ability, respectively. Nutritional status, assessed by body mass index, the Mini Nutritional Assessment-Short Form, and energy intake; activity of daily living, assessed by the Barthel Index; hand-grip strength; duration of oral intake restriction; and cognitive status were measured. Dysphagia (Functional Oral Intake Scale ≤ 5) was determined after 2 months.
  
  
  RESULTS
  The participants' mean age was 83.2 ± 8.0 years; 63% were women. Of the surviving 82 patients, 63 (77%) had sarcopenia and 21 (26%) developed dysphagia, all of whom had sarcopenia (p = .002). Most variables were risk factors for dysphagia on univariate analysis. Decreased skeletal muscle index (odds ratio [OR] 24.0, 95% confidence interval [CI] 3.6-159.0, p = .001), Barthel Index (OR 12.9, 95% CI 2.1-78.4, p = .005), and body mass index (OR 11.4, 95% CI 1.8-70.5, p = .009) were independent predictors of dysphagia in the multivariate analysis.
  
  
  CONCLUSIONS
  This study provides evidence for sarcopenic dysphagia and its risk factors. Preventive and therapeutic interventions require further study.
authors.affiliation: Department of Nutrition and Dysphagia Rehabilitation.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Swallowing and Nutritional Therapy.
authors.forename: Miki
authors.initials: M
authors.lastname: Takaki
authors.affiliation: Department of Surgery, Tamana Regional Health Medical Center, Kumamoto, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Akagi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003071:Cognition; D003680:Deglutition Disorders / Q000209:etiology*; D002149:Energy Intake; D005260:Female; D015577:Geriatric Assessment; D018737:Hand Strength; D006801:Humans; D008297:Male; D015596:Nutrition Assessment; D011446:Prospective Studies; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications*
keywords: Causal relationship; Sarcopenia; Swallowing difficulty