Skip to main content
SpringerLink
Log in

Relationship Between Dysphagia and Sarcopenia with Comprehensive Geriatric Evaluation

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

Oropharyngeal dysphagia has features of geriatric syndromes and is strongly associated with sarcopenia. In this cross-sectional study, we aimed to evaluate the association between dysphagia and sarcopenia, in a practical way, accompanied by comprehensive geriatric assessment. Dysphagia and sarcopenia were defined by the EAT-10 and SARC-F questionnaires, respectively. Cognition and mood, was evaluated by the Mini-mental State Examination (MMSE) and Geriatric Depression Scale (GDS), respectively. Physical performance was assessed by the Timed up and Go Test (TUG) and muscle strength was determined by Hand Grip Strength (HGS). Functionality was stated by Katz and Lawton Indexes. Serum levels of hemoglobin, triglyceride, albumin, and total cholesterol were recorded. A total of 512 (151 male/361 female) patients age 60 and older were included in the study. Prevalences of dysphagia and sarcopenia were 23% and 40.6%, respectively. In multivariate analysis sarcopenia (OR:2.596, p = 0.008), depressive symptoms (OR:1.115, p < 0.001), and lower KATZ scores (OR:0.810, p = 0.036) were independently related with dysphagia. Dysphagic patients with sarcopenia had lower scores on the Katz and Lawton scales (p < 0.001, rpb = 0.380 and p < 0.001, rpb = 0.447 respectively) and TUG performances were worse (p = 0.009, rpb = − 0.254). Serum hemoglobin and albumin levels were significantly low in dysphagic patients with sarcopenia (p < 0.001, rpb = 0.345, p = 0.008, rpb = 0.243). Dysphagia is independently associated with sarcopenia, depressive symptoms, and functionality. Dysphagia coexist with sarcopenia is associated with worse clinical consequences than without sarcopenia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Chen PH, Golub JS, Hapner ER, Johns MM. Prevalence of perceived dysphagia and quality-of-life impairment in a geriatric population. Dysphagia. 2009;24(1):1–6.

    Article  Google Scholar 

  2. Baijens LW, Clavé P, Cras P, Ekberg O, Forster A, Kolb GF, Leners JC, Masiero S, Mateos-Nozal J, Ortega O, Smithard DG, Speyer R, Walshe M. European Society for Swallowing Disorders–European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Interv Aging. 2016;11:1403–28.

    Article  Google Scholar 

  3. Yeom J, Song YS, Lee WK, Oh BM, Han TR, Seo HG. Diagnosis and clinical course of unexplained dysphagia. Ann Rehabil Med. 2016;40(1):95–101.

    Article  Google Scholar 

  4. Cha S, Kim WS, Kim KW, Han JW, Jang HC, Lim S, Paik NJ. Sarcopenia is an independent risk factor for dysphagia in community-dwelling older adults. Dysphagia. 2019;34(5):692–7.

    Article  Google Scholar 

  5. Wakabayashi H, Takahashi R, Murakami T. The Prevalence and prognosis of sarcopenic dysphagia in patients who require dysphagia rehabilitation. J Nutr Health Aging. 2019;23(1):84–8.

    Article  CAS  Google Scholar 

  6. Zhao WT, Yang M, Wu HM, Yang L, Zhang XM, Huang Y. Systematic review and meta-analysis of the association between sarcopenia and dysphagia. J Nutr Health Aging. 2018;22(8):1003–9.

    Article  Google Scholar 

  7. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M, Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.

    Article  Google Scholar 

  8. Malmstrom TK, Miller DK, Simonsick EM, Ferrucci L, Morley JE. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7(1):28–36.

    Article  Google Scholar 

  9. Bahat G, Yilmaz O, Kılıç C, Oren MM, Karan MA. Performance of SARC-F in regard to sarcopenia definitions, muscle mass and functional measures. J Nutr Health Aging. 2018;22(8):898–903.

    Article  CAS  Google Scholar 

  10. Maeda K, Akagi J. Sarcopenia is an independent risk factor of dysphagia in hospitalized older people. Geriatrics Gerontol Int. 2015;16(4):515–21.

    Article  Google Scholar 

  11. Cesari M, Pedone C, Chiurco D, Cortese L, Conte ME, Scarlata S, Incalzi RA. Physical performance, sarcopenia and respiratory function in older patients with chronic obstructive pulmonary disease. Age Ageing. 2012;41:237–41.

    Article  Google Scholar 

  12. Kuroda Y, Kuroda R. Relationship between thinness and swallowing function in japanese older adults: implications for sarcopenic dysphagia. J Am Geriatr Soc. 2012;60(9):1785–6.

    Article  Google Scholar 

  13. Wakabayashi H. Presbyphagia and sarcopenic dysphagia: association between aging, sarcopenia, and deglutition disorders. J Frailty Aging. 2014;3:97–103.

    CAS  PubMed  Google Scholar 

  14. Mori T, Fujishima I, Wakabayashi H et al (2017) Development, reliability, and validity of a diagnostic algorithm for sarcopenic dysphagia. JCSM clinical reports vol 2(2). https://jcsm-clinical-reports.info/index.php/jcsm-cr/article/view/17. Accessed 5 Nov 2018.

  15. Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117:919–24.

    Article  Google Scholar 

  16. Clavé P, Arreola V, Romea M. Accuracy of the volumeviscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin Nutr. 2008;27:806–15.

    Article  Google Scholar 

  17. Azzolino D, Damanti S, Bertagnoli L, Lucchi T, Cesari M. Sarcopenia and swallowing disorders in older people. Aging Clin Exp Res. 2019;31(6):799–805.

    Article  Google Scholar 

  18. Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47:1245–51.

    Article  CAS  Google Scholar 

  19. Katz S, Akpom CA. 12. Index of ADL. Med Care. 1976;14:116–8.

    Article  CAS  Google Scholar 

  20. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–86.

    Article  CAS  Google Scholar 

  21. Ertan T, Eker E. Reliability, validity, and factor structure of the geriatric depression scale in Turkish elderly: are there different factor structures for different cultures? Int Psychogeriatr. 2000;12:163–72.

    Article  CAS  Google Scholar 

  22. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.

    Article  CAS  Google Scholar 

  23. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: themini nutritional assessment as part of the geriatric evaluation. Nutr Rev. 1996;54:59–65.

    Article  Google Scholar 

  24. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–8.

    Article  CAS  Google Scholar 

  25. Fujishima I, Fujiu-Kurachi M, Arai H, Hyodo M, Kagaya H, Maeda K, Mori T, Nishioka S, Oshima F, Ogawa S, Ueda K, Umezaki T, Wakabayashi H, Yamawaki M, Yoshimura Y. Sarcopenia and dysphagia: position paper by four professional organizations. Geriatr Gerontol Int. 2019;19(2):91–7.

    Article  Google Scholar 

  26. Maeda K, Akagi J. Decreased tongue pressure is associated with sarcopenia and sarcopenic dysphagia in the elderly. Dysphagia. 2015;30(1):80–7.

    Article  Google Scholar 

  27. Maeda K, Takaki M, Akagi J. Decreased skeletal muscle mass and risk factors of sarcopenic dysphagia: a prospective observational cohort study. J Gerontol. 2017;72(9):1290–4.

    Google Scholar 

  28. Ogawa N, Mori T, Fujishima I, Wakabayashi H, Itoda M, Kunieda K, Shigematsu T, Nishioka S, Tohara H, Yamada M, Ogawa S. Ultrasonography to measure swallowing muscle mass and quality in older patients with sarcopenic dysphagia. J Am Med Dir Assoc. 2018;19(6):516–22.

    Article  Google Scholar 

  29. Kim JY, Lee YW, Kim HS, Lee EH. The mediating and moderating effects of meaning in life on the relationship between depression and quality of life in patients with dysphagia. J Clin Nurs. 2019;28(15–16):2782–9.

    Article  Google Scholar 

  30. Verdonschot RJ, Baijens LW, Serroyen JL, Leue C, Kremer B. Symptoms of anxiety and depression assessed with the Hospital Anxiety and Depression Scale in patients with oropharyngeal dysphagia. J Psychosom Res. 2013;75(5):451–5.

    Article  Google Scholar 

  31. Han M, Ohnishi H, Nonaka M, Yamauchi R, Hozuki T, Hayashi T, Saitoh M, Hisahara S, Imai T, Shimohama S, Mori M. Relationship between dysphagia and depressive states in patients with Parkinson’s disease. Parkinsonism Relat Disord. 2011;17(6):437–9.

    Article  Google Scholar 

  32. Tagliaferri S, Lauretani F, Pelá G, Meschi T, Maggio M. The risk of dysphagia is associated with malnutrition and poor functional outcomes in a large population of outpatient older individuals. Clin Nutr. 2019;38(6):2684–9.

    Article  Google Scholar 

  33. Özsürekci C, Arslan SS, Demir N, Çalışkan H, Şengül Ayçiçek G, Kılınç HE, Yaşaroğlu ÖF, Kızılarslanoğlu C, Doğrul TR, Balcı C, Sümer F, Karaduman A, Yavuz BB, Cankurtaran M, Halil MG. Timing of dysphagia screening in Alzheimer’s Dementia. JPEN J Parenter Enteral Nutr. 2019. https://doi.org/10.1002/jpen.1664(Epub ahead of print).

    Article  PubMed  Google Scholar 

  34. Wang H, Hai S, Liu Y, Cao L, Liu Y, Liu P, Zhou J, Yang Y, Dong B. Association between depressive symptoms and sarcopenia in older Chinese community-dwelling individuals. Clin Interv Aging. 2018;13:1605–11.

    Article  Google Scholar 

  35. Yoshimura Y, Wakabayashi H, Bise T, Tanoue M. Prevalence of sarcopenia and its association with activities of daily living and dysphagia in convalescent rehabilitation ward inpatients. Clin Nutr. 2018;37(6 PT A):2022–8.

    Article  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Division of Geriatrics, Department of Internal Medicine, Erciyes School of Medicine, Erciyes University, Melikgazi, 38090, Kayseri, Turkey

    Firuzan Fırat Ozer, Sibel Akın, Tuba Soysal & Bilge Müge Gokcekuyu

  2. Department of Biostatistics, Erciyes School of Medicine, Erciyes University, Melikgazi, 38090, Kayseri, Turkey

    Gözde Erturk Zararsız

  3. Division of Geriatrics, Department of Internal Medicine, Kayseri City Hospital, Kocasinan, 38080, Kayseri, Turkey

    Firuzan Fırat Ozer

Authors
  1. Firuzan Fırat Ozer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sibel Akın
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tuba Soysal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bilge Müge Gokcekuyu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gözde Erturk Zararsız
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Firuzan Fırat Ozer.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fırat Ozer, F., Akın, S., Soysal, T. et al. Relationship Between Dysphagia and Sarcopenia with Comprehensive Geriatric Evaluation. Dysphagia 36, 140–146 (2021). https://doi.org/10.1007/s00455-020-10120-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-020-10120-3

Keywords

Search

Navigation