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Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly.

ABSTRACT: The term "oral frailty" reflects the fact that oral health is associated with physical frailty and mortality. The gold standard methods for evaluating the swallowing function have several problems, including the need for specialized equipment, the risk of radiation exposure and aspiration, and general physicians not possessing the requisite training to perform the examination. Hence, several simple and non-invasive techniques have been developed for evaluating swallowing function, such as those for measuring tongue pressure and tongue thickness. The aim of this study was to investigate the relationship between tongue thickness ultrasonography and tongue pressure in the Japanese elderly. We evaluated 254 elderly patients, who underwent tongue ultrasonography and tongue pressure measurement. To determine tongue thickness, we measured the vertical distance from the surface of the mylohyoid muscle to the tongue dorsum using ultrasonography. The results of the analyses revealed that tongue thickness was linearly associated with tongue pressure in both sexes. In male participants, dyslipidemia, lower leg circumference, and tongue pressure were independently and significantly associated with tongue thickness. In female participants, body mass index and tongue pressure were independently and significantly associated with tongue thickness. The optimal cutoff for tongue thickness to predict the tongue pressure of < 20 kPa was 41.3 mm in males, and 39.3 mm in females. In the Japanese elderly, tongue thickness using ultrasonography is associated with tongue pressure. Tongue thickness and tongue pressure, which are sensitive markers for oral frailty, decrease with age. We conclude that tongue ultrasonography provides a less invasive technique for determining tongue thickness and predicts oral frailty for elderly patients.

SUBMITTER: Nakamori M

PROVIDER: S-EPMC7413413 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly.

Nakamori Masahiro M Imamura Eiji E Fukuta Masako M Tachiyama Keisuke K Kamimura Teppei T Hayashi Yuki Y Matsushima Hayato H Ogawa Kanami K Nishino Masami M Hirata Akiko A Mizoue Tatsuya T Wakabayashi Shinichi S

PloS one 20200807 8

The term "oral frailty" reflects the fact that oral health is associated with physical frailty and mortality. The gold standard methods for evaluating the swallowing function have several problems, including the need for specialized equipment, the risk of radiation exposure and aspiration, and general physicians not possessing the requisite training to perform the examination. Hence, several simple and non-invasive techniques have been developed for evaluating swallowing function, such as those ...[more]

PMID: 32764766

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Project description:The tongue plays an important role in swallowing, and its dysfunction theoretically leads to inadequate oral intake and subsequent malnutrition. This study aimed to explore how different levels of tongue pressure are related to malnutrition among community-dwelling older individuals. The target population was community-dwelling adults aged ≥ 65 years. Tongue pressure was measured using the Iowa Oral Performance Instrument, whereas the mini nutrition assessment (MNA) test was administered to determine the nutritional status. A full MNA score of less than 24 points was defined as risk of malnutrition. Multivariate logistic regression analyses were conducted to calculate the odds ratio (OR) of risk of malnutrition among different quartiles of tongue pressure. Among the 362 participants, 26 (7.1%) were classified as having risk of malnutrition. Body weight, body mass index, handgrip strength, skeletal muscle mass index, sum MNA score, and serum levels of albumin were lower in the malnutrition risk groups than in the normal nutrition status group. A positive correlation was identified between tongue pressure and the MNA score (r = 0.143, p < 0.01). Treating the subgroup of the highest quartile of tongue pressure as the reference, the crude odds ratio (OR) of having risk of malnutrition was 5.37 (95% CI, 1.14-25.28) in the subgroup at the third quartile, 3.10 (95% CI, 0.60-15.84) in the subgroup at the second quartile, and 3.95 (95% CI, 0.81-19.15) in the subgroup at the lowest quartile. After adjustment for age and sex, the subgroup in the third quartile still presented with a significantly higher risk (OR, 4.85; 95% CI, 1.02-22.99) of risk of malnutrition. Compared with the subgroup at the highest quartile of tongue pressure, the crude OR for all the subgroups in the lower three quartiles was 4.17 (95% CI, 0.96-18.04), showing borderline significance (p = 0.05). In conclusion, we found hints for an association between decreased tongue pressure and an increased risk of malnutrition in community-dwelling older individuals. Older people with suboptimal tongue pressure should undergo a thorough assessment of their nutritional status and swallowing function for the early identification of subclinical malnutrition and dysphagia.

Project description:PurposeTo measure choroidal thickness and to determine parameters associated with it.DesignCross-sectional study.ParticipantsSeventy-four glaucoma patients and glaucoma suspects.MethodsSpectral domain optical coherence tomography (SD-OCT) scans were obtained to estimate average choroidal thickness in a group of glaucoma suspects and glaucoma patients. The average thickness was calculated from enhanced depth SD-OCT images and manually analyzed with Image J software. Open-angle glaucoma, open-angle glaucoma suspect, primary angle-closure glaucoma, primary angle closure, and primary angle-closure suspect were defined by published criteria. Glaucoma suspects had normal visual fields bilaterally. Glaucoma was defined by specific criteria for optic disc damage and visual field loss in ?1 eye. The most affected eye was analyzed for comparisons across individuals, and right/left and upper half/lower half comparisons were made to compare thickness against degree of visual field damage.Main outcome measuresAverage macular and peripapillary choroidal thickness measured using SD-OCT.ResultsThe choroidal-scleral interface was visualized in 86% and 96% of the macular and peripapillary scans, respectively. In multivariable linear regression analysis, the macular choroid was significantly thinner in association with 4 features: Longer eyes (22 ?m per mm longer [95% confidence interval (CI), -33, -11]), older individuals (31 ?m thinner per decade older [95% CI, -44, -17]), lower diastolic ocular perfusion pressure (26 ?m thinner per 10 mmHg lower [95% CI, 8, 44]), and thicker central corneas (6 ?m per 10 ?m thicker cornea [95% CI, -10, 0]). The choroid was not significantly thinner in glaucoma patients than in suspects (14 ?m [95% CI, -54, 26]; P = 0.5). Peripapillary choroidal thickness was not significantly different between glaucoma and suspect patients. Thickness was not associated with damage severity as estimated by visual field mean deviation or nerve fiber layer thickness, including comparisons of right with left eye or upper with lower values.ConclusionsAge, axial length, CCT, and diastolic ocular perfusion pressure are significantly associated with choroidal thickness in glaucoma suspects and glaucoma patients. Degree of glaucoma damage was not consistently associated with choroidal thickness.Financial disclosure(s)Proprietary or commercial disclosure may be found after the references.

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Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly.

Publications

Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly.

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