Digastric muscle mass and intensity in older patients with sarcopenic dysphagia by ultrasonography

Geriatr Gerontol Int. 2021 Jan;21(1):14-19. doi: 10.1111/ggi.14079. Epub 2020 Nov 23.

Abstract

Aim: The aim of this study was to investigate digastric muscle mass and intensity between no sarcopenic dysphagia and sarcopenic dysphagia.

Methods: Patients aged ≥65 years were enrolled. According to the diagnostic algorithm for sarcopenic dysphagia, the patients were divided into two groups, no sarcopenic dysphagia and sarcopenic dysphagia. Handgrip strength, gait speed, skeletal muscle mass, tongue pressure, Mini Nutritional Assessment-Short Form and Food Intake LEVEL Scale were investigated. Digastric muscle mass and intensity were examined by ultrasonography. Univariate and multivariate analyses were performed to analyze two groups. Multivariate logistic regression analysis was performed to determine independent factors for the presence of sarcopenic dysphagia. To estimate the accuracy of diagnosing sarcopenic dysphagia, a receiver operating characteristic curve analysis was performed for digastric muscle mass and intensity.

Results: Forty-five patients (mean ± SD, 84.3 ± 7.8 years, 22 men, 23 women) including 19 no sarcopenic dysphagia and 26 sarcopenic dysphagia were examined. In sarcopenic dysphagia, lower BMI, Food Intake LEVEL Scale, Mini Nutritional Assessment-Short Form and smaller muscle mass and greater muscle intensity were found compared with no sarcopenic dysphagia. In multivariate logistic regression analysis, digastric muscle mass and intensity were identified as independent factors for sarcopenic dysphagia. The cut-off value of muscle mass was 75.1 mm2 (area under curve: 0.731, sensitivity: 0.692, specificity: 0.737) and muscle intensity was 27.8 (area under curve: 0.823, sensitivity: 0.923, specificity: 0.632).

Conclusions: Digastric muscle mass was smaller and muscle intensity was greater in sarcopenic dysphagia than no sarcopenic dysphagia. Ultrasonography of digastric muscle, as well as the tongue and geniohyoid muscle, is useful. Geriatr Gerontol Int 2021; 21: 14-19.

Keywords: deglutition disorders; muscle atrophy; nutrition; sarcopenia; ultrasonography.

MeSH terms

  • Aged
  • Deglutition Disorders* / diagnostic imaging
  • Female
  • Hand Strength
  • Humans
  • Male
  • Muscle Strength
  • Muscle, Skeletal / diagnostic imaging
  • Pressure
  • Sarcopenia* / diagnosis
  • Sarcopenia* / diagnostic imaging
  • Tongue
  • Ultrasonography