Tongue pressure (TP) is used to assess tongue muscle strength and is related to function and frailty. While performing TP, it is necessary to elevate the tongue and oral floor by contracting the suprahyoid muscles. However, the association between TP and suprahyoid muscle strength remains unclear. Accordingly, this study investigated the relationship between TP and jaw-opening force (JOF), an indicator of suprahyoid muscle strength. This cross-sectional study included 88 independent community-dwelling participants aged ≥65 years. Age, sex, and the number of remaining teeth were recorded. Ultrasonography was used to evaluate the cross-sectional area of the tongue and geniohyoid muscle, as representatives of the suprahyoid muscles. Sarcopenia was diagnosed based on appendicular skeletal muscle mass index, handgrip strength, and gait speed. Multiple regression analysis was performed with TP as the dependent variable. TP was significantly associated with JOF (β = 0.371, p = 0.003). This study revealed that decreased TP was associated with a decline in JOF and suprahyoid muscle mass in older adults. Thus, low TP may be associated with decreased JOF. Prevention of the weakness of the suprahyoid muscles and maintaining TP may also contribute to the prevention of frailty associated with TP.

The precise correlations among tongue function and characteristics remain unknown, and no previous studies have attempted machine learning-based classification of tongue ultrasonography findings. This cross-sectional observational study aimed to investigate relationships among tongue characteristics and function by classifying ultrasound images of the tongue using a K-means clustering algorithm. During 2017–2018, 236 healthy older participants (mean age 70.8 ± 5.4 years) were enrolled. The optimal number of clusters determined by the elbow method was 3. After analysis of tongue thickness and echo intensity plots, tongues were classified into three groups. One-way ANOVA was used to compare tongue function, tongue pressure, and oral diadochokinesis for /ta/ and /ka/ in each group. There were significant differences in all tongue functions among the three groups. The worst function was observed in patients with the lowest values for tongue thickness and echo intensity (tongue pressure [P = 0.023], /ta/ [P = 0.007], and /ka/ [P = 0.038]). Our results indicate that ultrasonographic classification of tongue characteristics using K-means clustering may aid clinicians in selecting the appropriate treatment strategy. Indeed, ultrasonography is advantageous in that it provides real-time imaging that is non-invasive, which can improve patient follow-up both in the clinic and at home.

Objectives In this study, we examined the factors influencing the presence or absence of dental intervention in patients with pneumonia in an acute-care hospital, focusing on oral intake and its status. Design Observational study. Setting Teikyo University School of Medicine, Mizonokuchi Hospital. Participants Patients ≥65 years of age who were admitted to the Teikyo University School of Medicine, Mizonokuchi Hospital between January 1, 2018 and December 31, 2019 with pneumonia who were referred to the Department of Rehabilitation with suspected dysphagia were included in the study. Fifty patients who underwent dental intervention were compared with 50 controls who had received no dental interventions prior to the opening of the dental department. Measurements Time series matching was retrospectively performed using the Oral Health Assessment Tool (OHAT). From the medical records, age at admission, sex, pneumonia severity classification (age, dehydration, respiratory failure, orientation disturbance, and blood pressure [A-DROP] score), body mass index, Charlson’s Comorbidity Index, OHAT, functional oral intake scale (FOIS) score at admission and discharge, and the length of hospital stay were retrieved; FOIS level ≥4 was defined as established oral intake. Results The number of patients in the control group before matching was 179. Twelve patients with missing information and seven patients who died in the hospital were excluded from this study. Multivariable logistic regression analysis showed that dental intervention (odds ratio 3.0, p = 0.014) was associated with the establishment of oral intake at discharge. Multiple logistic regression analysis showed that dental intervention was a significant factor for FOIS at discharge (p = 0.002) and the length of hospital stay (p = 0.039). Conclusion Oral management with dental intervention was associated with establishing oral intake and reducing hospital stay in patients with pneumonia, regardless of pneumonia severity or comorbidities.

The cough reflex does not change with age. However, older adults with chronic diseases often have a reduced cough reflex. The effects of several risk factors on reduced cough sensitivity in older adults remain unclear. This study aims to clarify the risk factors for reduced cough sensitivity in older adults with chronic diseases. This cross-sectional study included participants aged <65 years (young group; n = 21), those aged ≥65 years (older adults with chronic disease group; n = 18), and those with dysphagia (dysphagia group; n = 16). A cough test was performed on all participants using an ultrasonic nebulizer with a mist of 1% w/v citric acid physiologic saline. Cough response was observed in the young (21/21), older adult (9/18), and dysphagia (13/16) groups. The difference between the young and older adult groups was significant (p < 0.01). The older adult and dysphagia groups had decreased cough sensitivity compared to the younger group. Cough sensitivity was affected by risk factors for silent cerebral infarct and age. Our findings show that cough test results might be affected by risk factors for silent cerebral infarction in older adults with chronic diseases.

This retrospective study determined the significant predictive factors for the number of days required to remove nasogastric tubes (NGTs) after surgery in patients with oral cancer (OC). In this study, patients underwent a videofluoroscopic swallowing study (VFSS) approximately 2 weeks after surgery. Videofluoroscopic images were analyzed, and variables such as swallowing and swallowing kinematics were measured. Patient characteristics, swallowing kinematics, and swallowing results were assessed using a Cox proportional hazards model. This study assessed 129 participants (66 men, 63 women, mean age: 69.0 ± 14.1 years) with nine types of cancer. The Cox proportional hazard ratio revealed that sex, body mass index before surgery, radiotherapy and/or chemotherapy, dysphagia before surgery, normalized pharyngeal constriction ratio, upper esophageal sphincter (UES) opening, and laryngeal vestibule disclosure (LVC) disorder were predictive factors for the removal of NGTs when adjusted for age. The study identified several predictive factors for the removal of NGTs and oral intake recovery in patients with OC. Regarding swallowing kinematics, UES opening is the most significant predictive factor. After surgery for OC, VFSS should be performed to assess safe eating methods and predict the recovery of oral intake and removal of the NGT.

Physical performance shows approximately 30% diurnal variation; however, diurnal variation in oral function remains unclear. This study aimed to determine the diurnal variation in oral and swallowing function in older adults requiring long-term care. The participants included 13 adults aged >60 years (3 men and 10 women, mean age: 77.2 ± 6.3 years, age range: 62–90 years) requiring long-term care. Tongue strength (TS) and oral mucosal moisture were measured as indices of oral and swallowing function, while hand grip strength was measured as an index of general muscle strength. The patients were asked to participate in a “test” after breakfast, lunch, and dinner on the same day. Multilevel linear regression analysis was used to examine diurnal differences in each item. Multilevel linear regression analysis with adjustment for age and sex revealed that TS was significantly higher at noon (p = 0.001) than in the morning. Therefore, caregivers who provide support during meals to older people requiring long-term care should consider the possibility of swallowing function differing according to the time of the day. In conclusion, it may be beneficial to establish a nutritional therapy that accounts for the diurnal variation in TS.