[[alternative]]Swallowing ability of the elderly in Taiwan

[[abstract]]背景與目的：吞嚥是一有眾多肌肉參與其中的過程，當中以舌肌與舌骨上肌群為主要參與的肌肉群，在老年族群中，會因全身性肌肉質量與力量下降而造成肌少症，除了會影響需要骨骼肌的肢體動作之外，是否亦會影響對於吞嚥功能相當重要的舌肌與舌骨上肌群仍有待探討。方法：本研究納入126名65歲以上居住於臺北市社區的長者，使用愛荷華口腔功能評量器（IOPI）評估舌肌力量和耐受力，並使用VitalStim®Plus測量在五項吞嚥任務中舌骨上肌群的sEMG變化，包含峰值、吞嚥時長及%MVC，以推算肌肉力量和耐受力，後續與年齡進行關聯性探討。接著測量肌少症相關向度並探討肌少症與舌肌和舌骨上肌群的力量與耐受力之相關性。結果：本研究族群中，舌肌與舌骨上肌群之力量及耐受力與老化未能呈現顯著線性關係（p>.05）；比較有無肌少症族群後，觀察到於舌尖最大力量［F(1, 120)= 6.02，p=.02，ηp2=.048］、舌根最大力量［F(1, 120)= 5.28，p=.02，ηp2=.042］及舌根耐受力［F(1, 120)= 6.39，p=.01，ηp2=.042］具有顯著效果。肌少症相關性的部分，舌根耐受力與肌少症具有顯著負相關（β=-.141，p=.039）。討論與結論：本研究探討舌肌與舌骨上肌群在老年族群中的變化，以及與肌少症間的關聯性，研究結果未能呈現舌肌和舌骨上肌群之力量及耐受力與老化相關，可能是由於受試者族群年齡受限於65歲以上；相關性探討中，舌根耐受力與肌少症具有顯著負相關。本研究觀察舌肌與舌骨上肌群於老年族群中的變化，並初步探討肌少症對於舌肌與舌骨上肌群的關聯性，以供臨床人員及研究者參考。[[abstract]]Background and Propose: Swallowing is a process that involves many muscles, including two main functioning groups: the tongue muscle and the suprahyoid muscles. In the elderly population, sarcopenia is caused by a systematic decrease in skeletal muscle mass and strength, which affects the movement of the limbs. Nevertheless, whether sarcopenia will lead to a decrease of the mass and the strength of the tongue muscle and the suprahyoid muscles remains unknown.Methods: This study recruited 126 adults, aged over 65 from the community. Tongue strength and endurance were measured by Iowa Oral Performance Instrument (IOPI), and VitalStim®Plus was used to measure the sEMG of the suprahyoid muscles. The sEMG results include peak value, swallowing duration and %MVC during five different swallowing tasks (saliva, 10ml water, 20ml water, 10ml jelly, and effortful swallow saliva). The correlation between aging and the strength and endurance of tongue muscle and suprahyoid muscle was estimated. Furthermore, a logistic regression is conducted to estimate the correlation between sarcopenia and swallowing muscles.Results: In this study, it shows insignificant correlation between aging and the strength and endurance of tongue muscle and suprahyoid muscle. There are significant differences between sarcopenia group and healthy group, including anterior tongue strength [F(1, 120)= 6.02，p=.02，ηp2=.048], posterior tongue strength [F(1, 120)= 5.28，p=.02，ηp2=.042], and posterior tongue endurance [F(1, 120)= 6.39，p=.01，ηp2=.042]. Furthermore, the posterior tongue endurance was significantly negatively correlated with sarcopenia (β=-.141，p=.039).Dussicussion and Conclusion: This study investigated: 1.the relation of the tongue muscle and suprahyoid muscles in the elderly population, 2.the association between sarcopenia and tongue muscle, 3. the association between sarcopenia and suprahyoid muscles. The results did not show that the strength and endurance of tongue muscle and suprahyoid muscles were significantly correlation with aging, possibly due to the age limit of the study. However, there is significant correlation between posterior tongue endurance and sarcopenia. The current study reveals the change of performance of the tongue and suprahyoid muscles in the elderly, and preliminarily explores the relationship between sarcopenia, tongue muscle and suprahyoid muscles, which can serve as clinical practice guidelines for both medical practitioners and researchers