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This report was written by the Japanese Society of Dysphagia Rehabilitation, the Japanese Association of Rehabilitation Nutrition, the Japanese Association on Sarcopenia and Frailty, and the Society of Swallowing and Dysphagia of Japan to consolidate the currently available evidence on the topics of sarcopenia and dysphagia. Histologically, the swallowing muscles are of different embryological origin from somatic muscles, and receive constant input stimulation from the respiratory center. Although the swallowing muscles are striated, their characteristics are different from those of skeletal muscles. The swallowing muscles are inevitably affected by malnutrition and disuse; accumulating evidence is available regarding the influence of malnutrition on the swallowing muscles. Sarcopenic dysphagia is defined as dysphagia caused by sarcopenia of the whole body and swallowing‐related muscles. When sarcopenia does not exist in the entire body, the term "sarcopenic dysphagia" should not be used. Additionally, sarcopenia due to neuromuscular diseases should be excluded; however, aging and secondary sarcopenia after inactivity, malnutrition and disease (wasting disorder and cachexia) are included in sarcopenic dysphagia. The treatment of dysphagia due to sarcopenia requires both dysphagia rehabilitation, such as resistance training of the swallowing muscles and nutritional intervention. However, the fundamental issue of how dysphagia caused by sarcopenia of the swallowing muscles should be diagnosed remains unresolved. Furthermore, whether dysphagia can be caused by primary sarcopenia should be clarified. Additionally, more discussion is required on issues such as the relationship between dysphagia and secondary sarcopenia, as well as the diagnostic criteria and means for diagnosing dysphagia caused by sarcopenia. Geriatr Gerontol Int 2019; 19: 91–97. [ABSTRACT FROM AUTHOR]

Aim: The relationship between oral health‐related quality of life (OHRQoL) and sarcopenia is unknown. The purpose of the present study was to clarify the prevalence of sarcopenia in older dental clinic outpatients and its relationship with OHRQoL and oral health status. Methods: This cross‐sectional study used data from consecutive dental clinic outpatients aged ≥65 years. The Oral Health Impact Profile‐14 was used for the evaluation of OHRQoL, and the Oral Health Assessment Tool was used to assess oral health status. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia criteria. Uni‐ and multivariable analyses were carried out to investigate the relationship between sarcopenia and Oral Health Impact Profile‐14 and Oral Health Assessment Tool scores. Results: This study involved 279 patients (173 women, 106 men) with a mean age of 76 ± 7.5 years. The sarcopenia prevalence rate was 30.2%, and patients with sarcopenia had significantly poorer OHRQoL and oral health status than did patients without sarcopenia. Furthermore, sarcopenia was independently associated with Oral Health Impact Profile‐14 and Oral Health Assessment Tool scores even after adjusting for confounding factors, such as age, sex, nutritional status, activities of daily living, dysphagia, comorbidities, polypharmacy and clinical dental findings. Conclusions: Sarcopenia was associated with OHRQoL and oral health status in older dental clinic outpatients. The prevalence of sarcopenia in older outpatients visiting the dental clinic was relatively high. Rehabilitation nutrition together with dental care might be necessary for sarcopenia treatment and prevention. Geriatr Gerontol Int 2018; 18: 915–921 [ABSTRACT FROM AUTHOR]

Aim: Aspiration pneumonia is a common disease resulting in poor outcomes for older adults. It is known that silent aspiration might lead to aspiration pneumonia, but its role in this is unclear. The aim of the present study was to investigate whether silent aspiration is associated with mortality in aspiration pneumonia patients. Methods: A multicenter (acute hospital) study including 170 aspiration pneumonia patients was carried out. Cough latency time after inhalation of 1% citric acid mist was used to assess silent aspiration. Patients were divided into two groups: silent aspirator (SA) and no‐SA groups based on the latency time of ≥29/<29 s. Results: The mean age of the participants was 84.0 ± 8.8 years. A total of 82% of them had moderate aspiration pneumonia. A total of 99 (58.2%) patients were in the SA group. Silent aspiration patients were more likely to be inactive compared with those in the no‐SA group (Barthel Index score 5 [IQR 0–45] vs 30 [IQR 5–65], P = 0.023) and had worse oral conditions (Oral Health Assessment Tool score 5.3 ± 3.2 vs 3.8 ± 3.1, P = 0.003). Nine of the SA patients and one of the no‐SA patients (P = 0.047) died within a month. Multivariate regression analysis showed that silent aspiration was associated with mortality after adjusting for confounders (odds ratio 2.65, 95% CI 1.01–6.98, P = 0.049). Conclusions: Silent aspiration detected by a cough latency test can predict 1‐month mortality in older patients with aspiration pneumonia. More studies are required to investigate whether enhancing cough reflex treatments would help patients recover from aspiration pneumonia. Geriatr Gerontol Int 2018; 18: 828–832 [ABSTRACT FROM AUTHOR]

Background/Aims: The ability to readily diagnose sarcopenia and malnutrition in a clinical setting is essential. This study is aimed at clarifying the calf circumference (CC) cut-off values for decreased skeletal muscle mass (SMM), according to the Asian Work Group for Sarcopenia's criteria definition of sarcopenia, and those for European Society for Clinical Nutrition and Metabolism-defined malnutrition, in hospitalized Japanese patients. Methods: The study involved 1,164 patients aged ≥ 65 years. Predictive CC cut-off values were determined using receiver operating curve (ROC) analyses. The predictive validity of the cut-off values was confirmed against in-hospital mortality. Results: There were 654 females and 510 males (mean age, 83.5 ± 8.2 years). Decreased SMM and malnutrition were observed in 80.4 and 32.8% of all patients, respectively. ROC analyses identified CCs of ≤ 29 cm (female, area under the curve [AUC] 0.791) and ≤ 30 cm (male, AUC 0.832) as cut-off values for decreased SMM, and CCs of ≤ 26 cm (female, AUC 0.798) and ≤ 28 cm (male, AUC 0.837) for malnutrition. CC cut-off values for SMM and malnutrition were independently correlated with inhospital mortality. Conclusions: The study determined appropriate cut-off values for CC to identify decreased SMM and malnutrition according to the relevant guidelines. [ABSTRACT FROM AUTHOR]

Objectives To verify the reliability and validity and develop an English version of an instrument (Kuchi-Kara Taberu Index ( KT Index)) to comprehensively assess and intervene in problems with eating and swallowing. Design Multicenter cross-sectional study. Setting Nursing homes. Participants Individuals aged 65 and older (mean age 88.3 ± 6.8; 80.0% female) who had lived in a nursing home for longer than 1 month (N = 115). Measurements The KT index consisted of 13 items: desire to eat, overall condition, respiratory condition, oral condition, cognitive function while eating, oral preparatory and propulsive phases, dysphagia severity, position and endurance while eating, eating, daily life, food intake level, food modification, and nutrition. Weighted kappa coefficients, Cronbach alpha, and Spearman rank correlation coefficients were determined. Results Weighted kappa values in the inter- and intrarater reliability tests ranged from 0.54 to 0.96 and 0.68 to 0.98, respectively. Cronbach alpha was 0.892. Spearman rank correlation coefficients (r) between the total KT index and external criteria were determined (Functional Oral Intake Scale, r = 0.790; Barthel Index, r = 0.830; Mini Nutritional Assessment Short Form, r = 0.582; Cognitive Performance Scale, r = −0.673; all P < .001). Similar correlations were observed when some items related to each external criterion were removed from the total KT index. Translation-retranslation procedures were conducted to develop an English version of the KT index. Conclusion The study provided evidence of the reliability and validity of the KT index and developed an English version. Future studies regarding validation of health-related quality of life indices and their effect on clinical courses of eating and swallowing conditions are needed. [ABSTRACT FROM AUTHOR]

A simple, short, cheap, and reasonably sensitive and specific screening tool assessing both nutritional and non-nutritional risk factors for sarcopenia is needed. Potentially, such a tool may be the Mini Sarcopenia Risk Assessment (MSRA) Questionnaire, which is available in a seven-item (MSRA-7) and five-item (MSRA-5) version. The study's aim was Polish translation and validation of both MSRA versions in 160 volunteers aged ≥60 years. MSRA was validated against the six sets of international diagnostic criteria for sarcopenia used as the reference standards. PL-MSRA-7 and PL-MSRA-5 both had high sensitivity (≥84.9%), regardless of the reference standard. The PL-MSRA-5 had better specificity (44.7–47.2%) than the PL-MSRA-7 (33.1–34.7%). Both questionnaires had similarly low positive predictive value (PL-MSRA-5: 17.9–29.5%; PL-MSRA-7: 14.4–25.2%). The negative predictive value was generally high for both questionnaires (PL-MSRA-7: 89.8–95.9%; PL-MSRA-5: 92.3–98.5%). PL-MSRA-5 had higher accuracy than the PL-MSRA-7 (50.0–55% vs. 39.4–45%, respectively). Based on the results, the Mini Sarcopenia Risk Assessment questionnaire was successfully adopted to the Polish language and validated in community-dwelling older adults from Poland. When compared with PL-MSRA-7, PL-MSRA-5 is a better tool for sarcopenia risk assessment. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented considering a study published in the journal on the link of age, body mass index (BMI), dietary variety score (DVS), locomotive syndrome, and household status to sarcopenia.