Ultrasonography Shows Age-related Changes and Related Factors in the Tongue and Suprahyoid Muscles

Objectives: To investigate age and other factors related to the deterioration of the muscles used for swallowing, including the tongue and suprahyoid muscles. Design: Cross-sectional study. Setting and Participants: This study included 146 participants: 47 younger adults (23 men and 24 women; age range 23-44 years) recruited from a dental hospital and 99 community-dwelling older adults (37 men and 62 women, age range 65-86 years). Methods: Age (<65 years or >65 years), body mass index (BMI), skeletal muscle mass index (SMI), and tooth loss (Eichner classification) were measured. The cross-sectional areas (CSAs) of the tongue, geniohyoid muscle, and anterior belly of the digastric muscle were measured using an ultrasonic diagnostic apparatus. The correlation between each muscle's CSA and strength was examined. Multiple regression analyses were performed separately for each sex using each muscle CSA as the dependent variable and age, BMI, SMI, and the Eichner classification as explanatory variables. Results: Older men had a significant positive correlation between tongue pressure and CSA (r = 0.35, P = .031). Jaw opening force was positively correlated with geniohyoid muscle CSA (r = 0.41, P = .001) in older women. In the multiple regression analysis, age, BMI, and SMI were significantly associated with tongue CSA in men. Age was significantly and inversely associated with suprahyoid muscle CSA in both men and women. No explanatory variables were significantly associated with geniohyoid muscle CSA except age. Conclusions and Implications: The tongue increased in volume, and the suprahyoid muscles underwent atrophy with age. The study results suggest that interventions to prevent dysphagia associated with aging should be tailored toward specific muscles. Direct muscle training is required for the suprahyoid muscles, whereas the maintenance of tongue muscle mass and function, as well as training for the tongue, requires attention to ensure optimal nutritional status and whole-body skeletal muscle mass. (c) 2020 AMDA -The Society for Post-Acute and Long-Term Care Medicine.