健常高齢者の舌の脂肪と筋力

健常高齢者の舌の脂肪と筋力の関係をみた論文を紹介します。

Butler SG, Lintzenich CR, Leng X, Stuart A, Feng X, Carr JJ, Kritchevsky SB. Tongue adiposity and strength in healthy older adults. Laryngoscope. 2012 Jul;122(7):1600-4. doi: 10.1002/lary.23290.

舌の脂肪はCTで、筋力は舌圧計で前方と舌根部で評価しています。結果ですが、舌根部の脂肪と筋力には有意な関連(r = 0.32, P = .05)を認めましたが、嚥下圧とは有意な関連を認めませんでした。舌の脂肪は年齢、性別、誤嚥の有無でも有意差を認めませんでした。健常高齢者の誤嚥は舌根部の脂肪の影響を受けないという結論です。

舌のサルコペニアと嚥下機能・誤嚥には一定の関連があると私は考えていますが、舌の脂肪とはあまり関連がないのかもしれません。舌にせよ頸部や咽頭にせよ、脂肪ではなく筋肉量と筋力、嚥下機能・誤嚥の関係を調査するのが基本ではないかと感じます。

Abstract

OBJECTIVES/HYPOTHESIS:

To identify treatable risk factors for aspiration in older adults, particularly those associated with sarcopenia, we examined tongue composition. We hypothesized that isometric and swallowing posterior tongue strength would positively correlate with posterior tongue adiposity, and healthy older adults who aspirate would have greater tongue adiposity than healthy older adults who did not aspirate.

STUDY DESIGN:

Prospective.

METHODS:

Participants were 40 healthy adults, comprised of 20 aspirators (mean age, 78 years) and 20 nonaspirators (mean age, 81 years), as identified via flexible endoscopic evaluation of swallowing. Measures of maximal isometric posterior tongue strength and posterior swallowing tongue strength were acquired via tongue manometry. An index of posterior tongue adiposity was acquired via computed tomography for a 1-cm region of interest.

RESULTS:

Posterior tongue adiposity was correlated with posterior tongue isometric (r = 0.32, P = .05) but not swallowing pressures (P > .05) as examined with separate partial correlation analyses. Tongue adiposity did not significantly differ as a function of age, gender, or aspiration status (P > .05).

CONCLUSIONS:

Lower posterior isometric tongue strength was associated with greater posterior tongue adiposity. However, aspiration in healthy older adults was not affected by posterior tongue adiposity. This finding offers insight into the roles of tongue composition and strength in healthy older adults.