Effect of deterioration of swallowing functions on the frailty status in older adults: a longitudinal cohort study

Abstract Background Deterioration of swallowing function (DSF) is common among aging adults and can lead to negative health outcomes such as increased risk of malnutrition. However, the longitudinal relationship between the DSF and frailty status remains unclear. This study aimed to investigate whet...

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Main Authors: En-Chih Weng, Yoko Hasegawa, Tasuku Yoshimoto, Ma. Therese Sta. Maria, Koutatsu Nagai, Naoko Sato, Kana Tokumoto, Kazuhiro Hori, Hiroshi Kusunoki, Hiromitsu Kishimoto, Ken Shinmura
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-05896-8
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author En-Chih Weng
Yoko Hasegawa
Tasuku Yoshimoto
Ma. Therese Sta. Maria
Koutatsu Nagai
Naoko Sato
Kana Tokumoto
Kazuhiro Hori
Hiroshi Kusunoki
Hiromitsu Kishimoto
Ken Shinmura
author_facet En-Chih Weng
Yoko Hasegawa
Tasuku Yoshimoto
Ma. Therese Sta. Maria
Koutatsu Nagai
Naoko Sato
Kana Tokumoto
Kazuhiro Hori
Hiroshi Kusunoki
Hiromitsu Kishimoto
Ken Shinmura
author_sort En-Chih Weng
collection DOAJ
description Abstract Background Deterioration of swallowing function (DSF) is common among aging adults and can lead to negative health outcomes such as increased risk of malnutrition. However, the longitudinal relationship between the DSF and frailty status remains unclear. This study aimed to investigate whether declining swallowing function is linked to frailty progression in independent older adults. Methods This study included 795 community-dwelling Japanese individuals aged ≥ 65 years who participated in two surveys: one at baseline and one after two years. Swallowing function was evaluated using the repetitive saliva swallowing test, tongue pressure test, and questionnaire. DSF was identified by meeting more than one of three criteria: Repeated Saliva Swallow Test below 3, tongue pressure under 27.4 kPa for men and 26.5 kPa for women, and a “yes” response to the questionnaire. Frailty status was assessed using the Kihon Checklist, with participants showing a decline categorized into the “aggravation group.” Oral function (number of teeth, occlusal force, masticatory performance, and oral dryness) and physical function (body mass index, gait speed, grip strength, and skeletal muscle mass index) were evaluated. Comparisons between the two groups were made using the Student’s t-test or the χ2 test. Differences among the three groups were assessed using the one-way analysis of variance or the χ2 test. Significant differences in continuous variables were analyzed using the Least Significant Difference method, with P-values adjusted using the Bonferroni correction. Results Initially, 87 (10.9%) participants were frail. By follow-up, 149 participants (37.9%) had progressed to frailty, 83 of whom (55.7%) exhibited impaired swallowing function at baseline. At baseline, frailty was significantly associated with age, gait speed, decreased swallowing function, number of functional teeth, occlusal force, and masticatory performance. None of the three swallowing function assessment methods were significantly associated with the progression of frailty. In contrast, logistic regression analysis of frailty progression showed that impaired swallowing function was a significant explanatory variable (OR, 1.53; 95% CI: 1.04–2.21). Conclusion This study found a significant association between frailty and multiple factors, particularly oral function. Specifically, diminished swallowing function has emerged as a notable independent predictor of frailty progression.
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spelling doaj-art-5fb630f286cd48e0b1fd4ba9f19d1dbe2025-08-20T03:27:09ZengBMCBMC Geriatrics1471-23182025-06-0125111010.1186/s12877-025-05896-8Effect of deterioration of swallowing functions on the frailty status in older adults: a longitudinal cohort studyEn-Chih Weng0Yoko Hasegawa1Tasuku Yoshimoto2Ma. Therese Sta. Maria3Koutatsu Nagai4Naoko Sato5Kana Tokumoto6Kazuhiro Hori7Hiroshi Kusunoki8Hiromitsu Kishimoto9Ken Shinmura10Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental SciencesDivision of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental SciencesDivision of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental SciencesDivision of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental SciencesDepartment of Physical Therapy, School of Rehabilitation, Hyogo Medical UniversityDivision of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental SciencesDepartment of Oral and Maxillofacial Surgery, School of Medicine, Hyogo Medical UniversityDivision of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental SciencesDepartment of Internal Medicine, Osaka Dental UniversityDepartment of Oral and Maxillofacial Surgery, School of Medicine, Hyogo Medical UniversityDepartment of General Internal Medicine, School of Medicine, Hyogo Medical UniversityAbstract Background Deterioration of swallowing function (DSF) is common among aging adults and can lead to negative health outcomes such as increased risk of malnutrition. However, the longitudinal relationship between the DSF and frailty status remains unclear. This study aimed to investigate whether declining swallowing function is linked to frailty progression in independent older adults. Methods This study included 795 community-dwelling Japanese individuals aged ≥ 65 years who participated in two surveys: one at baseline and one after two years. Swallowing function was evaluated using the repetitive saliva swallowing test, tongue pressure test, and questionnaire. DSF was identified by meeting more than one of three criteria: Repeated Saliva Swallow Test below 3, tongue pressure under 27.4 kPa for men and 26.5 kPa for women, and a “yes” response to the questionnaire. Frailty status was assessed using the Kihon Checklist, with participants showing a decline categorized into the “aggravation group.” Oral function (number of teeth, occlusal force, masticatory performance, and oral dryness) and physical function (body mass index, gait speed, grip strength, and skeletal muscle mass index) were evaluated. Comparisons between the two groups were made using the Student’s t-test or the χ2 test. Differences among the three groups were assessed using the one-way analysis of variance or the χ2 test. Significant differences in continuous variables were analyzed using the Least Significant Difference method, with P-values adjusted using the Bonferroni correction. Results Initially, 87 (10.9%) participants were frail. By follow-up, 149 participants (37.9%) had progressed to frailty, 83 of whom (55.7%) exhibited impaired swallowing function at baseline. At baseline, frailty was significantly associated with age, gait speed, decreased swallowing function, number of functional teeth, occlusal force, and masticatory performance. None of the three swallowing function assessment methods were significantly associated with the progression of frailty. In contrast, logistic regression analysis of frailty progression showed that impaired swallowing function was a significant explanatory variable (OR, 1.53; 95% CI: 1.04–2.21). Conclusion This study found a significant association between frailty and multiple factors, particularly oral function. Specifically, diminished swallowing function has emerged as a notable independent predictor of frailty progression.https://doi.org/10.1186/s12877-025-05896-8Older adultsOral hypofunctionDysphagiaFrailtySwallowing
spellingShingle En-Chih Weng
Yoko Hasegawa
Tasuku Yoshimoto
Ma. Therese Sta. Maria
Koutatsu Nagai
Naoko Sato
Kana Tokumoto
Kazuhiro Hori
Hiroshi Kusunoki
Hiromitsu Kishimoto
Ken Shinmura
Effect of deterioration of swallowing functions on the frailty status in older adults: a longitudinal cohort study
BMC Geriatrics
Older adults
Oral hypofunction
Dysphagia
Frailty
Swallowing
title Effect of deterioration of swallowing functions on the frailty status in older adults: a longitudinal cohort study
title_full Effect of deterioration of swallowing functions on the frailty status in older adults: a longitudinal cohort study
title_fullStr Effect of deterioration of swallowing functions on the frailty status in older adults: a longitudinal cohort study
title_full_unstemmed Effect of deterioration of swallowing functions on the frailty status in older adults: a longitudinal cohort study
title_short Effect of deterioration of swallowing functions on the frailty status in older adults: a longitudinal cohort study
title_sort effect of deterioration of swallowing functions on the frailty status in older adults a longitudinal cohort study
topic Older adults
Oral hypofunction
Dysphagia
Frailty
Swallowing
url https://doi.org/10.1186/s12877-025-05896-8
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