Calf Circumference Is a Useful Index for Assessing Dysphagia among Community Dwelling Elderly Recipients of Long-Term Care

Calf Circumference Is a Useful Index for Assessing Dysphagia among Community Dwelling Elderly Recipients of Long-Term Care

YUKIKO KUROSAWA,¹ KOJI HARA,¹ HARUKA TOHARA,¹ CHIZURU NAMIKI,¹ ARIYA CHANTARAMANEE,¹ AYAKO NAKANE,¹ KAZUHARU NAKAGAWA,¹ KOHEI YAMAGUCHI,¹ KANAKO YOSHIMI,¹ JUNICHI FURUYA² and SHUNSUKE MINAKUCHI¹

¹Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
²Department of Oral Health Care Sciences for Community and Welfare, Graduate School of Medical and Dental Sciences,Tokyo Medical and Dental University, Tokyo, Japan

Dysphagia is a common problem among older adults, causing aspiration pneumonia and malnutrition. It has been reported that calf circumference (CC), an index of nutritional status and physical activity, correlated with dysphagia in acute care hospitals, suggesting that CC can be a useful index for assessing dysphagia. We therefore aimed to explore the association between dysphagia and CC among community elderly people who require long-term care and determined the optimal CC cut-off value for patients with dysphagia. Our cross-sectional study, conducted at Tokyo Metropolis, included 154 participants (65 men) aged > 65 years (mean age: 80.1 ± 7.1) who required long-term care and were examined for dental disease and dysphagia during home visiting treatment. Age, body mass index (BMI), mini-nutritional assessment short-form (MNA-SF) score, Barthel index (BI), CC, functional oral intake scale (FOIS), and dysphagia severity scale (DSS) were evaluated. A DSS score < 5 was defined as dysphagia. To determine the association between CC and dysphagia, we performed logistic regression analysis and calculated the CC cut-off value for dysphagia. Thirty-seven participants (24.0%) were diagnosed with dysphagia. The logistic regression analysis showed that the presence of dysphagia was independently associated with CC after adjusting for age and sex. The CC cut-off value for the presence of dysphagia was 31.0 cm in men (sensitivity, 0.818; specificity, 0.868) and 29.3 cm in women (sensitivity, 0.760; specificity, 0.859). CC is a useful index for assessing dysphagia among community dwelling individuals who require long-term care.

keywords —— calf circumference; dysphagia; elderly; malnutrition; mini nutritional assessment short-form

===============================

Tohoku J. Exp. Med., 2019, 248, 201-208

Correspondence: Koji Hara, Department of Gerodontology, Division of Gerontology and Gerodontology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.

e-mail: koji19831031@gmail.com