Relationship between tongue strength, lip strength, and nutrition-related sarcopenia in older rehabilitation inpatients: a cross-sectional study

Figures & data

Table 1 Participants’ characteristics

Variables	All (n=201)	NRS group (n=78)	Non-NRS group (n=123)	P-value
Age (years)	84 (79–89)	85 (82–89)	84 (78–89)	0.156
Men	70 (34.8)	38 (48.7)	32 (26)	0.001
CCI	1 (0–2)	1 (1–3)	1 (0–2)	<0.001
Primary disease				0.008
Orthopedic	114 (56.7)	35 (44.9)	79 (64.2)
Cardiology	16 (8)	10 (12.8)	6 (4.9)
Respiratory	25 (12.4)	15 (19.2)	10 (8.1)
Others	46 (22.9)	18 (23.1)	28 (22.8)
Days in acute care hospital	36 (23.5–51.5)	37 (23.8–54.3)	33 (23–51)	0.313
Remaining teeth	20 (7–26)	17 (5.3–25.3)	21 (9–27)	0.066
Eichner Index group A	151 (75.1)	54 (69.2)	97 (78.9)	0.345
MNA-SF	8 (6–9)	6 (4–7)	8 (8–10)	<0.001
Decline in food intake	2 (1–2)	1 (1–2)	2 (2–2)	<0.001
Weight loss	2 (1–3)	1.5 (0–2)	3 (2–3)	<0.001
Mobility	1 (1–1)	1 (0–1)	1 (1–1)	<0.001
Neuropsychological problems	2 (2–2)	2 (1–2)	2 (2–2)	0.007
BMI	1 (0–2)	0 (0–1)	1 (0–3)	<0.001
BMI (kg/m^2)	19.2 (17.1–22.1)	17.3 (15.2–19.1)	20.7 (18.7–23.2)	<0.001
Malnutrition in MNA-SF	90 (44.8)	78 (100)	12 (9.8)	<0.001
Grip strength (kg)	15.1 (11.7–19.5)	12.7 (9.4–15.5)	16.7 (13.4–20.4)	<0.001
CC (cm)	29 (26.5–31.5)	26.5 (24.6–28.9)	30.3 (28–32.4)	<0.001
Sarcopenia	153 (76.1)	78 (100)	75 (61)	<0.001
BI	65 (52.5–82.5)	60 (40–75)	75 (60–90)	<0.001
MMSE	26 (23–28)	24.5 (22–27)	26 (23–29)	0.002
CRP (mg/dL)	0.23 (0.1–0.73)	0.36 (0.13–0.99)	0.17 (0.09–0.49)	0.005
Tongue strength (kPa)	26.8 (21.8–32.6)	22.9 (17.7–27.7)	29.7 (24.8–35.1)	<0.001
Lip strength (N)	9.3 (6.8–11.3)	7.2 (5.6–9.8)	9.9 (8.4–12.3)	<0.001
FOIS	7 (5–7)	5 (5–7)	7 (6–7)	<0.001
Low oral intake level	60 (29.9)	47 (60.3)	13 (10.6)	<0.001

Note: Data are expressed as n (%) or median (interquartile range).

Abbreviations: BI, Barthel Index; BMI, body mass index; CC, calf circumference; CCI, Charlson Comorbidity Index; CRP, C-reactive protein; FOIS, Functional Oral Intake Scale; MMSE, Mini-Mental State Examination; MNA-SF, Mini Nutritional Assessment – Short Form; NRS, nutrition-related sarcopenia.

Table 2 The association between sarcopenia and malnutrition

Variables	Sarcopenia (n=153)	Non-sarcopenia (n=48)	P-value
Malnutrition	78 (51.0)	12 (25.0)	0.002
Non-malnutrition	75 (49.0)	36 (75.0)

Note: Data are expressed as n (%).

Table 3 Multiple regression analyses for tongue strength and lip strength with MNA-SF subitems

MNA-SF subitem	Dependent variable	B	SE	95% CI	Coefficients (beta)	P-value
Decline in food intake	Tongue strength	2.55	0.97	0.64–4.45	0.19	0.009
over the past 3 months	Lip strength	1.84	0.69	0.48–3.19	0.21	0.008
Weight loss over the	Tongue strength	0.48	0.46	−0.44–1.39	0.07	0.305
past 3 months	Lip strength	0.05	0.33	−0.60–0.69	0.01	0.890
Mobility	Tongue strength	5.47	1.37	2.77–8.18	0.26	<0.001
	Lip strength	1.14	0.97	−0.78–3.06	0.08	0.243
Neuropsychological	Tongue strength	0.43	1.30	−2.13–2.98	0.02	0.743
problems	Lip strength	1.37	0.92	−0.44–3.19	0.10	0.138
BMI	Tongue strength	0.43	0.45	1.15–2.92	0.28	<0.001
	Lip strength	1.02	0.32	0.40–1.65	0.22	0.002

Abbreviations: BMI, body mass index; CI, confidence interval; MNA-SF, Mini Nutritional Assessment – Short Form; SE, standard error.

Table 4 Logistic regression analysis for NRS

Variables	Univariable analysis				Multivariable analysis
	OR	95% CI	SE	P-value	OR	95% CI	SE	P-value
Age	1.04	1–1.08	0.21	0.82	0.97	0.92–1.03	0.03	0.329
Men	2.70	1.48–4.92	0.31	0.001	3.32	1.40–7.85	0.44	0.006
CCI	1.62	1.26–2.07	0.13	<0.001	1.14	0.79–1.65	0.19	0.474
BI	0.97	0.96–0.98	0.01	<0.001	0.99	0.97–1.00	0.01	0.318
MMSE	0.86	0.77–0.95	0.05	0.002	1.00	0.86–1.16	0.08	0.984
Tongue strength	0.87	0.83–0.92	0.02	<0.001	0.93	0.87–0.98	0.03	0.012
Lip strength	0.73	0.65–0.82	0.06	<0.001	0.76	0.66–0.88	0.07	<0.001
Low oral intake level	12.8	6.17–26.68	0.37	<0.001	3.65	1.47–9.08	0.46	0.005

Abbreviations: BI, Barthel Index; CCI, Charlson Comorbidity Index; CI, confidence interval; MMSE, Mini-Mental State Examination; NRS, nutrition-related sarcopenia; OR, odds ratio; SE, standard error.