Sarcopenia Risk is Associated With Decreased Swallow Safety in Patients With Dysphagia

Sarcopenia, characterized by the loss of skeletal muscle mass and strength, is associated with adverse health outcomes in older adults. This study aimed to evaluate the relationship between sarcopenia risk, handgrip strength, and swallowing function in patients with dysphagia undergoing Fiberoptic Endoscopic Evaluation of Swallowing (FEES).

Retrospective chart review.

A tertiary dysphagia clinic.

Medical records of individuals aged 65 years and older who attended the dysphagia clinic over a 6-month period were reviewed. Data collected included demographics, clinical symptoms, handgrip strength, SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls) scores, Penetration Aspiration Scale (PAS) scores, and Yale residue scale scores from FEES. Critically weak grip strength was defined using previously established thresholds. Correlations between sarcopenia indicators and swallowing outcomes were analyzed using Spearman's rho.

Thirty-three patients were included (mean age 77.6 ± 7.5 years; 52% male). Twenty-five (76%) demonstrated critically weak grip strength, and 9 (27%) had SARC-F ≥ 4, indicating sarcopenia risk. SARC-F scores were negatively correlated with Functional Oral Intake Scale (FOIS) (rs = -0.45, P = .01) and positively correlated with liquid PAS (rs = 0.41, P = .02). Handgrip strength was negatively correlated with age (rs = -0.39, P = .03).

Most older adults undergoing FEES exhibited critically weak grip strength, suggesting high sarcopenia risk. Higher sarcopenia risk correlated with worse swallowing safety and reduced oral intake. These findings highlight the importance of assessing and addressing nutritional and muscle strength deficits in dysphagic older adults.