Association of Dysphagia Severity with Nutritional Status and Muscle Function in Outpatients with Multiple Sclerosis:...

Background/Objectives: Dysphagia may adversely affect nutritional status in patients with Multiple Sclerosis (MS). This study aimed to investigate the associations between dysphagia severity and (i) nutritional status, assessed by the Malnutrition Universal Screening Tool (MUST) and Global Leadership Initiative on Malnutrition (GLIM) criteria, and (ii) secondary sarcopenia indicators according to the European Working Group on Sarcopenia in Older People-2 (EWGSOP2) framework. Materials and Methods: This cross-sectional study enrolled 32 consecutive adult outpatients with confirmed MS and self-reported dysphagia (DYMUS ≥ 1). Dysphagia severity was evaluated using the Dysphagia in Multiple Sclerosis (DYMUS) questionnaire, the Eating Assessment Tool-10 (EAT-10), and the Yale Swallow Protocol. Nutritional assessment included MUST screening and GLIM-based malnutrition diagnosis. Muscle function was evaluated via handgrip strength, calf circumference, and 4-metre gait speed. Results: GLIM-defined malnutrition was identified in 12 (37.5%) patients. Dysphagia severity was significantly associated with MUST score (ρ = 0.596, p < 0.001) and the presence of GLIM-defined malnutrition (median DYMUS 6.5 vs. 4.0; p = 0.012). In exploratory logistic regression, higher DYMUS scores were associated with GLIM-defined malnutrition. Conversely, no significant associations were found between dysphagia severity and handgrip strength, calf circumference, or sarcopenia classification (p > 0.30 for all). The categorical severe-sarcopenia rate was not considered reliably interpretable because of a pronounced gait speed floor effect. Conclusions: In ambulatory MS patients with dysphagia, dysphagia severity was associated with nutritional risk indicators and GLIM-defined malnutrition, but not with the primary muscle strength and mass indicators evaluated. Because MUST and GLIM reflect composite nutritional risk rather than confirmed protein-energy deficiency, these findings should be regarded as exploratory and hypothesis-generating. The present data did not permit a reliable estimate of sarcopenia prevalence because of a pronounced gait speed floor effect and the absence of body composition measurement. As a preliminary practical consideration, these findings may support combined dysphagia and nutritional screening in multidisciplinary MS outpatient care, pending confirmation in larger prospective cohorts.