Elucidation of pathophysiology and creation of definitive diagnostic criteria in of sarcopenic dysphagia

• Project/Area Number: 19H03979
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Review Section: Basic Section 59010:Rehabilitation science-related
• Research Institution: Tokyo Women's Medical University
• Principal Investigator: Wakabayashi Hidetaka 東京女子医科大学, 医学部, 教授 (80508797)
• Co-Investigator(Kenkyū-buntansha): 糸田 昌隆 大阪歯科大学, 医療保健学部, 教授 (10624984) ; 貴島 真佐子 大阪歯科大学, 医療保健学部, 講師(非常勤) (40838091)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2022)
• Budget Amount: ¥17,810,000 (Direct Cost: ¥13,700,000、Indirect Cost: ¥4,110,000); Fiscal Year 2021: ¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000); Fiscal Year 2020: ¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000); Fiscal Year 2019: ¥10,790,000 (Direct Cost: ¥8,300,000、Indirect Cost: ¥2,490,000)
• Keywords: サルコペニア / 摂食嚥下障害 / リハビリテーション栄養

Outline of Research at the Start

サルコペニアの摂食嚥下障害の病態、リスク因子、診断を解明するために、以下の研究を行う。①超音波エコーによる嚥下関連筋の筋肉量・輝度の変化を継時的にみる（症例報告・集積）。②超音波エコーによる嚥下関連筋の筋肉量・輝度と、咽頭残留との関連をみる（横断研究）。③サルコペニアの摂食嚥下障害の様々なセッティングでの有病割合およびリスク因子を調べる（横断研究、多施設データベース研究）。④サルコペニアの摂食嚥下障害診断フローチャートを改訂して確定診断を創る研究。

Outline of Final Research Achievements

467 patients with dysphagia were included in the Japanese Sarcopenic Dysphagia Database. The mean age was 80.4 years, 105 (23%) had probable sarcopenic dysphagia, 182 (39%) had possible sarcopenic dysphagia, and 179 (38%) had no sarcopenic dysphagia. Poor prognostic factors for dysphagia were identified as undernutrition by the GLIM criteria, CRP, modified Glasgow Prognostic Score (mGPS), calf circumference, handgrip strength, and skeletal muscle mass index. Sarcopenic dysphagia was associated with worse improvement in swallowing function and ADL than dysphagia due to other causative diseases.

Academic Significance and Societal Importance of the Research Achievements

摂食嚥下障害の原因としてサルコペニア（筋肉量と筋力の低下）があることは、10年前にはほとんど認識されていなかった。今回、サルコペニアの摂食嚥下障害に関する多くのエビデンスを構築したことで、超高齢社会の日本では、高齢者の摂食嚥下障害の原因としてサルコペニアが重要なことが明らかになった。サルコペニアの摂食嚥下障害に関連する因子や機能予後が悪いことを明らかにしたので今後、摂食嚥下リハビリテーションの臨床現場でサルコペニアが見落とされる可能性が低くなると考える。

Research Products

• [Journal Article] The Relationship between Low Skeletal Muscle Mass and Subsequent Oral Intake Ability among the Aged Population (2023)
  • Author(s): Nakao-Kato Mari、Izumi Shin-Ichi、Nishioka Shinta、Momosaki Ryo、Wakabayashi Hidetaka
  • Journal Title: Healthcare Volume: 11 Issue: 5 Pages: 729-729
  • DOI: 10.3390/healthcare11050729
  • Peer Reviewed / Open Access
• [Journal Article] Effects of Undernutrition on Swallowing Function and Activities of Daily Living in Hospitalized Patients: Data from the Japanese Sarcopenic Dysphagia Database (2023)
  • Author(s): Abe Sayaka、Kokura Yoji、Maeda Keisuke、Nishioka Shinta、Momosaki Ryo、Matsuoka Hiroki、Tomii Yasuomi、Sugita Shinnosuke、Shimizu Kenta、Esashi Nanami、Wakabayashi Hidetaka
  • Journal Title: Nutrients Volume: 15 Issue: 5 Pages: 1291-1291
  • DOI: 10.3390/nu15051291
  • Peer Reviewed / Open Access
• [Journal Article] Association between board-certified physiatrist involvement and functional outcomes in sarcopenic dysphagia patients: a retrospective cohort study of the Japanese Sarcopenic Dysphagia Database (2023)
  • Author(s): Nagai Takako、Wakabayashi Hidetaka、Nishioka Shinta、Momosaki Ryo
  • Journal Title: Journal of Rural Medicine Volume: 18 Issue: 1 Pages: 21-27
  • DOI: 10.2185/jrm.2022-026
  • ISSN: 1880-487X, 1880-4888
  • Peer Reviewed / Open Access
• [Journal Article] Functional prognosis in patients with sarcopenic dysphagia: An observational cohort study from the Japanese sarcopenic dysphagia database (2022)
  • Author(s): Nagai Takako、Wakabayashi Hidetaka、Nishioka Shinta、Momosaki Ryo
  • Journal Title: Geriatrics & Gerontology International Volume: 22 Issue: 10 Pages: 839-845
  • DOI: 10.1111/ggi.14466
  • Peer Reviewed
• [Journal Article] Sensitivity and Specificity of Body Mass Index for Sarcopenic Dysphagia Diagnosis among Patients with Dysphagia: A Multi-Center Cross-Sectional Study (2022)
  • Author(s): Togashi Shintaro、Wakabayashi Hidetaka、Ohinata Hironori、Nishioka Shinta、Kokura Yoji、Momosaki Ryo
  • Journal Title: Nutrients Volume: 14 Issue: 21 Pages: 4494-4494
  • DOI: 10.3390/nu14214494
  • Peer Reviewed / Open Access
• [Journal Article] Discriminative Evaluation of Sarcopenic Dysphagia Using Handgrip Strength or Calf Circumference in Patients with Dysphagia Using the Area under the Receiver Operating Characteristic Curve (2022)
  • Author(s): Kishimoto Hiroshi、Wakabayashi Hidetaka、Nishioka Shinta、Momosaki Ryo
  • Journal Title: Journal of Clinical Medicine Volume: 12 Issue: 1 Pages: 118-118
  • DOI: 10.3390/jcm12010118
  • Peer Reviewed / Open Access
• [Journal Article] Sarcopenia Is Associated with Fecal Incontinence in Patients with Dysphagia: Implication for Anal Sarcopenia (2022)
  • Author(s): S Mizuno, H Wakabayashi, M Yamakawa, F Wada, R Kato, Y Furiya, S Nishioka, R Momosaki
  • Journal Title: J Nutr Health Aging Volume: 26 Issue: 1 Pages: 84-88
  • DOI: 10.1007/s12603-021-1711-6
  • Peer Reviewed
• [Journal Article] Prevalence of Hoarseness and Its Association with Severity of Dysphagia in Patients with Sarcopenic Dysphagia (2022)
  • Author(s): H Wakabayashi, M Kishima, M Itoda, I Fujishima, K Kunieda, T Ohno, T Shigematsu, F Oshima, T Mori, N Ogawa, S Nishioka, R Momosaki, M Yamada, S Ogawa
  • Journal Title: J Nutr Health Aging Volume: 26 Issue: 3 Pages: 266-271
  • DOI: 10.1007/s12603-022-1754-3
  • Peer Reviewed / Open Access
• [Journal Article] Association between Inflammation and Functional Outcome in Patients with Sarcopenic Dysphagia (2022)
  • Author(s): T Mori, H Wakabayashi, M Kishima, M Itoda, I Fujishima, K Kunieda, T Ohno, T Shigematsu, F Oshima, N Ogawa, S Nishioka, R Momosaki, A Shimizu, Y Saito, M Yamada, S Ogawa
  • Journal Title: J Nutr Health Aging Volume: 26 Issue: 4 Pages: 400-406
  • DOI: 10.1007/s12603-022-1769-9
  • Peer Reviewed
• [Journal Article] Rehabilitation nutrition for individuals with frailty, disability, sarcopenic dysphagia, or sarcopenic respiratory disability (2022)
  • Author(s): Mizuno S, Wakabayashi H, Wada F
  • Journal Title: Curr Opin Clin Nutr Metab Care Volume: 25 Issue: 1 Pages: 29-36
  • DOI: 10.1097/mco.0000000000000787
  • Peer Reviewed / Open Access
• [Journal Article] Construction and Quality Evaluation of the Japanese Sarcopenic Dysphagia Database (2021)
  • Author(s): S Mizuno, H Wakabayashi, I Fujishima, M Kishima, M Itoda, M Yamakawa, F Wada, R Kato, Y Furiya, S Nishioka, R Momosaki
  • Journal Title: J Nutr Health Aging Volume: 25 Issue: 7 Pages: 926-932
  • DOI: 10.1007/s12603-021-1646-y
  • Peer Reviewed
• [Journal Article] Improvement of swallowing-related muscle mass assessed by ultrasonography in malnourished patient with Wallenberg syndrome: A case report (2021)
  • Author(s): Hidetaka Wakabayashi, Masako Kishima, Masataka Itoda
  • Journal Title: J Gen Fam Med Volume: 22 Issue: 6 Pages: 341-343
  • DOI: 10.1002/jgf2.428
  • Peer Reviewed / Open Access
• [Journal Article] Assessment of swallowing function and muscle using ultrasonography in general and family medicine (2020)
  • Author(s): Hidetaka Wakabayashi
  • Journal Title: J Gen Fam Med Volume: 21 Issue: 2 Pages: 1-2
  • DOI: 10.1002/jgf2.298
  • Peer Reviewed / Open Access
• [Presentation] Sarcopenic Dysphagia, Respiratory Sarcopenia, and Rehabilitation Nutrition (2023)
  • Author(s): Hidetaka Wakabayashi
  • Organizer: Annual convention of Taiwan Academy of Physical Medicine and Rehabilitation
  • Int'l Joint Research / Invited
• [Presentation] Respiratory sarcopenia: A position paper by four professional organizations (2023)
  • Author(s): Hidetaka Wakabayashi, Susumu Sato, Shinjiro Miyazaki, Akira Tamaki, Yoshihiro Yoshimura, Hidenori Arai, Dai Fujiwara, Hideki Katsura, Atsuyoshi Kawagoshi, Ryo Kozu, Keisuke Maeda, Sumito Ogawa, Jun Ueki
  • Organizer: 13th International Conference on Frailty and Sarcopenia Research
  • Int'l Joint Research
• [Presentation] リハビリテーション栄養と呼吸サルコペニア-最新情報と未来に向けて (2022)
  • Author(s): 若林秀隆
  • Organizer: 第6回日本リハビリテーション医学会秋季学術集会
  • Invited
• [Presentation] リハビリテーション栄養からみた対策 (2022)
  • Author(s): 若林秀隆
  • Organizer: 第32回日本呼吸ケア・リハビリテーション学会学術集会
  • Invited
• [Presentation] サルコペニアの摂食嚥下障害のセッティング別有病割合 (2021)
  • Author(s): 若林秀隆、水野聡子、和田太、百崎良、藤島一郎、重松孝、國枝顕二郎、巨島文子
  • Organizer: 第58回日本リハビリテーション医学会学術集会
• [Presentation] Sarcopenic dysphagia and rehabilitation nutrition (2021)
  • Author(s): Wakabayashi H, Fujishima I
  • Organizer: 2nd World Dysphagia Summit
  • Int'l Joint Research / Invited
• [Presentation] 全身のサルコペニアについて最近の考え方と嚥下障害への影響 (2021)
  • Author(s): 若林秀隆
  • Organizer: 第26・27回 合同学術大会日本摂食嚥下リハビリテーション学会
  • Invited
• [Presentation] Sarcopenic dysphagia, rehabilitation nutrition and rehabilitation pharmacotherapy (2019)
  • Author(s): Hidetaka Wakabayashi
  • Organizer: 5th Asian Conference on Frailty and Sarcopenia
  • Int'l Joint Research / Invited
• [Presentation] Symptoms of patients with cachexia and their therapy: Swallowing problems. (2019)
  • Author(s): Hidetaka Wakabayashi
  • Organizer: 12th International Conference on Cachexia, Sarcopenia & Muscle Wasting
  • Int'l Joint Research / Invited
• [Presentation] サルコペニアの摂食嚥下障害と医科歯科連携 (2019)
  • Author(s): 若林秀隆
  • Organizer: 第25回日本摂食嚥下リハビリテーション学会学術集会
  • Invited
• [Presentation] リハビリテーション栄養によるサルコペニア・フレイル介入 (2019)
  • Author(s): 若林秀隆
  • Organizer: 第6回日本サルコペニア・フレイル学会大会
  • Invited
• [Presentation] リハビリテーション栄養の視点で考える誤嚥性肺炎予防 (2019)
  • Author(s): 若林秀隆
  • Organizer: 第29回日本呼吸ケア・リハビリテーション学会学術集会
  • Invited
• [Presentation] 2020年代のリハ栄養の展望と課題 (2019)
  • Author(s): 若林秀隆
  • Organizer: 第9回日本リハビリテーション栄養学会学術集会
  • Invited