# The Pathophysiology of Sarcopenic Dysphagia: Consideration of Videofluoroscopic Swallowing Studies

## TL;DR

This study explores how muscle loss (sarcopenia) affects swallowing by analyzing pharyngeal and hyoid movement in older patients.

## Contribution

The study identifies specific biomechanical indicators of sarcopenic dysphagia using videofluoroscopic swallowing data.

## Key findings

- Sarcopenic dysphagia is linked to a higher pharyngeal constriction ratio, indicating weaker pharyngeal contraction.
- Patients with sarcopenic dysphagia show a shorter anterior movement distance of the hyoid bone.
- These findings suggest impaired swallowing mechanics due to muscle loss in older adults.

## Abstract

Background

The pathophysiology of sarcopenic dysphagia remains insufficiently understood. The aim of this study was to clarify the pathophysiology of sarcopenic dysphagia by analyzing data from videofluoroscopic swallowing studies, focusing on the pharyngeal constriction ratio (PCR) as an objective indicator of pharyngeal contraction strength and on the anterior movement distance of the hyoid (AMDH), which contributes to the opening of the upper esophageal sphincter.

Methods

The study had a cross-sectional design and included 52 patients aged 65 years or older who were deemed to require a videofluoroscopic swallowing study. Data obtained during the swallowing of 5 mL of a moderately thick liquid were used to calculate the pharyngeal constriction ratio and the anterior movement distance of the hyoid. Sarcopenic dysphagia is a swallowing disorder caused by sarcopenia of the whole body, including the swallowing muscles. The patients were classified into a sarcopenic dysphagia group (n = 27) and a control group (no sarcopenia and no dysphagia; n = 25). The pharyngeal constriction ratio and anterior movement distance of the hyoid were compared between the two groups.

Results

The pharyngeal constriction ratio was significantly higher (r = 0.76; p < 0.001), and the anterior movement distance of the hyoid was significantly shorter (r = 0.30; p = 0.031) in the sarcopenic dysphagia group.

Conclusions

The pathophysiology of sarcopenic dysphagia may involve reduced pharyngeal contraction strength and decreased anterior movement distance of the hyoid.