Association of Oral Diadochokinesis, Physical Function and Swallowing Function in Community-Dwelling Elderly People

Objective: Oral diadochokinesis (ODK) has been shown to be associated with oral frailty. In this study, we investigate the relationship between physical function, swallowing function, nutritional evaluation, and each syllable of ODK. Methods: The subjects are 26 elderly people living in an area where they can walk. ODK, tongue pressure, modified water swallowing test, EAT-10, grip strength, MNA-SF, skeletal muscle index, height, weight, and BMI were evaluated. For statistical analysis based on ODK values, the subjects were divided into two groups on the basis of the number of times the syllables /pa/, /ta/, and /ka/ were repeated: 1) The first group with >6 repetitions exceeded six; 2) the second group with ≤5 repetitions. Both groups were compared using the Mann-Whitney U test (Model 1). In addition, the syllables /pa/, /ta/, and /ka/ were also divided among the groups and a comparison was performed (Model 2). Results: In Model 1, the tongue pressure value was significantly higher in the good group (p < 0.01). In Model 2, the good group showed significantly higher values for the syllables /pa/ (p < 0.01) and /ta/ (p < 0.05). There was no significant difference in the values for the syllable /ka/. Conclusion: In community-dwelling elderly people, tongue pressure was positively associated with ODK values for the syllables /pa/ and /ta/, suggesting that tongue pressure may be associated with strength of the lip and tongue tip muscles. Furthermore, it was suggested that the ODK values may even be lower than normal values in the elderly who maintain skeletal muscle mass and thus have adequate tongue pressure;therefore, these indicators may be used as a guideline to assess oral frailty.

Relationships between Tongue and Lip Movement and Physical Fitness among Independent Community-Dwelling Elderly in Japan

Aim: The present study aims to examine the association between tongue and lip movement and physical fitness with a sample of independent community-dwelling elderly. Methods: A total of 119 older adults living in a city of Japan participated in this study. Tongue and lip movement was evaluated with oral diadochokinesis (ODK) rate for the syllable “pa”, “ta”, and “ka” measured by counting syllable repetitions within one second. Physical fitness was objectively evaluated with the Timed-Up and Go Test (TUG) and the 30-Second Chair Stand Test (CS-30). Subjective physical fitness was also assessed with a Physical Component Summary score (PCS) of the 36-item Short-Form Health Survey (SF-36). Partial correlation coefficients between ODK rates and physical fitness measures were obtained after adjusting the effects of age and the number of present teeth. Results: There were significant differences in ODK rates for the syllable “ta” and “ka” between the participants aged 65 - 74 and 75 or older. Significant differences in all the physical fitness measures were also observed in the two age groups. Partial correlation analysis with age and number of present teeth as covariates yielded significant correlations of ODK rates to TUG and PCS, but not with CS-30. Conclusion: Older adults whose functional mobility declined tended to maintain the movement of tongue and lips. Moreover, those who perceived declining physical fitness also tended to show a decline of tongue and lip movement. Thus, the present study added some knowledge on the relationships between general physical fitness and tongue and lip movement. It also made several suggestions for future interventions based on the findings.