Combined association of tongue pressure and occlusal support with malnutrition risk in older adults with dysphagia: a cross-sectional study

BACKGROUND: Tongue pressure and occlusal support are associated with the nutritional risk of older adults with dysphagia; however, the combined association of these factors with malnutrition risk remains unexplored. This study aimed to examine the prevalence of malnutrition risk across different combinations of tongue pressure and occlusal support status in older adults with dysphagia. METHODS: We analyzed data from 212 older adults with dysphagia (mean age, 79.1 ± 7.2 years). Malnutrition risk was defined as a Mini Nutritional Assessment Short-Form score of ≤ 11. Low tongue pressure was defined as < 20 kPa, and impaired occlusal support corresponded to an Eichner classification B or C with dentures. Participants were classified into four groups based on tongue pressure and occlusal support status. Multivariable logistic regression was used to examine the association between tongue pressure, occlusal support, and malnutrition risk. RESULTS: Overall, 59.4% of the participants were at risk of malnutrition. In the individual factor model, low tongue pressure was significantly associated with malnutrition risk (odds ratio [OR] = 3.11, 95% confidence interval [CI]: 1.71 to 5.74). In the four-group model, compared with participants with normal tongue pressure and normal occlusal support, the odds of malnutrition risk were significantly higher in those with normal tongue pressure and impaired occlusal support (OR = 3.54, 95% CI: 1.27 to 10.99), low tongue pressure and normal occlusal support (OR = 3.92, 95% CI: 2.01 to 7.86), and low tongue pressure and impaired occlusal support (OR = 4.17, 95% CI: 1.54 to 12.72). CONCLUSIONS: Among older adults with dysphagia, low tongue pressure and/or impaired occlusal support were associated with higher odds of malnutrition risk. These findings suggest that both tongue pressure and occlusal support may warrant consideration when assessing malnutrition risk in this population, although prospective studies are needed to clarify the temporal and causal relationships.