ArticleBMC geriatrics2025
Accuracy of tongue strength, endurance, and pressure using Iowa oral performance instrument and predictors of dysphagia in community-dwelling older adults: a cross-sectional study.
Article in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Suprahyoid Muscle Activity and Fatigue During Tongue Elevation Compared With the Head Lift Exercise: A Surface EMG Study.Journal of oral rehabilitation · 2026Article
- Frequency-dependent effects of motor thalamus deep brain stimulation on speech and swallowing.Nature communications · 2026Article
- Exploring Factors Related to Dysphagia Among Community-Dwelling Older Adults: A Scoping Review.Dysphagia · 2026Review
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9 authors.
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Abstract
backgroundDecreased tongue strength, pressure, and endurance are key indicators in determining oropharyngeal dysphagia (OD). This study aimed to examine the accuracy of the Iowa Oral Performance Instrument (IOPI) in assessing tongue strength, endurance, and pressure, and to identify predictors of OD.
methodsIn this study, we analyzed data of community-dwelling older adults (age ≥ 65 years) collected between March to December 2022. The accuracy for IOPI was examined with Receiver operating characteristic curve using area under the ROC curve (AUC), sensitivity (Se) and specificity (Sp) and optimal cutoff with Youden index (J). Bivariate and multivariate logistic regression analysis for predictors of OD were performed presenting odds ratio (OR) with 95% confidence interval (CI).
resultsThe cohort consisted of 85 older adults with mean age of 83.25 years (SD 6.76), of which 64 (75.3%) were female. The prevalence of OD using EAT-10 was 8.3%. Tongue strength demonstrated better diagnostic accuracy using anterior tongue strength (ATS): cut-off: 37.5 kPa (AUC: 0.79, Se: 0.86, and Sp: 0.65) and posterior tongue strength: cut-off: 31.5 kPa (AUC: 0.73, Se: 0.71, and Sp: 0.79). Tongue endurance demonstrated better diagnostic accuracy using anterior endurance target second (ATE-Target Sec): cut-off: 2.4 (AUC: 0.96, Se: 0.86, and Sp: 0.90), PTE-Target Sec: cut-off: 1.7 (AUC: 0.93, Se: 0.86, and Sp: 0.83), ATE-Target Max with cut-off: 34.4 kPa (AUC 0.81, Se = 0.86, and Sp = 0.64), and PTE-Target Max with cut-off: 29.5 kPa (AUC: 0.77, Se = 0.86, and Sp = 0.69). Tongue pressure revealed limited diagnostic accuracy using saliva swallowing pressure with cut-off: 23.3 kPa (AUC: 0.60) and effortful swallowing pressure with cut-off: 28.5 kPa (AUC: 0.62). Significant predictors for OD were frailty (3.02, 95%CI: 1.56-5.88), age (1.17, 95%CI: 1.01-1.35), nutritional status (0.72, 95%CI: 0.57-0.92), ATS (0.86, 95%CI: 0.77-0.97), ATE-Target Max (0.90, 95%CI: 0.84-0.97), PTE-Target Max (0.92, 95%CI: 0.86-0.99), ADL (0.91), IADL (0.67), and depression (1.32).
conclusionsThe findings suggest that tongue strength and endurance, measured by IOPI, are more effective parameters than tongue pressure, with frailty, age, nutritional status, ATS, ATE-Target Max, PTE-Target Max, ADL, IADL, and depression being essential for early screening of OD in community-dwelling older adults. CLINICAL TRIAL NUMBER: Not applicable.
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