ArticleDysphagia2026
Utility of Calf Circumference in Predicting Swallowing Penetration in Sarcopenic Older Adults: A FEES-Based Study.
Article in Dysphagia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Sex-specific predictive ability of SARC-F and SARC-CalF for ultrasound-based sarcopenia in older adults.BMC geriatrics · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This study investigated clinical and anthropometric parameters, including ultrasound-derived swallowing muscle measurements, for predicting clinically significant swallowing penetration in sarcopenic older adults. Eighty adults aged ≥ 65 years (50 sarcopenic, 30 controls) attending a university hospital geriatric clinic were enrolled. Exclusion criteria were major neurological disorders, malignancy, head and neck surgery/radiotherapy, advanced organ failure, severe COPD, and rheumatologic disease. All underwent comprehensive geriatric assessments, including frailty (Fried criteria), cognitive and nutritional screening, EAT-10, and ultrasound-based sarcopenia assessment. Sarcopenia was defined as low handgrip strength and low STAR index (anterior thigh muscle thickness/BMI) using national cut-offs. Swallowing-related muscle thickness (genioglossus, geniohyoid, tongue), geniohyoid area, and elevation were measured ultrasonographically. Sarcopenic patients consenting to fiberoptic endoscopic evaluation of swallowing (FEES) were assessed using the Penetration-Aspiration Scale (PAS); PAS ≥ 3 indicated clinically significant penetration. Participants' mean age was 75.86 ± 6.89 years. Sarcopenic individuals were older, predominantly male, with lower genioglossus and tongue thickness, higher frailty scores, lower MMSE, and greater prevalence of diabetes and coronary artery disease. Among sarcopenic patients, 20% exhibited significant penetration. These patients had smaller arm/calf circumferences, slower gait speed, and higher EAT-10 scores, but no significant differences in swallowing muscle measurements or cognitive and nutritional status. Multivariate analysis identified lower calf circumference as the sole independent predictor (OR: 0.772, 95% CI: 0.613-0.972, p = 0.027). A threshold ≤ 32 cm yielded an AUC of 0.733 (p = 0.025), with 70% sensitivity and 77.5% specificity. In sarcopenic older adults, calf circumference is an independent, non-invasive predictor of clinically significant swallowing penetration, outperforming ultrasound-based swallowing muscle metrics in aspiration risk screening.
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