Association of Coexisting Low Tongue Pressure and Sarcopenia with Pharyngeal Residue in Older Adults with Presbyphagia.

In age-related swallowing decline, low tongue pressure (LTP) represents a localized functional decline, and sarcopenia represents a systemic functional decline. However, their combined relationship with swallowing function is not fully understood. We examined whether the coexistence of LTP and sarcopenia is associated with pharyngeal residue, an indicator of swallowing efficiency, among older patients with dysphagia. A cross-sectional study was conducted in 102 outpatients aged 65 years or older with dysphagia and no clear underlying pathology. LTP and sarcopenia were assessed, and their coexistence was quantified using an original Tongue-Sarcopenia Composite Score (TSCS; 0-2 points). The primary outcome was pharyngeal residue (Bolus Residue Scale ≥ 2) after ingestion of semisolid food, as evaluated via videofluoroscopic swallowing studies. The association was analyzed using multiple logistic regression. LTP was observed in 69.6% of patients, sarcopenia in 49.0%, and their coexistence in 38.2%. The prevalence of pharyngeal residue increased stepwise across TSCS groups: 30.0% in the 0-point group, 60.5% in the 1-point group, and 82.1% in the 2-point group (p < 0.001). Multivariable analysis showed an association between TSCS and pharyngeal residue (adjusted odds ratio, 3.53; 95% confidence interval, 1.86 to 7.22). This association remained consistent across sensitivity analyses. In older patients with dysphagia who had no clear underlying pathology, the coexistence of LTP and sarcopenia was associated with pharyngeal residue. Combined assessment of both factors revealed stepwise differences in prevalence.