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Interest of a Tongue Strength Measurement in the Screening for Sarcopenia in Hospitalized Elderly Patients

Completed
Conditions
Sarcopenia
Interventions
Device: Tongue strength measurement
Procedure: Blood sampling
Diagnostic Test: Mini Mental State Examination (MMSE)
Diagnostic Test: Minimal nutritional assessment (MNA-SF)
Diagnostic Test: Dual-energy x-ray absorptiometry (DEXA)
Device: Dynamometer (Hand grip )
Diagnostic Test: Walking speed
Registration Number
NCT03417609
Lead Sponsor
Murielle Surquin
Brief Summary

Sarcopenia is a syndrome characterized by a progressive and generalized loss of skeletal muscle mass, strength and function that increases the risk of physical dependence, impaired quality of life and mortality. This is a major public health problem. Indeed, its prevalence has been estimated at 63.8% for elderly patients hospitalized in acute geriatric unit.

Several methods of sarcopenia screening exist at present. The European Working Group on Sarcopenia in Older People (EWGSOP) proposes to carry out three examinations for the diagnosis of sarcopenia: the Dual-Energy X-ray Absorptiometry (DEXA) test and two motor tests (walking speed and hand test). These measurements have already been evaluated and validated. They are reliable, inexpensive and easily achievable in clinical routine.

Recent studies have shown that decreased muscle mass and / or strength could be associated with dysphagia. Indeed, many muscles of the head and neck are simultaneously solicited for swallowing coordination. This suggests that a reduction in the mass or strength of these muscles could impact the swallowing function. The investigator's hypothesize that loss of lingual muscle strength may be associated with sarcopenia. The study will measure the tongue strength using the Iowa Oral Performance Instrument (IOPI) in a geriatric population with or without sarcopenia.

* Determine the incidence of lingual hypotonia in hospitalized elderly sarcopenia patients.

* To compare the sensitivity, the specificity of the measurement of the force of the tongue with the usual measures proposed by the EWGSOP in the context of screening for sarcopenia.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
110
Inclusion Criteria

Patients hospitalized in an acute geriatric unit within the CHU Brugmann.

Exclusion Criteria

None

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
SarcopeniaBlood samplingElderly patients with sarcopenia
ControlWalking speedElderly patients without sarcopenia
SarcopeniaTongue strength measurementElderly patients with sarcopenia
ControlDynamometer (Hand grip )Elderly patients without sarcopenia
ControlBlood samplingElderly patients without sarcopenia
SarcopeniaMini Mental State Examination (MMSE)Elderly patients with sarcopenia
SarcopeniaDual-energy x-ray absorptiometry (DEXA)Elderly patients with sarcopenia
SarcopeniaWalking speedElderly patients with sarcopenia
ControlTongue strength measurementElderly patients without sarcopenia
SarcopeniaDynamometer (Hand grip )Elderly patients with sarcopenia
ControlMinimal nutritional assessment (MNA-SF)Elderly patients without sarcopenia
SarcopeniaMinimal nutritional assessment (MNA-SF)Elderly patients with sarcopenia
ControlMini Mental State Examination (MMSE)Elderly patients without sarcopenia
ControlDual-energy x-ray absorptiometry (DEXA)Elderly patients without sarcopenia
Primary Outcome Measures
NameTimeMethod
Tongue strength6 months

The Iowa Oral Performance Instrument is a validated device for assessing the strength of the tongue. This involves placing the tip of a tube in the mouth and asking the patient to exert pressure on it. Thus, a pressure measurement expressed in kPa makes it possible to objectify the tongue strength.

Secondary Outcome Measures
NameTimeMethod
Albumin concentration6 months

Albumin and pre-albumin are biological markers for undernutrition. Pre-albumin is an earlier marker than albumin because of its shorter half-life, 48 hours versus 21 days.The normal values of albumin are between 40 and 45g/L, between 30 and 35g/L there is moderate undernutrition and under 30g/L it is severe undernutrition.

Skeletal Mass Muscle Index6 months

Dual-energy x-ray absorptiometry (DEXA) is the imaging technique recommended for the diagnosis of sarcopenia. It gives minimal irradiation and gives an adequate estimate of the appendicular muscle mass (ALM). By dividing the ALM by the size in centimeters, we obtain the Skeletal Mass Muscle Index (SMI). SMI values below 2 standard deviations from the mean point towards sarcopenia.

Pre-Albumin concentration6 months

Albumin and pre-albumin are biological markers for undernutrition. Pre-albumin is an earlier marker than albumin because of its shorter half-life, 48 hours versus 21 days. The normal pre-albumin values are between 200 and 400 mg /L, undernutrition is serious if it is less than 150mg/dL.

Hand grip strength6 months

By placing a dynamometer in the patient's hand and asking him to apply maximum pressure to it, the muscular strength of the extremities of the limbs is estimated.

Mini Mental State Examination (MMSE) score6 months

Also called Folstein test, it is an assessment of the patient cognitive and memory functions. It detects cognitive disorders or dementia. The MMSE is quickly realizable and explores several cognitive functions through 30 questions divided into 7 items: Orientation ability - Learning and transcription skills - Attention and calculation skills - Memory retention capacity - Language and naming capability - Constructive Praxy.

A MMSE score over 27 indicates normal cognitive functions (maximum: 29). A MMSE score between 24 and 27 indicates mild cognitive impairment. A MMSE score under 24 indicates dementia.

Minimal nutritional assessment (MNA-SF) score6 months

The minimal nutritional assessment - short form is a simple, non - invasive and validated scale for the detection of malnutrition in the elderly patient. It takes into account the patient's loss of appetite, weight loss, motor skills, recent health status, neuropsychological disorders

The maximum score of the MNA-SF is 14:

* Greater than or equal to 11: normal nutritional status.

* Between 8 and 11: risk of malnutrition.

* Less than 8: proven malnutrition.

Walking speed6 months

Walking speed evaluates the muscular performance. The seated patient must get up and walk a distance of 6 meters as quickly as possible without the help of a third party. It has been shown that there is a non-linear relationship between walking speed and muscle strength.

Trial Locations

Locations (1)

CHU Brugmann

🇧🇪

Brussels, Belgium

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