Swallowing difficulty serves as a significant predictor of frailty progression in older adults, according to new research following nearly 800 community-dwelling Japanese seniors over two years.

The study, published in BMC Geriatrics, tracked independent adults aged 65 and older to examine how swallowing difficulties affect the development of frailty. Researchers found that participants with deteriorating swallowing function had a 53% higher risk of progressing to frailty compared to those with normal swallowing ability.

Nearly half (46.7%) of study participants met the criteria for deteriorating swallowing function (DSF) at the study’s start. DSF was defined as having an adverse result in any one of three assessments: low saliva swallowing frequency, reduced tongue pressure or self-reported difficulty swallowing liquids. This broad definition reflects the range of ways swallowing issues can present in older adults, even before clinical dysphagia is formally diagnosed.

The research revealed notable gender differences in specific swallowing function tests, with women showing significantly lower tongue pressure and fewer saliva swallows than men. Study authors suggest hormonal changes during menopause may contribute to the observed differences in muscle strength, coordination and neural control involved in swallowing.

Researchers evaluated swallowing function using three methods: counting how many times participants could swallow saliva in 30 seconds, measuring tongue pressure strength and asking about self-reported difficulty swallowing liquids. Participants meeting adverse criteria on any of these measures were classified as having deteriorating swallowing function.

Over the two-year follow-up period, 149 participants (18.7%) experienced worsening frailty status. Among those with swallowing problems at baseline, 22.4% developed worsening frailty compared to those without swallowing issues.

The findings remained significant even after researchers accounted for other factors like age, body weight, physical function, and cognitive ability, suggesting swallowing problems represent an independent risk factor for frailty development in older adults.