The relationship between sarcopenia, dysphagia, malnutrition, and frailty: making the case for proactive swallowing exercises to promote healthy aging

Purpose of review The purpose of this review is to summarize current evidence regarding the relationship between sarcopenia of the swallowing muscles, dysphagia, malnutrition, and frailty in the context of aging. Further, this review will provide preliminary support for proactive swallowing exercises to reverse and/or prevent sarcopenia of the swallowing muscles. Recent findings Recent studies lend support to a cyclic relationship between sarcopenia of the swallowing muscles, dysphagia, malnutrition, and frailty. Unfortunately, all studies are limited by their study design and lack instrumental imaging of swallowing function. Research (in the limbs) supports the use of proactive exercises and protein supplementation to reverse sarcopenia, especially in prefrail individuals. This provides a foundation to design and test similar preventive exercises for the swallowing muscles. As the population is rapidly aging, it is vital to understand how the natural loss of muscle in aging impacts swallowing function and the downstream impact on nutritional and physical function. Prospective, longitudinal research with sophisticated outcome measures are required to fully understand this cycle and provide an opportunity to test methods for interrupting the cycle.

Automated summary

The purpose of this review is to summarize the current evidence on the relationship between sarcopenia of swallowing muscles, dysphagia, malnutrition, and frailty in the context of aging. Recent studies support a cyclic relationship between these factors, but are limited by study design and lack of imaging data. Proactive exercises and protein supplementation have shown promise in reversing sarcopenia, providing a foundation for similar preventive exercises to be designed and tested for swallowing muscles. It is important to understand the impact of muscle loss on swallowing function and overall physical health as the population ages. Prospective, longitudinal research with sophisticated outcome measures is needed to fully understand and interrupt this cycle.