Effect of oral intake initiation-establishment interval on hospital stay after oral cancer surgery.

OBJECTIVES: To clarify the effect of the period between initiation of oral intake (IOI) and establishment of oral intake (EOI) on length of hospital stay. METHODS: This retrospective study included postoperative oral cancer patients. The number of days from surgery to IOI and EOI and between IOI and EOI were recorded. We performed intergroup comparisons and Cox regression analysis using the number of days until discharge, representing hospital stay length as the dependent variable. RESULTS: The median number of days between IOI and EOI was 3 days for eligible patients and 4.5 and 1.5 for older and younger patients, respectively. The median number of days from surgery to IOI was 15 days. There was a significant correlation between the period between IOI and EOI and the length of hospital stay (r = 0.40, p < 0.01). The period between IOI and EOI was a significant independent variable for the length of hospital stay (HR [95% confidence interval] = 0.45 [0.28-0.72]). CONCLUSIONS: Shortening the IOI to EOI intervals was identified as an independently associated factor for shortening hospital stay, even in older postoperative patients with dysphagia who struggled with early oral intake initiation. Professional, step-by-step dysphagia rehabilitation tailored to the patient's condition yields beneficial outcomes.

Impact of oral health management by nurses and dental professionals on oral health status in inpatients eligible for the Nutrition Support Team: A longitudinal study.

OBJECTIVE: As the participation of dental professionals in multidisciplinary care is often limited, instructions on oral health management provided by dental professionals to other professionals are important to achieve transdisciplinary oral health management; however, the effectiveness of such instructions remains unclear. In this longitudinal study, we aimed to determine the impact of oral health management provided by dental professionals and nurses instructed on oral health management by dental professionals on the oral health of inpatients eligible for a Nurition Support Team (NST). METHODS: The study participants were 117 patients (66 men and 51 women, mean age: 71.9 ± 12.5 years) who received oral health management during the NST intervention period. The participants received oral health management from nurses (Ns group) or dental professionals (D group). The nurses who conducted the oral health management received instructions from dental professionals. Oral health was assessed at the beginning and end of the NST intervention using the Oral Health Assessment Tool (OHAT). RESULT: The Ns and D groups showed significant improvements in the total OHAT scores at the end of the NST intervention. Both groups showed significant improvements in the OHAT subitems of lip, tongue, gums and tissues, saliva, oral cleanliness and dental pain, while only the D group showed a significant improvement in the denture subitem. CONCLUSION: Effective oral health management provided by dental professionals or by nurses trained by them improved the oral health status of inpatients eligible for NST at an acute-care hospital.

Development and evaluation of a new intraoral voice assist device called the voice retriever.

Objective: Patients lose their voice after laryngectomy for laryngeal cancer or aspiration prevention surgery for severe dysphagia. To assist such patients, we developed and verified the utility of a novel vocalization method using a device termed the voice retriever (VR), in which the sound source is placed in the mouth. Methods: We investigated the effectiveness of the VR in patients. The VR consists of a mouthpiece with a built-in speaker and a dedicated application that serves as the sound source. We compared the speech intelligibility and naturalness in normal participants using VR and an electrolarynx (EL) for the first time as well as the voice-related quality of life (V-RQOL) in patients with dysphonia before and after using the VR. Results: The VR produced significantly higher 100-syllable test scores as well as fluency, amount of additional noise, intonation, intelligibility and overall long reading test ratings in the first-time VR and EL users. Furthermore, the VR use significantly improved the V-RQOL of participants with dysphonia. Conclusion: Compared to EL, VR allows more effective speech improvement in participants without experience using an alternative vocalization method and improves the V-RQOL in patients with dysphonia. Level of Evidence: Step 4.

Effect of poor oral health status at hospital admission on in-hospital outcomes of older patients with aspiration pneumonia.

PURPOSE: To investigate the effects of oral health status at admission on in-hospital outcomes and how it varies during hospitalization in older patients with aspiration pneumonia. METHODS: This prospective cohort study involved patients aged ≥ 65 years who were admitted to an acute care hospital with a diagnosis of aspiration pneumonia. The patients' basic health information, length of hospital stay (LOS), and oral health assessment tool (OHAT), functional oral intake scale (FOIS), pneumonia severity index, and clinical frailty scale scores were recorded. Patients were divided into two groups based on their median OHAT scores, and intergroup changes were analyzed as a function of time. The relationship between the LOS, FOIS score upon discharge, and OHAT scores at admission was examined using multiple regression analysis. RESULTS: Of the 89 participants (52 were men, with a mean age of 84.8 ± 7.9 years), 75 were discharged. The patients' oral health was measured weekly for 3 weeks after the initial assessment via the OHAT, wherein the median score was 7, with a significant between-group difference. Moreover, OHAT scores improved within both groups throughout their stay. OHAT scores at admission were independently associated with the LOS (B = 5.51, P = 0.009). CONCLUSION: Poor oral health status at admission was associated with longer hospital stays. Both the high- and low-OHAT groups showed OHAT score improvements. Oral health status is critical in preventing the onset of and treating aspiration pneumonia.

Kinematic analysis of chewing and swallowing function after cervical spine surgery.

PURPOSE: Although movement of the hyoid bone is different for masticatory swallowing and liquid swallowing in normal subjects, it has not been studied after cervical spine surgery. Therefore, we analyzed the swallowing dynamics of masticatory swallowing in anterior cervical spine disease surgery using foods that require chewing close to actual meals. METHODS: A day before and one week after the surgery, a videofluoroscopic swallow study (VFSS) was performed, and the distance of hyoid bone movement in the anterior and superior directions, amount of opening of the upper esophageal sphincter (UES), time of passage through the pharynx, number of swallows, and amount of pharyngeal residual were measured on the VFSS images during a masticatory swallow of corn flakes. The swallowing function was evaluated by DSS (dysphagia severity scale) and FOIS (functional oral intake scale). Imaging software was used for the measurements. RESULTS: Postoperative hyoid movement during masticatory swallowing was not significantly different for anterior movement but significantly limited in upward movement (p = 0.002); UES opening volume was significantly decreased (p < 0.001), and bolus residue was significantly worse (p < 0.001), compared to preoperative. The pharyngeal transit time was not significantly different; the number of swallows increased (p < 0.001), along with DSS (p < 0.001) and FOIS (p < 0.001), with significant differences before and after surgery, indicating worsened swallowing function. CONCLUSIONS: Swallowing function worsened in masticatory swallowing after surgery for cervical spine disease, mainly due to the restriction of upward movement of the hyoid bone and the resulting increase in pharyngeal residuals after swallowing.

Relationship between the jaw-closing force and dietary form in older adults without occlusal support requiring nursing care.

In clinical practice, we encounter cases wherein older adults lacking occlusal support consume foods requiring mastication and adequate swallowing function. This study investigated the relationship between jaw-closing force (JCF) and dietary form in older adults without occlusal support requiring nursing care. This prospective cross-sectional study included 123 older adults requiring nursing care who lost their molar occlusal support and consumed food orally without dentures. JCF was defined as the force required for crushing food with the edentulous ridges or with the tooth and edentulous ridge while closing the mouth. Participants were classified into four groups based on the International Dysphagia Diet Standardization Initiative framework for recommended dietary forms. Basic information was collected, and tongue pressure and JCF were measured. Differences in JCF were analyzed using one-way analysis of variance, while factors related to dietary form were evaluated using ordinal logistic regression analysis. Significant differences in JCF were observed among the four groups. Factors such as the Barthel Index, tongue pressure, and JCF were dietary form-related. Our findings suggest that older adults requiring nursing care tend to have higher JCF when consuming meals requiring mastication. Therefore, JCF could serve as an index for determining appropriate dietary forms in this population.

Tongue Strength of Older Adults Requiring Long-Term Care Varies throughout the Day.

Physical performance shows approximately 30% diurnal variation; however, diurnal variation in oral function remains unclear. This study aimed to determine the diurnal variation in oral and swallowing function in older adults requiring long-term care. The participants included 13 adults aged >60 years (3 men and 10 women, mean age: 77.2 ± 6.3 years, age range: 62-90 years) requiring long-term care. Tongue strength (TS) and oral mucosal moisture were measured as indices of oral and swallowing function, while hand grip strength was measured as an index of general muscle strength. The patients were asked to participate in a "test" after breakfast, lunch, and dinner on the same day. Multilevel linear regression analysis was used to examine diurnal differences in each item. Multilevel linear regression analysis with adjustment for age and sex revealed that TS was significantly higher at noon (p = 0.001) than in the morning. Therefore, caregivers who provide support during meals to older people requiring long-term care should consider the possibility of swallowing function differing according to the time of the day. In conclusion, it may be beneficial to establish a nutritional therapy that accounts for the diurnal variation in TS.

Free-flap volume correlates with body mass index in patients with tongue squamous cell carcinoma.

Objectives: This study aimed to investigate the relationship between postoperative reconstructed tongue flap volume (RTFV) and body mass index (BMI) and identify factors affecting the flap volume in patients with tongue squamous cell carcinoma. Methods: Thirty-two patients were evaluated for RTFV from computed tomography images and BMI. The first and second evaluations were done at 6 months and 1.5 years after surgery respectively. RTFV rate changes and BMI differences from the first and second evaluations were calculated. The correlation between RTFV rate change and BMI difference was assessed using Spearman's rank correlation coefficient. Multiple regression analysis evaluated the relationship between the flap volume rate change and age, sex, flap type, and BMI difference to identify influencing factors. Results: The flap volume rate change and BMI difference correlated significantly (r = .594, p < .05). BMI difference and flap type were independent factors that affected reconstructed flap volume rate change in multiple regression analysis (p < .05). Conclusion: The flap volume of patients with tongue squamous cell carcinoma correlates with the BMI change in the chronic phase. Patients after tongue reconstruction need to be well nourished to maintain BMI and thus postoperative tongue volume to maintain the quality of life. Level of Evidence: Level 3.

Homemade blenderized tube feeding improves gut microbiome communities in children with enteral nutrition.

Enteral nutrition for children is supplied through nasogastric or gastrostomy tubes. Diet not only influences nutritional intake but also interacts with the composition and function of the gut microbiota. Homemade blenderized tube feeding has been administered to children receiving enteral nutrition, in addition to ready-made tube feeding. The purpose of this study was to evaluate the oral/gut microbial communities in children receiving enteral nutrition with or without homemade blenderized tube feeding. Among a total of 30 children, 6 receiving mainly ready-made tube feeding (RTF) and 5 receiving mainly homemade blenderized tube feeding (HBTF) were analyzed in this study. Oral and gut microbiota community profiles were evaluated through 16S rRNA sequencing of saliva and fecal samples. The α-diversity representing the number of observed features, Shannon index, and Chao1 in the gut were significantly increased in HBTF only in the gut microbiome but not in the oral microbiome. In addition, the relative abundances of the phylum Proteobacteria, class Gammaproteobacteria, and genus Escherichia-Shigella were significantly low, whereas that of the genus Ruminococcus was significantly high in the gut of children with HBTF, indicating HBTF altered the gut microbial composition and reducing health risks. Metagenome prediction showed enrichment of carbon fixation pathways in prokaryotes at oral and gut microbiomes in children receiving HBTF. In addition, more complex network structures were observed in the oral cavity and gut in the HBTF group than in the RTF group. In conclusion, HBTF not only provides satisfaction and enjoyment during meals with the family but also alters the gut microbial composition to a healthy state.

Factors influencing the selection of oral healthcare providers in multidisciplinary Nutrition Support Team for malnourished inpatients: A cross-sectional study.

BACKGROUND: Oral health management involving dental professionals in a multidisciplinary Nutritional Support Team (NST) is effective collaborative care. However, the indicators for the triage of oral health management requirements and selection of oral healthcare providers remain unclear. OBJECTIVE: This cross-sectional study included inpatients with malnutrition and aimed to investigate the factors associated with determining the need for oral health management involving dental professionals and selecting primary oral healthcare providers when needed. METHODS: Participants included 255 inpatients (154 males and 101 females, mean age 69.7 ± 14.4 years) aged ≥20 years who underwent oral assessment by the NST between April 2016 and July 2019. Participants were assigned to the following groups: good oral health group, oral health management by nurses under the supervision of dental professionals group, and oral health management by dental professionals group. The comprehensive oral health status was investigated using the Oral Health Assessment Tool (OHAT). The total OHAT score ranges from 0 to 16, with a higher score indicating a poorer oral environment. RESULTS: The total OHAT score had a significant correlation with the need for oral health management by dental professionals. Inpatients with denture problems required oral health management from dental professionals. The optimal cutoff value of the total OHAT score for determining the need for oral health management was four. CONCLUSION: The need for oral health management by dental professionals increased with worsening oral health status, especially denture problems. The OHAT score could be used to triage inpatients who require oral health management collaborated with dental professionals.

Usefulness of a newly developed endoscope for the observation of the posterior tracheal wall.

Objective: Videoendoscopic evaluation of swallowing is an objective swallowing function evaluation method used in dysphagia rehabilitation. However, it is anatomically difficult to detect the entry of foreign substances through the posterior tracheal wall using a conventional endoscope (CE). In this study, we developed an endoscope that can observe the posterior tracheal wall and investigated its reliability and validity in healthy adults. Methods: Twenty healthy adults were included. The trachea was observed from inside the larynx using a CE and a portable, flexible two-step angulation endoscope (two-AE) with a two-step curved shaft tip. The visibility of the anterior and posterior walls was recorded. The time from the endoscope tip entering the larynx to the posterior tracheal wall was measured. Additionally, discomfort events were assessed after the examination. McNemar's test and a paired t-test were used for statistical analysis. Kappa coefficients and concordance rates were calculated. Results: The anterior tracheal wall was observed using both endoscopes. The posterior tracheal wall was significantly observed in 18 participants with the two-AE (p < .001), compared to only three of 20 participants with the CE. The time to observation of the posterior tracheal wall for examiners 1 and 2 was 13.3 ± 6.5 and 12.0 ± 6.7 s, respectively, with no difference between groups (p = .400). The kappa coefficients of examiners 1 and 2 and between the examiners were 0.444, 0.643, and 0.643, respectively, with concordance rates of 90%, 95%, and 95%, respectively. Conclusion: Regardless of the examiner's years of experience, we observed that the two-AE could observe the posterior tracheal wall. Level of Evidence: Step 5.

Factors Related to Oral Problems in Patients with Prolonged Disorders of Consciousness in Long-Term Care: A Cross-Sectional Study.

Factors influencing oral problems, such as malocclusion and oral motor dysfunction, in patients with prolonged disorders of consciousness (DOC) remain unclear. This study aimed to clarify the relationship between oral problems and physical function, communication, respiration, and oral intake status, as well as related factors in patients with DOC receiving long-term care at home. A cross-sectional study was conducted in October 2018; 127 patients who developed DOC > 5 years ago were analyzed. The differences between patients with and without oral problems were examined, and a binomial logistic regression analysis was performed to examine factors associated with oral problems, with the presence of oral problems as the dependent variable, and age, the number of years since onset, drooling, oral intake status, and the presence of a family dentist as explanatory variables. A post hoc power analysis of the binomial logistic regression analysis for oral problems (odds ratio: 2.05, alpha value: 0.05, incidence of oral problems: 0.80, and total sample size: 127) demonstrated an observed power of 93.09%. Oral intake status (p = 0.010) and the number of years since onset (p = 0.046) were significantly related to oral problems. Preventive oral management and rehabilitation from the early stage after onset may be effective for oral problems in patients with DOC.

Association between characteristics of swallowing-related muscles and trunk muscle mass.

Swallowing function is associated with systemic factors. Whether trunk or appendicular skeletal muscle mass is a better indicator of swallowing-related muscle characteristics in community-dwelling older adults is not clear. Hence, we investigated the association between the characteristics of swallowing-related muscles (e.g., mass and quality) and trunk muscle mass. Community-dwelling older adults aged ≥ 65 years (n = 141; men: n = 45, women: n = 96) were recruited for this cross-sectional observational study via a health survey conducted in 2018. Trunk muscle mass index (TMI) and appendicular skeletal muscle mass index (SMI) were measured using bioelectrical impedance analysis. Cross-sectional areas (CSAs) and echo intensity (EI) of the geniohyoid muscle (GHM) and tongue were evaluated using an ultrasonic diagnostic apparatus. Multiple regression analysis was used to examine the relationship of the characteristics of swallowing-related muscle with TMI and SMI. Multiple regression analysis showed that CSA of the GHM was positively associated with both TMI (B = 24.9, p < 0.001) and SMI (B = 13.7, p = 0.002). EIs of swallowing-related muscles were not associated with TMI and SMI. Trunk muscle mass was associated with swallowing-related muscle mass and not muscle quality. The results of this study shed light on the elucidation of association of dysphagia with TMI and SMI.

The Safety of Oral Rehydration Solution Jelly for Water and Electrolyte Intake in Patients with Dysphagia.

Purpose: Oral rehydration solutions (ORSs) are effective in replacing fluids and electrolytes and are widely used. OS-1 Jelly (Otsuka Pharmaceutical Factory, Tokushima, Japan) is a jelly drink corresponding to code 2-1 of the 2021 Japanese Dysphagia Diet. Although jelly drinks are less likely to be aspirated than liquids, their physical properties vary depending on the product. Therefore, the severity of dysphagia may affect intake status. This study aimed to investigate the association between the intake status of ORS jelly and swallowing function. Patients and Methods: Thirty-six patients with dysphagia who required videoendoscopic swallowing evaluation at our university hospital were enrolled. Videoendoscopic swallowing evaluation was performed, and each participant swallowed 5 mL of OS-1 Jelly or thickened water modified to International Dysphagia Diet Standardization Initiative (IDDSI) level 2 three times. Statistical analysis was performed to determine the difference in the number of swallows, time until the swallowing reflex, position for inducing the swallowing reflex, presence of pharyngeal residue, penetration, or aspiration between ORS jelly and thickened water. Results: The time until the swallowing reflex was induced and the position of the swallowing reflex triggered were significantly earlier for ORS jelly (p=0.012, p=0.001). The incidence of pharyngeal residue was significantly lower with ORS jelly (p=0.002). The Penetration-Aspiration Scale score was similar for both samples (p=0.062), and no aspiration was observed in either sample. Conclusion: Patients with dysphagia who can swallow thickened water modified to IDDSI level 2 can consume ORS jelly. ORS jelly, which requires no thickening and can be easily and safely consumed, is effective for water and electrolyte intake in patients with dysphagia.

Effects of tongue right positioner use on tongue pressure: a pilot study.

The effectiveness of the tongue right positioner (TRP) use on oral and swallowing functions remains unclear. To investigate the effects of TRP use on tongue function in patients with dysphagia. This interventional study included eight participants with dysphagia who visited a university dental hospital. The measurement variables included tongue pressure (TP) as the primary outcome and lip and tongue movements, peak nasal inspiratory flow, and changes in the tongue and suprahyoid muscle regions on ultrasonography as the secondary outcomes. Each participant was asked to use a TRP for at least 8 h every night for 2 months. The measurement variables before and after the intervention were compared using the paired t test and Wilcoxon signed-rank test. TP after intervention (31.5 ± 13.1 kPa) was significantly higher than that before intervention (23.0 ± 13.4 kPa), while other measurement variables did not significantly improve. Numerous exercises have been suggested to improve TP; however, most require patients' adherence to instructions. In contrast, although participants did not perform active exercises, most participants in this study observed an improved TP. Our findings show that TRP can greatly improve TP after 2 months of usage.Trial registration number: University Hospital Medical Information Network Clinical Trials Registry (UMIN000040253, date of first registration: 27/04/2020).

Associations of swallowing-related muscle quantity and quality with sarcopenic parameters.

PURPOSE: To examine the associations between swallowing-related muscle characteristics and sarcopenic parameters. METHODS: We included 147 community-dwelling older adults (age: 71.6 ± 4.7 years, body mass index: 23.0 ± 2.7 kg/m2 (mean ± standard deviation), men: 50; women: 97) and categorized them into robust (n = 125), low-function (n = 17), and sarcopenia (n = 5) groups based on the diagnostic criteria of the Asia Working Group for Sarcopenia 2019. We evaluated the geniohyoid muscle (GHM) and tongue characteristics (muscle quantity and quality). The cross-sectional area (CSA) indicated the muscle quantity, and echo intensity (EI) values indicated the muscle quality. A multiple regression analysis was performed to clarify the relationship of swallowing-related muscle characteristics and strength with sarcopenic parameters. RESULTS: The grip strength (CSA of GHM: ß = 1.64, p = 0.03) and skeletal muscle mass index (CSA of tongue: ß = 74.81, p = 0.003, EI of tongue: ß = 1.92, p = 0.009) were better indicators of swallowing-related muscle characteristics. CONCLUSION: These findings may facilitate the early detection of aging-related deterioration in swallowing-related musculature through the diagnostic process of sarcopenia and increase our understanding of muscle physiology.

Analysis of swallowing function after anterior/posterior surgery for cervical degenerative disorders and factors related to the occurrence of postoperative dysphagia.

BACKGROUND CONTEXT: Dysphagia is one of the postoperative complications of cervical degenerative disorders. However, few studies have evaluated the pre- and postoperative swallowing function in detail. PURPOSE: To analyze pre- and postoperative swallowing dynamics kinetically and investigate factors associated with postoperative dysphagia in patients with cervical degenerative disorders. STUDY DESIGN: Retrospective review of prospectively collected data. PATIENT SAMPLE: A total of 41 consecutive patients who underwent an anterior approach (anterior cervical discectomy/corpectomy and fusion (ACDF, ACCF), hybrid surgery (ACDF+ACCF) and total disc replacement) and 44 consecutive patients who underwent a posterior approach (laminoplasty and laminoplasty/laminectomy with fusion). OUTCOME MEASURES: We compared the pre- and postoperative functional oral intake scale (FOIS), dysphagia severity scale (DSS), esophageal dysphagia, anterior/superior hyoid movement, upper esophageal sphincter (UES) opening, pharyngeal transit time, bolus residue scale (BRS), and the number of swallows. METHODS: Videofluoroscopy was performed on the day before surgery and within two weeks after surgery. Data related to age, gender, disease, surgical procedure, surgical site, operative time, and blood loss were collected from the medical records. Pre- and postoperative data were compared for each item in the anterior and posterior approaches. The odds ratio of dysphagia after an anterior approach was also calculated. RESULTS: In the anterior approach, DSS, FOIS, the anterior and superior hyoid movements, maximum UES opening, BRS, and number of swallows worsened postoperatively (p<.05, respectively). In the posterior approach, DSS, FOIS, the anterior hyoid movement, and BRS worsened postoperatively (p<.05, respectively). The factors associated with dysphagia were a proximal surgical site above C3 (OR: 14.40, CI: 2.84-73.02), blood loss >100 mL (OR: 9.60, CI: 2.06-44.74), an operative time >200 minutes (OR: 8.18, CI: 1.51-44.49), and an extensive surgical field of more than three intervertebral levels (OR: 6.72, CI: 1.50-30.07). The decline in swallowing function after the posterior approach was related to aging (p=.045). CONCLUSIONS: Each approach may decrease swallowing function, especially because of the limitation on the anterior hyoid movement. Dysphagia after anterior approaches was associated with the operative site, operative time, and blood loss.

Higher extracellular water/total body water ratio is associated with lower tongue and grip strength: A cross-sectional study.

PURPOSE: This study aimed to investigate the relationship between tongue factors (tongue strength and tongue volume), systemic factors (grip strength and walking speed), and the extracellular water/total body water ratio. METHODS: This cross-sectional study included community-dwelling adults. Body water composition and skeletal muscle mass index were measured using bioelectrical impedance analysis. Moreover, tongue grip strength, tongue volume, occlusal support condition (Eichner classification), and walking speed were measured. Multiple linear regression analysis was performed to investigate the relationship between the tongue and systemic factors as dependent variables and body water composition. RESULTS: We included 171 community-dwelling adults (62 men and 109 women) aged 70.0 years (interquartile range: 8). Tongue strength (r=-0.22, P=0.004) and grip strength (r=-0.39, P<0.001) were correlated with the extracellular water/total body water ratio. In multiple linear regression analysis, tongue strength was associated with the extracellular water/total body water ratio (ß=-0.20, P=0.034), and grip strength was associated with the extracellular water/total body water ratio (ß=-0.12, P=0.047), sex, body mass index, skeletal muscle mass index, and occlusal support condition. CONCLUSIONS: A higher extracellular water/total body water ratio indicates lower tongue and grip strength. Dentists and dental hygienists should be aware of systemic factors present in patients with lower tongue and grip strength. These findings may lead to further medical investigations and diagnosis of other systemic diseases.

Time Spent Away from Bed to Maintain Swallowing Function in Older Adults.

INTRODUCTION: The aim of this study was to determine the associations of time spent away from bed with whole-body muscle mass and swallowing function in older adults with low activities of daily living (ADL). METHODS: This cross-sectional study was conducted at Tokyo Medical and Dental University and included adults over 65 years of age who underwent a medical intervention at their residence. Data regarding age, sex, body height and weight, activity status, medical history, time spent away from bed, and Functional Oral Intake Scale (FOIS) were collected. We calculated the body mass index, Charlson Comorbidity Index, whole-body muscle mass, the appendicular skeletal muscle mass index (ASMI), and the trunk muscle mass index (TMI). According to the time spent away from bed, the subjects were grouped as follows: <4 but ≥0 h (S), <6 but ≥4 h (M), and ≥6 h (L). These variables were analyzed using the one-way analysis of variance, the Kruskal-Wallis test, and the χ2 test, then differences among the three groups were examined. To adjust for confounding factors, we performed multiple regression analysis with ASMI and TMI as the dependent variables and ordinal logistic regression analysis with FOIS as the objective variable. RESULTS: Ninety subjects (male: n = 42; female: n = 48; mean age = 82.9 ± 8.8 years, and groups S: n = 23; M: n = 30; L: n = 37) were analyzed. Group L had a significantly higher ASMI, TMI, and FOIS score than groups S and M, while group M had a significantly higher ASMI and FOIS score than group S. After adjusting for confounding factors, the significant explanatory factors for ASMI were sex, activity status, time spent away from bed, and TMI. The factors for TMI were activity status, time spent away from bed, ASMI, and FOIS. The factors for FOIS were time spent away from bed and TMI. CONCLUSION: Spending 4 or more hours away from the bed is related to appendicular skeletal muscle mass and FOIS, while spending 6 or more hours is related to appendicular skeletal muscle mass, trunk muscle mass, and FOIS in this population. These findings highlight factors that can prevent a decline in swallowing function in the daily life of older adults with low ADL who have difficulty performing exercises to preserve swallowing function.