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This one-year multicenter longitudinal study aimed to assess whether older adult residents of long-term care facilities should switch from a normal to a dysphagia diet. Using the results of our previous cross-sectional study as baseline, older adults were subdivided into those who maintained a normal diet and those who switched to a dysphagia diet. The explanatory variables were age, sex, body mass index (BMI), Barthel Index, clinical dementia rating (CDR), and 13 simple and 5 objective oral assessments (remaining teeth, functional teeth, oral diadochokinesis, modified water swallowing test, and repetitive saliva swallowing test), which were used in binomial logistic regression analysis. Between-group comparison showed a significantly different BMI, Barthel Index, and CDR. Significant differences were also observed in simple assessments for language, drooling, tongue movement, perioral muscle function, and rinsing and in objective assessments. In multi-level analysis, switching from a normal to a dysphagia diet was significantly associated with simple assessments of tongue movement, perioral muscle function, and rinsing and with the objective assessment of the number of functional teeth. The results suggest that simple assessments can be performed regularly to screen for early signs of discrepancies between food form and eating/swallowing functions, which could lead to the provision of more appropriate food forms.

Malnourished older inpatients referred to a nutrition support team (NST) usually receive multidisciplinary oral health management during NST intervention. However, the effects of multidisciplinary oral health management on the nutrition-intake method and oral health in these patients remain unclear. This longitudinal study aimed to investigate the effects of NST-mediated multidisciplinary oral health management on the nutrition-intake methods, oral health, and the systemic and oral factors influencing the changes in the nutrition-intake method. A total of 117 inpatients (66 men, 51 women, mean age, 71.9 ± 12.5 years) who underwent NST-mediated multidisciplinary oral health management between April 2016 and July 2019 were enrolled. Demographic data and Functional Oral Intake Scale (FOIS), Dysphagia Severity Scale (DSS), and Oral Health Assessment Tool (OHAT) scores at the time of referral to the NST and completion of the NST intervention were evaluated. After multidisciplinary NST intervention, FOIS, DSS, and OHAT scores showed significant improvements (p < 0.001). Even after adjusting the results for systemic parameters, FOIS score improvement correlated positively with the length of NST intervention (p = 0.030) and DSS score improvement (p < 0.001) as well as OHAT score improvement (p = 0.047). NST interventions with multidisciplinary oral health management could improve the nutrition-intake method.

The aim was to examine the relationships between oral functions and support/care-need certification in older people aged ≥ 75 years using the National Health Insurance (NHI) database system and data from Kani City, Gifu, Japan. In total, 732 older Japanese people aged ≥ 75 years who did not have support/care-need certification and underwent dental check-ups in Kani City in 2017 were followed up until 2020. Chewing state, tongue and lip function, and swallowing function were assessed by a self-administered questionnaire, an oral diadochokinesis test, and a repetitive saliva-swallowing test, respectively. The presence or absence of systemic diseases and of support/care-need certification was based on data collected by the NHI database. At follow up, 121 (17%) participants had support/care-need certification. The participants with support/care-need certification included more women (p < 0.001) and older people (p < 0.001); and had more hypertension (p = 0.003), musculoskeletal disorders (p < 0.001), pneumonia (p = 0.044), poor chewing state (p < 0.001), and poor swallowing function (p = 0.003) than those without support/care-need certification. Furthermore, the presence of support/care-need certification at follow up was associated with sex (woman: odds ratio [OR], 2.120; 95% confidence interval [CI], 1.354 to 3.317), age (OR, 1.203; CI, 1.139 to 1.270), chewing state (poor: OR, 2.534; CI, 1.409 to 4.557), and swallowing function (poor: OR, 2.372; CI, 1.248 to 4.510) at baseline. However, tongue and lip function were not associated with support/care-need certification. The results indicate that older Japanese people aged ≥ 75 years with a poor chewing state and poor swallowing function at baseline had a higher risk for support/care-need certification after three years.

This 1-year multicenter prospective cohort study aimed to determine the association between observable eating and swallowing function factors and outcomes (death/hospitalization or survival) among elderly persons in long-term care insurance facilities in Japan. Baseline assessments of factors, such as language, drooling, halitosis, hypersalivation, tongue movement, perioral muscle function, coughing, respiration after swallowing, rinsing, and oral residue, among others, were conducted. A score of 0 was considered positive, and a score of 1 or 2 was considered negative. Patient age, sex, body mass index, Barthel index, and Clinical Dementia Rating were recorded. The death/hospitalization or survival rates over 1 year were recorded, and patients were allocated into groups depending on the respective outcome (death/hospitalization group or survival group) and baseline characteristics. A total of 986 residents from 32 facilities were included, with 216 in the death/hospitalization group and 770 in the survival group. Language, salivation, halitosis, perioral muscle, coughing, respiration after swallowing, rinsing, and oral residue were significantly associated with the outcomes (p < 0.05). Therefore, routine performance of these simple assessments by caregivers may allow early detection and treatment to prevent death, pneumonia, aspiration, and malnutrition in elderly persons.

IntroductionOropharyngeal dysphagia (OD) is a common and significant complication of Parkinson’s disease (PD), contributing to malnutrition, respiratory complications and impaired medication intake. The pathophysiology of OD in PD is heterogeneous, involving basal ganglia dysfunction with associated motor impairments in the oropharynx, cortical pathophysiology, and α-synuclein pathology in peripheral nerves. While deep brain stimulation (DBS) is an established intervention for motor symptom management in PD, its effects on swallowing function remain poorly understood and controversial. This narrative review aims to critically evaluate the current evidence on the effects of DBS on OD in PD and to outline potential future research directions, grounded in current understanding of OD pathophysiology and DBS mechanisms.MethodsA narrative review of clinical studies examining the effects of DBS on swallowing function in people with PD was conducted. Studies were identified through database searching of MEDLINE, Embase and Cochrane Library, from inception of the databases until May 2025. Inclusion criteria encompassed clinical studies and case reports investigating DBS effects on swallowing outcomes in people with PD, with no language restrictions applied. Data regarding study design, DBS intervention and stimulation parameters, swallow-related outcomes and assessment methods were extracted and compiled systematically.ResultsA total of 24 clinical studies, including prospective and retrospective observational studies and case reports, were included in this review. Evidence regarding DBS effects remains inconsistent. Subthalamic DBS shows the greatest variability: some studies report improvements in aspiration frequency or pharyngeal timing, while others describe no change or even long-term deterioration in swallowing safety. Pallidal DBS appears to neither improve nor deteriorate swallowing function, however, evidence is limited to four mainly retrospective studies with small sample sizes. Evidence on combined or alternative targets remains sparse and heterogeneous. Patient-reported swallowing outcomes are often more favorable than instrumental measures.DiscussionDBS may influence swallowing in PD, but outcomes likely depend on OD phenotypes, stimulation targets and parameters. Future research should recruit adequately powered cohorts, apply standardized instrumental assessments including detailed OD phenotyping, systematically explore stimulation parameters, distinguish short- from long-term effects, and integrate OD outcomes into DBS programming.

Ze-Ying Hu,1 Ling-nv Xie,2 Guan-Mian Liang,2 Yu-wei Liu,2 Xiao-xue Wen,2 Jian-Wen Hou1 1Department of Head and Neck Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, 310022, People’s Republic of China; 2Nursing Department, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, 310022, People’s Republic of ChinaCorrespondence: Jian-Wen Hou, Department of Head and Neck Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, 310022, People’s Republic of China, Tel +86 13567147265, Fax +86 0571-88128221, Email jianwenhou2025@163.comObjective: Oral cancer patients frequently experience high rates of dysphagia, multiple complications, and poor rehabilitation compliance post-surgery. This study aims to evaluate the effectiveness of specialized nurse-led dysphagia rehabilitation program in improving patients’ swallowing function, quality of life, adherence, and nutritional status.Methods: A single center randomized controlled trial design was employed. 89 patients admitted to the Department of Oral and Maxillofacial Surgery at Zhejiang Cancer Hospital between July 17, 2025, and October 20, 2025, were randomly assigned to an intervention group (n=45) or a usual care group (n=44). The intervention group received a comprehensive rehabilitation program (diagnostic phase, perioperative phase, pre-discharge preparation phase, adjustment and adaptation phase) implemented by a multidisciplinary team led by specialized nurses, supported by a WeChat mini-program. The usual care group received a standard rehabilitation program. Outcome measures included functional oral intake scale, swallowing-related quality of life scale, swallowing function exercise compliance scale, and body mass index. Assessments were conducted at baseline (T0), 1 week post-surgery (T1), 2 weeks (T2), and 4 weeks (T3). Generalized estimating equations were used to analyze changes in outcomes over time.Results: Post-intervention, the intervention group demonstrated significantly superior scores compared to the usual care group in swallowing function (at T2 and T3), quality of life (at T1, T2, and T3), and adherence (at T1, T2, and T3). Nutritional status was also significantly better in the intervention group at T1 and T2. Generalized estimating equations analysis revealed statistically significant group-by-time interaction effects for swallowing function, quality of life, adherence, and nutritional status.Conclusion: Compared with conventional rehabilitation protocols, a swallowing rehabilitation program led by specialized nurses effectively improves swallowing function, quality of life, adherence, and early nutritional status in patients after oral cancer surgery.Keywords: oral cancer, dysphagia, rehabilitation nursing, specialist nurse, swallowing function

Dysphagia is a syndrome of abnormal eating function resulting from a variety of causative diseases, and is associated with malnutrition. To date, the swallowing function has been difficult to examine without the use of invasive and expensive methods, such as the videofluorographic swallowing study or fiberoptic endoscopic evaluation of swallowing. In recent years, progress has been made in the clinical application of ultrasound equipment for the evaluation of body compositions near the body surface, including the assessment of nutritional status. Ultrasound examination is a noninvasive procedure and relatively inexpensive, and the equipment required is highly portable thanks to innovations such as wireless probes and tablet monitoring devices. The process of using ultrasound to visualize the geniohyoid muscle, digastric muscle, mylohyoid muscle, hyoid bone, tongue, masseter muscle, genioglossus muscle, orbicularis oris muscle, temporalis muscle, pharynx, esophagus, and larynx, and the methods used for evaluating these structures, are provided in this study in detail. This study also aims to propose a protocol for the assessment of swallowing-related muscles that can be applied in real-world clinical practice for the diagnosis of sarcopenic dysphagia, which can occur in elderly patients with sarcopenia, and has received much attention in recent years.

Prophylactic swallowing exercises (PSE) during head-and-neck cancer (HNC) (chemo)radiotherapy (CRT) have a positive effect on swallowing function and muscle strength. Adherence rates to PSE are, however, moderate to low, undermining these effects. PRESTO already showed that the service-delivery mode (SDM), the way the exercises are offered, can influence adherence. The aim of this study was to investigate the effect of SDM on swallowing function and muscle strength during and post-CRT. In addition, the effect of overall adherence (OA), independent of SDM, was also investigated. A total of 148 HNC patients, treated with CRT, were randomly assigned to one of the three SDM’s (paper-supported, app-supported, or therapist-supported PSE) and performed a 4-week PSE program. OA was calculated based on the percentage of completed exercises. Patients were divided into OA levels: the OA75+ and OA75− group performed respectively ≥ 75 and < 75% of the exercises. Swallowing function based on Mann Assessment of Swallowing Ability-Cancer (MASA-C), tongue and suprahyoid muscle strength during and up to 3 months after CRT were compared between the SDM’s and OA levels. Linear Mixed-effects Models with post hoc pairwise testing and Bonferroni–Holm correction was used. No significant differences were found between the three SDMs. Significant time effects were found: MASA-C scores decreased and muscle strength increased significantly during CRT. By the end of CRT, the OA75+ showed significantly better swallowing function compared to OA75−. Muscle strength gain was significantly higher in the OA75+ group. SDM had no impact on swallowing function and muscle strength; however, significant effects were shown for OA level. Performing a high level of exercise repetitions is essential to benefit from PSE.Trial registration ISRCTN, ISRCTN98243550. Registered December 21, 2018—retrospectively registered, https://www.isrctn.com/ISRCTN98243550?q=gwen%20van%20nuffelen&filters=&sort=&offset=1&totalResults=2&page=1&pageSize=10&searchType=basic-search

Background and purpose It has been proved that electrical vagus nerve stimulation can promote the recovery of motor function after stroke. There were no trials on the use of transcutaneous auricular electrical vagus nerve stimulation (ta-VNS) in patients with dysphagia after acute stroke. Our aim was to confirm whether ta-VNS can promote the recovery of swallowing function in these acute stroke patients with dysphagia. Methods We conducted a sham-controlled, double-blinded, parallel pilot study in 40 acute stroke patients randomly assigned to receive ta-VNS or sham ta-VNS combined with conventional rehabilitation training. The intensity of ta-VNS treatment was adjusted according to the patient’s tolerance, 30 min each time, twice a day, five times a week, with a total course of 3 weeks. In the sham group, the parameters were the same except energy output. Swallowing function was assessed with Modified Mann assessment of swallowing ability (MASA), functional communication measure swallowing test (FCM), and the Rosenbek leakage/aspiration scale (RAS) according to swallowing video fluoroscopic (SVF) before the intervention (baseline, T0), immediately after the intervention (T1) and 4 weeks after the intervention (T2). Results After treatment, ta-VNS group statistically and clinically had larger change of MASA, FCM, and RAS scores compared with control group ( P  < 0.05) and this improvement continued at least 4 weeks after the end of treatment. There were no serious adverse events occurred during the whole intervention. Conclusion The transcutaneous auricular electrical vagus nerve stimulation is effective as a novel and noninvasive treatment strategy for patients with dysphagia after acute stroke. Trial registration No: kelunshen No. 63 in 2020.

We developed a wearable swallowing assessment device using a hetero-core fiber-optic pressure sensor for the detection of laryngeal movement during swallowing. The proposed pressure sensor (comfortably attached to the skin of the neck) demonstrated a high sensitivity of 0.592 dB/kPa and a linearity of R2 = 0.995 within a 14 kPa pressure band, which is a suitable pressure for the detection of laryngeal movement. In addition, since the fabricated hetero-core fiber-optic pressure sensor maintains appreciable sensitivity over the surface of the sensor, the proposed wearable swallowing assessment device can accurately track the subtle pressure changes induced by laryngeal movements during the swallowing process. Sixteen male subjects and one female subject were evaluated in a variety of age groups ranging from 30 to 60 years old. For all subjects, characteristic swallowing waveforms (with two valleys based on laryngeal movements consisting of upward, forward, backward, and downward displacements) were acquired using the proposed wearable swallowing assessment device. Since the denoted time of the first valley in the acquired waveform determines the “aging effect”, significant differences in swallowing functions among the different age groups were ultimately determined based on the time of the first valley. Additionally, by analyzing each age group using the proposed device, due to p-values being consistently less than 0.05, swallowing times were found to exhibit statistically significant differences within the same groups.