Exercise habits and swallowing-related symptoms in older adults: a cross-sectional and a single-arm pre-post intervention study.

BACKGROUND

In a super-aged society, extending healthy life expectancy is a critical challenge. Impaired swallowing function especially impacts upon quality of life of older adults and it is known to increase the risk of conditions such as aspiration pneumonia. We investigated the relationship between exercise habits and swallowing-related symptoms. To clarify the relationship with oral function, we examined the exercise habits of community-dwelling older adults, with particular attention to swallowing-related symptoms, through a cross-sectional study. Further, we sought to clarify the change of swallowing-related symptoms before and after an exercise program in groups with different exercise habits.

METHODS

In Study I, a cross-sectional study conducted in September 2024, we analyzed the exercise habits and swallowing-related symptoms of 308 participants. Study II was a single-arm pre-post intervention study conducted between January and March 2025 after registration in November 2024. We compared the swallowing-related symptoms of 67 participants before and after an exercise intervention (60 min, once weekly, for 10 weeks). The primary outcome was the score from the Seirei swallowing questionnaire (low representing fewer/milder swallowing symptoms, high representing more/more severe swallowing symptoms), and secondary outcome was dysphagia if any item on the questionnaire was marked 'A' (severe/frequent). We categorized participants into low exercise habit (≤ 1 day/week) and high exercise habit ≥ 2 days/　week) groups based on their habits.

RESULTS

In Study I, multivariable analysis showed that higher exercise frequency was independently associated with a lower swallowing score. Consistently, a significant linear trend was observed across increasing exercise frequency categories. In Study II, a significant decrease in swallowing scores was observed in the low exercise habit group after the intervention. However, two-way repeated measures analysis of variance revealed a significant main effect of Time, but the Time × Group interaction was not significant. When the presence or absence of dysphagia was examined before and after the intervention, a significant decrease in dysphagia was observed in the low exercise habit group.

CONCLUSION

We observed an association between exercise habits and swallowing-related symptoms in community-dwelling older adults. We also observed a reduction in swallowing-related symptoms in our participants over the course of a 10-week exercise program.

TRIAL REGISTRATION: University Hospital Medical Information Network Centre (UMIN) (registration number: UMIN000056010).