Clinical nutrition ESPEN · 2026
Dysphagia, oral health burden, and stool-detected oral-associated taxa in older inpatients after stroke: A cross-sectional study.
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Yoshimura Yoshihiro, Matsumoto Ayaka, Yoneda Kouki, Wakabayashi Hidetaka, Maeda Keisuke
Аннотация
BACKGROUND & AIMS: Swallowing and oral intake limitations and poor oral health may accompany altered stool microbial profiles after stroke. We examined their associations with a stool-detected oral-associated taxa profile in older inpatients.
METHODS: This registry-based cross-sectional analysis included 156 inpatients aged ≥65 years. Swallowing/oral intake status and oral health were assessed using the Food Intake Level Scale (FILS) and Revised Oral Assessment Guide (ROAG). The outcome was a study-defined, standardized six-genera stool-detected oral-associated taxa score. Linear regression used HC3 robust standard errors and clinical covariates. FILS <7 was the primary exposure; continuous FILS and ROAG were secondary exposures. Additional sensitivity analyses addressed score construction, ordinal FILS, nutritional exposure, missingness, and model diagnostics.
RESULTS: Participants had a mean age of 78.4 years; 55.8% were men, and 25 (16.0%) had FILS <7. In separately adjusted models, the score was lower with FILS <7 (β -0.99; 95% CI -1.34 to -0.63), higher per FILS point (β 0.15; 95% CI 0.10-0.20), and lower with each 1-SD increase in ROAG (β -0.32; 95% CI -0.45 to -0.18; all p < 0.001). In the joint model, ROAG was attenuated (β -0.13; 95% CI -0.30 to 0.03; p = 0.111), whereas FILS remained associated. The primary association persisted after energy/protein adjustment and diagnostic checks.
CONCLUSIONS: Poorer swallowing/oral intake status and greater oral health burden were each associated with a lower stool-detected oral-associated taxa profile in separately adjusted models. The exploratory findings do not establish independent oral-health effects, oral origin, causality, or clinical utility.
METHODS: This registry-based cross-sectional analysis included 156 inpatients aged ≥65 years. Swallowing/oral intake status and oral health were assessed using the Food Intake Level Scale (FILS) and Revised Oral Assessment Guide (ROAG). The outcome was a study-defined, standardized six-genera stool-detected oral-associated taxa score. Linear regression used HC3 robust standard errors and clinical covariates. FILS <7 was the primary exposure; continuous FILS and ROAG were secondary exposures. Additional sensitivity analyses addressed score construction, ordinal FILS, nutritional exposure, missingness, and model diagnostics.
RESULTS: Participants had a mean age of 78.4 years; 55.8% were men, and 25 (16.0%) had FILS <7. In separately adjusted models, the score was lower with FILS <7 (β -0.99; 95% CI -1.34 to -0.63), higher per FILS point (β 0.15; 95% CI 0.10-0.20), and lower with each 1-SD increase in ROAG (β -0.32; 95% CI -0.45 to -0.18; all p < 0.001). In the joint model, ROAG was attenuated (β -0.13; 95% CI -0.30 to 0.03; p = 0.111), whereas FILS remained associated. The primary association persisted after energy/protein adjustment and diagnostic checks.
CONCLUSIONS: Poorer swallowing/oral intake status and greater oral health burden were each associated with a lower stool-detected oral-associated taxa profile in separately adjusted models. The exploratory findings do not establish independent oral-health effects, oral origin, causality, or clinical utility.