Characteristics of the study participants.

Pneumonia is a major cause of morbidity and mortality in older adults. In the aging society, screening methods for predicting aspiration pneumonia are crucial for its prevention. Changes in the oropharyngeal morphology and hyoid bone position may increase the risk of aspiration pneumonia. This multicenter study aimed to investigate a simple and effective screening method for predicting dysphagia and aspiration pneumonia. Overall, 191 older adults (aged 65 years or older) were randomly sampled using the simple random sampling technique. Oropharyngeal morphology was assessed using the modified Mallampati classification, which reflects the size of the tongue in the oropharyngeal cavity. The hyoid position was measured as the distance between the menton and laryngeal prominence to evaluate aging-related changes in the muscles of the laryngopharynx. Dysphagia was assessed using the repetitive saliva swallowing test (RSST), which measures the number of swallowing movements in 30 seconds; dysphasia is defined as less than 3 swallowing movements in 30 seconds. The aspiration signs were assessed based on history of choking or coughing reflex during eating or drinking and medical history of pneumonia. The study findings revealed that the modified Mallampati classification was significantly correlated with a medical history of pneumonia. A higher incidence of pneumonia was evident in the lower Mallampati classification, which shows the smaller size of the tongue base in the oropharyngeal cavity. The results of this study suggest that the modified Mallampati classification may be a possible screening method to predict the occurrence of pneumonia.

肺炎是老年人群发病与死亡的主要诱因之一。在老龄化社会中，用于预测吸入性肺炎（aspiration pneumonia）的筛查方法对其预防至关重要。口咽形态改变与舌骨位置异常可能会升高吸入性肺炎的发病风险。本项多中心研究旨在探索一种简便有效的筛查方案，用于预测吞咽障碍（dysphagia）及吸入性肺炎风险。本研究通过简单随机抽样技术，共招募191名65岁及以上的老年受试者。采用改良马兰帕蒂分级（modified Mallampati classification）评估口咽形态，该分级指标可反映舌体在口咽腔内的体积大小。通过测量颏点（menton）至喉结（laryngeal prominence）的距离，评估喉咽肌群的衰老相关性改变，以此表征舌骨位置。采用重复唾液吞咽测试（repetitive saliva swallowing test, RSST）评估吞咽障碍：该测试统计受试者30秒内的吞咽动作次数，若30秒内吞咽次数少于3次，则判定为吞咽障碍。吸入性相关体征则通过进食或饮水时的呛咳或咳嗽反射史，以及肺炎病史进行评估。研究结果显示，改良马兰帕蒂分级与肺炎病史存在显著相关性。马兰帕蒂分级更低的人群，其肺炎发病率显著更高，这类人群的口咽腔内舌根部体积更小。本研究结果表明，改良马兰帕蒂分级或可作为预测肺炎发生风险的潜在筛查工具。