{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:15:10Z","timestamp":1788786910851,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Although swallowing decline is common after aspiration pneumonia treatment, the impact of early acute\u2010phase energy intake on swallowing outcomes remains poorly understood. We aimed to clarify the association between acute\u2010phase energy intake (Days 3\u20137) and swallowing decline at discharge in older patients with aspiration pneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single\u2010center retrospective cohort study included patients aged \u2265\u200965\u2009years with aspiration pneumonia who maintained oral intake before admission (Functional Oral Intake Scale [\n                      <jats:styled-content style=\"fixed-case\">FOIS<\/jats:styled-content>\n                      ] Score 4\u20137). The exposure was mean energy intake during Days 3\u20137 (kcal\/kg\/day). Swallowing decline was defined as \u2265\u20091\u2010point\n                      <jats:styled-content style=\"fixed-case\">FOIS<\/jats:styled-content>\n                      reduction at discharge. We compared the incidence of swallowing decline across energy\u2010intake quartiles and fitted a multivariable logistic regression model, with covariates selected using a directed acyclic graph.\n                      <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>\n                      and restricted cubic spline analyses were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 200 patients, 109 (54.5%) experienced swallowing decline at discharge. The incidence decreased across energy\u2010intake quartiles, from 68.0% to 36.0% (\n                      <jats:italic>p<\/jats:italic>\n                      for trend &lt;\u20090.001). In multivariable analysis, lower energy intake was independently associated with swallowing decline (adjusted odds ratio 0.927, 95% confidence interval 0.885\u20130.971,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                      <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>\n                      analysis identified an optimal cutoff of 15.3\u2009kcal\/kg\/day (area under the curve 0.648; sensitivity 69.6%; specificity 57.4%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Insufficient early acute\u2010phase energy intake was independently associated with swallowing decline in older patients with aspiration pneumonia. Because energy and protein intake were strongly correlated, energy intake below 15.3\u2009kcal\/kg\/day\u2014possibly reflecting overall macronutrient insufficiency\u2014may serve as a practical reference point for identifying at\u2010risk patients, although prospective validation is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70660","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:34:05Z","timestamp":1783730045000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Early Acute\u2010Phase Energy Intake Is Independently Associated With Swallowing Decline in Older Patients With\u00a0Aspiration Pneumonia: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8256-6624","authenticated-orcid":false,"given":"Mitsuaki","family":"Shigemasa","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition Shobara Red Cross Hospital  Shobara Japan"},{"name":"Field of Food Resources Science, Program in Life Systems Science, Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima  Shobara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Yatomi","sequence":"additional","affiliation":[{"name":"Section of Speech\u2010Language\u2010Hearing Therapy, Department of Rehabilitation Shobara Red Cross Hospital  Shobara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Kayashita","sequence":"additional","affiliation":[{"name":"Faculty of Region Development, Prefectural University of Hiroshima  Hiroshima Japan"},{"name":"Faculty of Nutrition, Kobe Gakuin University  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Hattori","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Shobara Red Cross Hospital  Shobara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Tanimoto","sequence":"additional","affiliation":[{"name":"Faculty of Region Development, Prefectural University of Hiroshima  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Vital Statistics of Japan","author":"Ministry of Health, Labour and Welfare","year":"2025"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.01597.x"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12506"},{"key":"e_1_2_12_5_1","first-page":"613","article-title":"Pharyngeal Sensation and Dysphagia in Aspiration Pneumonia","volume":"34","author":"Ebihara S.","year":"2019","journal-title":"Dysphagia"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2018.08.037"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.12.012"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgf2.625"},{"issue":"6","key":"e_1_2_12_9_1","first-page":"827","article-title":"Acute Sarcopenia Secondary to Hospitalisation\u2014An Emerging Condition Affecting Older Adults","volume":"47","author":"Welch C.","year":"2018","journal-title":"Age and Ageing"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.16.1772-b"},{"issue":"1","key":"e_1_2_12_11_1","first-page":"97","article-title":"Sarcopenia and Dysphagia: Position Paper by Four Professional Organizations","volume":"34","author":"Fujishima I.","year":"2019","journal-title":"Dysphagia"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.11.049"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1581ST"},{"issue":"4","key":"e_1_2_12_15_1","first-page":"249","article-title":"JRS Guidelines for the Management of Pneumonia in Adults 2017","volume":"55","author":"The Japanese Respiratory Society","year":"2017","journal-title":"Respiratory Investigation"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2008.01329.x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2018.08.002"},{"key":"e_1_2_12_19_1","first-page":"61","article-title":"Functional Evaluation: The Barthel Index","volume":"14","author":"Mahoney F. 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