{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:03:07Z","timestamp":1792425787951,"version":"4.5.0"},"reference-count":39,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,7,11]],"date-time":"2021-07-11T00:00:00Z","timestamp":1625961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST108-2218-E- 010-005"],"award-info":[{"award-number":["MOST108-2218-E- 010-005"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST109-2224-E- 010-001"],"award-info":[{"award-number":["MOST109-2224-E- 010-001"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Personalized tongue pressure (TP) training focuses on improving swallowing. This study aims to establish the TP values of different age levels and compare changes between different swallowing status among community-dwelling elders. In this cross-sectional study, 1000 participants, aged 60 years old and above, were recruited from community care centers. All participants were classified into non chewing and\/or swallowing difficulties (NCSD) and with chewing and\/or swallowing difficulties (CSD) groups and their diseases and dieting status were recorded using a structured questionnaire. A disposable oral probe was used to measure TP by asking participants to compress it against the hard palate with maximum voluntary effort. Among 1000 elders, 63.10% had CSD and their TP (from 31.76 to 18.20 kPa) was lower than the NCSD group (from 33.56 to 24.51 kPa). Both groups showed the same tendency for TP decline with increasing age. Decline of TP makes CSD elderly have a poor appetite, eat a soft or liquid diet, and take longer to eat a meal (all p &lt; 0.050). The secondary risk factor dominating TP decline for NCSD and CSD elders is having an education level less than primary school and an abnormal eating assessment, respectively. Our results demonstrated that TP decline has a significant relationship with age changes. Education level and an abnormal eating assessment score are closely associated with TP decline. A series of TP values can be used as a reference indicator of personalized medicine during the aging process among community-dwelling older adults.<\/jats:p>","DOI":"10.3390\/jpm11070653","type":"journal-article","created":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T00:23:36Z","timestamp":1626049416000},"page":"653","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Decreased Tongue Pressure Associated with Aging, Chewing and Swallowing Difficulties of Community-Dwelling Older Adults in Taiwan"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0626-3595","authenticated-orcid":false,"given":"Hsiu-Yueh","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"},{"name":"Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen-Hao","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"},{"name":"Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8995-3515","authenticated-orcid":false,"given":"Kun-Jung","family":"Hsu","sequence":"additional","affiliation":[{"name":"School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"},{"name":"Department of Family Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan"},{"name":"Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0307-270X","authenticated-orcid":false,"given":"Ching-Teng","family":"Yao","sequence":"additional","affiliation":[{"name":"Master Program of Long-Term Care in Aging, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0357-8081","authenticated-orcid":false,"given":"Ping-Ho","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"},{"name":"Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szu-Yu","family":"Hsiao","sequence":"additional","affiliation":[{"name":"School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"},{"name":"Division of Pediatric Dentistry and Special Needs Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5958-0949","authenticated-orcid":false,"given":"Chun-Li","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, National Yang-Ming Chiao-Tung University, Hsinchu 30010, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1093\/geront\/gnv107","article-title":"Aging in Taiwan: Building a Society for Active Aging and Aging in Place","volume":"56","author":"Lin","year":"2016","journal-title":"Gerontologist"},{"key":"ref_2","unstructured":"National Development Council (2021, May 18). Population Projections for the R.O.C. (Taiwan): 2020~2070, Available online: https:\/\/www.ndc.gov.tw\/en\/cp.aspx?n=2E5DCB04C64512CC."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/j.healthpol.2019.08.004","article-title":"LTC 2.0: The 2017 reform of home- and community-based long-term care in Taiwan","volume":"123","author":"Hsu","year":"2019","journal-title":"Health Policy"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1177\/0022034510370801","article-title":"Age-related changes in tongue pressure during swallowing","volume":"89","author":"Tamine","year":"2010","journal-title":"J. Dent. Res."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Castell, M.V., S\u00e1nchez, M., Juli\u00e1n, R., Queipo, R., Mart\u00edn, S., and Otero, \u00c1. (2013). Frailty prevalence and slow walking speed in persons age 65 and older: Implications for primary care. BMC Fam. Pract., 14.","DOI":"10.1186\/1471-2296-14-86"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s00455-013-9469-6","article-title":"Age-related differences in tongue-palate pressures for strength and swallowing tasks","volume":"28","author":"Fei","year":"2013","journal-title":"Dysphagia"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1589\/jpts.28.442","article-title":"Comparison of maximal tongue strength and tongue strength used during swallowing in relation to age in healthy adults","volume":"28","author":"Park","year":"2016","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_8","first-page":"523","article-title":"Swallowing Disorder in the Elderly of a Taipei Community","volume":"5","author":"Wang","year":"2001","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1046\/j.1532-5415.2002.50270.x","article-title":"Prevalence of impaired swallowing in institutionalized older people in Taiwan","volume":"50","author":"Lin","year":"2002","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_10","first-page":"229","article-title":"Effect of aging on oral and swallowing function after meal consumption","volume":"10","author":"Hiramatsu","year":"2015","journal-title":"Clin. Interv. Aging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1111\/joor.12737","article-title":"Association between tongue muscle strength and masticatory muscle strength","volume":"46","author":"Hara","year":"2019","journal-title":"J. Oral Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1093\/gerona\/55.11.M634","article-title":"Age effects on the temporal evolution of isometric and swallowing pressure","volume":"55","author":"Nicosia","year":"2000","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e13859","DOI":"10.1111\/nmo.13859","article-title":"Association between maximum tongue pressure and swallowing safety and efficacy in amyotrophic lateral sclerosis","volume":"32","author":"Pizzorni","year":"2020","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.jds.2020.05.027","article-title":"Five-year change in maximum tongue pressure and physical function in community-dwelling elderly adults","volume":"15","author":"Higa","year":"2020","journal-title":"J. Dent. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1111\/ggi.13166","article-title":"Validity of maximum isometric tongue pressure as a screening test for physical frailty: Cross-sectional study of Japanese community-dwelling older adults","volume":"18","author":"Yamanashi","year":"2018","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1007\/s00455-013-9451-3","article-title":"A systematic review and meta-analysis of measurements of tongue and hand strength and endurance using the Iowa Oral Performance Instrument (IOPI)","volume":"28","author":"Adams","year":"2013","journal-title":"Dysphagia"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1007\/s00455-007-9142-z","article-title":"Standard values of maximum tongue pressure taken using newly developed disposable tongue pressure measurement device","volume":"23","author":"Utanohara","year":"2008","journal-title":"Dysphagia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1111\/joor.13076","article-title":"Variability in tongue pressure among elderly and young healthy cohorts: A systematic review and meta-analysis","volume":"48","author":"Arakawa","year":"2021","journal-title":"J. Oral Rehabil."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/ggi.13591","article-title":"Sarcopenia and dysphagia: Position paper by four professional organizations","volume":"19","author":"Fujishima","year":"2019","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1590\/S2317-17822013000400010","article-title":"Management of dysphagia in Parkinson\u2019s disease and amyotrophic lateral sclerosis","volume":"25","author":"Luchesi","year":"2013","journal-title":"Codas"},{"key":"ref_21","unstructured":"Center for Survey Research, Research Center for Humanities and Social Sciences, Academia Sinica (2021, May 18). The Typology of Townships in Taiwan 2014. Available online: https:\/\/survey.sinica.edu.tw\/research\/document\/01_2_2014.pdf."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"90","DOI":"10.9734\/jsrr\/2020\/v26i530263","article-title":"Sample size determination in survey research","volume":"26","author":"Adam","year":"2020","journal-title":"J. Sci. Res. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1177\/001316447003000308","article-title":"Determining sample size for research activities","volume":"30","author":"Krejcie","year":"1970","journal-title":"Educ. Psychol. Meas."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/j.ridd.2010.08.005","article-title":"The impact of dietary and tooth-brushing habits to dental caries of special school children with disability","volume":"31","author":"Liu","year":"2010","journal-title":"Res. Dev. Disabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1177\/000348940811701210","article-title":"Validity and reliability of the Eating Assessment Tool (EAT-10)","volume":"117","author":"Belafsky","year":"2008","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/ger.12347","article-title":"Oral hypofunction in the older population: Position paper of the Japanese Society of Gerodontology in 2016","volume":"35","author":"Minakuchi","year":"2018","journal-title":"Gerodontology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"375","DOI":"10.2490\/jjrm1963.37.375","article-title":"The repetitive saliva swallowing test (RSST) as a screening test of functional dysphagia. (1). Normal values of RSST","volume":"37","author":"Oguchi","year":"2000","journal-title":"Jpn. J. Rehabil. Med."},{"key":"ref_28","unstructured":"World Health Organization (2013). Oral Health Surveys-Basic Methods, World Health Organization. [5th ed.]."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1007\/s11136-013-0574-7","article-title":"Masticatory factors as predictors of oral health-related quality of life among elderly people in Kaohsiung City, Taiwan","volume":"23","author":"Hsu","year":"2014","journal-title":"Qual. Life Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/ggi.13911","article-title":"Number of functional teeth more strongly predicts all-cause mortality than number of present teeth in Japanese older adults","volume":"20","author":"Maekawa","year":"2020","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Suma, S., Naito, M., Wakai, K., Naito, T., Kojima, M., Umemura, O., Yokota, M., Hanada, N., and Kawamura, T. (2018). Tooth loss and pneumonia mortality: A cohort study of Japanese dentists. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0195813"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Liu, H.Y., Chen, C.H., Kuo, C.H., Feng, M.C., Chen, J.H., Wang, H.W., Chen, K.C., and Lin, C.L. (2021). A Novel Tongue Pressure Measurement Instrument with Wireless Mobile Application Control Function and Disposable Positioning Mouthpiece. Diagnostics (Basel), 11.","DOI":"10.3390\/diagnostics11030489"},{"key":"ref_33","first-page":"375","article-title":"Characterization of tongue pressure in the elderly","volume":"19","author":"Junior","year":"2014","journal-title":"Audiol. Commun. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00455-012-9425-x","article-title":"The influence of age, sex, bulb position, visual feedback, and the order of testing on maximum anterior and posterior tongue strength and endurance in healthy Belgian adults","volume":"28","author":"Vanderwegen","year":"2013","journal-title":"Dysphagia"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.jpor.2018.03.007","article-title":"Factors related to masticatory performance in healthy elderly individuals","volume":"62","author":"Morita","year":"2018","journal-title":"J. Prosthodont. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.2147\/CIA.S212980","article-title":"Effects of oral environment on frailty: Particular relevance of tongue pressure","volume":"14","author":"Satake","year":"2019","journal-title":"Clin. Interv. Aging"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.archger.2018.05.015","article-title":"Age-related declines in the swallowing muscle strength of men and women aged 20\u201389 years: A cross-sectional study on tongue pressure and jaw-opening force in 980 subjects","volume":"78","author":"Hara","year":"2018","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"77","DOI":"10.3109\/17549507.2016.1154983","article-title":"Tongue strength and endurance: Comparison in active and non-active young and older adults","volume":"19","author":"Mefferd","year":"2017","journal-title":"Int. J. Speech Lang. Pathol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/j.clnu.2015.08.001","article-title":"The effect of tongue strength on meal consumption in long term care","volume":"35","author":"Namasivayam","year":"2016","journal-title":"Clin. Nutr."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/11\/7\/653\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:29:00Z","timestamp":1760164140000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/11\/7\/653"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,11]]},"references-count":39,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["jpm11070653"],"URL":"https:\/\/doi.org\/10.3390\/jpm11070653","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,11]]}}}