Association of Clinical, Laboratory, and Ultrasonographic Parameters of the Geniohyoid and Digastric Muscles with Increased Dysphagia Risk in Older Adults Receiving Palliative Care

Background and Objectives: Data regarding swallowing-muscle ultrasonography in older adults receiving palliative care remain scarce. This study aimed to investigate the association of clinical, laboratory, and ultrasonographic parameters of the geniohyoid and digastric muscles with increased dysphagia risk. Materials and Methods: This prospectively recruited cross-sectional study included older adults receiving palliative care. Increased dysphagia risk was defined as an Eating Assessment Tool-10 score ≥3. Demographic and clinical characteristics, nutritional and functional status, selected laboratory parameters, and ultrasonographic measurements of geniohyoid muscle thickness (GHMT), geniohyoid cross-sectional area (GHCSA), digastric muscle thickness (DMT) and digastric cross-sectional area (DCSA) were recorded. Results: A total of 123 patients were included (mean age: 75.4 ± 11.9 years; 52.8% female). Increased dysphagia risk was present in 66.6% of participants. Compared with patients without increased dysphagia risk, those with increased risk had a higher prevalence of dementia, higher Nutritional Risk Screening-2002 scores and C-reactive protein levels, lower Palliative Performance Scale scores, lower lymphocyte counts and albumin and 25(OH) vitamin D levels, and lower GHMT, GHCSA, DMT, and DCSA values (all p < 0.05). In multivariable analyses, lower values of GHMT, GHCSA, DMT, and DCSA remained associated with increased dysphagia risk across the models (all p < 0.05). GHCSA and DMT showed modest discriminative ability, with AUCs of 0.712 and 0.736, respectively. Conclusions: Increased dysphagia risk was common in older adults receiving palliative care and was associated with cognitive, nutritional, functional, inflammatory, and swallowing-muscle characteristics. Ultrasonographic assessment of the geniohyoid and digastric muscles may represent a feasible bedside adjunct for identifying older adults at increased risk of dysphagia in this vulnerable population.