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Komiyama T, Ohi T, Miyoshi Y, Kogure M, Nakaya N, Hozawa A, Tsuji I, Watanabe M, Hattori Y. Number of teeth and functional disability in community-dwelling older adults. Gerodontology 2024. [PMID: 38985947 DOI: 10.1111/ger.12775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 07/12/2024]
Abstract
INTRODUCTION This study determined whether tooth loss was associated with the development of functional disability and estimated the population attributable fraction (PAF) of functional disability due to tooth loss, along with risk factors for functional disability such as physical function and cognitive impairment. METHODS The participants were 838 community-dwelling older adults aged ≥70 years living in the Tsurugaya district in Japan in 2003. The exposure variable was the number of remaining teeth (counted by trained dentists). Other variables were age, sex, depressive symptoms, cognitive impairment, educational attainment, physical function and social support. The Cox proportional hazards model was applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the incidence of functional disability for each risk factor, such as tooth loss. The functional disability PAF due to tooth loss was estimated, and risk factors for functional disability were identified. RESULTS In total, 619 (73.9%) participants developed functional disability during follow-up. A multivariable model showed that those with <20 teeth (HR, 1.28; 95% CI, 1.08-1.53) were more likely to develop functional disability than those with 20 teeth or more. PAF estimation for functional disability was shown to have decreasing values in the following order: age, female sex, tooth loss and reduced physical function. CONCLUSIONS Tooth loss was associated with the development of functional disability in community-dwelling older Japanese adults. While retaining teeth may be a potential strategy for avoiding functional disability, clinical studies on the effect of dental treatment on preventing functional disability are warranted.
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Affiliation(s)
- Takamasa Komiyama
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Takashi Ohi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan
- Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan
| | - Yoshitada Miyoshi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Mana Kogure
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Makoto Watanabe
- Institute of Living and Environmental Sciences, Miyagi Gakuin Women's University, Sendai, Miyagi, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan
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Smit MJD, Nijholt W, Bakker MH, Visser A. The predictive value of masticatory function for adverse health outcomes in older adults: a systematic review. J Nutr Health Aging 2024; 28:100210. [PMID: 38489994 DOI: 10.1016/j.jnha.2024.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/31/2023] [Indexed: 03/17/2024]
Abstract
Masticatory function is associated with a variety of health outcomes. The aim of this systematic review is to clarify the predictive value of masticatory function for adverse health outcomes, such as frailty, sarcopenia and malnutrition, in older adults. An online literature search covered articles published in English or Dutch in three databases (PubMed, Embase and CINAHL, last searched November 4th 2022). Inclusion criteria were: an observational study design, focus on adults aged ≥65 years and evaluation of the association between masticatory function and health outcomes. Reviews and articles published before the year 2000 were excluded. Methodological quality and risk of bias were assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the U.S. National Institutes of Health. Study population demographics, methods for assessing masticatory function, and the association between masticatory function and adverse health outcomes were extracted. From the 34 included studies, 5 studies had a prospective design, 2 had a retrospective design, and the other 27 studies had cross-sectional design. The majority of the studies were conducted in Japan (74%, n = 26). Twenty studies (59%) used one indicator for masticatory function, the other 41% used two (n = 9) or more (n = 5) indicators. Masticatory function was most frequently assessed with the maximum occlusal force (MOF) (79%, n = 27). The identified health outcomes were clustered into 6 categories: physical parameters and sarcopenia, history of falling, nutritional status, frailty, cognitive function and mortality. Despite the complex and multidimensional character of both masticatory function and most identified adverse health outcomes, some significant associations were reported. Prospective studies showed that reduced masticatory function in older adults is associated with incidence of frailty and frailty progression, cognitive decline and all-cause mortality. Regarding the other identified adverse health outcomes, i.e., physical measures and sarcopenia, history of falling and nutritional status, only cross-sectional studies were available and results were less concordant. As all prospective studies showed that reduced masticatory function in older adults is associated with adverse health outcomes, prevention of decline of masticatory function by adequate oral care may contribute to healthy ageing.
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Affiliation(s)
- Menke J de Smit
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Willemke Nijholt
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mieke H Bakker
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Anita Visser
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Fukuyama Y, Komiyama T, Ohi T, Hattori Y. Association between oral health and nutritional status among older patients requiring long-term care who received home-visit dental care. J Oral Sci 2024; 66:130-133. [PMID: 38462493 DOI: 10.2334/josnusd.23-0344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
PURPOSE This study examined the association between oral health and nutritional status among older patients receiving home-visit dental care. METHODS This study enrolled 110 older patients (age ≥65 years) requiring long-term care who received home-visit dental care. The oral health indicators evaluated included number of teeth, occlusal support, number of functional teeth, tongue pressure, tongue coating index (TCI), and rinsing ability. Nutritional indicators included skeletal muscle mass index (SMI) and the mini-nutritional assessment short-form (MNA-SF). A multivariate modified Poisson regression analysis (adjusted for age, sex, medical history, care level, and housing type) was used to calculate prevalence ratios and 95% confidence intervals (CIs). RESULTS The prevalence ratio for low SMI was not significantly higher for patients with ≥20 teeth than for those with 1-19 or no teeth. Number of teeth was not significantly associated with MNA-SF score. A high TCI score (2.15, 95% CI: 1.07-4.32) and poor rinsing ability (2.32, 95% CI: 1.25-4.30) were significantly associated with low SMI. High TCI scores were associated with low scores in MNA-SF categories (1.25, 95% CI: 1.01-1.55). CONCLUSION TCI and rinsing ability, rather than number of teeth, were associated with nutritional status in older patients requiring long-term care.
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Affiliation(s)
- Yutaka Fukuyama
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry
| | - Takamasa Komiyama
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London
| | - Takashi Ohi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry
- Japanese Red Cross Ishinomaki Hospital
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry
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Dibello V, Lobbezoo F, Lozupone M, Sardone R, Ballini A, Berardino G, Mollica A, Coelho-Júnior HJ, De Pergola G, Stallone R, Dibello A, Daniele A, Petruzzi M, Santarcangelo F, Solfrizzi V, Manfredini D, Panza F. Oral frailty indicators to target major adverse health-related outcomes in older age: a systematic review. GeroScience 2023; 45:663-706. [PMID: 36242694 PMCID: PMC9886742 DOI: 10.1007/s11357-022-00663-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/14/2022] [Indexed: 02/03/2023] Open
Abstract
A well-preserved oral function is key to accomplishing essential daily tasks. However, in geriatric medicine and gerodontology, as age-related physiological decline disrupts several biological systems pathways, achieving this objective may pose a challenge. We aimed to make a systematic review of the existing literature on the relationships between poor oral health indicators contributing to the oral frailty phenotype, defined as an age-related gradual loss of oral function together with a decline in cognitive and physical functions, and a cluster of major adverse health-related outcomes in older age, including mortality, physical frailty, functional disability, quality of life, hospitalization, and falls. Six different electronic databases were consulted by two independent researchers, who found 68 eligible studies published from database inception to September 10, 2022. The risk of bias was evaluated using the National Institutes of Health Quality Assessment Toolkits for Observational Cohort and Cross-Sectional Studies. The study is registered on PROSPERO (CRD42021241075). Eleven different indicators of oral health were found to be related to adverse outcomes, which we grouped into four different categories: oral health status deterioration; decline in oral motor skills; chewing, swallowing, and saliva disorders; and oral pain. Oral health status deterioration, mostly number of teeth, was most frequently associated with all six adverse health-related outcomes, followed by chewing, swallowing, and saliva disorders associated with mortality, physical frailty, functional disability, hospitalization, and falls, then decline in oral motor skills associated with mortality, physical frailty, functional disability, hospitalization, and quality of life, and finally oral pain was associated only with physical frailty. The present findings could help to assess the contribution of each oral health indicator to the development of major adverse health-related outcomes in older age. These have important implications for prevention, given the potential reversibility of all these factors.
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Affiliation(s)
- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Madia Lozupone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario Ernesto Quagliariello, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Berardino
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Anita Mollica
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Hélio José Coelho-Júnior
- School of Physical Education, University of Campinas, Cidade Universitaria Zeferino Vaz, Barao Geraldo, Campinas, Brazil
| | - Giovanni De Pergola
- Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, Bari, Italy
| | - Roberta Stallone
- Neuroscience and Education, Human Resources Excellence in Research, University of Foggia, Foggia, Italy
| | - Antonio Dibello
- Accident and Emergency Department (AED), F. Perinei Hospital, Altamura, Bari, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
- Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, Section of Dentistry, University of Bari Medical School, Bari, Italy
| | | | - Vincenzo Solfrizzi
- Cesare Frugoni Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, Bari, Italy
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy.
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Kato K, Matsuda N, Takahata M, Koseki C, Yamaki M, Sato T. Relationship between occlusal force and endothelial function in community‐dwelling elderly women: A pilot study. Clin Exp Dent Res 2022; 8:1207-1212. [PMID: 35869685 PMCID: PMC9562566 DOI: 10.1002/cre2.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 12/02/2022] Open
Abstract
Objective In this study, age, endothelial function as flow‐mediated dilation (FMD), occlusal force, grip strength, and advanced glycation end products (AGEs) were obtained. AGEs were measured as indicators of aging, while grip strength was measured as an indicator of muscle strength. This study aimed to explain the relationship between occlusal force and endothelial function and determine whether occlusal force can be a new indicator in community preventative care projects. Materials and Methods In 38 community‐dwelling women (age, 76.7 ± 5.7 years), the occlusal force and grip strength were measured, the endothelial function was evaluated by FMD, and AGEs were obtained. The relationship between occlusal force, measurement items, and factors were investigated independently related to endothelial function. Results There were significant correlations between occlusal force and grip strength (r = .54, p < .01). The degree of FMD was significantly associated with occlusal force (r = .60, p < .01) and grip strength (r = .35, p < .05) or increase in AGEs (r = −.37, p < .05). Multiple regression analysis revealed that occlusal force was significantly associated with the degree of FMD (p < .01). Conclusion Occlusal force can be an important indicator of endothelial function in the community‐dwelling elderly. This study may help understand the general health of the elderly in communities.
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Affiliation(s)
- Kanna Kato
- Area of Occupational Therapy, Graduate School of Health Sciences Yamagata Prefectural University of Health Sciences Yamagata City Yamagata Prefecture Japan
| | - Naoko Matsuda
- Area of Occupational Therapy, Graduate School of Health Sciences Yamagata Prefectural University of Health Sciences Yamagata City Yamagata Prefecture Japan
| | - Miki Takahata
- Area of Occupational Therapy, Graduate School of Health Sciences Yamagata Prefectural University of Health Sciences Yamagata City Yamagata Prefecture Japan
| | - Chika Koseki
- Yamagata City Welfare Council Kanai Regional Comprehensive Support Center Yamagata City Yamagata Prefecture Japan
| | - Michiyasu Yamaki
- Area of Occupational Therapy, Graduate School of Health Sciences Yamagata Prefectural University of Health Sciences Yamagata City Yamagata Prefecture Japan
- Department of Occupational Therapy Yamagata Prefectural University of Health Sciences Yamagata City Yamagata Prefecture Japan
| | - Toshiaki Sato
- Area of Occupational Therapy, Graduate School of Health Sciences Yamagata Prefectural University of Health Sciences Yamagata City Yamagata Prefecture Japan
- Department of Occupational Therapy Yamagata Prefectural University of Health Sciences Yamagata City Yamagata Prefecture Japan
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Kato K, Sato K, Chiba K, Koseki C, Sato T. Characteristics of Three Oral Functions in Young and Older Females—A Pilot Study. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2055251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kanna Kato
- Area of Occupational Therapy, Graduate School of Health Science, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Kanako Sato
- Department of Rehabilitation, General Incorporated Association Hamadori Home-Visit Rehabilitation Promotion Foundation, Haramachi, Japan
| | - Kyoka Chiba
- Department of Rehabilitation, Osaki Citizen Hospital, Osaki, Japan
| | - Chika Koseki
- Department of Rehabilitation, Social Welfare Corporation Yamagata City Social Welfare Council, Yamagata, Japan
| | - Toshiaki Sato
- Area of Occupational Therapy, Graduate School of Health Science, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
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Relationship between maximum occlusal force and gastrointestinal cancer in community-dwelling older Japanese adults. Sci Rep 2022; 12:440. [PMID: 35013438 PMCID: PMC8748517 DOI: 10.1038/s41598-021-04158-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/15/2021] [Indexed: 11/24/2022] Open
Abstract
Globally, the cancer burden is expected to increase as populations are ageing. Therefore, cancer prevention among older age groups is important. This prospective cohort study examined the relationship between the number of remaining teeth, maximum occlusal force, and incidence of gastrointestinal cancer in community-dwelling older Japanese individuals using data from the Tsurugaya project; 847 participants were included. The exposure variables were the number of remaining teeth and the maximum occlusal force, with the outcome being the incidence of gastrointestinal cancer. Covariates were age, sex, medical history, smoking, alcohol consumption, educational attainment, and physical function. The Cox proportional hazard model was used to examine the relationship between the number of remaining teeth, maximum occlusal force, and incidence of gastrointestinal cancer. With a median follow-up of 7.6 years, 63 participants were confirmed to have gastrointestinal cancer. The risk of gastrointestinal cancer was significantly higher in those with an occlusal force lower than the median (hazard ratio, 2.80; 95% confidence interval, 1.54–5.10). No significant risk difference was found according to the number of remaining teeth. Low maximum occlusal force was associated with the incidence of gastrointestinal cancer in community-dwelling older Japanese adults.
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Nagamine Y, Kamitani T, Yamazaki H, Ogawa Y, Fukuhara S, Yamamoto Y. Poor oral function is associated with loss of independence or death in functionally independent older adults. PLoS One 2021; 16:e0253559. [PMID: 34166420 PMCID: PMC8224883 DOI: 10.1371/journal.pone.0253559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/07/2021] [Indexed: 11/19/2022] Open
Abstract
AIM To clarify the association of poor oral function with loss of independence (LOI) or death in functionally independent older adults in the community. METHODS We conducted a secondary analysis of data from a prospective cohort study in two municipalities in Japan. We included participants who were older than 65 years of age and had no certification in long-term care at baseline. Poor oral function was evaluated by the Kihon Checklist. Among participants with poor oral function, they were further classified by the degree of quality of life (QOL) impairment due to dysphagia. Main outcome is LOI or death from all cause. The hazard ratio (HR) and 95% confidence of intervals (CIs) were estimated by Cox proportional hazard models adjusted for potential confounders. RESULTS Of 1,272 participants, 150 participants (11.8%) had poor oral function. The overall incidence of LOI or death was 10.0% in the participants with poor oral function, while 3.3% in the participants without. Participants with poor oral function were more likely to develop LOI or death than those without (crude HR = 3.17 [95% CIs 1.74-5.78], adjusted HR = 2.30 [95% CIs 1.22-4.36]). 10 participants (0.79%) were classified as poor oral function with QOL impairment, and were more likely to develop LOI or death than those without poor oral function (crude HR = 7.45 [95% CIs 1.80-30.91], adjusted HR = 8.49 [95% CIs 1.88-38.34]). CONCLUSIONS Poor oral function was associated with higher risk of LOI or death in functionally independent older adults in the community.
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Affiliation(s)
- Yusuke Nagamine
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Anesthesiology and Critical Care Medicine, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Tsukasa Kamitani
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hajime Yamazaki
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yusuke Ogawa
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- * E-mail:
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