1
|
Watanabe D, Yoshida T, Watanabe Y, Yokoyama K, Yamada Y, Kikutani T, Yoshida M, Miyachi M, Kimura M. Oral frailty is associated with mortality independently of physical and psychological frailty among older adults. Exp Gerontol 2024; 191:112446. [PMID: 38679352 DOI: 10.1016/j.exger.2024.112446] [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: 02/13/2024] [Revised: 03/18/2024] [Accepted: 04/25/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Although oral frailty is independently associated with an increased risk of mortality, evidence for the usefulness of screening tools for oral frailty is less than that for physical frailty screening tools. We aimed to investigate the relationship between oral frailty and mortality in older adults. METHODS This prospective cohort study included 11,374 adults aged ≥65 years, who provided valid responses to a baseline mail survey questionnaire from the Kyoto-Kameoka study. Oral frailty status was evaluated using the Oral Frailty Index-8 (range, 0 [best] to 10 [worst]). Participants were classified into four categories according to the Oral Frailty Index-8: robust (score, 0-2), oral pre-frailty (score, 3), oral frailty (score, 4-6), and oral severe frailty (score ≥ 7). Physical and psychological frailty were evaluated using the validated frailty-screening index and defined as a score of ≥3 out of a possible 5 points. Mortality data were collected from 30 July 2011 to 30 November 2016. Hazard ratios (HR) for all-cause mortality were calculated using a multivariable Cox proportional hazards model. RESULTS During the 5.3-year median follow-up period (57,157 person-years), 1184 deaths were recorded. After adjusting for confounders, including physical and psychological frailty, medical history, and lifestyle, in comparison with a robust oral status, oral pre-frailty (HR, 1.29; 95 % confidence interval [CI], 1.02-1.63), oral frailty (HR, 1.22; 95 % CI, 1.01-1.48), and oral severe frailty (HR, 1.43; 95 % CI, 1.16-1.76) were associated with higher HRs of mortality (p for trend = 0.002). CONCLUSION Oral frailty is associated with mortality independent of physical and psychological frailty in older adults. The Oral Frailty Index-8 may be useful for identifying individuals at high risk of mortality.
Collapse
Affiliation(s)
- Daiki Watanabe
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan; National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan.
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Senior Citizen's Welfare Section, Kameoka City Government, 8 Nonogami, Yasu-machi, Kameoka-city, Kyoto 621-8501, Japan; National Institute of Biomedical Innovation, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saito-Asagi, Ibaraki-city, Osaka 567-0085, Japan.
| | - Yuya Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Faculty of Sport Study, Biwako Seikei Sport College, 1204 Kitahira, Otsu-city, Shiga 520-0503, Japan.
| | - Keiichi Yokoyama
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; National Institute of Biomedical Innovation, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saito-Asagi, Ibaraki-city, Osaka 567-0085, Japan.
| | - Takeshi Kikutani
- Division of Rehabilitation for Speech and Swallowing Disorders, Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo 184-0011, Japan.
| | - Mitsuyoshi Yoshida
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake-city, Aichi 470-1192, Japan.
| | - Motohiko Miyachi
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan; National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan.
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto-city, Kyoto 602-8566, Japan.
| |
Collapse
|
2
|
Uemura I, Takahashi-Suzuki N, Sano A, Yamada S, Nakata A, Satoh T. Curcumin effects on age-related changes in oral immunity: an in vivo study. Br J Nutr 2024:1-9. [PMID: 38634264 DOI: 10.1017/s0007114524000801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
The current study aimed to investigate the effects of ageing on oral immunity using β-defensin (DEFB) 1/2 as a marker and evaluate the effects of curcumin (CUR) on these processes. The study sample included thirty male C57BL/6J mice divided into three groups based on the treatment method used. The young control (YC) and old control (OC) groups received 0·5 % methylcellulose-400 (CUR vehicle) orally for 5 days, whereas the CUR group of older mice received a CUR solution suspended in 0·5 % methylcellulose-400 (dose: 3·0 mg/kg body). DEFB1/2 and immune indicator levels were measured in the saliva and salivary glands post-treatment. The saliva volume and protein content were significantly reduced in the OC group compared with the YC group. CUR administration restored these parameters, decreased DEFB1 expression in the salivary gland and increased DEFB1/2 secretion and DEFB2 expression. These findings were supported by epigenetic gene regulation and partial cytokine activation from changes in WD40 repeat protein 5, TNF alpha and IL-1beta. CUR can partially restore age-related changes in oral immune responses and promote oral health, thereby preventing frailty in the older population through a nutritional therapeutic pathway.
Collapse
Affiliation(s)
- Ippei Uemura
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, 7-Jo 15-4-1 Maeda, Teine-ku, Sapporo, Hokkaido006-8585, Japan
| | - Natsuko Takahashi-Suzuki
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, 7-Jo 15-4-1 Maeda, Teine-ku, Sapporo, Hokkaido006-8585, Japan
| | - Akari Sano
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, 7-Jo 15-4-1 Maeda, Teine-ku, Sapporo, Hokkaido006-8585, Japan
| | - Shogo Yamada
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, 7-Jo 15-4-1 Maeda, Teine-ku, Sapporo, Hokkaido006-8585, Japan
| | - Akifumi Nakata
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, 7-Jo 15-4-1 Maeda, Teine-ku, Sapporo, Hokkaido006-8585, Japan
| | - Takashi Satoh
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, 7-Jo 15-4-1 Maeda, Teine-ku, Sapporo, Hokkaido006-8585, Japan
| |
Collapse
|
3
|
Watanabe D, Yoshida T, Nanri H, Watanabe Y, Itoi A, Goto C, Ishikawa-Takata K, Yamada Y, Fujita H, Miyachi M, Kimura M. Dose-Response Relationships between Diet Quality and Mortality among Frail and Non-Frail Older Adults: A Population-Based Kyoto-Kameoka Prospective Cohort Study. J Nutr Health Aging 2023; 27:1228-1237. [PMID: 38151874 DOI: 10.1007/s12603-023-2041-7] [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: 09/07/2023] [Accepted: 11/12/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES Although better diet quality is inversely associated with mortality risk, the association between diet quality and mortality remains unclear in frail and non-frail older adults. Thus, we aimed to examine this association in older Japanese adults. DESIGN A prospective cohort study. SETTING AND PARTICIPANTS We used the data of 8,051 Japanese older adults aged ≥65 years in the Kyoto-Kameoka study. MESUREMENTS Dietary intake was estimated using a validated food frequency questionnaire. Diet quality was evaluated by calculating the adherence scores to the Japanese Food Guide Spinning Top (range, 0 [worst] to 80 [best]), which were stratified into quartiles. Frailty status was assessed using the validated self-administered Kihon Checklist (KCL) and the Fried phenotype (FP) model. Survival data were collected between February 15, 2012 and November 30, 2016. Statistical analysis was performed using the multivariate Cox proportional hazard analysis and the spline model. RESULTS During the median 4.75-year follow-up (36,552 person-years), we recorded 661 deaths. After adjusting for confounders, compared with the bottom adherence score quartile, the top quartile was associated with lower hazard ratio (HR) of mortality in frailty (HR, 0.73; 95% confidence interval [CI], 0.54-1.00) and non-frailty, as defined by the KCL (HR, 0.72; 95% CI, 0.52-1.01). In the spline model, regardless of frailty status defined by the KCL and FP model, adherence score showed a strongly dose-dependent inverse association with mortality up to approximately 55 points; however, no significant differences were observed thereafter. This association was similar to the results obtained in individuals with physical, cognitive, and depression as domains of KCL in the spline model. CONCLUSIONS Our findings demonstrate an L-shaped association between diet quality and mortality in both frail and non-frail individuals. This study may provide important knowledge for improving poor diet quality in older individuals with frailty or domains of frailty.
Collapse
Affiliation(s)
- D Watanabe
- Daiki Watanabe, RD, PhD, Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan. Tel.: +81-4-2947-6936. E-mail:
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Watanabe D, Kurotani K, Yoshida T, Nanri H, Watanabe Y, Date H, Itoi A, Goto C, Ishikawa-Takata K, Kimura M, Miyachi M, Yamada Y. Diet quality and physical or comprehensive frailty among older adults. Eur J Nutr 2022; 61:2451-2462. [PMID: 35152337 PMCID: PMC8852878 DOI: 10.1007/s00394-022-02819-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/25/2022] [Indexed: 12/18/2022]
Abstract
Abstract
Purpose
While the association between diet quality and mortality has been previously demonstrated, the association between frailty and diet quality has not been evaluated well. This study aimed to investigate the association between diet quality and prevalence of both physical and comprehensive frailty, using two validated tools, in a community-based cohort of older adults.
Methods
We conducted cross-sectional analyses using baseline data of 7022 participants aged ≥ 65 years in the Kyoto-Kameoka study. Diet quality was assessed by calculating the adherence scores to the Japanese Food Guide Spinning Top using a validated questionnaire; the participants were stratified into quartile groups based on these scores. Physical and comprehensive frailty was assessed using the Fried phenotype model-based Frailty Screening Index and the Kihon Checklist, respectively. Multivariable logistic regression and the restricted cubic spline model were used to calculate odds ratios (ORs) and their 95% confidence intervals (CIs) for associations between adherence scores and frailty prevalence.
Results
Higher adherence scores signified a higher intake of vitamin C, vegetables, dairy products, and fruits. Physical and comprehensive frailty prevalence was 14.2 and 35.8%, respectively. In a multivariable adjusted model, compared with the bottom adherence score quartile, the top quartile was associated with lower ORs of physical (OR 0.64; 95% CI 0.52–0.80) and comprehensive frailty (OR 0.60; 95% CI 0.51–0.71). These relationships were similar to results in the spline model.
Conclusions
This study shows an inverse dose–response relationship between diet quality and prevalence of both physical and comprehensive frailty in older adults.
Collapse
Affiliation(s)
- Daiki Watanabe
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636 Japan
- Institute for Active Health, Institute of Interdisciplinary Research, Kyoto University of Advanced Science, Kyoto, 621-8555 Japan
| | - Kayo Kurotani
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636 Japan
- Faculty of Food and Health Sciences, Showa Women’s University, Tokyo, 154-8533 Japan
| | - Tsukasa Yoshida
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636 Japan
- Institute for Active Health, Institute of Interdisciplinary Research, Kyoto University of Advanced Science, Kyoto, 621-8555 Japan
| | - Hinako Nanri
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636 Japan
| | - Yuya Watanabe
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636 Japan
- Institute for Active Health, Institute of Interdisciplinary Research, Kyoto University of Advanced Science, Kyoto, 621-8555 Japan
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, 192-0001 Japan
| | - Heiwa Date
- Department of Data Science, Shiga University, Shiga, 522-8522 Japan
| | - Aya Itoi
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636 Japan
- Department of Health, Sports and Nutrition, Faculty of Health and Welfare, Kobe Women’s University, Hyogo, 650-0046 Japan
| | - Chiho Goto
- Department of Health and Nutrition, Faculty of Health and Human Life, Nagoya Bunri University, Aichi, 492-8520 Japan
| | - Kazuko Ishikawa-Takata
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636 Japan
- Faculty of Applied Biosciences, Tokyo University of Agriculture, Tokyo, 156-8502 Japan
| | - Misaka Kimura
- Institute for Active Health, Institute of Interdisciplinary Research, Kyoto University of Advanced Science, Kyoto, 621-8555 Japan
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, 602-8566 Japan
- Department of Nursing, Doshisha Women’s College of Liberal Arts, Kyoto, 610-0394 Japan
| | - Motohiko Miyachi
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636 Japan
- Faculty of Sport Sciences, Waseda University, Saitama, 359-1192 Japan
| | - Yosuke Yamada
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636 Japan
- Institute for Active Health, Institute of Interdisciplinary Research, Kyoto University of Advanced Science, Kyoto, 621-8555 Japan
| | - Kyoto-Kameoka Study Group
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636 Japan
| |
Collapse
|