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Yamaga R, Chikaishi M, Iwasaki T, Tada A, Mizutani S, Amano K, Iwase Y, Taniguchi H. Pilot study on the relationship between oral function or subjective symptoms and appetite. J Oral Rehabil 2024; 51:2261-2269. [PMID: 39054906 DOI: 10.1111/joor.13811] [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: 04/02/2024] [Revised: 07/07/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE This pilot study evaluated the relationships between appetite and oral function, and between appetite and the subjective symptoms of decreased oral function. METHODS Seventy-one adult dental clinic patients (22 males, 66.0 ± 14.0 years) participated in this study. A Council on Nutrition Appetite Questionnaire score of ≤28 indicated anorexia, and the Mini Nutritional Assessment Short-form, body mass index and skeletal muscle mass index were used to define subject characteristics. Seven oral function tests and seven subjective symptoms related to oral function were evaluated. The relationship between subject characteristics, oral function tests, subjective symptoms and anorexia was analysed using the chi-square test and univariate and multivariate logistic regression. RESULT There were significant differences between the normal appetite group and the anorexia group for the 10-item Eating Assessment Tool (EAT-10) survey and the question 'Food remains in the oral cavity after eating' (p < .05). Univariate logistic regression found significant differences in the items of masticatory function, the EAT-10 survey and the question 'Food remains in the oral cavity after eating'. Multivariate logistic regression revealed significant differences in masticatory function (AOR 4.35; 95% CI: 1.03-18.35; p = .045) and EAT-10 (AOR 6.27; 95% CI: 1.40-24.02; p = .016). CONCLUSION This pilot study investigated the influence of factors related to oral function on appetite. Relationships were found among poor masticatory function, poor swallowing function and anorexia.
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Affiliation(s)
- Ryosuke Yamaga
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Department of Dentistry for Persons with Disabilities, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Yamaga Dental Clinic, Kuwana, Japan
| | - Masato Chikaishi
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Department of Dentistry for Persons with Disabilities, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Department of Dentistry and Oral-Maxillofacial Surgery, Chikaishi Hospital, Medical Corporation Touhoukai, Gifu, Japan
| | - Toshihiro Iwasaki
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Akira Tada
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Department of Oral Surgery, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Saki Mizutani
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
- Department of Dentistry for Persons with Disabilities, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Kota Amano
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Yoko Iwase
- Department of Dentistry for Persons with Disabilities, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Hiroshige Taniguchi
- Department of Dysphagia Rehabilitation, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
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Tanaka T, Hirano H, Ikebe K, Ueda T, Iwasaki M, Minakuchi S, Arai H, Akishita M, Kozaki K, Iijima K. Consensus statement on "Oral frailty" from the Japan Geriatrics Society, the Japanese Society of Gerodontology, and the Japanese Association on Sarcopenia and Frailty. Geriatr Gerontol Int 2024. [PMID: 39375858 DOI: 10.1111/ggi.14980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/22/2024] [Accepted: 09/01/2024] [Indexed: 10/09/2024]
Abstract
The concept of oral frailty was first proposed in Japan in 2014 by the "Joint Working Committee on Oral Frailty," consisting of three academic societies-the Japan Geriatrics Society, the Japanese Society of Gerodontology, and the Japanese Association on Sarcopenia and Frailty-to enhance public understanding of oral frailty. Oral frailty is a state between robust oral function (a "healthy mouth") and its decline, characterized by slight declines in oral function, including tooth loss and difficulties in eating and communicating, which increase the risk of impaired oral functional capacity but can be reversed with proper intervention and treatment. Oral frailty can be assessed using the Oral Frailty 5-item Checklist (OF-5) without the need for a dental health professional. Oral frailty is defined as having at least two of the following components: (i) fewer teeth, (ii) difficulty chewing, (iii) difficulty swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. Approximately 40% of community-dwelling older adults have oral frailty. Oral frailty is associated with poor dietary variety, social isolation, physical frailty, disability, and mortality. This statement introduces the concept and definition of oral frailty, a new assessment tool (OF-5), and concept diagrams for healthcare professionals and the general public. These tools aim to promote public awareness and facilitate collaboration between medical and dental healthcare providers. Geriatr Gerontol Int 2024; ••: ••-••.
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Affiliation(s)
- Tomoki Tanaka
- Joint Working Committee on Oral Frailty by the Japan Geriatrics Society, Japanese Society of Gerodontology, and Japanese Association on Sarcopenia and Frailty, Tokyo, Japan
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Hirohiko Hirano
- Joint Working Committee on Oral Frailty by the Japan Geriatrics Society, Japanese Society of Gerodontology, and Japanese Association on Sarcopenia and Frailty, Tokyo, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kazunori Ikebe
- Joint Working Committee on Oral Frailty by the Japan Geriatrics Society, Japanese Society of Gerodontology, and Japanese Association on Sarcopenia and Frailty, Tokyo, Japan
- Department of Removable Prosthodontics and Gerodontology, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Takayuki Ueda
- Joint Working Committee on Oral Frailty by the Japan Geriatrics Society, Japanese Society of Gerodontology, and Japanese Association on Sarcopenia and Frailty, Tokyo, Japan
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Masanori Iwasaki
- Joint Working Committee on Oral Frailty by the Japan Geriatrics Society, Japanese Society of Gerodontology, and Japanese Association on Sarcopenia and Frailty, Tokyo, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Shunsuke Minakuchi
- Joint Working Committee on Oral Frailty by the Japan Geriatrics Society, Japanese Society of Gerodontology, and Japanese Association on Sarcopenia and Frailty, Tokyo, Japan
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hidenori Arai
- Joint Working Committee on Oral Frailty by the Japan Geriatrics Society, Japanese Society of Gerodontology, and Japanese Association on Sarcopenia and Frailty, Tokyo, Japan
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Masahiro Akishita
- Joint Working Committee on Oral Frailty by the Japan Geriatrics Society, Japanese Society of Gerodontology, and Japanese Association on Sarcopenia and Frailty, Tokyo, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Koichi Kozaki
- Joint Working Committee on Oral Frailty by the Japan Geriatrics Society, Japanese Society of Gerodontology, and Japanese Association on Sarcopenia and Frailty, Tokyo, Japan
- Department of Geriatric Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Katsuya Iijima
- Joint Working Committee on Oral Frailty by the Japan Geriatrics Society, Japanese Society of Gerodontology, and Japanese Association on Sarcopenia and Frailty, Tokyo, Japan
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
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Sakai K, Hayashi K, Hoshino E, Nakayama E, Iijima K, Tanaka T, Momosaki R, Sakata N. Association of oral hypofunction with aspiration pneumonia, fractures, and mortality in older Japanese adults. Geriatr Gerontol Int 2024; 24:1053-1059. [PMID: 39228115 DOI: 10.1111/ggi.14973] [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: 04/18/2024] [Revised: 07/18/2024] [Accepted: 08/16/2024] [Indexed: 09/05/2024]
Abstract
AIM In Japan's public health system, dentists can assess and intervene in oral hypofunction cases. However, the associations between oral hypofunction and health outcomes and costs remain unclear. This study aimed to identify these associations. METHODS This retrospective cohort study using a Japanese health insurance claims database included 45 916 individuals aged ≥65 years who underwent dental examinations for oral hypofunction. The primary outcomes were incidence rates of aspiration pneumonia, femoral or vertebral fractures and all-cause mortality. Secondary outcomes were annual medical and dental costs. We used competing risk regression and Cox models to estimate primary outcomes, and gamma regression models for secondary outcomes. RESULTS The adjusted hazard ratios were 0.84 (95% CI 0.74-0.96) for the incidence of aspiration pneumonia, 1.11 (1.02-1.21) for the incidence of femoral or vertebral fractures and 1.27 (1.07-1.50) for all-cause mortality in individuals with oral hypofunction compared with those without. The adjusted relative risk was 1.05 (1.01-1.10) for annual medical costs and 0.94 (0.81-1.09) for annual dental costs in individuals with oral hypofunction compared with those without. CONCLUSIONS Individuals with oral hypofunction were at increased risk of femoral or vertebral fractures and all-cause mortality, and they incurred significantly higher annual medical costs, compared with those without this condition. Notably, they showed a lower risk of aspiration pneumonia, suggesting potential benefits of dental intervention. Integrating dental care into medical strategies might be necessary to improve health outcomes and reduce healthcare costs for those with oral hypofunction. Geriatr Gerontol Int 2024; 24: 1053-1059.
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Affiliation(s)
- Kotomi Sakai
- Department of Research, Heisei Medical Welfare Group Research Institute, Tokyo, Japan
- Division of Policy Evaluation, Department of Health Policy, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | | | - Eri Hoshino
- Division of Policy Evaluation, Department of Health Policy, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Enri Nakayama
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Mie, Japan
| | - Nobuo Sakata
- Department of Research, Heisei Medical Welfare Group Research Institute, Tokyo, Japan
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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Yamamoto T, Mochida Y, Irie K, Altanbagana NU, Fuchida S, Aida J, Takeuchi K, Fujita M, Kondo K. Regional Inequalities in Oral Frailty and Social Capital. JDR Clin Trans Res 2024; 9:368-377. [PMID: 38654451 DOI: 10.1177/23800844241238648] [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: 04/26/2024] Open
Abstract
INTRODUCTION Oral frailty leads to poor nutritional status, which, in turn, leads to frailty. This cross-sectional study aimed to determine regional differences in the prevalence of oral frailty and to identify factors associated with oral frailty using 3-level multilevel models. METHODS This study comprised 165,164 participants aged ≥65 y without long-term care requirements in the Japan Gerontological Evaluation Study. The dependent variable was oral frailty, which was calculated based on age, number of teeth, difficulty in eating tough foods, and choking. The individual-level independent variables included sociodemographics, present illness, social participation, frequency of meeting friends, and social capital. The local district-level independent variable was social capital (n = 1,008) derived from exploratory factor analyses. The municipality-level independent variable was population density (n = 62). Three-level multilevel Poisson regression analysis was performed to calculate the prevalence ratios (PRs). RESULTS The prevalence of oral frailty in municipalities ranged from 39.9% to 77.6%. Regarding district-level factors, higher civic participation was significantly associated with a lower probability of oral frailty. At the municipality level, the PR of the rural-agricultural area was 1.17 (95% confidence interval, 1.11-1.23) (reference: metropolitan). CONCLUSION These results highlight the usefulness of oral frailty prevention measures in encouraging social participation in rural areas. KNOWLEDGE TRANSFER STATEMENT The results of the present study showed regional differences in oral frailty. In particular, rural-agricultural areas show higher prevalence rates of oral frailty than those in metropolitan cities. Promoting measures of social participation among older adults may help prevent oral frailty in rural areas.
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Affiliation(s)
- T Yamamoto
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - Y Mochida
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - K Irie
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - N U Altanbagana
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - S Fuchida
- Department of Education Planning, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - J Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - K Takeuchi
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - M Fujita
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | - K Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Chiba, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Shimamura Y, Matsuda Y, Takeda M, Morioka R, Kotani T, Kanno T. Effect of body mass index on post-treatment oral function in patients with oral cancer: a cross-sectional study. Sci Rep 2024; 14:21869. [PMID: 39300157 DOI: 10.1038/s41598-024-67246-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/09/2024] [Indexed: 09/22/2024] Open
Abstract
This single-center cross-sectional study used sequential sampling to examine the influence of body mass index (BMI) on oral function after oral cancer treatment. Patients who completed primary oral cancer treatment between September 2019 and March 2023 (102 patients, 74 male [72.5%] and 28 female [27.5%]; mean age, 69.6 years) were analyzed. Patient background data were collected from electronic medical records. Post-treatment oral function measurements were conducted on all patients using six assessment tools. Statistical analysis was conducted using Pearson's correlation coefficient, one-way analysis of variance, the Jonckheere-Terpstra test, and multiple linear regression. Pre-treatment BMI showed a statistically significant relationship with postoperative oral function, particularly tongue pressure (P = 0.01). While the mean values of the groups showed no significant differences, the Jonckheere-Terpstra test revealed a statistically significant trend toward a stepwise increase in tongue pressure for each BMI group (P = 0.03). Multiple linear regression analysis revealed a statistically significant correlation between tongue pressure and pre-treatment BMI (P < 0.05). Pre-treatment BMI was significantly associated with tongue pressure. Since BMI is a variable factor that can be controlled by nutritional therapy even before treatment, nutritional intervention, weight control, and treatment strategies including reconstructive interventions to maintain tongue pressure may be important in oral cancer treatment.
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Affiliation(s)
- Yukiho Shimamura
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Yuhei Matsuda
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Mayu Takeda
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Reon Morioka
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Tatsuhito Kotani
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan.
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Xie HY, Chen JL, Xia CQ, Zhang N, Xia ZX, Zhao HY, Huang YH. Association of oral frailty and gait characteristics in patients with cerebral small vessel disease. BMC Neurol 2024; 24:336. [PMID: 39256704 PMCID: PMC11386381 DOI: 10.1186/s12883-024-03848-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 09/03/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND The objectives of this study were twofold: (1) to compare gait characteristics between cerebral small vessel disease (CSVD) patients with low-risk oral frailty (OF) and high-risk OF, particularly during dual-task walking (DTW); (2) to investigate the association of OF, the gait characteristics of DTW, and falls among older adults patients with CSVD. METHODS A total of 126 hospitalized patients diagnosed with CSVD were recruited and classified into a low-risk group (n = 90) and a high-risk group (n = 36) based on OF status in our study. Comprehensive data pertaining to basic parameters (cadence, as well as stride time, velocity and length), variability, asymmetry, and coordination were gathered during both single-task walking (STW) and DTW. Additionally, the number of falls was calculated. Subsequently, t-test or chi-squared test was used for comparison between the two groups. Furthermore, linear regression analysis was employed to elucidate the association of the OF index-8 score and gait parameters during cognitive DTW. Also, logistic regression models were utilized to assess the independent association of OF risk and falls. RESULTS During cognitive DTW, the high-risk group demonstrated inferior performance in terms of basic parameters (p < 0.01), coefficient of variation (CV) of velocity and stride length (p < 0.05), as well as phase coordination index (PCI) when compared with the low-risk group (p < 0.05). Notably, differences in basic gait parameters were observed in cognitive DTW and STW conditions between the two groups (p < 0.01). However, only the high-risk group evinced significant variations in CV and PCI during cognitive DTW, as opposed to those during STW (p < 0.05). Furthermore, our findings also revealed the association of OF, the gait characteristics of cognitive DTW, (p < 0.01) and falls (p < 0.05). CONCLUSION CSVD patients with a high risk of OF need to pay more attention to their gait variability or coordination. Also, they are recommended to undergo training involving dual-task activities while walking in daily life, thereby reducing the deterioration and mitigating the risk of falls. Besides, this study has confirmed an association of OF and DTW gait as well as falls in patients with CSVD.
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Affiliation(s)
- Hong-Yang Xie
- Department of Neurology, The Seven Medical Center of PLA General Hospital, Dongsi Shitiao, Dongcheng District, Nanmencang, Beijing, 100007, China
| | - Jun-Li Chen
- Department of Hematology, The Fifth Medical Center of PLA General Hospital, Fengtai District, Beijing, 100039, China
| | - Cui-Qiao Xia
- Department of Neurology, The Seven Medical Center of PLA General Hospital, Dongsi Shitiao, Dongcheng District, Nanmencang, Beijing, 100007, China
| | - Nan Zhang
- Department of Neurology, The Seven Medical Center of PLA General Hospital, Dongsi Shitiao, Dongcheng District, Nanmencang, Beijing, 100007, China
| | - Zhen-Xi Xia
- Department of Neurology, The Seven Medical Center of PLA General Hospital, Dongsi Shitiao, Dongcheng District, Nanmencang, Beijing, 100007, China
| | - Hong-Yi Zhao
- Department of Neurology, The Seven Medical Center of PLA General Hospital, Dongsi Shitiao, Dongcheng District, Nanmencang, Beijing, 100007, China
- Department of Neurology, Number 984 Hospital of the PLA, Haidian District, Beijing, 100094, China
| | - Yong-Hua Huang
- Department of Neurology, The Seven Medical Center of PLA General Hospital, Dongsi Shitiao, Dongcheng District, Nanmencang, Beijing, 100007, China.
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Manda Y, Kodama N, Mori K, Adachi R, Matsugishi M, Minagi S. Basic characteristics of tongue pressure and electromyography generated by articulation of a syllable using the posterior part of the tongue. Sci Rep 2024; 14:20756. [PMID: 39237702 PMCID: PMC11377720 DOI: 10.1038/s41598-024-71909-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 09/02/2024] [Indexed: 09/07/2024] Open
Abstract
The basic function of the tongue in pronouncing diadochokinesis and other syllables is not fully understood. This study investigates the influence of sound pressure levels and syllables on tongue pressure and muscle activity in 19 healthy adults (mean age: 28.2 years; range: 22-33 years). Tongue pressure and activity of the posterior tongue were measured using electromyography (EMG) when the velar stops /ka/, /ko/, /ga/, and /go/ were pronounced at 70, 60, 50, and 40 dB. Spearman's rank correlation revealed a significant, yet weak, positive association between tongue pressure and EMG activity (ρ = 0.14, p < 0.05). Mixed-effects model analysis showed that tongue pressure and EMG activity significantly increased at 70 dB compared to other sound pressure levels. While syllables did not significantly affect tongue pressure, the syllable /ko/ significantly increased EMG activity (coefficient = 0.048, p = 0.013). Although no significant differences in tongue pressure were observed for the velar stops /ka/, /ko/, /ga/, and /go/, it is suggested that articulation is achieved by altering the activity of both extrinsic and intrinsic tongue muscles. These findings highlight the importance of considering both tongue pressure and muscle activity when examining the physiological factors contributing to sound pressure levels during speech.
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Affiliation(s)
- Yousuke Manda
- Department of Occlusal and Oral Functional Rehabilitation, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Naoki Kodama
- Department of Occlusal and Oral Functional Rehabilitation, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan.
| | - Keitaro Mori
- Department of Occlusal and Oral Functional Rehabilitation, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Reimi Adachi
- Department of Occlusal and Oral Functional Rehabilitation, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Makoto Matsugishi
- Department of Occlusal and Oral Functional Rehabilitation, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Shogo Minagi
- Department of Occlusal and Oral Functional Rehabilitation, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
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8
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Sawada N, Takeuchi N, Ekuni D, Morita M. Effect of oral health status and oral function on malnutrition in community-dwelling older adult dental patients: A two-year prospective cohort study. Gerodontology 2024; 41:393-399. [PMID: 37847782 DOI: 10.1111/ger.12718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES To survey oral status in detail and clarify the factors associated with nutritional status as evaluated by the Mini Nutritional Assessment. BACKGROUND Malnutrition is common in older adults and increases the risk of frailty, sarcopenia, and mortality. However, few longitudinal studies have been performed to investigate the causal effect of oral status on malnutrition in detail, and the information reported in those longitudinal studies has been limited to dentition status and swallowing ability. MATERIALS AND METHODS The participants in this prospective cohort study were patients who visited the Preventive Dentistry Clinic at Okayama University Hospital from November 2017 to January 2021. The number of teeth, periodontal condition, oral function (oral diadochokinesis, masticatory ability, number of bacteria in tongue coating, occlusal force, oral moisture, tongue pressure, swallowing function), nutritional status, the number of comorbidities, and mental health status were examined. These variables were analysed using structural equation modelling (SEM). RESULTS The final analysis included 141 participants (40 males and 101 females; mean age, 73.5 ± 6.3 years; follow-up rate: 79.7%). The results of the SEM revealed that oral status (number of teeth present and swallowing function) was positively associated with nutritional status 2 years later. In addition, age was negatively associated with oral status. CONCLUSION In community-dwelling older adult dental patients (age ≥60 years), oral function at baseline was associated with nutritional status two years later.
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Affiliation(s)
- Nanami Sawada
- Department of Preventive Dentistry, Okayama University Hospital, Okayama, Japan
| | - Noriko Takeuchi
- Department of Preventive Dentistry, Okayama University Hospital, Okayama, Japan
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Manabu Morita
- Department of Oral Health, Takarazuka University of Medical and Health Care, Takarazuka, Japan
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Izumikawa T, Doi K, Iwaguro S, Tsuga K. A novel implant placement technique using a three-dimensionally printed duplicate denture for implant-supported overdenture in patients with severe residual ridge resorption: A case report. Clin Case Rep 2024; 12:e9389. [PMID: 39219780 PMCID: PMC11364582 DOI: 10.1002/ccr3.9389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 08/07/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024] Open
Abstract
The treatment method of placing a small number of implants in the mandible as a removable implant-supported overdenture (IOD) enables implant placement and denture stability, even in cases with severe residual ridge resorption. In this case report, a new implant placement technique was performed using a three-dimensionally (3D)-printed duplicate denture fabricated by a 3D printer, resulting in the restoration of masticatory function through IOD.
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Affiliation(s)
- Tomoko Izumikawa
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Kazuya Doi
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shogo Iwaguro
- Division of Dental Technician, Department of Clinical Practice and SupportHiroshima University HospitalHiroshimaJapan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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Su Y, Yuki M, Huang H, Luo N, Wang L. Development of a Screening Tool for Oral Frailty in Community-Dwelling Older Adults: A Cross-Sectional Study. J Am Med Dir Assoc 2024; 25:105171. [PMID: 39033783 DOI: 10.1016/j.jamda.2024.105171] [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: 03/26/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 07/23/2024]
Abstract
OBJECTIVES To develop a Screening for Oral Frailty Tool (SOFT) and evaluate its reliability and validity among Chinese community-dwelling older adults. DESIGN Cross-sectional analysis. SETTING AND PARTICIPANTS The study was conducted as part of an ongoing community-based prospective study in Shanghai. A total of 307 older adults, aged between 60 and 96 years, participated in the study. METHODS This study was conducted in 3 stages: item development, scale development, and scale evaluation. This study was based on a visual model depicting the deterioration of oral function, and a draft scale was generated based on a literature review, existing scales, expert consultations, and cognitive interviews. Between December 2023 and February 2024, the validity and reliability of the SOFT were evaluated using a questionnaire administered to 307 community-dwelling older adults. Data including demographics, frailty, and sarcopenia were collected. RESULTS The oral frailty scale comprises 6 items, including number of teeth, difficulty in swallowing, difficulty in chewing, difficulty in articulatory oral motor, dry mouth, and oral pain, and is assessed using a yes or no question. The correlations ranged from 0.40 to 0.66 when correlating each item with the total score of the scale. Using frailty and sarcopenia as criteria, the area under the curve for the SOFT was 0.71. The optimal cutoff for the SOFT was 2, using frailty as a criterion, with a higher Youden index and a high negative predictive value (94.9%), but a low positive predictive value (19.3%). The SOFT showed low internal consistency (Kuder-Richardson formula 20 coefficients 0.50) and good test-retest reliability (intraclass correlation coefficients 0.86). CONCLUSIONS AND IMPLICATIONS The SOFT does not require specialized equipment and is not affected by cultural differences. It can be used for oral frailty screening in Chinese community-dwelling older adults and is simple and rapid.
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Affiliation(s)
- Ya Su
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Michiko Yuki
- Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hanjun Huang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Ningning Luo
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
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Tanaka K, Kikutani T, Takahashi N, Tohara T, Furuya H, Ichikawa Y, Komagata Y, Mizukoshi A, Ozeki M, Tamura F, Tominaga T. A prospective cohort study on factors related to dental care and continuation of care for older adults receiving home medical care. Odontology 2024:10.1007/s10266-024-00984-4. [PMID: 39141260 DOI: 10.1007/s10266-024-00984-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/17/2024] [Indexed: 08/15/2024]
Abstract
Information on the effects of dental treatment must be identified and factors that hinder the continuation of dental treatment must be identified to provide appropriate domiciliary dental care (DDC). This study aimed to clarify the treatment outcomes of DDC for older adults and the factors that impede the continuation of such care. This prospective study was conducted at a Japanese clinic specializing in dental care for older adults. The functional status, nutritional status, oral assessment, details of the dental treatment, and outcomes after 6 months of older adults receiving DDC were surveyed. The Oral Health Assessment Tool (OHAT) was used for oral assessment. Cox proportional hazards analysis was used to analyze the factors at the first visit that were associated with treatment continuation. A total of 72 participants (mean age, 85.8 ± 6.9) were included. Twenty-three participants (31.9%) could not continue treatment after 6 months. The most frequently performed procedures were oral care and dysphagia rehabilitation, followed by prosthetic treatment, then tooth extraction. The percentage of participants with teeth that required extraction after 6 months and the total OHAT score decreased significantly. The Barthel Index, Mini Nutritional Assessment Short-Form, and rinsing ability were significantly associated with treatment continuation. Furthermore, instrumental activities of daily living (ADL) and the OHAT "tongue" sub-item were correlated with treatment continuation. In conclusion, DDC improved the oral health status of older adults after 6 months. Factors that impeded treatment continuation were decreased ADL, decreased nutritional status, difficulty in rinsing, and changes in the tongue such as tongue coating.
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Affiliation(s)
- Kumi Tanaka
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Takeshi Kikutani
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan.
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan.
| | - Noriaki Takahashi
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Takashi Tohara
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Hiroyasu Furuya
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Yoko Ichikawa
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Yuka Komagata
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Arato Mizukoshi
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
| | - Maiko Ozeki
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
| | - Fumiyo Tamura
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo, 184-0011, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
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12
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Yata T, Aoyama N, Fujii T, Kida S, Taniguchi K, Iwane T, Tamaki K, Minabe M, Komaki M. Decreased Tongue-Lip Motor Function in Japanese Population with Low Taste Sensitivity: A Cross-Sectional Study. J Clin Med 2024; 13:4711. [PMID: 39200853 PMCID: PMC11355394 DOI: 10.3390/jcm13164711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/04/2024] [Accepted: 08/08/2024] [Indexed: 09/02/2024] Open
Abstract
Background/Objectives: Taste disorders have a negative impact on meal enjoyment, which is essential for maintaining adequate nutrition and quality of life. Japan is a rapidly aging society with an increasing number of individuals with taste disorders. However, despite the increasing prevalence of taste disorders, the correlation between oral frailty and taste sensitivity remains largely unknown. The objective of this study was to assess the relationship between oral health status and taste sensitivity among the Japanese population. Methods: Participants were recruited from Kanagawa Dental University Hospital Medical-Dental Collaboration Center between 2018 and 2021. The exclusion criteria were severe systemic infections, pregnancy, or lactation. Clinical examinations, oral function assessments, and taste tests were conducted using tap water and 1% sweet, 0.3% salty, 0.03% umami, and 0.1% umami tastants. The relationships between oral function, systemic indicators, and taste sensitivity were statistically evaluated. Results: Of the 169 participants included in this cross-sectional study, 39.6% were male and 60.4% were female (median age, 68 years). Participants with low taste sensitivity showed a decline in tongue-lip motor function, independent of age, sex, or smoking status. A multiple logistic regression analysis conducted using two age categories-younger than 65 years and older than 65 years-revealed an association between tongue-lip motor function and taste sensitivity among participants younger than 65 years. Conclusions: Decreased taste sensitivity is associated with tongue-lip motor function. Therefore, the early maintenance of oral function and taste sensitivity may be beneficial for optimal tongue-lip motor function.
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Affiliation(s)
- Tomomi Yata
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan; (T.Y.); (T.F.); (S.K.); (K.T.); (M.K.)
| | - Norio Aoyama
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan; (T.Y.); (T.F.); (S.K.); (K.T.); (M.K.)
- Department of Education Planning, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan
| | - Toshiya Fujii
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan; (T.Y.); (T.F.); (S.K.); (K.T.); (M.K.)
| | - Sayuri Kida
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan; (T.Y.); (T.F.); (S.K.); (K.T.); (M.K.)
| | - Kentaro Taniguchi
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan; (T.Y.); (T.F.); (S.K.); (K.T.); (M.K.)
| | - Taizo Iwane
- Center for Innovation Policy, Graduate School of Health Innovation, Kanagawa University of Human Services, 3-25-10 Tonomachi, Kawasaki-ku, Kawasaki 210-0821, Kanagawa, Japan;
| | - Katsushi Tamaki
- Department of Functional Recovery of TMJ and Occlusion, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan;
| | - Masato Minabe
- Bunkyou Dori Dental Clinic, 2-4-1 Anagawa, Inage-ku, Chiba 263-0024, Chiba, Japan;
- Department of Environmental Pathology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan
| | - Motohiro Komaki
- Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan; (T.Y.); (T.F.); (S.K.); (K.T.); (M.K.)
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13
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Miyahara S, Maeda K, Kawamura K, Matsui Y, Satake S, Arai H, Umegaki H. Association between intrinsic capacity and oral health in older patients in a frailty clinic. Eur Geriatr Med 2024; 15:1119-1127. [PMID: 38438830 DOI: 10.1007/s41999-024-00956-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/24/2024] [Indexed: 03/06/2024]
Abstract
PURPOSE This study aimed to investigate how intrinsic capacity (IC) deficit is associated with oral functional decline. METHODS This cross-sectional study enrolled older adults at a research hospital frailty clinic between July 2021 and May 2023. IC evaluation included the locomotion, cognition, vitality, psychology, and sensory domains. Criteria for deficits were established within each domain, and the number of IC deficit domains was calculated for each patient. Oral function assessment included oral hygiene, oral dryness, occlusal force, tongue-lip motor function, tongue pressure, masticatory function, and swallowing function. Patients who met three or more criteria were classified into the oral hypofunction (OHF) group. Univariate and multivariate logistic regression analyses were performed to investigate the relationship between IC deficit and OHF. RESULTS Of 222 included patients (mean age 78.3 ± 6.3 years; 39.6% men), 105 (47.3%) met the criteria for OHF. This OHF group showed a significantly higher prevalence of locomotion, cognition, psychology, and sensory domain deficits than the normal oral function group. Multivariate analysis adjusted for age and sex revealed a significant association between IC deficits and OHF (odds ratio [OR], 1.33; 95% confidence interval [CI] 1.04-1.70). A significant association was also observed between the locomotion domain and OHF (OR, 2.06; 95% CI 1.13-3.76). CONCLUSION This study highlights the potential relationship between the number of IC domain deficits and oral functional decline, with the most significant domain being locomotion. Furthermore, it suggests a possible link between sensory and oral function.
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Affiliation(s)
- Shuzo Miyahara
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan.
- Nutrition Therapy Support Center, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
| | - Koki Kawamura
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
| | - Shosuke Satake
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
- Department of Frailty Research, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
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14
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Yang C, Gao Y, An R, Lan Y, Yang Y, Wan Q. Oral frailty: A concept analysis. J Adv Nurs 2024; 80:3134-3145. [PMID: 38214108 DOI: 10.1111/jan.16042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 11/20/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024]
Abstract
AIM To clarify the concept of oral frailty to provide a clear and standardized conceptual basis for further research in older people. DESIGN Rodgers and Knafl's evolutionary concept analysis approach. METHODS The narrative analysis detailedly extracted and synthesized the attributes of oral frailty, as well as its antecedents, consequences and related terms under the guidance of Rodgers' evolutionary method. DATA SOURCES Multiple databases including Pubmed, CINAHL and Cochrane were searched using selected search terms 'oral frail*', 'oral health' and 'aged' respectively. Articles written between 2013 and 2023 were included, and grey literature was excluded. RESULTS A total of 32 articles were included for further analysis and synthesis. The attributes of oral frailty were hypofunction, predisposing in nature, non-specific and multidimensional. Antecedents of prefrailty were classified into four categories, namely, sociodemographic characteristics, comorbidity, physical function and psychosocial factors. Consequences of oral frailty include three themes: increased risk of adverse outcomes, poor nutritional status and possibility of social withdrawal. Related terms that had shared attributes with oral frailty were oral health, functional dentition, oral hypofunction and deterioration of oral function. CONCLUSIONS Oral frailty is an age-related phenomenon reflected in decreased oral function. The findings of this concept analysis are conducive to understanding and clarifying the oral frailty, which can help clinicians or other healthcare providers to consider how to distinguish oral frailty in older adults and further promote the development of this field. IMPACT Oral frailty is increasingly recognized as an age-related phenomenon reflected in decreased oral function. As it is newly proposed, no consensus has been reached regarding the theoretical and operational concept of it. Through clarifying the concept, this paper will guide future healthcare research on oral frailty regarding the influencing factors, mechanisms and interventions, thus raising the awareness with regard to oral health among older adults. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: In the context of older adults, oral frailty is a concept that requires further research to guide future theoretical development, and the influencing factors, mechanisms and interventions need to be further studied. Raise awareness with regard to oral health among older people and more attention will be paid to the early identification and intervention of oral frailty, so as to further improve the quality of life of older adults.
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Affiliation(s)
- Chengfengyi Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Yajing Gao
- School of Nursing, Peking University, Beijing, China
| | - Ran An
- School of Nursing, Peking University, Beijing, China
| | - Yue Lan
- School of Nursing, Peking University, Beijing, China
| | - Yue Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China
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15
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Kawamura K, Maeda K, Miyahara S, Shimizu A, Ishida Y, Ueshima J, Nagano A, Kagaya H, Matsui Y, Arai H, Mori N. Association between oral frailty and sarcopenia among frailty clinic outpatients: A cross-sectional study. Nutrition 2024; 124:112438. [PMID: 38657417 DOI: 10.1016/j.nut.2024.112438] [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: 12/07/2023] [Revised: 03/03/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES In this study, we aimed to investigate the prevalence of oral frailty and explore its relationship with oral function and sarcopenia among older outpatients. MATERIALS AND METHODS In this cross-sectional study, we retrospectively included older patients who visited a frailty outpatient clinic. We assessed total oral frailty employing, among other measures, oral diadochokinesis (/ta/ sound) for tongue-lip movement and tongue pressure. Patients who did not meet the cut-off values for three or more of these were classified as having oral frailty. Sarcopenia was assessed according to Asian Working Group for Sarcopenia 2019 criteria and analyzed for the relationship with oral function. RESULTS The mean ± standard deviation age of the 111 patients was 77.2 ± 5.7 y; 63 were women (57%). Fifteen patients (14%) had either sarcopenia or dynapenia. The overall prevalence of oral frailty was 38%, with no significant difference in its prevalence between the sarcopenia/dynapenia group (44%) and the robust (no sarcopenia/dynapenia) group (35%). The following oral function assessments significantly differed between the sarcopenia/dynapenia group and the robust group: median (interquartile range) total oral frailty score, 2 (2-4) and 2 (1-3) (P = 0.019); tongue-lip motor function, 5.4 ± 1.2 and 5.9 ± 1.2 times/s (P = 0.049); and tongue pressure, 27.3 ± 8.5 kPa and 31.7 ± 8.0 kPa (P = 0.009). CONCLUSIONS Approximately 40% of patients exhibited a decline in oral function regardless of the presence of sarcopenia. Sarcopenia and dynapenia may particularly affect tongue function. Although assessing patients for sarcopenia is crucial, separate evaluations of oral function should also be considered.
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Affiliation(s)
- Koki Kawamura
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Nutrition Therapy Support Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan; Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
| | - Shuzo Miyahara
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Akio Shimizu
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Department of Health Science, Faculty of Health and Human Development, Nagano University, Nagano-shi, Nagano, Japan
| | - Yuria Ishida
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Department of Nutrition, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Junko Ueshima
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Department of Nutritional Service, NTT Medical Center Tokyo, Tokyo, Japan
| | - Ayano Nagano
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Hyogo, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Palliative Care Center, Aichi Medical University, Nagakute, Aichi, Japan
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16
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Iwasaki M, Ohta Y, Furusho N, Kakuta S, Muraoka K, Ansai T, Awano S, Fukuhara M, Nakamura H. Association between oral frailty and nutritional status among hemodialysis patients aged ≥50 years. Geriatr Gerontol Int 2024. [PMID: 39091075 DOI: 10.1111/ggi.14947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/21/2024] [Accepted: 07/15/2024] [Indexed: 08/04/2024]
Abstract
AIM Malnutrition is a prevalent health issue among hemodialysis patients. Oral frailty, a condition characterized by impairments in multiple oral health aspects and functions, has been associated with nutritional status in the general population. We aimed to determine whether oral frailty was associated with nutritional status in hemodialysis patients aged ≥50 years. Our secondary aim was to determine the prevalence of oral frailty in this population. METHODS This cross-sectional study included hemodialysis patients who were admitted to a single medical center. According to the Oral Frailty 5-item Checklist, oral frailty is characterized by the presence of two or more of the following criteria: (i) fewer teeth, (ii) difficulty in chewing, (iii) difficulty in swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. Patients' nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI). Multivariable ordinal logistic regression analysis was performed to assess the association between oral frailty and nutritional status (classified into three categories according to the GNRI: >98, 92-98, and <92). RESULTS In total, 152 hemodialysis patients (55 women and 97 men) with a mean age of 70.4 years were included. The prevalence of oral frailty was 61.2%. After adjusting for health characteristics and sociodemographic background, oral frailty was associated with poor nutritional status according to the GNRI (odds ratio = 2.04, 95% confidence interval = 1.02-4.09). CONCLUSIONS In this study, approximately 60% of hemodialysis patients aged ≥50 years exhibited oral frailty, and hemodialysis patients with oral frailty had poor nutritional status according to the GNRI. Geriatr Gerontol Int 2024; ••: ••-••.
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Affiliation(s)
- Masanori Iwasaki
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yuko Ohta
- Division of General Internal Medicine, Kyushu Dental University, Fukuoka, Japan
| | | | - Satoko Kakuta
- Division of Community Oral Health Development, Kyushu Dental University, Fukuoka, Japan
| | - Kosuke Muraoka
- Department of Clinical Education Development and Research, Kyushu Dental University, Fukuoka, Japan
| | - Toshihiro Ansai
- Division of Community Oral Health Development, Kyushu Dental University, Fukuoka, Japan
| | - Shuji Awano
- Department of Clinical Education Development and Research, Kyushu Dental University, Fukuoka, Japan
| | - Masayo Fukuhara
- Division of General Internal Medicine, Kyushu Dental University, Fukuoka, Japan
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17
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Sekimoto Y, Matsuo K, Sakai A, Shibata S, Minakuchi S. Improvement of oral function and its impact on oral food intake in subacute stroke patients: A prospective study with dental intervention. J Oral Rehabil 2024; 51:1365-1372. [PMID: 38651211 DOI: 10.1111/joor.13711] [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: 11/24/2023] [Revised: 03/19/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The association between oral food intake and oral function during the subacute stage of stroke is not well known. OBJECTIVE To investigate (1) oral function changes in subacute stroke patients and (2) association between oral function and oral intake status at several time points. METHODS In a prospective study involving 324 stroke patients at a convalescent rehabilitation unit, four oral function parameters (maximum tongue pressure, MTP; lip-tongue motor function, LTMF; maximum occlusal force, MOF and oral health assessment tool, OHAT) were quantitatively measured upon admission (T0), at 1 month (T1) and 2 months (T2). Oral feeding status was assessed using the Functional Oral Intake Scale (FOIS) and divided based on the FOIS score into the dysphagic and regular diet groups. The changes in oral functions at the three time points were tested using generalized estimating equation analysis. The association between FOIS groups and oral functions at T1 and T2 was analysed by means of logistic regression analysis. RESULTS All oral function parameters improved significantly over time during the hospital stay (mean differences: 4.9 for MTP, 0.6 for LTMF, 1.1 for MOF and -1.8 for OHAT). The FOIS groups were significantly associated with MTP (p < .05) and OHAT (p < .05) at both T1 and T2. CONCLUSION Our findings suggest that oral function significantly improves in patients during subacute stroke rehabilitation and better oral health can be associated with better oral intake. Improved oral function through dental intervention and oral rehabilitation may contribute to gains in oral food intake.
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Affiliation(s)
- Yu Sekimoto
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Dentistry, PL General Hospital, Medical Corporation Hosho, Tokyo, Japan
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Koichiro Matsuo
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayu Sakai
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University Hospital, Toyoake, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Eggimann AK, Badura L, Zehnder R, Koemeda M, Buser R, Schimmel M. A Comparison of Oral Function in Older In- and Outpatients: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:995. [PMID: 39200606 PMCID: PMC11353424 DOI: 10.3390/ijerph21080995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/19/2024] [Accepted: 07/24/2024] [Indexed: 09/02/2024]
Abstract
(1) Background: Insufficient data exist regarding oral function among older adults in Europe. Therefore, we aimed to assess and compare oral function between older in- and outpatients and identify predictors of low masticatory performance. (2) Methods: Patients were consecutively recruited from the outpatient center (n = 31) and the inpatient geriatric department (n = 31) at a tertiary University Hospital in Switzerland in 2023. Assessments on oral function included the total number of intraoral eruptive teeth, number of supporting zones with dentures, maximal bite force (Dental Prescale II, Fuji Film Corp., Tokyo, Japan), and masticatory performance (Hue-Check Gum©, University of Bern, Bern, Switzerland) using a visual (SA1-SA5) and a digital (SD_Hue) scale. The visual and digital assessment of masticatory performance showed a strong correlation (Kendall tau = 0.83). Low masticatory performance was defined as SA-Grade 1-2 (vs. SA3-SA5 as reference). In a multivariate model adjusting for age, sex, and clinical setting, we investigated associations of maximal bite force, few eruptive teeth, and few supporting zones with low masticatory performance. (3) Results: Mean age was 81.9 (standard deviation (sd) 5.2) years, and 62.9% were female. Overall, maximal bite force was 247 N (sd 261). A total of 39 patients (63.9%) had a low masticatory performance, 62.9% a low maximal bite force, and 50% a low number of eruptive teeth (<10). Masticatory performance, number of eruptive teeth, and maximal bite force did not significantly differ between in- and outpatients. The number of supporting zones was significantly higher in outpatients compared to inpatients (median 4, interquartile range (IQR) 4-4; vs. 4, IQR 2-4; p = 0.03). In the multivariate model, maximal bite force and a low number of eruptive teeth were independently associated with low masticatory performance (adjusted odds ratio 7.4 (95% CI, 1.8-30.4; p < 0.01), and OR 7.8 (95% CI, 1.7-36.4; p < 0.01), respectively). (4) Conclusions: Impaired oral function is highly prevalent in both European older in- and outpatients to a similar degree. The association of low masticatory performance with maximal bite force and with a low number of eruptive teeth may indicate that a basic screening should include either of these parameters to identify impaired oral function.
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Affiliation(s)
- Anna K. Eggimann
- Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland
| | - Leo Badura
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Rahel Zehnder
- Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland
- Medical Faculty, University of Bern, 3012 Bern, Switzerland
| | - Miriam Koemeda
- Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland
| | - Ramona Buser
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
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Kaurani P, Kakodkar P, Bhowmick A, Samra RK, Bansal V. Association of tooth loss and nutritional status in adults: an overview of systematic reviews. BMC Oral Health 2024; 24:838. [PMID: 39049002 PMCID: PMC11267674 DOI: 10.1186/s12903-024-04602-1] [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: 04/01/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Association of tooth loss and nutritional status has been widely researched with conflicting results. This overview aimed to analyse and summarize findings from systematic reviews on association of tooth loss with nutritional status, in view of their quality assessment and methodological characteristics. METHODS Overview was conducted as per Cochrane Overviews of Reviews guidelines. 5 databases (PubMed, Dentistry and Oral Sciences Source, Scopus, Cochrane Register of Systematic Reviews, Epistemonikos.org) and one online source (Google Scholar) were searched for systematic reviews published between 2010 - July 2022, with inclusion criteria; population: participants aged 18 years or above, intervention/exposure: loss of teeth, comparison: not applicable, outcome: nutritional status, study: systematic reviews and meta-analysis. Reviews on association of prosthetic interventions with nutritional status were not included. Data were extracted for study characteristics, details of primary studies, and main findings. Narrative synthesis of data, overlap of primary studies and quality assessment of studies were done using AMSTAR 2 tool (A Measurement Tool to Assess Systematic Reviews). RESULT Of 1525 articles found, seven systematic reviews were selected (four were systematic reviews, three were systematic reviews with meta-analysis). Five studies showed some or positive association, one found weak association and for one study the association was unclear. Overlap of primary studies was 'very slight'. Meta-analysis of two studies concluded fully or partially edentulous individuals were more likely to be malnourished or at risk of malnutrition, (RR = 1.095, 95% CI 1.007 to 1.190, p = 0.033. RR = 1.22; 95% CI 1.11 to 1.32 p < 0.01), but one found that edentulism was not associated with malnutrition. (RR = 1.072, 95% CI 0.9657-1.200). Quality assessment revealed four studies were 'high', one was 'low' and two were 'critically low.' CONCLUSION This overview confirms the association between tooth loss and nutritional status specially in elderly. It is evident that tooth loss increases the likelihood of poor nutritional status. Overall, studies show high heterogeneity in the methodology and quality assessment reveals low confidence in the available evidence. Future studies should use standard assessment tools for tooth loss and nutritional status.
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Affiliation(s)
- Pragati Kaurani
- Department of Prosthodontics and Crown & Bridge, Mahatma Gandhi Dental College and Hospital, Jaipur, India
| | | | - Anamitra Bhowmick
- West Bengal University of Health Sciences, Kolkata, West Bengal, India
| | - Rupandeep Kaur Samra
- Department of Prosthodontics and Crown & Bridge, DJ College of Dental Sciences and Research, Modinagar, Ghaziabad, Uttar Pradesh, 201204, India.
- , House no.10, Doctor's Colony, Bhadson Road, Patiala, Punjab, 147001, India.
| | - Vineeta Bansal
- Department of Clinical Nutrition and Dietetics, Mahatma Gandhi Medical College and Hospital, Jaipur, India
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Kawamura K, Maeda K, Miyahara S, Shimizu A, Sakaguchi T, Ishida Y, Kagaya H, Matsui Y, Arai H, Mori N. Oral hypofunction and social aspects in older adults visiting frailty outpatient clinic. J Oral Rehabil 2024. [PMID: 39044315 DOI: 10.1111/joor.13803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/26/2024] [Accepted: 07/03/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Oral and social problems can exacerbate long-term care. Understanding the relationship between social aspects and oral hypofunction can help identify high-risk factors for long-term care. OBJECTIVE This study aimed to investigate the social aspects of oral hypofunction among medical outpatients. METHODS This retrospective cross-sectional study included patients who visited an outpatient clinic for frailty. The oral function was assessed using seven items: oral hygiene, occlusal force, masticatory function, tongue-lip motor function, tongue pressure, oral dryness and swallowing function. Participants with three or more functional declines were classified as having 'oral hypofunction'. Social aspects were assessed using 21 items in four categories: general resources, basic social needs, social resources and social behaviours/activities. We analysed the relationship between oral hypofunction and each social aspect. RESULTS A total of 316 participants (age 78.5 ± 6.4 years) were included, and 128 (41%) had oral hypofunction. Participants with oral hypofunction were significantly more likely to have limited education, require long-term care, not use transportation, depend on others for shopping, not participate in events, lack association membership and not engage in charity or volunteer work. After logistic regression analysis, 'long-term care' and 'no association membership' remained significantly associated with oral hypofunction (odds ratios 2.3, 2.3; 95% CI 1.1-5.0, 1.1-4.7, respectively). CONCLUSION Participants with oral hypofunction faced challenges in 'general resources' and 'social behaviour/activities', which were linked to oral function issues. Future longitudinal studies are necessary to further investigate this relationship.
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Affiliation(s)
- Koki Kawamura
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
- Nutrition Therapy Support Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Shuzo Miyahara
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Akio Shimizu
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
- Department of Health Science, Faculty of Health and Human Development, Nagano University, Nagano-shi, Nagano, Japan
| | - Tatsuma Sakaguchi
- Palliative Care Center, Aichi Medical University, Nagakute, Aichi, Japan
| | - Yuria Ishida
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
- Department of Nutrition, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
- Palliative Care Center, Aichi Medical University, Nagakute, Aichi, Japan
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Okawa J, Hori K, Izuno H, Fukuda M, Ujihashi T, Kodama S, Yoshimoto T, Sato R, Ono T. Developing tongue coating status assessment using image recognition with deep learning. J Prosthodont Res 2024; 68:425-431. [PMID: 37766551 DOI: 10.2186/jpr.jpr_d_23_00117] [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: 09/29/2023]
Abstract
PURPOSE To build an image recognition network to evaluate tongue coating status. METHODS Two image recognition networks were built: one for tongue detection and another for tongue coating classification. Digital tongue photographs were used to develop both networks; images from 251 (178 women, 74.7±6.6 years) and 144 older adults (83 women, 73.8±7.3 years) who volunteered to participate were used for the tongue detection network and coating classification network, respectively. The learning objective of the tongue detection network is to extract a rectangular region that includes the tongue. You-Only-Look-Once (YOLO) v2 was used as the detection network, and transfer learning was performed using ResNet-50. The accuracy was evaluated by calculating the intersection over the union. For tongue coating classification, the rectangular area including the tongue was divided into a grid of 7×7. Five experienced panelists scored the tongue coating in each area using one of five grades, and the tongue coating index (TCI) was calculated. Transfer learning for tongue coating grades was performed using ResNet-18, and the TCI was calculated. Agreement between the panelists and network for the tongue coating grades in each area and TCI was evaluated using the kappa coefficient and intraclass correlation, respectively. RESULTS The tongue detection network recognized the tongue with a high intersection over union (0.885±0.081). The tongue coating classification network showed high agreement with tongue coating grades and TCI, with a kappa coefficient of 0.826 and an intraclass correlation coefficient of 0.807, respectively. CONCLUSIONS Image recognition enables simple and detailed assessment of tongue coating status.
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Affiliation(s)
- Jumpei Okawa
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiromi Izuno
- Department of Oral Health Sciences, Faculty of Nursing and Health Care, BAIKA Women's University, Ibaraki, Japan
| | - Masayo Fukuda
- Department of Oral Health Science, Faculty of Health Science, Kobe Tokiwa University, Kobe, Japan
| | - Takako Ujihashi
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Oral Health Science, Faculty of Health Science, Kobe Tokiwa University, Kobe, Japan
| | - Shohei Kodama
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tasuku Yoshimoto
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Rikako Sato
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
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Masutomi K, Bando M, Inagaki Y, Kido R, Uemura Y, Hatada Y, Kido JI, Fukui M, Hinode D, Yumoto H. Relationship between oral hypofunction and salivary biomarkers in older adults: a cross-sectional study. BMC Oral Health 2024; 24:766. [PMID: 38971720 PMCID: PMC11227702 DOI: 10.1186/s12903-024-04556-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 07/02/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Oral health problems have increased among older adults. Oral hypofunction is characterized by seven signs and symptoms: oral uncleanness, oral dryness, decline in occlusal force, decline in the movement function of the tongue and lips, decline in tongue pressure, decline in masticatory function, and decline in swallowing function, the latter being a significant risk factors for oral frailty. Recent research has suggested that salivary biomarkers can be used to assess not only oral diseases, including dental caries and periodontitis, but also systemic diseases, such as cancer and diabetes mellitus. This cross-sectional study investigated the relationship between oral hypofunction and the levels of salivary biomarkers. METHODS In total, 116 patients, aged 65 years or older, were included in this cross-sectional study. If three or more signs or symptoms in seven kinds of tests met the criteria of each test, oral hypofunction was diagnosed. The levels of biomarkers in the saliva collected from the patients were analyzed using an enzyme-linked immunosorbent assay. RESULTS In total, 63.8% of patients were diagnosed with oral hypofunction. Multivariable linear regression analysis showed that calprotectin levels in the saliva were significantly related to oral moisture and masticatory function. Furthermore, 8-OHdG levels in saliva were associated with the movement function of the tongue and lips and oral hygiene level, and salivary AGE correlated only with the movement function of the tongue and lips. Multiple logistic regression analysis revealed that calprotectin levels in the saliva were significantly correlated with the prevalence of oral hypofunction, even after adjusting for age, sex, and periodontal status. However, none of the biomarker levels in the saliva had a significant relationship with the number of examinations outside the reference range. CONCLUSIONS Calprotectin, 8-OHdG, and AGE levels are associated with oral hypofunction in older adults.
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Affiliation(s)
- Kenji Masutomi
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Mika Bando
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan.
| | - Yuji Inagaki
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Rie Kido
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Yuta Uemura
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Yukari Hatada
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Jun-Ichi Kido
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Makoto Fukui
- Department of Hygiene and Oral Health Science, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Daisuke Hinode
- Department of Hygiene and Oral Health Science, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
| | - Hiromichi Yumoto
- Department of Periodontology and Endodontology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-Cho, Tokushima, 770-8504, Japan
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Ito Y, Tanaka Y, Daidoji A, Al Khalili H, Hattori Y. Relationship between texture perception and oral function: A preliminary study in young, healthy adults. J Oral Rehabil 2024; 51:1229-1235. [PMID: 38641861 DOI: 10.1111/joor.13702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/05/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Oral frailty, characterised by reduced oral function, is associated with systemic health issues in older adults. Although the criteria for diminished oral function often focus on motor and secretory abilities, texture perception also plays a crucial role in health due to its impact on food intake and palatability. OBJECTIVE This study aimed to explore the relationship between thickness discrimination ability (TDA) and oral motor and secretory functions in healthy young individuals. METHODS Twenty-eight adults were assessed for texture perception using eight concentrations of aqueous xanthan gum solutions to determine TDA scores. Measurements of occlusal force, masticatory performance, tongue pressure, stimulated salivary flow rate and tongue-lip motor function were conducted. Spearman's correlation analysis was used to evaluate the relationship between TDA scores and oral functions. Participants were divided into high-sensitivity and low-sensitivity groups based on their TDA scores to compare oral function test results. RESULTS The TDA scores varied among the participants, with higher scores correlating with higher masticatory performance (r = 0.41, p < .05). Masticatory performance in the high-sensitivity group was significantly higher than in the low-sensitivity group (211.9 ± 59.2 mg/dL vs. 157.9 ± 43.0 mg/dL, p = .013), with no significant differences in other oral functions. CONCLUSION Masticatory performance was correlated with TDA, suggesting a link between the selection function of mastication and thickness discrimination. These findings highlight the potential relevance of texture perception in oral function and indicate the need for further exploration, particularly in older adults with declining oral health.
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Affiliation(s)
- Yuki Ito
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yasue Tanaka
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Akinari Daidoji
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Hala Al Khalili
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Liu Y, Lei F, Yao D, Zhang X, Huang X, Cai J, Deng KQ, Cheng B. Ill-fitting prosthesis is associated with an increased risk of elevated blood pressures. J Oral Rehabil 2024; 51:1123-1134. [PMID: 38491740 DOI: 10.1111/joor.13684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 12/08/2023] [Accepted: 03/02/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE Previous studies focused on the benefits of adequate prosthodontic treatment, while few studies have investigated the prosthodontic-related risks to health. As a modifiable oral health indicator, the association of ill-fitting prosthesis (IFP) with hypertension has not been fully explored. METHODS This cross-sectional study involved 158,659 adults in Beijing (2009-2017) receiving intra-oral examinations and blood pressure measurements. Logistic regression models were applied to assess the association of IFP with the prevalence of hypertension, systolic blood pressure (SBP) ≧ 140 mmHg and diastolic blood pressure (DBP) ≧ 90 mmHg, as well as subgroup analyses by different fixed IFP subgroups (according to involved teeth number) and removable IFP subgroup. We further investigated effect modifications among stratified populations. RESULTS 158,659 individuals were included for analysis, 346 (26.86%) in IFP group and 27,380 (17.40%) in non-IFP group (p < 0.001) were hypertensive. After adjustment of sex, age, obesity, dyslipidaemia, diabetes, hsCRP, family history of CVD, self-reported smoking, self-reported drinking and WC, ORs of hypertension, SBP ≧ 140 mmHg and DBP ≧ 90 mmHg were 1.330 (95% CI: 1.162-1.522), 1.277 (95% CI: 1.098-1.486) and 1.376 (95% CI: 1.186-1.596), respectively (p < 0.05). Furthermore, after full adjustment, the number of involved teeth showed a significant incremental trend with hypertension risk in the population with and without IFP (p for trend <0.001). The IFP-blood pressure associations were more pronounced in females, 18-60 years, non-obese and diabetic participants. CONCLUSION As a modifiable oral indicator, IFP was significantly associated with a higher risk of hypertension.
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Affiliation(s)
- Yang Liu
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Fang Lei
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Dongai Yao
- Health Examination Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xingyuan Zhang
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Xuewei Huang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jingjing Cai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ke-Qiong Deng
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bo Cheng
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Tanaka K, Tominaga T, Kikutani T, Sakuda T, Tomida H, Tanaka Y, Mizukoshi A, Ichikawa Y, Ozeki M, Takahashi N, Tamura F. Oral status of older adults receiving home medical care: A cross-sectional study. Geriatr Gerontol Int 2024; 24:706-714. [PMID: 38830832 DOI: 10.1111/ggi.14917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/19/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024]
Abstract
AIM This study examined the oral status and the presence of teeth requiring treatment among older adults receiving home medical care. METHODS This cross-sectional study was conducted at a Japanese dental clinic specializing in geriatric treatment. We recruited older adults receiving home medical care in the community who had begun to receive domiciliary dental care. The Japanese version of the Oral Health Assessment Tool (OHAT-J), as well as the presence of teeth requiring extraction and the need for assistance in maintaining oral hygiene were used to evaluate the participants' oral health and its association with other items. RESULTS Ninety-three participants (44 male and 49 female, median age: 87.0 years) were surveyed. The median OHAT-J score was 6. The duration since the previous dental visit was 23 months. Sixty-two (73.8%) of 84 participants with ≥1 natural tooth had severe caries or teeth with severe mobility that required extraction. Logistic analysis revealed that requiring assistance in maintaining oral hygiene, mild dementia, severe dementia, and depression were significantly associated with an OHAT score of ≥6. CONCLUSIONS Older adults receiving home medical care had poor oral health, with approximately 70% of them requiring tooth extraction. The need for assistance in maintaining oral hygiene and poor mental status contribute to poor oral health. Geriatr Gerontol Int 2024; 24: 706-714.
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Affiliation(s)
- Kumi Tanaka
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | | | - Takeshi Kikutani
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Taeko Sakuda
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Hiroko Tomida
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Yuko Tanaka
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Arato Mizukoshi
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Yoko Ichikawa
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Maiko Ozeki
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Noriaki Takahashi
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
| | - Fumiyo Tamura
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tokyo, Japan
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Morinaga D, Nagai S, Kaku T, Itoh T, Soejima Y, Takeshita F, Horikawa T, Abe N, Iijima T, Soejima D, Hara T, Sato R, Murakami M, Sawase T, Nishimura M. Effects of various prosthetic methods for patients with Kennedy Class I partial edentulism on oral hypofunction, subjective symptoms, and oral health-related quality of life. Int J Implant Dent 2024; 10:33. [PMID: 38935335 PMCID: PMC11211286 DOI: 10.1186/s40729-024-00555-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/24/2024] [Indexed: 06/28/2024] Open
Abstract
PURPOSE This propensity score matching, multicenter, cross-sectional study was performed to examine the effects of various prosthetic methods for dental clinic outpatients with Kennedy Class I partial edentulism (KCIPE) on oral hypofunction, subjective frailty symptoms, and oral health-related quality of life (QOL). METHODS Patients (n = 348) were classified into the following three groups for analysis: NT, patients with natural dentition providing intermaxillary contact in four occlusal supporting zones; RPD, patients with KCIPE who received removable partial dentures; and ISFP, patients with KCIPE who received implant-supported fixed prostheses. Participants' basic characteristics were recorded, and oral function tests were conducted. Subjective symptoms of physical and oral frailty were investigated via questionnaire. Oral health-related QOL was assessed using the Japanese short version of the Oral Health Impact Profile (OHIP-JP16). Propensity score matching was performed to adjust for patient background factors that could influence oral hypofunction in each group. RESULTS Compared with the ISFP group, the RPD group had significantly higher rates of poor oral hygiene, reduced occlusal force, decreased masticatory function, and declines in swallowing function and oral hypofunction; the odds ratio for oral hypofunction was 4.67. Compared with the ISFP group, the RPD group had significantly greater subjective symptoms of physical frailty and oral frailty, as well as higher OHIP scores. CONCLUSIONS Prosthetic treatment of KCIPE affected oral hypofunction, subjective frailty symptoms, and oral health-related QOL in dental clinic outpatients.
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Affiliation(s)
- Daisaku Morinaga
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Shoji Nagai
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Toshio Kaku
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Takatoshi Itoh
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Yoshiki Soejima
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Fumitaka Takeshita
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Tadashi Horikawa
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Naruyoshi Abe
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Toshikazu Iijima
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Daigo Soejima
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Toshihiro Hara
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Ryuta Sato
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
| | - Mamoru Murakami
- Removable Prosthodontics and Implant Dentistry, Advanced Dentistry Center, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Takashi Sawase
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
- Nagasaki University Hospital Dental Implant Center, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Masahiro Nishimura
- Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
- Department of Fixed Prosthodontics and Orofacial Function, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, 565-0871, Japan
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Arai E, Watanabe Y, Nakagawa S, Ohara Y, Iwasaki M, Hirano H, Ikebe K, Ono T, Iijima K, Adachi A, Watanabe T, Yamazaki Y. Association of oral frailty with medical expenditure in older Japanese adults: The study of late-stage older adults in Tottori (START Tottori). Gerodontology 2024. [PMID: 38887126 DOI: 10.1111/ger.12771] [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: 06/04/2024] [Indexed: 06/20/2024]
Abstract
OBJECTS This study aimed to determine the association between annual medical expenses and oral frailty in later-stage older adults (aged ≥ 75 years). No studies have investigated the association between medical costs and oral frailty, which would elucidate the association between oral frailty and the deterioration of mental and overall physical function. MATERIALS AND METHODS In this cross-sectional study, 2190 adults (860 men and 1330 women aged 75-94 years) covered by the Medical System for the Elderly and residing in Tottori Prefecture, Japan, between April 2016 and March 2019, were included. Participants were classified into three groups: healthy, pre-orally frail or orally frail, based on dental health screening findings. The medical and dental expenses over the years, number of days of consultations and comorbidities were obtained from the Japanese Health Insurance Claims Database. RESULTS The number of days of medical and dental consultations and annual medical expenses for outpatient care differed among the three study groups. A significant association was observed between oral frailty and high annual expenses for outpatient medical and dental care. Oral frailty was associated with higher medical expenses in participants with poor masticatory function. Higher and lower dental expenses were associated with subjective poor masticatory function and subjective impairment of swallowing function respectively. CONCLUSION Medical and dental expenses for orally frail older adults are high, indicating that oral frailty may be related to the occurrence and severity of diseases other than oral health issues. Future studies should examine the mechanism by which oral weakness affects physical and mental functions.
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Affiliation(s)
- Eri Arai
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo City, Hokkaido, Japan
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo City, Hokkaido, Japan
| | - Sayuri Nakagawa
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo City, Hokkaido, Japan
| | - Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo City, Hokkaido, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita-city, Osaka, Japan
| | - Takahiro Ono
- Department of Geriatric Dentistry, Osaka Dental University, Chuo-ku, Osaka, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Institute for Future Initiative, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | | | | | - Yutaka Yamazaki
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo City, Hokkaido, Japan
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Okamoto M, Yoshida M, Tsuga K, Matsuo K, Ikebe K, Ueda T, Minakuchi S. Associations of sex, age, and number of remaining teeth with performance on oral hypofunction tests. Gerodontology 2024. [PMID: 38874012 DOI: 10.1111/ger.12770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Oral hypofunction comprises seven aspects of oral condition, including oral hygiene, oral dryness, bite strength, tongue-lip motor function, tongue pressure, masticatory function, and swallowing function. Each of these seven has a single diagnostic criterion; however, the use of a single indicator without consideration of sex, age, or other factors is controversial. The purpose of this study was to evaluate the association between the oral hypofunction test and sex, age, and number of remaining teeth. METHODS The study was conducted at 12 facilities by the members of the Japanese Society of Geriatric Dentistry during April to December 2019. The participants comprised 181 healthy older adults aged 65 years and over (56.9% female; age range 65-95 years) who regularly visited these facilities. All tests of oral function and oral status available in Japan were performed on the participants, and the association between these tests and sex, age, and number of remaining teeth was examined. RESULTS Sex differences were observed in masticatory function, bite force, lip closure force, jaw-opening force, oral diadochokinesis "ka," and tongue coating index (p < .05). In men, age was weakly (r = 0.20-0.40) associated with masticatory function, jaw-opening force, maximum tongue pressure, oral diadochokinesis, and swallowing function. In women, the number of remaining teeth, masticatory function, jaw-opening force, and oral diadochokinesis "ta" and "ka" was also weakly associated with age. CONCLUSIONS Performance on the oral hypofunction test differs by sex, age, and number of remaining teeth. This means that the current single criterion for evaluation requires caution in its interpretation.
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Affiliation(s)
- Mieko Okamoto
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Mitsuyoshi Yoshida
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koichiro Matsuo
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Removable Prosthodontics and Gerodontology, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Tennert C, Borg-Bartolo R, Prasinou M, Jaeggi MK, Schimmel M, Roccuzzo A, Campus G. Evaluation of the Association of Chewing Function and Oral Health-Related Quality of Life in a Population of Individuals Aged ≥ 45 Years and Residing in Communities in Switzerland: A Cross-Sectional Study. Dent J (Basel) 2024; 12:174. [PMID: 38920875 PMCID: PMC11203126 DOI: 10.3390/dj12060174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/28/2024] [Accepted: 05/31/2024] [Indexed: 06/27/2024] Open
Abstract
PURPOSE To analyse the association of masticatory performance and oral health-related quality of life in a representative population of individuals residing in communities in Switzerland aged ≥ 45 years. MATERIALS AND METHODS In total, 100 subjects completed two dedicated and validated questionnaires on their demographic data and the Geriatric Oral Health Assessment Index. A mixing ability test was performed for assessing masticatory performance. The qualitative analysis of the test was performed by categorizing the images into five categories, while the quantitative analysis was performed via a validated custom-made software. RESULTS Sixty-six samples could be analysed. Participants younger than 65 years of age showed significantly less frequent chewing deficiencies (17%) compared to those 65 years and older (50%, p < 0.01). However, retired participants had chewing deficiencies significantly more frequently (8%) compared to workers (51%, p < 0.01). A statistically significant positive association of having chewing deficiency was found between employment status (p < 0.01) and the presence of restorations (p = 0.04), while GOHAI did not show any statistically significant association. Overall, the enrolled subjects displayed moderate chewing function. Masticatory performance was positively associated with the number of present restorations. CONCLUSIONS The enrolled subjects residing in communities in Switzerland aged ≥ 45 years displayed moderate chewing function. Their masticatory performance was positively associated with the number of present restorations but not associated with oral health related quality of life (GOHAI).
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Affiliation(s)
- Christian Tennert
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland; (R.B.-B.); (M.P.); (M.K.J.); (A.R.); (G.C.)
| | - Roberta Borg-Bartolo
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland; (R.B.-B.); (M.P.); (M.K.J.); (A.R.); (G.C.)
| | - Maria Prasinou
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland; (R.B.-B.); (M.P.); (M.K.J.); (A.R.); (G.C.)
| | - Maurus Kurt Jaeggi
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland; (R.B.-B.); (M.P.); (M.K.J.); (A.R.); (G.C.)
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Geriodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland;
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Andrea Roccuzzo
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland; (R.B.-B.); (M.P.); (M.K.J.); (A.R.); (G.C.)
- Department of Periodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland; (R.B.-B.); (M.P.); (M.K.J.); (A.R.); (G.C.)
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Watanabe Y, Otake M, Ono S, Ootake M, Murakami K, Kumagai K, Matsuzawa K, Kasahara H, Hori K, Someya T. Decreased oral function in Japanese inpatients with schizophrenia. Neuropsychopharmacol Rep 2024; 44:356-360. [PMID: 38602056 PMCID: PMC11144619 DOI: 10.1002/npr2.12443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 04/12/2024] Open
Abstract
AIM Oral function in patients with schizophrenia has not been well-characterized. To address this, we performed a cross-sectional study of oral function in Japanese inpatients with schizophrenia. METHODS We measured oral function, including occlusal force, tongue-lip motor function, tongue pressure, and masticatory function in 130 Japanese inpatients with schizophrenia. We then compared the frequency of clinical signs of oral hypofunction among 63 non-elderly and 67 elderly inpatients with schizophrenia, as well as data from 98 elderly control participants from a previous Japanese study. RESULTS The frequency of reduced occlusal force was significantly higher in the elderly inpatients (76.2%) than in the non-elderly inpatients (43.9%) and elderly controls (43.9%). The frequency of decreased tongue-lip motor function in non-elderly inpatients (96.8%) and elderly inpatients (97.0%) was significantly higher than that in elderly controls (56.1%). The frequency of decreased tongue pressure in non-elderly inpatients (66.1%) and elderly inpatients (80.7%) was significantly higher than that in elderly controls (43.9%). Finally, the frequency of decreased masticatory function was highest in elderly inpatients (76.5%), followed by non-elderly inpatients (54.8%) and elderly controls (15.3%). CONCLUSION Oral function was decreased in both non-elderly and elderly Japanese inpatients with schizophrenia compared with elderly controls.
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Affiliation(s)
- Yuichiro Watanabe
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Masataka Otake
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Shin Ono
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Masaya Ootake
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Kazuhiro Murakami
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Koichiro Kumagai
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Koji Matsuzawa
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Hiroyuki Kasahara
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Faculty of Dentistry and Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Toshiyuki Someya
- Department of PsychiatryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
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Hayashi T, Sato R, Tamura K. Relationships among tooth loss, prefrailty, and dietary patterns in community-dwelling older Japanese females: a cross-sectional study. Nutr Res Pract 2024; 18:387-399. [PMID: 38854469 PMCID: PMC11156762 DOI: 10.4162/nrp.2024.18.3.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/22/2024] [Accepted: 04/08/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND/OBJECTIVES Poor oral health has been predicted the development of frailty and sarcopenia as well as the subsequent need for long-term care. This cross-sectional study examined the relationships among tooth loss, prefrailty, and dietary patterns in community-dwelling older Japanese females. SUBJECTS/METHODS Information on the number of teeth, food consumption, and lifestyle factors was collected from 271 participants aged ≥ 65 yrs using a questionnaire. The number of teeth was self-reported and classified into 2 groups: natural teeth ≥ 20 and natural teeth < 20. Prefrailty was assessed using the Japanese version of the Cardiovascular Health Study. Three dietary patterns ("vegetables and dairy products" [VD], "rice and fish and shellfish" [RF], and "bread and beverages") were adopted from a cluster analysis of the intakes of 20 foods evaluated using the Food Frequency Questionnaire. The odds ratios (ORs) for prefrailty and dietary patterns were calculated using a binary logistic regression analysis. RESULTS A total of 267 participants were analyzed, excluding those with frailty (n = 4). The rates of natural teeth < 20 and prefrailty were 57.3 and 37.4%, respectively. Natural teeth < 20 was positively correlated with prefrailty (OR, 4.66; 95% confidence interval [CI], 2.54-8.52) and inversely correlated with VD pattern (OR, 0.43; 95% CI, 0.27-0.69). Furthermore, both VD (OR, 0.38; 95% CI, 0.16-0.91) and RF (OR, 0.26; 95% CI, 0.11-0.62) patterns were inversely correlated with prefrailty. CONCLUSIONS Maintaining the number of natural teeth ≥ 20 into old age plays an important role in preventing a prefrailty. The promotion of VD and RF dietary patterns has potential as an effective nutritional strategy for preventing tooth loss and prefrailty.
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Affiliation(s)
- Tatsumi Hayashi
- Faculty of Economics, Shimonoseki City University, Shimonoseki 751-8510, Japan
- Faculty of Food and Nutrition, Kyushu Nutrition Welfare University, Kitakyushu 803-8511, Japan
| | - Rumi Sato
- Community Health Division, Council of Social Welfare, Bungo Ono City 879-7153, Japan
| | - Kazuo Tamura
- Research Promotion Division, Fukuoka University, Fukuoka 814-0180, Japan
- NPO Clinical Hematology Oncology Treatment Study Group, Fukuoka 819-0030, Japan
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Chen Y, Ku E, Tsai P, Lin C, Ko N, Huang S, Wang J, Yang Y. The relationship between oral frailty and oral dysbiosis among hospitalized patients aged older than 50 years. Clin Exp Dent Res 2024; 10:e890. [PMID: 38816943 PMCID: PMC11139674 DOI: 10.1002/cre2.890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/15/2024] [Accepted: 04/24/2024] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVE This study aimed to clarify the relationship between oral frailty and oral dysbiosis among hospitalized patients aged ≥ 50 years. METHODS A prospective observational study was conducted. Number of teeth, masticatory ability, articulatory oral motor skill, tongue pressure, swallowing pressure, and choking were used to assess oral frailty. Saliva samples were collected from the oral cavity for bacterial culture. RESULTS A total 103 in patients enrolled and 53.4% suffered from oral frailty. Oral frailty was found to have a 3.07-fold correlation with the presence of Enterobacterales in the oral cavity (p = 0.037), especially in poor articulatory oral motor skill, which showed at greater risk of Enterobacterales isolated from the oral cavity by 5.58-fold (p = 0.01). CONCLUSION Half of hospitalized patients was found to have oral frailty that was related to more Enterobacterales in the oral cavity. This evidence suggests that the enhancement of articulatory oral motor skills may serve as a potential strategy for mitigating the presence of Enterobacterales within the oral cavity.
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Affiliation(s)
- Yen‐Chin Chen
- College of MedicineNational Sun Yat‐sen UniversityKaohsiungTaiwan
- Department of Nursing, College of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - En‐Ni Ku
- Department of NursingLinkou Chang Gung Memorial HospitalTaipeiTaiwan
| | - Pei‐Fang Tsai
- Department of Pathology, National Cheng Kung University Hospital, College of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Che‐Wei Lin
- Department of Biomedical Engineering, College of EngineeringNational Cheng Kung UniversityTainanTaiwan
| | - Nai‐Ying Ko
- Department of Nursing, College of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Shun‐Te Huang
- Division of Pediatric Dentistry and Special Care DentistryKaohsiung Medical University HospitalKaohsiungTaiwan
| | - Jiun‐Ling Wang
- Department of Medicine, College of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Internal Medicine, National Cheng Kung University HospitalCollege of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Yi‐Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Family Medicine, College of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Geriatric and Gerontology, National Cheng Kung University HospitalCollege of Medicine, National Cheng Kung UniversityTainanTaiwan
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Kudo Y, Takeuchi K, Kusama T, Kojima T, Waguri-Nagaya Y, Nagayoshi M, Kondo K, Mizuta K, Osaka K, Kojima M. Differences in prevalence of self-reported oral hypofunction between older adult patients with rheumatoid arthritis and the general older population: A cross-sectional study using propensity score matching. J Oral Rehabil 2024; 51:924-930. [PMID: 38356183 DOI: 10.1111/joor.13658] [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: 06/22/2023] [Revised: 12/14/2023] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE To examine the association between rheumatoid arthritis (RA) and oral hypofunction (OHF) using propensity score matching (PSM) to adjust for differences between older adults with RA and the general older adult population. METHODS We conducted a cross-sectional survey among 189 older adults with RA in 2019 (mean age, 71.9 ± 3.6) and 47 178 independent older adult residents in 2016 (mean age, 71.6 ± 4.0), respectively. The questionnaire covered information on socio-demographic characteristics and OHF for both groups. Age, sex, educational level and smoking history were used to determine PSM. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of self-reported OHF (fewer remaining teeth, decreased masticatory function, deterioration of swallowing function and oral dryness) were estimated using Poisson regressions. RESULT OHF was observed in 44.4% of patients with RA and 27.5% of residents. Before PSM, the prevalence of OHF among patients with RA was higher than that of residents (PR, 1.75; 95% CI, 1.50-2.05). After PSM, there were 189 patients with RA and residents, and the prevalence of OHF among patients with RA was still higher (PR, 1.61; 95% CI, 1.22-2.13). Poisson regression showed that the prevalence of 19 or fewer teeth (PR, 1.06; 95% CI, 0.82-1.36), difficulties eating tough foods (PR, 1.18; 95% CI, 0.90-1.55), difficulties swallowing tea or soup (PR, 1.77; 95% CI, 1.19-2.63), and dry mouth (PR, 2.79; 95% CI, 1.90-4.07) was higher among patients with RA than residents. CONCLUSION Compared with the general older adult population, patients with RA have a higher prevalence of self-reported OHF.
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Affiliation(s)
- Yoko Kudo
- Division of Dento-Oral Anesthesiology, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Toshihisa Kojima
- Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya, Japan
- Department of Orthopedic Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yuko Waguri-Nagaya
- Department of Orthopedic Surgery, Nagoya City University East Medical Center, Nagoya, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsunori Kondo
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Social Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Kentaro Mizuta
- Division of Dento-Oral Anesthesiology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masayo Kojima
- Nagoya City University, Nagoya, Japan
- Department of Frailty, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Yamabe K, Nishida T, Ide Y, Honda S. Screening performance of a 100-mL water swallowing test in community-dwelling older adults: A receiver operating characteristic analysis. Australas J Ageing 2024; 43:369-375. [PMID: 38539043 DOI: 10.1111/ajag.13310] [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: 09/17/2023] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE The development of a dysphagia screening test is an urgent issue in the field of frailty prevention among community-dwelling older people. The purpose of this study was to evaluate the screening performance of a 100-mL water swallowing test (WST). METHODS The study employed a cross-sectional design. Participants were 304 (65 men and 239 women, mean age = 80 years) Japanese community-dwelling older adults aged over 65 years. We investigated swallowing disorder using the 10-item Eating Assessment Tool (EAT-10), and compared choking signs, swallowing time and number of swallows, and their combination in the 100-mL WST. We calculated the sensitivity and specificity of these indices. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value of swallowing time and number of swallows in the 100-mL WST based on the Youden Index among participants without choking signs. RESULTS The sensitivity and specificity of choking signs in the 100-mL WST were 20% and 91%, respectively. The discriminating ability of swallowing time and number of swallows among participants without any choking signs was .76 and .72, respectively, in the area under the ROC curve. Diagnostic sensitivity and specificity to discriminate dysphagia from normal swallowing ability were 65% and 74% when the cut-off was >10 s based on maximisation of the Youden Index. The 100-mL WST performed best when the indices of choking signs and swallowing time were combined, with a sensitivity and specificity of 72% and 68%, respectively. CONCLUSIONS The 100-mL WST would be an adequate screening tool when compared to the EAT-10.
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Affiliation(s)
- Kazumi Yamabe
- NPO Nagasaki Expert Group of Dysphagia, Sasebo, Japan
| | - Takahiro Nishida
- NPO Nagasaki Expert Group of Dysphagia, Sasebo, Japan
- Sasebo-Yoshii Community Comprehensive Support Center, Sasebo, Japan
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshihiko Ide
- NPO Nagasaki Expert Group of Dysphagia, Sasebo, Japan
- Department of Dementia Clinic, Sasebo-Chuo Hospital, Sasebo, Japan
| | - Sumihisa Honda
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Nakagawa S, Miura K, Arai E, Taira K, Watanabe Y, Shirobe M, Motokawa K, Ohara Y, Iwasaki M, Hirano H, Ono T, Adachi A, Watanabe T, Yamazaki Y. Oral frailty, appetite and dietary variety in late-stage older adults: A cross-sectional study (the STudy of lAte-stage oldeR adulTs in Tottori; START Tottori). Geriatr Gerontol Int 2024; 24:626-633. [PMID: 38714504 DOI: 10.1111/ggi.14892] [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: 12/15/2023] [Revised: 02/19/2024] [Accepted: 04/23/2024] [Indexed: 05/10/2024]
Abstract
AIM Efforts to combat frailty and preserve good health in older adults have highlighted oral frailty as an early indicator of overall frailty. Individuals showing oral frailty are at an elevated risk of insufficient nutritional intake compared with those without oral frailty; however, underlying mechanisms remain poorly explored. In this cross-sectional study, we aimed to examine the link between oral frailty and undernutrition, especially regarding poor appetite and low dietary diversity. METHODS The analysis included 2727 late-stage older adults (mean age 79.9 ± 4.3 years) who underwent dental checkups in a prefecture in Japan from 2016 to 2020. The examination involved a questionnaire survey (covering basic information, frailty screening index, appetite index: Simplified Nutritional Appetite Questionnaire; and dietary variety: Dietary Variety Score) and a measurement survey (including intraoral confirmation, oral diadochokinesis and masticatory efficiency test). Individuals with three or more indications of poor oral function, identified through oral function assessment, were defined as showing oral frailty. Binomial logistic regression and path analyses examined associations among oral frailty, Simplified Nutritional Appetite Questionnaire and Dietary Variety Score. RESULTS Among those analyzed, 1208 (44.3%) participants were categorized into the oral frailty group. Binomial logistic regression analysis showed that Simplified Nutritional Appetite Questionnaire (odds ratio for oral frailty per 1-point increase 0.88, 95% confidence interval 0.84-0.93) and Dietary Variety Score (odds ratio 0.95, 95% confidence interval 0.92-0.98) were significantly associated with oral frailty. The path analysis showed individual associations between each examined factor. CONCLUSIONS Oral frailty was associated with decreased appetite and dietary variety in late-stage older adults. Geriatr Gerontol Int 2024; 24: 626-633.
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Affiliation(s)
- Sayuri Nakagawa
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kazuhito Miura
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Eri Arai
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kenshu Taira
- Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Maki Shirobe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Masanori Iwasaki
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Takahiro Ono
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | | | | | - Yutaka Yamazaki
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
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Zhao H, Wu B, Zhou Y, Yang Z, Zhao H, Tian Z, Jiang M, Huang D. Oral frailty: a concept analysis. BMC Oral Health 2024; 24:594. [PMID: 38778380 PMCID: PMC11112910 DOI: 10.1186/s12903-024-04376-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Oral frailty has become a worldwide problem among older adults. Although researchers have conducted various studies on oral frailty, its definition remains controversial. PURPOSE To clarify the concept of oral frailty. METHODS Online databases PubMed, Web of Science, CINAHL, Cochrane Library, ProQuest, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang database were searched from inception to September 20, 2023. The reference lists of relevant studies were searched manually. Eligible articles, theses, and books were analyzed using Walker & Avant's concept analysis model. RESULTS The attributes of oral frailty were abnormal oral structure and/or decline in multi-faceted oral function and coexisting decline in physical, cognitive and social functions. Its antecedents were aging, social frailty, and severe periodontitis, whereas its consequences were decline in physical health and mental health, social withdrawal, lower quality of life and systemic frailty. CONCLUSION Oral frailty could result in worse conditions among older adults physically, psychologically and socially. Tools based on the concept analysis need to be developed to comprehensively assess oral frailty.
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Affiliation(s)
- Huimin Zhao
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Bei Wu
- Rory Meyers College of Nursing and NYU Aging Incubator, New York University, New York, NY, 10012, USA
| | - Yuqiu Zhou
- Department of Nursing, Harbin Medical University, Harbin, 150081, China
| | - Zhilan Yang
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Hua Zhao
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Ziwei Tian
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Manhong Jiang
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Deqin Huang
- School of Nursing, Hangzhou Normal University, Hangzhou, 311121, China.
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Suwanarpa K, Hasegawa Y, Paphangkorakit J, Pitiphat W, Hori K, Ono T. Development of the Food Acceptance Questionnaire for Thai Partial and Complete Edentulism. Nutrients 2024; 16:1432. [PMID: 38794670 PMCID: PMC11124462 DOI: 10.3390/nu16101432] [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: 03/21/2024] [Revised: 05/05/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
This study aimed to develop the Food Acceptance Questionnaire (FAQ) to assess the masticatory ability of Thai older adults (≥60 years). Fifty participants were interviewed using open-ended questions about food they regularly consumed and avoided due to difficulty chewing. From a list of 140 items, 100 were recruited for a trial version of the FAQ. A total of 154 participants responded to the 5-point Likert scale on their chewing perception of each food item (1, impossible to chew; 5, most easily eaten). The average response of each food item was used as the chewing index (CI). The 100 food items were ranked and divided into five grades based on their CIs. Masticatory performance (MP) was objectively assessed by a visual scoring method using gummy jelly (UHA Mikakuto). Two foods from each grade that demonstrated the highest correlation with MP were selected to form the final 10-item FAQ. The FAQ score was calculated by summarizing the responses of 10 items. MP correlated strongly with the FAQ score (r = 0.57, p < 0.001), indicating its predictive validity. Furthermore, the FAQ indicates strong internal consistency (Cronbach's alpha coefficient = 0.90), indicating high reliability. In conclusion, this newly developed 10-item FAQ is valid and reliable for assessing the masticatory ability of Thai older adults.
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Affiliation(s)
- Ketsupha Suwanarpa
- Department of Prosthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Yoko Hasegawa
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274 Gakkocho-dori, Niigata 951-850014, Japan;
| | - Jarin Paphangkorakit
- Department of Oral Biomedical Science, Faculty of Dentistry, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Waranuch Pitiphat
- Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274 Gakkocho-dori, Niigata 951-850014, Japan;
| | - Takahiro Ono
- Department of Geriatric Dentistry, Osaka Dental University, 1-5-17 Otemae, Osaka 540-0008, Japan;
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Ranjan M, Kumar S, Singh B, Mahuli AV, Jha AK, Naik SR. Laboratory Validation of a Novel Indigenously Developed Bite Force Measuring Device. Cureus 2024; 16:e60880. [PMID: 38910709 PMCID: PMC11193676 DOI: 10.7759/cureus.60880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
INTRODUCTION It is critical to measure the maximum voluntary bite force of patients receiving restorative dentistry. A new device known as "BYTE" has been developed indigenously to measure bite force in humans. The purpose of this study is to evaluate the BYTE device's consistency and accuracy in a lab setting. METHODOLOGY Testing and calibration were done in the laboratory. The calibration machine with load cell pressed the biting part of the device with various forces from 3 N to 444 N in 3 N increments for two to three seconds each. The recorded force value in Newton by the device was noted down. RESULTS At numerous standard loads, the minimum accuracy error is 0.333 N, while the maximum is 1.667 N. It marginally underestimates the load with an average accuracy error of 0.833 N. CONCLUSION The calibration report showed that the BYTE device is precise and reliable and can be used to measure maximum bite force.
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Affiliation(s)
- Madhu Ranjan
- Prosthodontics, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Surender Kumar
- Prosthodontics, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Bishnupati Singh
- Prosthodontics, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Amit V Mahuli
- Public Health Dentistry and Preventive Dentistry, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Awanindra K Jha
- Orthodontics, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Shantala R Naik
- Oral Medicine and Radiology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, IND
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Han X, Bai Z, Mogushi K, Hase T, Takeuchi K, Iida Y, Sumita YI, Wakabayashi N. Machine Learning Prediction of Tongue Pressure in Elderly Patients with Head and Neck Tumor: A Cross-Sectional Study. J Clin Med 2024; 13:2363. [PMID: 38673635 PMCID: PMC11051183 DOI: 10.3390/jcm13082363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
Background: This investigation sought to cross validate the predictors of tongue pressure recovery in elderly patients' post-treatment for head and neck tumors, leveraging advanced machine learning techniques. Methods: By employing logistic regression, support vector regression, random forest, and extreme gradient boosting, the study analyzed an array of variables including patient demographics, surgery types, dental health status, and age, drawn from comprehensive medical records and direct tongue pressure assessments. Results: Among the models, logistic regression emerged as the most effective, demonstrating an accuracy of 0.630 [95% confidence interval (CI): 0.370-0.778], F1 score of 0.688 [95% confidence interval (CI): 0.435-0.853], precision of 0.611 [95% confidence interval (CI): 0.313-0.801], recall of 0.786 [95% confidence interval (CI): 0.413-0.938] and an area under the receiver operating characteristic curve of 0.626 [95% confidence interval (CI): 0.409-0.806]. This model distinctly highlighted the significance of glossectomy (p = 0.039), the presence of functional teeth (p = 0.043), and the patient's age (p = 0.044) as pivotal factors influencing tongue pressure, setting the threshold for statistical significance at p < 0.05. Conclusions: The analysis underscored the critical role of glossectomy, the presence of functional natural teeth, and age as determinants of tongue pressure in logistics regression, with the presence of natural teeth and the tumor site located in the tongue consistently emerging as the key predictors across all computational models employed in this study.
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Affiliation(s)
- Xuewei Han
- Department of Advanced Prosthodontics, Graduate School, Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (X.H.); (Z.B.); (N.W.)
| | - Ziyi Bai
- Department of Advanced Prosthodontics, Graduate School, Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (X.H.); (Z.B.); (N.W.)
| | - Kaoru Mogushi
- Institute of Education, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (K.M.); (T.H.)
| | - Takeshi Hase
- Institute of Education, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (K.M.); (T.H.)
- Faculty of Pharmacy, Keio University, Tokyo 1088345, Japan
- Center for Mathematical Modelling and Data Science, Osaka University, Osaka 5608531, Japan
- The Systems Biology Institute, Tokyo 1410022, Japan
| | - Katsuyuki Takeuchi
- Institute of Education, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (K.M.); (T.H.)
| | - Yoritsugu Iida
- Institute of Education, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (K.M.); (T.H.)
| | - Yuka I. Sumita
- Department of Advanced Prosthodontics, Graduate School, Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (X.H.); (Z.B.); (N.W.)
- Department of Partial and Complete Denture, The Nippon Dental University School of Life Dentistry, Tokyo 1028159, Japan
| | - Noriyuki Wakabayashi
- Department of Advanced Prosthodontics, Graduate School, Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (X.H.); (Z.B.); (N.W.)
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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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Min SY, Pang NS, Kim YR, Jeong SA, Jung BY. Factors associated with age-related changes in oral diadochokinesis and masticatory function in healthy old adults. BMC Oral Health 2024; 24:462. [PMID: 38627762 PMCID: PMC11020950 DOI: 10.1186/s12903-024-04214-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/01/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND This cross-sectional study aimed to identify factors associated with age-related changes in masticatory performance (MP) and oral diadochokinesis (ODK) and to provide normal values in healthy old adults for the diagnosis of oral frailty. METHODS A total of 385 participants were divided into three age groups (Gr1-3): 20-64 years, 65-74 years, and ≥ 75 years. To investigate tongue-lip motor function, ODK was assessed as the number of repetitions of the monosyllables /pa/ta/ka/. Four questionnaires were used to assess subjective masticatory ability, cognitive ability, and psychological status. MP, bite force, and occlusal area were tested to assess dynamic objective masticatory function, and the number of remaining teeth and functional tooth pairs were determined to assess static objective masticatory function. Handgrip strength (HG), oral dryness, and tongue pressure (TP) were assessed to identify influencing factors. Intergroup differences were evaluated by ANOVA and the Kruskal‒Wallis test, and correlations between ODK and orofacial factors were evaluated. RESULTS This study revealed significant age-related declines in TP, HG, and ODK, especially after 65 years of age. Factors affecting MP were posterior teeth, the Eichner index, bite force, occluding area, the Korean Mini-Mental State Examination (KMMSE) score, and ODK. Each ODK syllable was associated with different factors, but common factors associated with ODK were MP, HG, and PHQ-9 score. For the syllables /pa/ta/, the Eichner Index, TP, and oral dryness were also associated. For the syllable /ka/ in Gr3, MP, TP, HG, oral dryness, and the KMMSE score were associated. CONCLUSIONS These results could provide practical guidelines for oral rehabilitation in old adults and contribute to improving the understanding of age-related changes in oral function and the multidimensional nature of masticatory dynamics.
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Affiliation(s)
- Se-Yeon Min
- Department of Dentistry, Graduate School, Yonsei University, Seoul, 03722, Korea
| | - Nan-Sim Pang
- Department of Advanced General Dentistry College of Dentistry, Yonsei University, 50 Yonseiro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Yu-Ri Kim
- Department of Advanced General Dentistry College of Dentistry, Yonsei University, 50 Yonseiro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Sol-Ah Jeong
- Department of Advanced General Dentistry College of Dentistry, Yonsei University, 50 Yonseiro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Bock-Young Jung
- Department of Advanced General Dentistry College of Dentistry, Yonsei University, 50 Yonseiro, Seodaemun-Gu, Seoul, 03722, South Korea.
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Park HJ, Jung EH, Kim SM, Park SC, Jo MJ, Lee YS, Kim SH, Han SY. Assessment of oral hypofunction and its association with age among Korean community-dwelling older adults. BMC Oral Health 2024; 24:441. [PMID: 38600517 PMCID: PMC11007876 DOI: 10.1186/s12903-024-04180-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Due to the increasing proportion of older adults in Korea and growing interest in aging, the concepts of oral aging and oral hypofunction have recently been introduced. Thus, it is necessary to investigate the age-specific oral function levels of Korean older adults and develop expert intervention methods for healthy aging. METHODS Dysphagia, independence of daily living, and oral hypofunction were assessed in 206 older adults living in Wonju, Gangwon State, South Korea. Subjective dysphagia was assessed through self-report questionnaires using the Dysphagia Handicap Index (DHI), the Korean version of Eating Assessment Tool-10, and the Korean version of the Modified Barthel Index. In addition, the oral hypofunction assessment items included decreased chewing ability, occlusal pressure, tongue pressure, oral dryness, and oral cleanliness. RESULTS DHI increased significantly with age, with those in their 80 s reporting the most difficulty swallowing. Oral function in terms of chewing ability (maximum occlusal pressure and number of remaining teeth), maximum occlusal pressure, and maximum tongue pressure also declined with increasing age. While there was no significant difference in oral dryness by age, those in their 80 s had dry mouth according to the criteria of the oral moisture checking device. CONCLUSIONS In an assessment of oral function in community-dwelling, independent Korean older adults, the number of items that were assessed as oral hypofunction increased with age. The findings can be used to standardize the oral hypofunction assessment item and develop age-based individualized intervention plans for the early management of oral health and individual oral myofunctional rehabilitation in Korean community-dwelling older adults.
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Affiliation(s)
- Hye-Jin Park
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Eun-Ha Jung
- Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Soo-Min Kim
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Seong-Chan Park
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Min-Ji Jo
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Yun-Seon Lee
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Sung-Hoon Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Republic of Korea
| | - Sun-Young Han
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea.
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Iwasaki M, Shirobe M, Motokawa K, Tanaka T, Ikebe K, Ueda T, Minakuchi S, Akishita M, Arai H, Iijima K, Sasai H, Obuchi S, Hirano H. Prevalence of oral frailty and its association with dietary variety, social engagement, and physical frailty: Results from the Oral Frailty 5-Item Checklist. Geriatr Gerontol Int 2024; 24:371-377. [PMID: 38390632 DOI: 10.1111/ggi.14846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/30/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
AIM This cross-sectional study had two aims: to assess the prevalence of oral frailty (OF), according to the Oral Frailty 5-Item Checklist (OF-5), among community-dwelling older adults; and to examine the associations among oral frailty, dietary variety, social engagement, and physical frailty. METHODS We pooled data from two population-based studies (the Otassha Study and the Itabashi Longitudinal Study on Aging). With the OF-5, OF is characterized by the presence of two or more of the following: (i) fewer teeth, (ii) difficulty in chewing, (iii) difficulty in swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. We calculated the OF prevalence for each sex. We assessed dietary variety, social engagement, and physical frailty. Generalized structural equation modeling was employed to investigate the associations among oral frailty, low dietary variety (dietary variety score ≤3), social isolation (Lubben Social Network Scale score <12), and physical frailty (Japanese version of the Cardiovascular Health Study score ≥3). RESULTS A total of 1206 individuals (626 women and 580 men) with a mean age of 74.7 years were included. The prevalence of OF was 36.7%, and it increased with age; however, there was no significant sex difference. OF was significantly indirectly associated with physical frailty via low dietary variety (odds ratio, 1.43; 95% confidence interval, 1.04-1.97) and social isolation (odds ratio, 1.42; 95% confidence interval, 1.04-1.94). CONCLUSIONS Two of five community-dwelling older adults exhibited OF. Low dietary variety and social isolation are potential underlying mechanisms through which OF is indirectly associated with physical frailty. Geriatr Gerontol Int 2024; 24: 371-377.
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Affiliation(s)
- Masanori Iwasaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Removable Prosthodontics and Gerodontology, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Sasai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Matsubara C, Yamaguchi K, Imada R, Yoshizawa A, Bando Y, Kusaka T, Furuya J, Tohara H. Factors associated with the oral health status of patients with schizophrenia: A cross-sectional study. J Oral Rehabil 2024; 51:695-702. [PMID: 38044570 DOI: 10.1111/joor.13632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Oral function deterioration attributed to ageing and medications is one of the main contributory factors of dysphagia. Therefore, oral health management is essential in older patients with schizophrenia. However, no previous studies have evaluated the oral function in patients with schizophrenia. OBJECTIVE We surveyed patients with schizophrenia to identify factors associated with ageing-related variations in oral function. METHODS This cross-sectional study included 34 male patients diagnosed with schizophrenia who were hospitalised at a psychiatric hospital between July and September 2021 and underwent a screening examination during dental care. The survey items included basic information, oral hygiene information, oral (oral diadochokinesis [ODK] and tongue pressure), physical function, and nutritional status. Thirty-six male community-dwelling older individuals were included as controls, and their outcomes were compared with those of patients with schizophrenia. RESULTS Compared with healthy older adults, patients with schizophrenia demonstrated significantly lower teeth numbers, ODK, and calf circumference (CC) (p < .05). Multiple regression analysis revealed that ODK was associated with age and schizophrenia (p < .05). Conversely, tongue pressure was associated with CC (p < .05), suggesting different factors' association with the parameters indicating decreased oral function. CONCLUSIONS Our study findings suggest that older patients with schizophrenia have decreased tongue pressure and generalised muscle mass, highlighting the need to manage oral function. Interventions for tongue pressure were more strongly associated with muscle mass and could be easier to manage than those with disease-dependent changes in ODK. TRIAL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Chiaki Matsubara
- Department of Dental Hygiene, University of Shizuoka, Junior College, Shizuoka, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoko Imada
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Medical Corporation Takanawakai, Tokyo, Japan
| | - Akira Yoshizawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Dental Oral Surgery, Nasu Chuo Hospital, Tochigi, Japan
| | | | - Teruo Kusaka
- Takatsuki Hospital, Tokyo, Japan
- Welfare Planning Office Minister's Secretariat Ministry of Economy, Trade and Industry, Tokyo, Japan
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junichi Furuya
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division of Oral Function Management, Department of Oral Health Management, Showa University School of Dentistry, Tokyo, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Miyahara S, Maeda K, Kawamura K, Matsui Y, Onaka M, Satake S, Arai H. Concordance in oral frailty five-item checklist and oral hypofunction: Examining their respective characteristics. Arch Gerontol Geriatr 2024; 118:105305. [PMID: 38056104 DOI: 10.1016/j.archger.2023.105305] [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: 10/11/2023] [Revised: 11/24/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVES This study examined the diagnostic concordance and characteristics of the oral frailty five-item checklist (OF-5) and oral hypofunction (OHF). MATERIALS AND METHODS In this extensive cross-sectional study, older adults were enrolled at a research hospital frailty clinic between July 2021 and July 2023. The diagnosis of OF-5 and OHF was conducted using the proposed assessment methods. The concordance rate of these criteria was determined by evaluating each patient and calculating the number of patients meeting each diagnosis's criteria. Patients who tested negative for the OF-5 and OHF criteria and those who met only one criterion were included in the OF-5 and OHF characteristic analysis. RESULTS A total of 248 patients were included in the analysis (mean age 77.6 ± 6.8 years; 36.7 % men). Among the patients, 114 (46.0 %) and 116 (46.8 %) met the OF-5 and OHF criteria, respectively. Furthermore, 78 (31.5 %) participants met both the OF-5 and OHF criteria, whereas 96 (38.7 %) did not meet either criterion. Moreover, 36 (14.5 %) and 38 (15.3 %) patients tested exclusively positive for OF-5 and OHF, respectively. The OF-5-positive and OHF-negative group showed an older age, lower Mini Nutritional Assessment Short Form score, and higher fall risk than the OF-5-negative and OHF-negative group. However, no significant differences were observed between the OF-5-negative and OHF-positive and OF-5-negative and OHF-negative groups. CONCLUSION The concordance rate of OF-5 and OHF diagnoses was 70.2 %. OF-5 showed a potential association with nutritional status and fall risk. Further longitudinal analyses are warranted to explore our study results.
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Affiliation(s)
- Shuzo Miyahara
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi 474-8511, Japan; Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi 474-8511, Japan; Nutrition Therapy Support Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Koki Kawamura
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi 474-8511, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi 474-8511, Japan
| | - Masami Onaka
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi 474-8511, Japan
| | - Shosuke Satake
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi 474-8511, Japan; Department of Frailty Research, Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi 474-8511, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi 474-8511, Japan
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Ishimura K, Sakaniwa R, Shirai K, Aida J, Takeuchi K, Kondo K, Iso H. Frequency of Going Outdoors and Risk of Poor Oral Health Among Older Japanese Adults: A Longitudinal Cohort From the Japan Gerontological Evaluation Study. J Epidemiol 2024; 34:63-69. [PMID: 36967120 PMCID: PMC10751189 DOI: 10.2188/jea.je20220221] [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: 08/08/2022] [Accepted: 01/09/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND The association between the frequency of going outdoors and the risk of poor oral health has been reported in several studies; however, the findings have been inconclusive. METHODS We conducted a 3-year longitudinal study of 19,972 Japanese adults aged ≥65 years who reported no poor oral condition at baseline in 2013. The respondents rated their frequency of going outdoors in three categories (≤1, 2-3, or ≥4 times/week), and the oral conditions reported in 2016 included tooth loss, chewing difficulty, swallowing difficulty, dry mouth, and composite outcomes. The associations between the frequency of going outdoors and the risk of poor oral health were examined as relative risk ratios (RRs) and 95% confidence intervals (CIs) using multivariable Poisson regression, while mediation analysis was performed to investigate indirect effects. RESULTS During the follow-up, 32.5% of participants developed poor oral health. In the mediation analysis, indirect effects were observed through low instrumental activities of daily living, depressive symptoms, little social network diversity, and underweight. Compared to going outdoors ≥4 times/week, the multivariable RRs of composite poor oral health conditions were 1.12 (95% CI, 1.05-1.20) for 2-3 times/week and 1.22 (95% CI, 1.07-1.39) for ≤1 time/week (P-trend < 0.001). Similar associations were observed for tooth loss, chewing difficulty, and swallowing difficulty; the corresponding RRs were 1.07 (95% CI, 0.97-1.19) and 1.36 (95% CI, 1.13-1.64) (P-trend = 0.002), 1.18 (95% CI, 1.06-1.32) and 1.30 (95% CI, 1.05-1.60) (P-trend < 0.001), and 1.15 (95% CI, 1.01-1.31) and 1.38 (95% CI, 1.08-1.77) (P-trend = 0.002), respectively. CONCLUSION The frequency of going outdoors was inversely associated with the risk of poor oral health through several modifiable risk factors in the older population.
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Affiliation(s)
- Keiko Ishimura
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ryoto Sakaniwa
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kokoro Shirai
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University Graduate School of Medical and Dental Science, Tokyo, Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hiroyasu Iso
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Healthcare Center Medicine, Tokyo, Japan
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Yoshikawa M, Nishikawa Y, Kitagawa M, Nagao A, Hiraoka A, Haruta A, Takeuchi M, Yoshida M, Tsuga K. Low tongue pressure and depression using Kihon Checklist for assessing frailty status among community-dwelling Japanese older adults: A pilot study. J Oral Rehabil 2024; 51:334-342. [PMID: 37775517 DOI: 10.1111/joor.13596] [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: 03/20/2023] [Revised: 08/04/2023] [Accepted: 09/07/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Evaluation of low tongue pressure is used to diagnose oral hypofunction. The pathophysiology of oral hypofunction is hypothesized to be associated with oral dysfunction related to ageing. Depression in older adults is a major problem and is related to handgrip strength, which is related to tongue pressure. We hypothesized that low tongue pressure could indicate depression mood in community-dwelling older adults. OBJECTIVES This study aimed to measure maximum tongue pressure and compare it to the responses to the Kihon Checklist (KCL), which is used to check mental and physical deterioration of community-dwelling older adults. METHODS A total of 49 community-dwelling independent older adults with stable dental condition (23 men, 26 women; median age, 79 years) answered the KCL, which contained questions on frailty status, cognitive function, nutritional and sarcopenia status. Oral function was measured to assess oral hypofunction. The relationship between tongue pressure differences and frailty status, cognitive function, nutritional and sarcopenia status was analysed using logistic regression analyses after adjusting for age and sex. RESULTS Nine participants (6 men and 3 women; median age, 81 years) had a tongue pressure <23.0 kPa, which was the lowest limit of the standard value of maximum tongue pressure in patients aged ≥70 years. Logistic regression analyses showed that only Question 21, which is related to a lack of fulfilment in daily life, was significantly associated with low tongue pressure (p = .027). CONCLUSION Low tongue pressure may be associated with sociopsychological factors in older adults.
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Affiliation(s)
- Mineka Yoshikawa
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa, Japan
| | - Masae Kitagawa
- Center of Clinical Oral Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Akiko Nagao
- Department of Dietary Management, Hiroshima University Hospital, Hiroshima, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Azusa Haruta
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Maho Takeuchi
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mitsuyoshi Yoshida
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University, Toyoake, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Izumi M, Fujii W, Akifusa S. Correlation between attitude towards dental care for older adults and ageism in dental students and clinical trainees: Cross-sectional study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:20-27. [PMID: 37118948 DOI: 10.1111/eje.12911] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/16/2023] [Accepted: 04/16/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Since the needs for dental care among older adults in Japan are expected to increase in the future, this study aimed to examine the influence of ageism among dental students and clinical trainees on the attitude towards the older adults in dental care. MATERIALS AND METHODS In 2022, we conducted a questionnaire survey of 9th-, 11th-semester dental students and first-year clinical trainees enrolled at Kyushu Dental University, using the Japanese version of Ageism Scale for Dental Students (ASDS-J), Japanese version of Fraboni Scale of Ageism (FSA-J). Questions on intention to provide dental care to the older adults, relationships with the older adults and living with the older adults were also surveyed. RESULTS There were 162 participants (84 males and 78 females), and the response rate was 71.7%. The participants were divided into the positive group for dental care to older adults (68 respondents) and the negative group (94 respondents). The ASDS-J score of the negative group was significantly higher than that of the positive group [49 (36-66) vs. 52 (34-88), p < .001]. The binomial logistic regression analysis revealed that the odds ratio of being negative attitude was 1.1 per one point of ASDS-J (95% confidence interval: 1.0-1.2) in the model adjusted for student grade, interaction with the older adults, gender, experience living with the older adults and FSA-J. CONCLUSION These findings suggest that ageism specific to dental students and clinical trainees (as assessed using the ASDS-J) was independently correlated with negative attitudes towards dental care for older adults.
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Affiliation(s)
- Maya Izumi
- School of Oral Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
| | - Wataru Fujii
- School of Oral Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
| | - Sumio Akifusa
- School of Oral Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
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Konishi M. Can oral diadochokinesis be used as an assessment tool of oral function in older adults requiring care in nursing home? J Oral Rehabil 2024; 51:328-333. [PMID: 37737483 DOI: 10.1111/joor.13594] [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: 11/04/2022] [Revised: 04/15/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Oral diadochokinesis (OD) test is an articulation test that analyses fine movements of the lips, cheeks and tongue. It is difficult to perform the test accurately in older people with reduced physical and cognitive functions. OBJECTIVES This study aimed to investigate the number of older adults who could not be tested for OD and to investigate their characteristics. METHODS The participants included 145 older residents of an aged care nursing home. They were divided into two groups: those who could be tested for OD and those who could not, and their characteristics were compared. The degree of requiring long-term care was classified into five levels. The degree of dementia was classified into five levels. Those having difficulty in performing daily activities alone and having degree III or higher dementia were considered to have severe dementia. RESULTS The participants included 41 men and 104 women with a median age of 89 years (range, 64-105 years). Sixty-eight participants failed the OD test (46.9%). In univariate and multivariate analyses, degree of dementia and oral care (among other characteristics in univariate analysis) showed statistically significant differences between the two groups. Cut-off values for older adults who could not perform OD test were level 4 or higher in need of care and degree III or higher in dementia. CONCLUSION This study suggests that additional assessment tools for oral function should be considered for older adults requiring a nursing care level of 4 or higher and a dementia degree of III or higher.
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Affiliation(s)
- Masaru Konishi
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, Hiroshima, Japan
- Department of Oral and Maxillofacial Surgery, Tango Furusato Hospital, Kyoto, Japan
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Ninomiya S, Fujii W, Matsumoto E, Yamaguchi K, Hiratsuka M. Association between tongue pressure and oral status and activities of daily living in stroke patients admitted to a convalescent rehabilitation unit. Clin Exp Dent Res 2024; 10:e825. [PMID: 38037529 PMCID: PMC10860403 DOI: 10.1002/cre2.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Clarifying how tongue pressure in convalescent stroke patients affects oral condition and activities of daily living (ADL) is important for developing oral rehabilitation programs and for rehabilitation care to reacquire ADL. OBJECTIVE To clarify how tongue pressure is associated with oral status, ADL, and nutritional status in stroke patients. METHODS Sixty-eight patients aged 77.9 ± 10.0 years participated. The Japanese version of the Oral Health Assessment Tool was used to evaluate oral status. Data such as the ADL index functional independence measure (FIM), nutritional intake method, serum albumin, and body mass index were extracted from medical records. To examine factors associated with tongue pressure, multiple regression analysis was performed adjusting for confounding factors. The level of statistical significance was set at p < .05. RESULTS In recovery phase stroke patients, tongue pressure was significantly lower in the total assistance group than in the partial assistance/independent group. In addition, tongue pressure was significantly lower in tube feeding patients than in oral feeding patients. FIM cognition score was an independent factor that had a significant effect on tongue pressure. CONCLUSION These findings suggest that ADL status also affects tongue pressure, thus patients' ADL including the FIM cognition subscale should also be evaluated while measuring tongue pressure.
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Affiliation(s)
- Shizuka Ninomiya
- Division of DentistryFukuoka Rehabilitation HospitalFukuokaJapan
- Graduate School of Dentistry, Department of Oral Health SciencesKyushu Dental UniversityKitakyushuJapan
| | - Wataru Fujii
- Unit of Interdisciplinary Promotion, School of Oral Health Sciences, Faculty of DentistryKyushu Dental UniversityKitakyushuJapan
| | - Erika Matsumoto
- Graduate School of Dentistry, Department of Oral Health SciencesKyushu Dental UniversityKitakyushuJapan
| | | | - Masao Hiratsuka
- Division of DentistryFukuoka Rehabilitation HospitalFukuokaJapan
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