1
|
Liu S, Guo Y, Hu Z, Zhou F, Li S, Xu H. Association of oral status with frailty among older adults in nursing homes: a cross-sectional study. BMC Oral Health 2023; 23:368. [PMID: 37287021 PMCID: PMC10249201 DOI: 10.1186/s12903-023-03009-8] [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: 10/23/2022] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND The oral status of an individual is a vital aspect of their overall health. However, older adults in nursing homes have a higher prevalence of frailty and poor oral health, particularly in the context of global aging. The objective of this study is to explore the association between oral status and frailty among older adults residing in nursing homes. METHODS The study involved 1280 individuals aged 60 and above from nursing homes in Hunan province, China. A simple frailty questionnaire (FRAIL scale) was used to evaluate physical frailty, while the Oral Health Assessment Tool was used to assess oral status. The frequency of tooth brushing was classified as never, once a day, and twice or more a day. The traditional multinomial logistic regression model was used to analyze the association between oral status and frailty. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated while controlling for other confounding factors. RESULTS The study found that the prevalence of frailty among older adults living in nursing homes was 53.6%, while the prevalence of pre-frailty was 36.3%. After controlling for all potential confounding factors, mouth changes requiring monitoring (OR = 2.10, 95% CI = 1.34-3.31, P = 0.001) and unhealthy mouth (OR = 2.55, 95% CI = 1.61-4.06, P < 0.001) were significantly associated with increased odds of frailty among older adults in nursing homes. Similarly, both mouth changes requiring monitoring (OR = 1.91, 95% CI = 1.20-3.06, P = 0.007) and unhealthy mouth (OR = 2.24, 95% CI = 1.39-3.63, P = 0.001) were significantly associated with a higher prevalence of pre-frailty. Moreover, brushing teeth twice or more times a day was found to be significantly associated with a lower prevalence of both pre-frailty (OR = 0.55, 95% CI = 0.34-0.88, P = 0.013) and frailty (OR = 0.50, 95% CI = 0.32-0.78, P = 0.002). Conversely, never brushing teeth was significantly associated with higher odds of pre-frailty (OR = 1.82, 95% CI = 1.09-3.05, P = 0.022) and frailty (OR = 1.74, 95% CI = 1.06-2.88, P = 0.030). CONCLUSIONS Mouth changes that require monitoring and unhealthy mouth increase the likelihood of frailty among older adults in nursing homes. On the other hand, those who brush their teeth frequently have a lower prevalence of frailty. However, further research is needed to determine whether improving the oral status of older adults can change their level of frailty.
Collapse
Affiliation(s)
- Siyue Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Yicong Guo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Feixiang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Shaojie Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078 China
| |
Collapse
|
2
|
Necessity of providing dental care to medically compromised patients in Japan's super-aged society and the way forward. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:279-285. [PMID: 36159184 PMCID: PMC9489755 DOI: 10.1016/j.jdsr.2022.09.002] [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: 08/21/2021] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 12/02/2022] Open
Abstract
Devising an appropriate dental treatment plan for patients with pre-existing medical conditions is a demanding task. Dentists must consider the sometimes life threatening, interactions between ongoing medical conditions and dental treatment. Stakes are particularly high for the elderly on prescription drugs and other therapies for medical conditions while they seek dental care for advanced oral diseases. Given that Japan is an ageing society, it is crucial to create avenues for medical and dental practitioners to share patient information and collaborate.to,improve care This paper examined trends from demographic data to suggest that there is an impending further rise in the number of medically compromised elderly seeking dental treatment. For patient safety and improved public health, it is important that dental practitioners evaluate the nature and ongoing treatment of pre-existing medical conditions amongst new patients and account for their impact on dedicated and dental status. This paper supports the relevance of comprehensive clinical practice guidelines and the need to train dental practitioners to adopt a multidisciplinary approach to dental care. In order to meet the future needs of an ageing population, the Japanese Society of Dentistry for Medically Compromised Patients needs to take initiative and suggest mechanisms to exchange patient information freely and encourage multidisciplinary dental practices.
Collapse
|
3
|
Michalak P, Polak-Szlósarczyk P, Dyduch-Dudek W, Kęsek B, Zarzecka-Francica E, Styrna M, Czekaj Ł, Zarzecka J. Oral and Mucosal Complaints among Institutionalized Care Seniors in Malopolska Voivodeship-The Utility of the Mirror Sliding Test in an Assessment of Dry Mouth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113776. [PMID: 36360656 PMCID: PMC9657787 DOI: 10.3390/ijerph192113776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 05/13/2023]
Abstract
The purpose of this article was to evaluate reported oral and mucosal complaints among seniors residing in institutionalized 24-h care of the Municipal Center for Older and Dependent People (MHCOD) and the 3-month rehabilitation program of the Daily Medical Care House (DMCH). We evaluated the feasibility of using the dental mirror slidding test to assess dry mouth of seniors. Patients underwent a questionnaire, and clinical examination. The Visual Analogue Scale (VAS) was used to assess pain, Fox's questionnaire and Challacombe's scale with Clinical Oral Dryness Score to assess dryness of the mouth, dental mirror slidding test to assess buccal mucosal resistance. Dryness, mucosal burning, impaired taste, food intake are symptoms associated with seniors, and their frequency does not depend on the type of care. The incidence of mucosal burning (Mdn = 4.0, IQR = 4.75, p = 0.032) and difficulty in using dental prosthetics (Mdn = 3.0, IQR = 4.00, p = 0.010) increase with the length of stay at MHCOD. Seniors are at risk of side effects of polypharmacy, which cause dryness (p = 0.036), complaints of lack of saliva (p = 0.009) and taste disorders (p = 0.041. Seniors with higher levels of dry mouth are more likely to exhibit mucosal burning (p = 0.026) and difficulty in taking food (p = 0.037). The implementation of the dental mirror slidding test in the scope of the primary care of geriatric examination should be discussed.
Collapse
Affiliation(s)
- Piotr Michalak
- Department of Conservative Dentistry with Endodontics Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
- Correspondence: ; Tel.: +48-607-505-906
| | - Paulina Polak-Szlósarczyk
- Department of Conservative Dentistry with Endodontics Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
| | - Wioletta Dyduch-Dudek
- Department of Conservative Dentistry with Endodontics Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
| | - Barbara Kęsek
- Department of Periodontology, Clinical Oral Pathology and Prophylaxis, Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
| | - Elżbieta Zarzecka-Francica
- Department of Prosthodontics and Orthodontics, Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
| | - Maria Styrna
- Municipal Health Centre for Older and Dependent Individuals, 30663 Krakow, Poland
| | - Łukasz Czekaj
- Department of Conservative Dentistry with Endodontics Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
| | - Joanna Zarzecka
- Department of Conservative Dentistry with Endodontics Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
| |
Collapse
|
4
|
Matsumoto A, Yoshimura Y, Shimazu S, Nagano F, Bise T, Kido Y, Shiraishi A, Sunahara T. Association of polypharmacy at hospital discharge with nutritional intake, muscle strength, and activities of daily living among older patients undergoing convalescent rehabilitation after stroke. JAPANESE JOURNAL OF COMPREHENSIVE REHABILITATION SCIENCE 2022; 13:41-48. [PMID: 37859847 PMCID: PMC10545045 DOI: 10.11336/jjcrs.13.41] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 10/21/2023]
Abstract
Matsumoto A, Yoshimura Y, Shimazu S, Nagano F, Bise T, Kido Y, Shiraishi A, Sunahara T. Association of polypharmacy at hospital discharge with nutritional intake, muscle strength, and activities of daily living among older patients undergoing convalescent rehabilitation after stroke. Jpn J Compr Rehabil Sci 2022; 13: 41-48. Objective To investigate the association between polypharmacy at discharge and nutritional intake, muscle strength, and activities of daily living (ADL) among older patients undergoing convalescent rehabilitation after stroke. Methods This cross-sectional study involved hospitalized patients aged 65 or older who underwent convalescent rehabilitation after stroke. Polypharmacy was defined as the use of six or more medications. Study outcomes included energy intake, protein intake, handgrip strength (HG), and motor subscore of Functional Independence Measure (FIM-motor) at hospital discharge. Multiple linear regression analysis was used to examine the association between polypharmacy at discharge and outcomes. Results Of 361 eligible patients (mean [±SD] age, 78.3 ± 7.7 years; 49.3% male), 62.9% had polypharmacy. Multiple regression analysis revealed that polypharmacy at discharge was negatively associated with energy intake (β = -0.122, p = 0.003), protein intake (β = -0.133, p = 0.013), HG (β = -0.070, p = 0.022), and FIM-motor score (β = -0.069, p = 0.031) at discharge. Conclusion The impact of polypharmacy should be considered when designing nutritional management strategies for rehabilitation patients to maximize rehabilitation outcomes.
Collapse
Affiliation(s)
- Ayaka Matsumoto
- Department of Pharmacy, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Sayuri Shimazu
- Department of Nutritional Management, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Fumihiko Nagano
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Takahiro Bise
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Yoshifumi Kido
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Ai Shiraishi
- Department of Dental Office, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Takako Sunahara
- Department of Nursing, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| |
Collapse
|
5
|
Salmi A, Komulainen K, Nihtilä A, Tiihonen M, Nykänen I, Hartikainen S, Suominen AL. Eating problems among old home care clients. Clin Exp Dent Res 2022; 8:959-968. [PMID: 35527353 PMCID: PMC9382049 DOI: 10.1002/cre2.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 11/17/2022] Open
Abstract
Aims The purpose was to examine the prevalence and determinants of self‐reported eating problems in old home care clients, screened separately by a clinical nutritionist and a dental hygienist. Methods and Results The data came from the Nutrition, Oral Health and Medication (NutOrMed) study, the participants of which were ≥75‐year‐old home care clients living in Finland. The structured interviews were conducted at the participants' (n = 250) homes. Of the participants, 29% reported poor appetite, 20% had problems with chewing, and 14% had problems with swallowing when asked by a clinical nutritionist. Additionally, 18% reported oral health‐related eating problems when asked by a dental hygienist. Participants with continuous xerostomia (odds ratio [OR]: 3.0, 95% confidence interval [CI]: 1.0–9.0) or poor self‐reported oral health (OR: 4.3, 95% CI: 1.4–13.0) had a higher risk for problems with chewing when asked by a clinical nutritionist. Edentulous participants (OR: 3.5, 95% CI: 1.2–10.9) and participants with toothache or problems with dentures (OR: 10.3, 95% CI: 4.0–26.0) had a higher risk for oral health‐related eating problems when asked by a dental hygienist. Conclusion Eating problems are common in older adults, and interprofessional collaboration is required for their identification and alleviation.
Collapse
Affiliation(s)
- Annina Salmi
- Institute of Dentistry, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kaija Komulainen
- Institute of Dentistry, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Annamari Nihtilä
- Institute of Dentistry, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Social and Health Services, City of Espoo, Espoo, Finland
| | - Miia Tiihonen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Irma Nykänen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Sirpa Hartikainen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anna L Suominen
- Institute of Dentistry, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Surgery, University Hospital Kuopio, Kuopio, Finland
| |
Collapse
|
6
|
Kanai N, Ando M, Shimodate M, Miyazaki Y, Saito T. Influence of Hospital Formularies on Outpatient Prescribing Practices: Analysis of the Introduction of a Local Formulary: A Single-Center, 2-Year Follow-Up, Retrospective Cohort Study of a Local Formulary in Japan. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221087876. [PMID: 35373631 PMCID: PMC8984845 DOI: 10.1177/00469580221087876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Purpose The impact of a hospital formulary was evaluated to provide a guide for the
establishment of local formularies to optimize patient care and healthcare
costs. Methods A formulary was introduced by formulary pharmacists of the Toda Medical Group
for suggesting recommended medicines to physicians based on the medication
history. Patients who were hospitalized in the rehabilitation ward of the
Niiza Hospital and prescribed medicines according to the formulary
introduced between April 2017 and March 2018 were included and followed-up
for six months. Results Of the 183 patients screened, 154 patients were enrolled as the formulary’s
introduction patients (76 males/78 females, median age 78 years); 92% of
these patients received formulary-proposed prescriptions at the specified
timepoints; and 19 patients re-consulted at the Niiza Hospital after
discharge and continued the same formulary medicines. The proposed
acceptance rate by physicians was 100%. Most changes suggested introduced
generic formulations. The doses were equivalent for all pharmacological
classes with the exception of medicines that interfere with the
renin–angiotensin system, which fell from 10.7 to 7.2 mg
(P< .0001). Overall daily medication costs fell at
discharge compared to admission (38.5 vs. 94.6 yen per patient,
respectively, P< .0001). This was valid for all
pharmacological classes except for calcium channel blockers. Conclusion Hospital formulary-prescribed medications continued after discharge and
promoted significant decreases in costs associated with outpatient
prescriptions. Introducing a hospital formulary provides a basis for the
introduction of local formularies and contributes to the reduction of local
healthcare costs.
Collapse
Affiliation(s)
| | - Masazumi Ando
- Department of Pharmacy, Niiza Hospital, Saitama, Japan
| | | | | | - Toshio Saito
- Department of Pharmacy, Todachuo General Hospital, Tokyo, Japan
| |
Collapse
|
7
|
Polypharmacy Negatively Affects Oral Health in Older Adults. Am J Nurs 2021; 121:66. [PMID: 33625018 DOI: 10.1097/01.naj.0000737328.82464.ab] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
According to this study: Polypharmacy is independently associated with poor oral health in older adults.
Collapse
|