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Ji H, Tang S, Liu X. Chewing ability and its associated factors among community-dwelling older adults in Chengdu, China: A cross-sectional study. Jpn J Nurs Sci 2024:e12603. [PMID: 38766689 DOI: 10.1111/jjns.12603] [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: 01/09/2024] [Revised: 04/04/2024] [Accepted: 04/29/2024] [Indexed: 05/22/2024]
Abstract
AIM To investigate the current status of chewing ability and analyze the risk factors among Chinese community-dwelling older adults. METHODS In this cross-sectional study, color-changeable gum and a color difference meter were used to assess chewing ability in the population. The statistical analysis employed multivariate logistic regression models to identify and quantify the factors influencing chewing ability. RESULTS A total of 373 community-dwelling adults aged 65 and older in Chengdu, in the west of China, were included in this study; 64 individuals (17.2%) exhibited signs of poor chewing ability. Female (odds ratio [OR]: 0.124, 95% CI: 0.057-0.268, p < .001), education level with college degree and above (OR: 0.114, 95% CI: 0.030-0.434, p = .001), number of teeth less than 20 (OR: 5.401, 95% CI: 2.509-11.626, p < .001), and decreased oral diadochokinesis (OR: 4.445, 95% CI: 1.775-11.132, p = .001) were significant factors in chewing ability in this study, after adjustment for potential variables. CONCLUSIONS The prevalence of decreased chewing ability among Chinese community-dwelling older adults was 17.2% and decreased chewing ability was associated with men, lower education level, less than 20 teeth and decreased oral diadochokinesis.
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Affiliation(s)
- Hongmiao Ji
- Day Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Sikai Tang
- Hemodialysis Center, Department of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xing Liu
- Department of General Administration Office, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Chen M, Wu X, Zhang J, Dong E. Prediction of total hospital expenses of patients undergoing breast cancer surgery in Shanghai, China by comparing three models. BMC Health Serv Res 2021; 21:1334. [PMID: 34903242 PMCID: PMC8667393 DOI: 10.1186/s12913-021-07334-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 11/25/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Breast cancer imposes a considerable burden on both the health care system and society, and becomes increasingly severe among women in China. To reduce the economic burden of this disease is crucial for patients undergoing the breast cancer surgery, hospital managers, and medical insurance providers. However, few studies have evidenced the prediction of the total hospital expenses (THE) for breast cancer surgery. The aim of the study is to predict THE for breast cancer surgery and identify the main influencing factors. METHODS Data were retrieved from the first page of medical records of 3699 patients undergoing breast cancer surgery in one tertiary hospital from 2017 to 2018. Multiple liner regression (MLR), artificial neural networks (ANNs), and classification and regression tree (CART) were constructed and compared. RESULTS The dataset from 3699 patients were randomly divided into training and test sets at a 70:30 ratio (2599 and 1100 records, respectively). The average total hospital expenses were 12520.54 ± 7844.88 ¥ (US$ 1929.20 ± 1208.11). MLR results revealed six factors to be significantly associated with THE: age, LOS, type of disease, having medical insurance, minimally invasive surgery, and receiving general anesthesia. After comparing three models, ANNs was the best model to predict THEs in patients undergoing breast cancer surgery, and its strong predictive performance was also validated. CONCLUSIONS To reduce the THEs, more attention should be paid to related factors of LOS, major and minimally invasive surgeries, and general anesthesia for these patient groups undergoing breast cancer surgery. This may reduce the information asymmetry between doctors and patients and provide more reliable cost, practical inpatient medical consumption standards and reimbursement standards reference for patients, hospital managers, and medical insurance providers ,respectively.
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Affiliation(s)
- Minjie Chen
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Road, Shanghai, 200127, People's Republic of China
| | - Xiaopin Wu
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Road, Shanghai, 200127, People's Republic of China
| | - Jidong Zhang
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Road, Shanghai, 200127, People's Republic of China.
| | - Enhong Dong
- School of Nursing and Health Management, Shanghai university of medicine and health sciences, No.279 Zhouzhu Road, Shanghai, 210318, China.
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Lo YTC, Wahlqvist ML, Chang YH, Lee MS. Combined Effects of Chewing Ability and Dietary Diversity on Medical Service Use and Expenditures. J Am Geriatr Soc 2017; 64:1187-94. [PMID: 27321597 DOI: 10.1111/jgs.14150] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To examine whether chewing ability affects healthcare use and expenditure and whether improving dietary quality alleviates any such effects. DESIGN Prospective cohort. SETTING The Elderly Nutrition and Health Survey in Taiwan (1999-2000), a nationwide community-based survey of people aged 65 and older. PARTICIPANTS Individuals aged 65 and older (N = 1,793; 903 men, 890 women). MEASUREMENTS Chewing ability (satisfactory or unsatisfactory) was assessed using a questionnaire, and dietary quality was assessed using a 24-hour dietary recall as a dietary diversity score. Data on annual medical use and expenditures from the interview date until December 31, 2006, were collected from National Health Insurance claims. Generalized linear models were used to assess the associations between chewing ability, dietary quality, and annual medical usage or expenditure. RESULTS After 8 years of follow-up, older adults with unsatisfactory chewing ability had considerably higher emergency, hospitalization, and total medical expenditures. Older adults with unsatisfactory chewing ability and a poor diet used fewer annual preventive care and dental services than those with satisfactory chewing ability but had longer hospital stays and higher expenditures. After adjusting for covariates, unsatisfactory chewing ability resulted in significantly longer hospital stays in participants with a poor diet (β = 2.34, 95% confidence interval = 2.02-2.71, P < .001). CONCLUSION Unsatisfactory chewing ability and a less-diverse diet together are associated with longer hospital stays and higher medical expenditures.
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Affiliation(s)
- Yuan-Ting C Lo
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Mark L Wahlqvist
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.,Monash Asia Institute, Monash University, Caulfield East, Melbourne, Victoria, Australia
| | - Yu-Hung Chang
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Monash Asia Institute, Monash University, Caulfield East, Melbourne, Victoria, Australia
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Park K, Hong GRS. Predictors of chewing ability among community-residing older adults in Korea. Geriatr Gerontol Int 2017; 17:78-84. [PMID: 28112491 DOI: 10.1111/ggi.12677] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2015] [Indexed: 11/30/2022]
Abstract
AIMS Decreased chewing ability in older adults can lead to poor nutritional and physical conditions, and eventually death. The present study examined the relationships between chewing ability and related characteristics (e.g. health promotion habits, health status and functional status), and identified predictors of chewing ability in community-residing older adults. METHODS Among the total of 11 542 participants in the 2011 National Survey on Older Adults in Korea, data from 10 543 participants were used for analysis. Chewing ability was evaluated using a self-report of chewing ability. Exercise ability was assessed by objective exercise ability and perceived exercise ability in both the upper and lower extremities. Depression and cognitive functions were measured using the Geriatric Depression Scale-Short Form and the Mini-Mental State Examination, respectively. RESULTS A total of 56.9% of participants had poor chewing abilities. After adjusting for age and sex, logistic regression analysis showed that depression (OR 1.76, 95% CI 1.60-1.92), cognitive impairment (OR 1.28, 95% CI 1.17-1.40), objective exercise ability (OR 1.24, 95% CI 1.11-1.41), regular exercise habits (OR 1.23, 95% CI 1.13-1.34), medical check-up history (OR 1.17, 95% CI 1.05-1.32), number of chronic diseases (OR 1.12, 95% CI 1.09-1.15) and perceived exercise ability in the lower extremities (OR 1.08, 95% CI 1.05-1.10) were significant predictors of chewing ability. CONCLUSION Chewing ability in older adults should be improved in consideration of mental and general health condition. Geriatr Gerontol Int 2017; 17: 78-84.
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Affiliation(s)
- Kyongok Park
- Nursing Department, Far East University, Eumseong, Korea
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Elderly Taiwanese who spend more on fruits and vegetables and less on animal-derived foods use less medical services and incur lower medical costs. Br J Nutr 2016; 115:823-33. [PMID: 26786998 DOI: 10.1017/s0007114515005140] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A higher intake of fruits and vegetables (F&V) compared with animal-derived foods is associated with lower risks of all-cause-, cancer- and CVD-related mortalities. However, the association between consumption patterns and medical costs remains unclear. The effects of various food group costs on medical service utilisation and costs were investigated. The study cohort was recruited through the Elderly Nutrition and Health Survey in Taiwan between 1999 and 2000 and followed-up for 8 years until 2006. It comprised free-living elderly participants who provided a 24-h dietary recall. Daily energy-adjusted food group costs were estimated. Annual medical service utilisation and costs for 1445 participants aged 65-79 years were calculated from the National Health Insurance claim data. Generalised linear models were used to appraise the associations between the food group costs and medical service utilisation and costs. Older adults with the highest F&V cost tertile had significantly fewer hospital days (30%) and total medical costs (19%), whereas those in the highest animal-derived group had a higher number of hospital days (28%) and costs (83%) as well as total medical costs (38%). Participants in the high F&V and low animal-derived cost groups had the shortest annual hospitalisation stays (5·78 d) and lowest costs (NT$38,600) as well as the lowest total medical costs (NT$75,800), a mean annual saving of NT$45 200/person. Older adults who spend more on F&V and less on animal-derived foods have a reduced medical-care system burden. This provides opportunities for nutritionally related healthcare system investment strategies.
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Hironaka M, Kayama Y, Misaka Y, Akifusa S. Relationship Between Self-Rated Masticatory Ability and Independent Life in Community-Dwelling Older Adults. Gerontol Geriatr Med 2015; 1:2333721415603193. [PMID: 28138466 PMCID: PMC5119806 DOI: 10.1177/2333721415603193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective: The aim of the present study was to elucidate the influence of self-rated masticatory ability on independent living in community-dwelling older adults. Method: A total of 1,377 subjects aged 65 and over who lived in Kumamoto City, Japan were participated in a survey to investigate critical factors for self-reliance in older adults. In this study, we defined independent life in older adults as self-perceived adequate health without long-term care certification. Logistic regression analysis was used to assess self-perceived masticatory ability in relation to the independent life. Results: The population with adequate self-rated masticatory ability included a significantly higher proportion of subjects with good self-perceived health without long-term care (72.7%) than the remaining subjects (27.3%). A logistic regression analysis revealed that there was significant relationship between subjective adequate mastication and living a self-reliant healthy life (p < .001). Conclusion: Our results showed that satisfactory masticatory function was positively related to a self-reliant life with subjective healthy conditions in community-dwelling older adults, which was associated with an extended active life expectancy.
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Laudisio A, Milaneschi Y, Bandinelli S, Gemma A, Ferrucci L, Incalzi RA. Chewing problems are associated with depression in the elderly: results from the InCHIANTI study. Int J Geriatr Psychiatry 2014; 29:236-44. [PMID: 23852611 PMCID: PMC6329002 DOI: 10.1002/gps.3995] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 05/23/2013] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Depression is increasingly recognized in older populations and associated with undernutrition, disability, and increased mortality. Chewing problems (CPs) share with depression these associations. The aim of the study was to evaluate the association, if any, between CPs and depression in older subjects. METHODS We assessed 927 participants aged 65 years and older, derived from the 'InCHIANTI' study. Mood was evaluated using the CES-D scale and defined depressed by a CES-D score ≥20. CPs were self-reported. Logistic regression was performed to assess the adjusted association between depression and CPs. The adjusted model was analyzed after stratifying for use of complete, partial dentures and edentulism. RESULTS Chewing problems were reported by 293/927 (31.6%) participants. Depression was present in 188/927(20.3%) participants. In multivariable logistic regression, CPs were associated with depression (OR = 1.81, 95% CI = 1.26-2.58; p = 0.001). No significant association was found among subjects who used complete dentures (OR = 1.12, 95% CI = 0.80-1.58, p = 0.515). Up to 27.8% of prevalent depression might be attributed to CPs. CONCLUSIONS Chewing problems are associated with depression in elderly population. Use of complete dentures hinder this association. Older depressed subjects should be screened for the presence of CPs; further studies are needed to evaluate the impact of early detection and correction of CPs on the development of depression.
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Affiliation(s)
- Alice Laudisio
- Area di Geriatria, Campus Bio-Medico University, Rome, Italy
| | - Yuri Milaneschi
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands
| | - Stefania Bandinelli
- Geriatric Rehabilitation Unit, Azienda Sanitaria di Firenze, Florence, Italy
| | - Antonella Gemma
- UOS Accesso e Presa in Carico Assistenziale, Azienda Sanitaria Locale Roma E, Rome, Italy
| | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland
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Hsu KJ, Lee HE, Wu YM, Lan SJ, Huang ST, Yen YY. Masticatory factors as predictors of oral health-related quality of life among elderly people in Kaohsiung City, Taiwan. Qual Life Res 2013; 23:1395-405. [DOI: 10.1007/s11136-013-0574-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2013] [Indexed: 11/29/2022]
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Taniguchi E, Asakura K, Murakami K, Masayasu S, Sasaki S. Relationship Between Diet Texture and Discharge Due to Deteriorating Health Condition in Nursing Home Residents in Japan. Asia Pac J Public Health 2013; 26:507-16. [DOI: 10.1177/1010539513483829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We conducted a multicenter 1-year prospective study to evaluate the relationship between diet texture and discharge due to deteriorating health condition. The staff dietitian at each nursing home in Japan retrieved participants’ data (N = 9528) from nursing records. Diet texture was categorized into 4 groups: “normal,” “chopped,” “pureed,” and “parenteral nutrition.” Discharge status was categorized into 2 groups: “discharge due to deteriorating health condition” and “stable health condition.” Multivariate adjusted odds ratios and 95% confidence intervals (CIs) for “discharge due to deteriorating health condition” (n = 1820) were 1 (reference) for “normal”, 1.23 (95% CI = 1.05-1.45) for “chopped,” 1.82 (95% CI = 1.48-2.24) for “pureed,” and 1.82 (95% CI = 1.41-2.35) for “parenteral nutrition.” In conclusion, even after adjusting for baseline health status, texture-modified diets and parenteral nutrition were independently and positively associated with discharge due to deteriorating health condition.
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Moriya S, Tei K, Murata A, Muramatsu M, Inoue N, Miura H. Perceived chewing ability and need for long-term care in the elderly: a 5-year follow-up study. J Oral Rehabil 2012; 39:568-75. [PMID: 22506492 DOI: 10.1111/j.1365-2842.2012.02302.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Increasing need for long-term care in older adults is expected with the ageing of Japan's population. The aim of the present study was to show the relationship between perceived chewing ability and long-term care needs for over 5 years in elderly persons. The chewing ability of 812 elderly persons living independently was evaluated at baseline using self-assessed masticatory ability, and it was classified into one of three categories: ability to chew all foods (good masticatory ability), ability to chew only slightly hard food (fair masticatory ability), and ability to only chew soft or pureed food (poor masticatory ability). Participants' care needs were then followed through Japan's long-term care insurance system for over 5 years. The log-rank test and Cox proportional hazard model were used to examine statistical differences in the frequency of care-needs certification between participants with good and fair or poor masticatory ability. Among participants aged 65-79 years, the frequency of care-needs certification was significantly higher in those with fair or poor masticatory ability than in those with good masticatory ability, and the relative hazard ratio was significantly higher in those with fair or poor masticatory ability than in those with good masticatory ability, after adjusting for age, gender, current employment status, educational background, social interaction, chronic medical conditions and dentition status. These relationships were not found among those aged 80-93 years. Impairment in perceived chewing ability may be associated with higher incidence of certification in Japan's long-term care insurance system among elderly persons aged 65-79.
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Affiliation(s)
- S Moriya
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan.
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