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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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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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Nakamori M, Imamura E, Maetani Y, Yoshida M, Yoshikawa M, Nagasaki T, Masuda S, Kayashita J, Mizoue T, Wakabayashi S, Maruyama H, Hosomi N. Prospective Observational Study for the Comparison of Screening Methods Including Tongue Pressure and Repetitive Saliva Swallowing With Detailed Videofluoroscopic Swallowing Study Findings in Patients With Acute Stroke. J Am Heart Assoc 2024; 13:e032852. [PMID: 38293925 PMCID: PMC11056116 DOI: 10.1161/jaha.123.032852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/20/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Simple, noninvasive, and repeatable screening methods are essential for assessing swallowing disorders. We focused on patients with acute stroke and aimed to assess the characteristics of swallowing screening tests, including the modified Mann Assessment of Swallowing Ability score, tongue pressure, and repetitive saliva swallowing test (RSST), compared with detailed videofluoroscopic swallowing study (VFSS) findings to contribute as a helpful resource for their comprehensive and complementary use. METHODS AND RESULTS We enrolled first-ever patients with acute stroke conducting simultaneous assessments, including VFSS, modified Mann Assessment of Swallowing Ability score, tongue pressure measurement, and RSST. VFSS assessed aspiration, laryngeal penetration, oral cavity residue, vallecular residue, pharyngeal residue, and swallowing reflex delay. Screening tests were compared with VFSS findings, and multiple logistic analysis determined variable importance. Cutoff values for each abnormal VFSS finding were assessed using receiver operating characteristic analyses. We evaluated 346 patients (70.5±12.6 years of age, 143 women). The modified Mann Assessment of Swallowing Ability score was significantly associated with all findings except aspiration. Tongue pressure was significantly associated with oral cavity and pharyngeal residue. The RSST was significantly associated with all findings except oral cavity residue. Receiver operating characteristic analyses revealed that the minimum cutoff value for all VFSS abnormal findings was RSST ≤2. CONCLUSIONS The modified Mann Assessment of Swallowing Ability is useful for broadly detecting swallowing disorders but may miss mild issues and aspiration. The RSST, with a score of ≤2, is valuable for indicating abnormal VFSS findings. Tongue pressure, especially in oral and pharyngeal residues, is useful. Combining these tests might enhance accuracy of the swallowing evaluation.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and TherapeuticsHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
- Department of NeurologySuiseikai Kajikawa HospitalHiroshimaJapan
| | - Eiji Imamura
- Department of NeurologySuiseikai Kajikawa HospitalHiroshimaJapan
| | - Yuta Maetani
- Department of Clinical Neuroscience and TherapeuticsHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
- Department of NeurologySuiseikai Kajikawa HospitalHiroshimaJapan
| | - Mitsuyoshi Yoshida
- Department of Dentistry and Oral‐Maxillofacial Surgery, School of MedicineFujita Health UniversityToyoakeAichiJapan
- Department of Advanced ProsthodonticsHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
| | - Mineka Yoshikawa
- Department of Advanced ProsthodonticsHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
| | - Toshikazu Nagasaki
- Department of Oral and Maxillofacial RadiologyHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
| | - Shin Masuda
- Department of Children SensoryHiroshima Prefectural HospitalHiroshimaJapan
| | - Jun Kayashita
- Department of Health Sciences, Faculty of Human Culture and SciencesPrefectural University of HiroshimaHiroshimaJapan
| | - Tatsuya Mizoue
- Department of NeurosurgerySuiseikai Kajikawa HospitalHiroshimaJapan
| | | | - Hirofumi Maruyama
- Department of Clinical Neuroscience and TherapeuticsHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
| | - Naohisa Hosomi
- Department of NeurologyChikamori HospitalKochiJapan
- Department of Disease Model, Research Institute of Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
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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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Nakamori M, Ishikawa R, Watanabe T, Toko M, Naito H, Takahashi T, Simizu Y, Yamazaki Y, Maruyama H. Swallowing sound evaluation using an electronic stethoscope and artificial intelligence analysis for patients with amyotrophic lateral sclerosis. Front Neurol 2023; 14:1212024. [PMID: 37602264 PMCID: PMC10435850 DOI: 10.3389/fneur.2023.1212024] [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: 04/25/2023] [Accepted: 07/11/2023] [Indexed: 08/22/2023] Open
Abstract
Background and purpose Non-invasive, simple, and repetitive swallowing evaluation is required to prevent aspiration pneumonia in neurological care. We investigated the usefulness of swallowing sound evaluation in patients with amyotrophic lateral sclerosis (ALS) using our new electronic stethoscope artificial intelligence (AI) analysis tool. Methods We studied patients with ALS who provided written informed consent. We used an electronic stethoscope, placed a Bluetooth-enabled electronic stethoscope on the upper end of the sternum, performed a 3-mL water swallow three times, and remotely identified the intermittent sound components of the water flow caused at that time by AI, with the maximum value as the swallowing sound index. We examined the correlation between the swallowing sound index and patient background, including swallowing-related parameters. Results We evaluated 24 patients with ALS (age 64.0 ± 11.8 years, 13 women, median duration of illness 17.5 months). The median ALS Functional Rating Scale-Revised (ALSFRS-R) score was 41 (minimum 18, maximum 47). In all cases, the mean swallowing sound index was 0.209 ± 0.088. A multivariate analysis showed that a decrease in the swallowing sound index was significantly associated with a low ALSFRS-R score, an ALSFRS-R bulbar symptom score, % vital capacity, tongue pressure, a Mann Assessment of Swallowing Ability (MASA) score, and a MASA pharyngeal phase-related score. Conclusion Swallowing sound evaluation using an electronic stethoscope AI analysis showed a correlation with existing indicators in swallowing evaluation in ALS and suggested its usefulness as a new method. This is expected to be a useful examination method in home and remote medical care.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Ruoyi Ishikawa
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tomoaki Watanabe
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroyuki Naito
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tamayo Takahashi
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yoshitaka Simizu
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yu Yamazaki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Ultrasonographic and manometric study of the tongue as biomarkers of dysphagia in patients with amyotrophic lateral sclerosis. Neurol Sci 2023; 44:931-939. [PMID: 36367593 DOI: 10.1007/s10072-022-06486-x] [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: 09/05/2022] [Accepted: 10/30/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND The possibility of having methods to assess dysphagia in amyotrophic lateral sclerosis (ALS) patients in a minimally invasive manner could facilitate follow-up and allow performing of therapeutic interventions at earlier stages of the disease. The aim of the study was to analyze the role of tongue strength and thickness in ALS patients and their correlation with dysphagia and bulbar function. METHODS A sample of outpatients with ALS was evaluated for demographic and clinical features. Tongue thickness and strength have been measured for each patient, and quantitative and qualitative data of the videofluoroscopy swallow study have been analyzed. RESULTS Of the 38 ALS patients studied, 47.4% were women, and 26.3% had bulbar onset. The median time between symptom onset and the study was 24 months (IQR 11.5-48), and 55.3% of the patients were carriers of non-invasive mechanical ventilation. Tongue strength identified patients with impaired oral and pharyngeal transit and those with bolus residue scale (BRS) > 1 or penetration-aspiration scale (PAS) ≥ 3. In contrast, tongue thickness is only associated with impaired oral transit. Finally, anterior tongue strength ≤ 34 kPa and posterior tongue strength ≤ 34.5 kPa detected ALS penetrators/aspirators (PAS ≥ 3) and patients with ALS with post-swallow residue (BRS > 1). CONCLUSIONS Our results suggest that measures that assess the functionality (strength) of the tongue are more valuable than morphological measurements (thickness) for the follow-up of patients with ALS. Alterations of the anterior and posterior lingual strength correlate with the presence of bronchoaspiration and post-swallowing residue (BRS > 1).
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Inoue M, Kimoto K, Honma Y, Tomita R, Manabe Y. Oral environment and cerebral blood flow in patients with neurodegenerative dementia: comparison of Alzheimer type dementia and dementia with Lewy bodies. Psychogeriatrics 2023; 23:23-31. [PMID: 36273804 DOI: 10.1111/psyg.12899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/22/2022] [Accepted: 10/10/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The number of patients with dementia is increasing worldwide. Modifying risk factors may significantly reduce the prevalence and cost of dementia. The number of remaining teeth, occlusal force, denture use, and periodontal disease status are associated with the risk of developing dementia. The oral environment may be a risk factor for dementia. This study aimed to investigate the association between the oral environment and cerebral blood flow in patients with mild cognitive impairment and dementia (either Alzheimer type dementia (ATD) or dementia with Lewy bodies (DLB)). We aimed to identify differences in the oral environment according to the underlying neurodegenerative disease. METHODS The participants were 25 patients with ATD and 25 patients with DLB who visited the Department of Dementia and Geriatric Medicine, Kanagawa Dental University Hospital. Patients were diagnosed with ATD and DLB by well-trained specialists certified by the Japanese Dementia Society and categorised as Level 3 or 4 by the Functional Assessment Staging of Alzheimer Disease scale. The correlation between oral environment (number of teeth, periodontal tissue, and oral function) and cerebral blood flow in each brain area calculated by single photon emission computed tomography was examined. RESULTS The DLB group showed a significant correlation between masticatory performance and cerebral blood flow in some areas, while no such correlation was observed in the ATD group. Significant correlations were found between periodontal pocket depth and bleeding on probing and cerebral blood flow in some areas in both groups, although the correlation was considerable in the ATD group. CONCLUSIONS The results of this study suggest that the association between changes in the oral environment and cerebral blood flow may differ among patients with ATD and DLB, depending on the underlying causative disease.
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Affiliation(s)
- Makoto Inoue
- Department of Fixed Prosthodontics, Kanagawa Dental University, Yokosuka, Japan
| | - Katsuhiko Kimoto
- Department of Fixed Prosthodontics, Kanagawa Dental University, Yokosuka, Japan
| | - Yuta Honma
- Department of Fixed Prosthodontics, Kanagawa Dental University, Yokosuka, Japan
| | - Rintaro Tomita
- Department of Fixed Prosthodontics, Kanagawa Dental University, Yokosuka, Japan
| | - Yuta Manabe
- Department of Dementia and Geriatric Medicine, Kanagawa Dental University, Yokosuka, Japan
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Effect of Tongue-Pressure Resistance Training in Poststroke Dysphagia Patients With Oral Motor Dysfunction: A Randomized Controlled Trial. Am J Phys Med Rehabil 2022; 101:1134-1138. [PMID: 35320813 DOI: 10.1097/phm.0000000000001998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aims of the study were to investigate the effect of tongue-pressure resistance training in poststroke dysphagia patients with oral motor dysfunction and to examine the therapeutic value of tongue-pressure resistance training in the oral and pharyngeal phases. DESIGN Patients were divided into an experimental and a control group. Both groups received 30 mins of traditional swallowing rehabilitation treatment every day for 4 wks. In addition, the experimental group received tongue-pressure resistance training for an extra 20 mins/d. Maximum tongue pressure and fiberoptic endoscopic examination of swallowing were assessed before and after treatments. RESULTS Compared with the control group, the experimental group showed significant improvement in Functional Communication Measure for swallowing, Oral Motor Function Scale, maximum tongue pressure, Murray Secretion Scale, Rosenbek Penetration-Aspiration Scale, and food residue in pyriform sinuses ( P < 0.05). There was no significant difference in food residue in epiglottic vallecula between both groups ( P > 0.05). CONCLUSIONS This study demonstrated that tongue-pressure resistance training is an effective approach to improve the overall swallowing function in patients with oral motor dysfunction. The improvement of oral motor function could facilitate the recovery of pharyngeal motor function. Tongue-pressure resistance training seems to have more clearance of residue in piriform sinus than epiglottic vallecula.
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Yamawaki K, Mori T, Itaki S, Haruta A, Takeda C, Hiraoka A, Maruyama M, Yoshikawa M, Yoshida M, Tsuga K. Relationship between Food Crushing and Oral Function in Older Adults Requiring Nursing Home Care: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063419. [PMID: 35329105 PMCID: PMC8949916 DOI: 10.3390/ijerph19063419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 01/25/2023]
Abstract
We investigated how jelly is crushed and examined the relationship between tongue pressure and tongue food crushing ability among older adults requiring nursing home care. Seventy-two participants were instructed to freely crush the test foods soft jelly (SJ) and hard jelly (HJ). We visually evaluated the crushability of the test food and identified the intraoral tissues (active sites) used to crush the test food. The active sites were consistent for all participants for both SJ and HJ, and they included the maxillary and mandibular teeth in 41 participants, teeth and residual ridges in 15 participants, maxillary and mandibular residual ridges in 10 participants, and tongue and palate in six participants. Two participants failed to crush the SJ; the active sites in both participants were the tongue and palate. No participant using the tongue and palate as active sites could crush the HJ. Furthermore, 64 participants could crush the SJ and 23 could crush the HJ using the tongue and palate. The cutoff value of the tongue pressure for crushability of the HJ was 22.0 kPa. Assessing tongue pressure and intraoral active sites involved in food crushing could help determine an appropriate diet for older adults requiring nursing home care.
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Affiliation(s)
- Kanako Yamawaki
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
- Correspondence:
| | - Takahiro Mori
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Sakiko Itaki
- PIA Nakamura Hospital, Tsuboi, 3-818-1, Saeki-ku, Hiroshima 731-5142, Japan;
| | - Azusa Haruta
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Chiho Takeda
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Aya Hiraoka
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Mariko Maruyama
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Mineka Yoshikawa
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
| | - Mitsuyoshi Yoshida
- Departments of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Dengakugakubo, 1-98, Kutsukake-cho, Toyoake 470-1192, Japan;
| | - Kazuhiro Tsuga
- Departments of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, 1-2-3, Minami-ku, Hiroshima 734-8553, Japan; (T.M.); (A.H.); (C.T.); (A.H.); (M.M.); (M.Y.); (K.T.)
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Tamura T, Tanaka Y, Watanabe Y, Sato K. Relationships between maximum tongue pressure and second formant transition in speakers with different types of dysarthria. PLoS One 2022; 17:e0264995. [PMID: 35259200 PMCID: PMC8903301 DOI: 10.1371/journal.pone.0264995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/21/2022] [Indexed: 11/18/2022] Open
Abstract
The effects of muscle weakness on speech are currently not fully known. We investigated the relationships between maximum tongue pressure and second formant transition in adults with different types of dysarthria. It focused on the slope in the second formant transition because it reflects the tongue velocity during articulation. Sixty-three Japanese speakers with dysarthria (median age, 68 years; interquartile range, 58–77 years; 44 men and 19 women) admitted to acute and convalescent hospitals were included. Thirty neurologically normal speakers aged 19–85 years (median age, 22 years; interquartile range, 21.0–23.8 years; 14 men and 16 women) were also included. The relationship between the maximum tongue pressure and speech function was evaluated using correlation analysis in the dysarthria group. Speech intelligibility, the oral diadochokinesis rate, and the second formant slope were based on the impaired speech index. More than half of the speakers had mild to moderate dysarthria. Speakers with dysarthria showed significantly lower maximum tongue pressure, speech intelligibility, oral diadochokinesis rate, and second formant slope than neurologically normal speakers. Only the second formant slope was significantly correlated with the maximum tongue pressure (r = 0.368, p = 0.003). The relationship between the second formant slope and maximum tongue pressure showed a similar correlation in the analysis of subgroups divided by sex. The oral diadochokinesis rate, which is related to the speed of articulation, is affected by voice on/off, mandibular opening/closing, and range of motion. In contrast, the second formant slope was less affected by these factors. These results suggest that the maximum isometric tongue strength is associated with tongue movement speed during articulation.
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Affiliation(s)
- Toshiaki Tamura
- Department of Speech, Language, and Hearing Sciences, Niigata University of Health and Welfare, Niigata city, Niigata, Japan
- Major in Health and Welfare, Niigata University of Health and Welfare Graduate School, Niigata city, Niigata, Japan
- * E-mail:
| | - Yasuhiro Tanaka
- Faculty of Psychological and Physical Science, Aichi Gakuin University, Nisshin city, Aichi, Japan
| | - Yoshihiro Watanabe
- Department of Rehabilitation, Uonuma Kikan Hospital, Uonuma city, Niigata, Japan
| | - Katsuro Sato
- Department of Speech, Language, and Hearing Sciences, Niigata University of Health and Welfare, Niigata city, Niigata, Japan
- Major in Health and Welfare, Niigata University of Health and Welfare Graduate School, Niigata city, Niigata, Japan
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11
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Regular Oral Health Management Improved Oral Function of Outpatients with Oral Hypofunction in Dental Hospital: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042154. [PMID: 35206345 PMCID: PMC8871729 DOI: 10.3390/ijerph19042154] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023]
Abstract
This longitudinal study aimed to clarify the impact of regular oral health management for oral hypofunction on the oral function of older dental outpatients. The 68 participants enrolled in this study were older dental outpatients (mean age 78.5 ± 8.1 years). According to the number of declined oral examinations after the first exam, participants were assigned to the oral hypofunction group (Hypo group, ≥3), receiving regular oral health management with a leaflet at the dental clinic, or the pre-oral hypofunction group (Pre-hypo group, ≤2), which served as a control. At the second oral examination, after approximately 6 months to 1 year, the Hypo group showed significant improvement in the tongue-lip motor function (Oral diadochokinesis, ODK) /pa/, /ta/, and masticatory function, while the Pre-hypo group showed significant worsening in oral hygiene and oral wetness. Temporal changes in ODK /pa/, /ta/, and the number of declined examination items were significantly different between the groups. Multiple analysis revealed that the number of improved oral examination items were associated with presence of regular oral health management after adjusting for age, sex, number of visits, measuring period, and dental treatment. Regular comprehensive oral health management for oral hypofunction improves and maintains oral function among older dental outpatients.
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Chen HH, Lin PY, Lin CK, Lin PY, Chi LY. Effects of oral exercise on tongue pressure in Taiwanese older adults in community day care centers. J Dent Sci 2022; 17:338-344. [PMID: 35028056 PMCID: PMC8740383 DOI: 10.1016/j.jds.2021.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/27/2021] [Indexed: 01/29/2023] Open
Abstract
Background/purpose Oral exercise is a training method for swallowing dysfunction in older adults. The study investigated the effect of oral exercise on tongue pressure in older adults in Taiwanese community day care centers over a 3-month period. Materials and methods Participants over age 50 who were able to communicate and participating for the duration of the 12-week period were recruited from five community day care centers. A 15-min weekly group oral exercise activity was conducted. The tongue pressures were measured and multivariable linear regression models were used to assess the effect of oral exercise intervention on the participants’ tongue pressures. Results A total of 66 older adult participants, among whom the mean age was 78.06 ± 10.74 years. Tongue pressure continued improving during the intervention period, and the mean tongue pressure at the end of the study was 20.63 ± 10.45 kPa, which was significantly higher than the baseline measurement (16.92 ± 10.62 kPa, p < 0.001). Participants exhibited significant improvement in tongue pressure regardless of their age groups. Moreover, participants with one to seven pairs of functional tooth units (FTUs) exhibited significantly more improvement in tongue pressure (16.00 kPa, 95% CI = 2.58–29.43) than those without FTUs (p = 0.021). Conclusion Oral exercise over a 3-month period significantly improved tongue pressure among the study participants regardless of their gender or age group. Oral exercise should be integrated into comprehensive health promotion programs to assist in the improvement and maintenance of oral function among older adults.
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Affiliation(s)
- Hsiu-Hsien Chen
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - Po-Yen Lin
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Kai Lin
- Department of Dentistry, National Defense Medical Center, Taipei, Taiwan
- Department of Dentistry, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan
| | - Ping-Yi Lin
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Corresponding author. Department of Dentistry, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City 220, Taiwan.
| | - Lin-Yang Chi
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- Corresponding author. Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei 112, Taiwan.
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Suzuki H, Furuya J, Hidaka R, Miyajima S, Matsubara C, Ohwada G, Asada T, Akazawa C, Sato Y, Tohara H, Minakuchi S. Patients with mild cognitive impairment diagnosed at dementia clinic display decreased maximum occlusal force: a cross-sectional study. BMC Oral Health 2021; 21:665. [PMID: 34961506 PMCID: PMC8711143 DOI: 10.1186/s12903-021-02027-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/15/2021] [Indexed: 12/14/2022] Open
Abstract
Background Previous research indicates that patients with mild cognitive impairment (MCI) are more likely to have poor oral health and impairments in oral functions, which may be due to few remaining teeth and impaired tongue and lip motor function. However, the oral health of those patients following comprehensive cognitive assessment by a dementia specialist has not been sufficiently investigated. Therefore, this study aimed to clarify the oral function of patients with MCI and the association between oral health and lower cognitive function. Methods This cross-sectional study included 96 participants (men: 35; women: 61; mean age: 73.3 ± 8.5 years) who visited a dementia clinic between December 2017 and January 2020. Participants’ cognitive function was assessed by a dementia specialist using neuropsychological and hematological tests and neuroimaging immediately after enrollment. The participants were divided into the healthy and MCI groups according to comprehensive cognitive assessment. Participants’ age, sex, body mass index, primary disease, education level, drinking habits, smoking habits, living environment, employment status, and exercise habits were evaluated. Moreover, oral outcomes, including the number of existing teeth, number of functional teeth (natural and prosthetic teeth which were occluded with antagonists), denture use, oral dryness, tongue and lip motor function, tongue pressure, occlusal force, masticatory ability, and swallowing ability were recorded. The Mann–Whitney U test, χ2, and Fisher’s exact tests were used for between-group comparisons. Furthermore, logistic regression analysis using MCI diagnosis as the target variable was performed. Results A comprehensive evaluation of the cognitive function of the study participants by the dementia specialist revealed that 48 participants (mean age: 69.8 ± 8.8 years) were healthy and 48 (mean age: 76.9 ± 6.7 years) had MCI. MCI participants were significantly older (p < 0.001) and had significantly fewer existing teeth (p = 0.031) and lower maximum occlusal force (p = 0.019) than healthy participants. Age (odds ratio: 1.126, p = 0.002) and maximum occlusal force (odds ratio: 0.978, p = 0.048) were significantly associated with lower cognitive function. Conclusions Patients with MCI had poorer oral health than healthy individuals. Decreased maximum occlusal force was independently associated with lower cognitive function, even when adjusted for age and sex.
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Affiliation(s)
- Hiroyuki Suzuki
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Junichi Furuya
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo, 145-8515, Japan. .,Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Rena Hidaka
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Saki Miyajima
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Chiaki Matsubara
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Gaku Ohwada
- Ohwada Dental Office, 1-2-45 Honcho, Kuki City, Saitama, 346-0005, Japan
| | - Takashi Asada
- Memory Clinic Ochanomizu, 1-5-34 Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan
| | - Chihiro Akazawa
- Intractable Disease Research Centre, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yuji Sato
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo, 145-8515, Japan
| | - Haruka Tohara
- Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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Nishi T, Ohta M, Takano T, Ogami K, Ueda T, Sakurai K. Oral function is associated with the body and muscle mass indices of middle-aged dental patients. Clin Exp Dent Res 2021; 8:217-224. [PMID: 34791824 PMCID: PMC8874037 DOI: 10.1002/cre2.514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 08/04/2021] [Accepted: 10/02/2021] [Indexed: 01/10/2023] Open
Abstract
Objectives Undernutrition is associated with frailty, one of the common reasons for seeking long‐term care. In older adults, nutritional status is known to be associated with oral function; however, it is not yet known if there is a similar association in middle‐aged adults. The present study determined the association between nutritional status and oral function in middle‐aged adults. Material and methods This cross‐sectional study was conducted in 117 outpatients aged 40–64 years who underwent dental check‐up at a private dental clinic. Factors associated with oral function, including oral moisture, number of teeth present, oral diadochokinesis, tongue pressure, lip‐seal strength, and masticatory performance, were evaluated. Body mass index (BMI), fat‐free mass index (FFMI), and skeletal muscle mass index (SMI) were analyzed as nutritional statuses. Pearson's correlation analysis was conducted to determine the correlation between nutritional statuses and other variables. Multiple linear regression analysis was performed, with adjustment for age and sex, using BMI, FFMI, or SMI as response variables and oral moisture, maximum tongue pressure, lip‐seal strength, oral diadochokinetic rate, and masticatory performance as explanatory variables. Results All nutritional statuses showed significant correlation with maximum tongue pressure and lip‐seal strength. Multiple linear regression analysis revealed that BMI was associated with maximum tongue pressure and lip‐seal strength, whereas FFMI and SMI showed significant association with sex, maximum tongue pressure, and lip‐seal strength. Conclusions In middle‐aged outpatients at a regional dental clinic, lip‐seal strength and tongue pressure were positively associated with BMI, FFMI, and SMI.
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Affiliation(s)
- Tomotaka Nishi
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Midori Ohta
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Tomofumi Takano
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
| | | | - Takayuki Ueda
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Kaoru Sakurai
- Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
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Characteristics and Prognostic Factors of Swallowing Dysfunction in Patients with Lateral Medullary Infarction. J Stroke Cerebrovasc Dis 2021; 30:106122. [PMID: 34583216 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/30/2021] [Accepted: 09/13/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Lateral medullary infarction mainly impairs the pharyngeal phase of swallowing. We aimed to investigate the utility of the assessment tools of swallowing function in patients with lateral medullary infarction and to determine the factors that could predict the outcomes of swallowing function. MATERIALS AND METHODS 15 patients with lateral medullary infarction who were admitted to Suiseikai Kajikawa Hospital between August 1, 2016, and March 31, 2020 (age 62.7 ± 14.8 years, 5 women) were enrolled in this prospective study. The diagnosis was made using brain magnetic resonance imaging. We analyzed the factors associated with severe swallowing dysfunction, which was defined as the necessity for tube feeding on the 90th day from admission, with multiple logistic regression analysis. RESULTS Multivariate analyses identified the repetitive saliva swallowing test, modified water swallowing test, and vertical spread of stroke lesions as independent significant factors affecting severe swallowing dysfunction (p = 0.002, 0.016, and 0.011, respectively). The sub-scores of the pharyngeal phase of the Mann Assessment of Swallowing Ability were also significantly associated with severe swallowing dysfunction (p < 0.001). However, tongue pressure, severe passage pattern abnormality on videofluoroscopic examination, and vertebral artery dissection were not significantly associated with swallowing dysfunction. CONCLUSIONS Since lateral medullary infarction presents with swallowing dysfunction mainly in the pharyngeal phase, tools that can be used to evaluate the pharyngeal phase of swallowing, such as repetitive saliva swallowing test and modified water swallowing test, are moreuseful than tongue pressure measurement.
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Relationship between Oral Hypofunction and Sarcopenia in Community-Dwelling Older Adults: The Otassha Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126666. [PMID: 34205795 PMCID: PMC8296410 DOI: 10.3390/ijerph18126666] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 12/31/2022]
Abstract
Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.
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Changes in Physical and Oral Function after a Long-Term Care Prevention Program in Community-Dwelling Japanese Older Adults: A 12-Month Follow-Up Study. Healthcare (Basel) 2021; 9:healthcare9060719. [PMID: 34208151 PMCID: PMC8230795 DOI: 10.3390/healthcare9060719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/03/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background: The aim of this prospective cohort study was to clarify changes in physical and oral function in older adults after completing a 3-month health program combining physical and oral exercise, oral health instruction, and nutritional guidance. Methods: Subjects were 34 women aged at least 70 years (mean age 79.2 years) in Bungotakada City, Oita Prefecture, Japan. Physical and oral function was investigated on the first day (baseline), at the end of the program, and 6 and 12 months after completing the health program. Physical function was measured using handgrip strength test, timed up and go (TUG) test and one-leg standing time test. Oral diadochokinesis test and repetitive saliva swallowing test (RSST) were employed to assess oral function. Results: TUG scores were significantly lower at 6 and 12 months than at baseline in participants aged ≥70 and <80 years. The repetition rate of the monosyllables /pa/, /ta/, and /ka/ was improved at the end of program in participants aged ≥70 and <80 years and increased to more than 6 times/second at 12 months. Conclusions: Our 3-month health program maintained improvements in oral and physical function in older women 1 year after completing the program.
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Nakamori M, Ishikawa K, Imamura E, Yamamoto H, Kimura K, Ayukawa T, Mizoue T, Wakabayashi S. Relationship between tongue pressure and dysphagia diet in patients with acute stroke. PLoS One 2021; 16:e0252837. [PMID: 34086830 PMCID: PMC8177488 DOI: 10.1371/journal.pone.0252837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/23/2021] [Indexed: 11/25/2022] Open
Abstract
A dysphagia diet is important for patients with stroke to help manage their nutritional state and prevent aspiration pneumonia. Tongue pressure measurement is a simple, non-invasive, and objective method for diagnosing dysphagia. We hypothesized that tongue pressure may be useful in making a choice of diet for patients with acute stroke. Using balloon-type equipment, tongue pressure was measured in 80 patients with acute stroke. On admission, a multidisciplinary swallowing team including doctors, nurses, speech therapists, and management dietitians evaluated and decided on the possibility of oral intake and diet form; the tongue pressure was unknown to the team. Diet form was defined and classified as dysphagia diet Codes 0 to 4 and normal form (Code 5 in this study) according to the 2013 Japanese Dysphagia Diet Criteria. In multivariate analysis, only tongue pressure was significantly associated with the dysphagia diet form (p<0.001). Receiver operating characteristic analyses revealed that the optimal cutoff tongue pressure for predicting diet Codes 1, 2, 3, 4, and 5 was 3.6 (p<0.001, area under the curve [AUC] = 0.997), 9.6 (p<0.001, AUC = 0.973), 12.8 (p<0.001, AUC = 0.963), 16.5 (p<0.001, AUC = 0.979), and 17.3 kPa (p<0.001, AUC = 0.982), respectively. Tongue pressure is one of the sensitive indicators for choosing dysphagia diet forms in patients with acute stroke. A combination of simple modalities will increase the accuracy of the swallowing assessment and choice of the diet form.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Kenichi Ishikawa
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Eiji Imamura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Haruna Yamamoto
- Department of Nursing, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Keiko Kimura
- Department of Nursing, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Tomoko Ayukawa
- Department of Rehabilitation, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Tatsuya Mizoue
- Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan
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Kugimiya Y, Oki T, Ohta M, Ryu M, Kobayashi K, Sakurai K, Ueda T. Distribution of lip-seal strength and its relation to oral motor functions. Clin Exp Dent Res 2021; 7:1122-1130. [PMID: 33963687 PMCID: PMC8638310 DOI: 10.1002/cre2.440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives Lip‐seal strength, which represents the muscle strength of the lips, appears to chiefly contribute to mastication and pronunciation. However, the functional characteristics of lip‐seal strength in adults are still undefined. The present study aimed to understand not only the distribution of lip‐seal strength in adult men and women but also the effect of age on this strength and identify oral motor functions correlated with lip‐seal strength. Materials and methods The subjects included 339 participants (men: 170, age 39.2 ± 18.2 years; women: 169, age 43.1 ± 19.7 years). Oral motor function was evaluated for lip‐seal strength, oral diadochokinesis (ODK), tongue pressure, occlusal force, and masticatory performance. Statistical analyses included the Shapiro–Wilk, Mann–Whitney U, and Jonckheere–Terpstra tests, in addition to the Spearman's correlation analysis and curvilinear regression analysis. Results Lip‐seal strength did not have a normal distribution (p < 0.001). The mean ± standard deviation and median (first quartile, third quartile) of lip‐seal strength were 11.2 ± 3.4 and 10.9 (8.7, 13.2)N for the whole sample, 12.3 ± 3.4 and 11.9 (9.4, 14.4)N for men, and 10.2 ± 3.0 and 9.9 (8.0, 12.0)N for women. A significant difference was observed in lip‐seal strength between men and women (p < 0.001). Oral motor functions showed a marked correlation with lip‐seal strength, including tongue pressure, occlusal force, and masticatory performance and ODK (/pa/ and /ta/), tongue pressure, and masticatory ability in men and women, respectively. In women, lip‐seal strength declined with increase in age. Conclusions Lip‐seal strength was non‐normally distributed in both men and women, and lip‐seal strength was affected by age only in women. Lip‐seal strength and multiple oral motor functions were significantly correlated. Because the indicators of perioral muscle strength and performance were correlated with lip‐seal strength, lip‐seal strength may also partially reflect the condition of the perioral muscles.
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Affiliation(s)
- Yoshihiro Kugimiya
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Takeshi Oki
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Midori Ohta
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Masahiro Ryu
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Kenichiro Kobayashi
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Kaoru Sakurai
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
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Hirata A, Ishizaka M, Sawaya Y, Shiba T, Urano T. [Relationship between the swallowing function, nutritional status, and sarcopenia in elderly outpatients]. Nihon Ronen Igakkai Zasshi 2021; 58:134-142. [PMID: 33627550 DOI: 10.3143/geriatrics.58.134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE It is important to prevent sarcopenia in community-dwelling elderly adults. Thus, we investigated the relationship between the swallowing function, nutritional status, and physical function in elderly outpatients. METHODS A total of 90 elderly outpatients (77.2±8.3 years) participated in the study. The investigation items included the Seirei dysphagia screening questionnaire, 20 masticable foods questionnaire, tongue pressure, grip strength, the skeletal muscle mass index (SMI), the questionnaire for sarcopenia screening (SARC-F), and the Mini Nutritional Assessment-Short Form (MNA-SF). The odds ratio for the swallowing function and six items was determined by a logistic regression analysis. RESULTS About 83.3% of the participants were at risk of dysphagia. The questions that detected the symptom in ≥30% of the participants were, "Do you cough during a meal?", "Have you become slower at eating?", and "Has it become more difficult to eat hard food?". The 20 masticable foods questionnaire, SARC-F, and MNA-SF were correlated with the Seirei dysphagia screening questionnaire. The results of the logistic regression analysis indicated that SARC-F was a significant predictor for a loss of the swallowing function. CONCLUSION Because elderly outpatients have a decreased oral function, including chewing, they are at an increased risk of dysphagia. This study suggested that the swallowing function in elderly outpatients is related to the chewing ability, nutritional status, and sarcopenia. The swallowing function can thus be used to detect sarcopenia in elderly outpatients at an early stage and is important for preventing dysphagia.
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Affiliation(s)
- Aya Hirata
- Department of Speech and Hearing Sciences, School of Health Science, International University of Health and Welfare
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for Elderly "Maronie-en"
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for Elderly "Maronie-en"
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for Elderly "Maronie-en".,Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare
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Hoshino D, Hirano H, Edahiro A, Motokawa K, Shirobe M, Watanabe Y, Motohashi Y, Ohara Y, Iwasaki M, Maruoka Y, Yokoyama Y, Narita M, Taniguchi Y, Shinkai S, Kitamura A. Association between Oral Frailty and Dietary Variety among Community-Dwelling Older Persons: A Cross-Sectional Study. J Nutr Health Aging 2021; 25:361-368. [PMID: 33575729 DOI: 10.1007/s12603-020-1538-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine the association between the severity of oral frailty (OF), which is one of the comprehensive oral functions evaluated, and dietary variety in community-dwelling older persons. DESIGN Cross-sectional study. SETTING Community-based. PARTICIPANTS A total of 769 community-dwelling older persons aged 65 and over. INTERVENTIONS We examined basic demographic information, functional status, cognitive status, depressive symptoms, medical history, and oral functions of the participants. MEASUREMENTS OF was defined by 1-2 and 3 or more of 6 items of oral function evaluation in the pre-oral frailty and oral frailty groups, respectively. Dietary variety was assessed using the dietary variety score (DVS). The participants were categorized into 3 groups for evaluation: those with a low score (0-2), medium score (3-5), and high score (≥6). Ordinal logistic regression analysis was performed to examine the association between OF and DVS. RESULTS The rate of OF in the participants was 21.6%, and its severity was significantly associated with DVS after adjusting for potential confounders (Pre-OF; adjusted odds ratio [OR] = 1.687, 95% confidence interval [CI] = 1.219-2.335, OF; adjusted OR = 2.857, 95% CI = 1.489-5.484). CONCLUSION The severity of OF was significantly associated with DVS in community-dwelling older persons. This suggests that DVS may be useful in understanding the effects of OF on the nutritional status. Further longitudinal studies are needed to elucidate the association between OF and DVS.
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Affiliation(s)
- D Hoshino
- Daichi Hoshino, Department of Special Needs Dentistry, Division of Community Based Comprehensive Dentistry, School of Dentistry, Showa University, Tokyo 145-8515, Japan, Phone: +81 337 87 1151, Fax: +81 337 85 6403,
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Miyoshi S, Saito A, Shigeishi H, Ohta K, Sugiyama M. Relationship between oral and physical function and length of participation in long-term care prevention programs in community-dwelling older Japanese women. Eur Geriatr Med 2020; 12:387-395. [PMID: 33145741 DOI: 10.1007/s41999-020-00424-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/16/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The present study aimed to clarify the relationship between community-dwelling older women's participation period in community-based exercise programs and their oral and physical functioning. METHODS From May to September 2019, we recruited 205 older women (mean age: 77.6 ± 5.5 years) who had joined weekly long-term care prevention programs such as community-based exercise programs that included oral and physical exercises, in Hiroshima Prefecture, Japan. Physical function was evaluated using a handgrip strength test, a Timed Up & Go test, a one-leg standing test, and a 30-s chair stand test. Tongue pressure, oral diadochokinesis, and Dysphagia Risk Assessment for the Community-dwelling Elderly were measured to evaluate oral functioning. After adjusting for clinical factors (i.e., age, BMI, hypertension, diabetes, stroke, heart disease, joint disease, osteoporosis, remaining teeth, denture use, oral wetness, history of dental examinations in the last year, use of interdental brush and/or dental floss), we compared the oral and physical function parameters of participants from varying program engagement periods using propensity score matching. RESULTS A significant increase in mean handgrip strength was found in people who had been participating for ≥ 5 years compared with those who had been participating for < 5 years (p = 0.01). Furthermore, repetition of the monosyllable/ka/was significantly greater for people in the ≥ 5 years group compared with those in the < 5 years group (p = 0.03). CONCLUSION Long-term participation in an exercise program is positively associated with handgrip strength and tongue motor function in independent older women.
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Affiliation(s)
- Sanae Miyoshi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.,Takehara-Toyota Dental Hygienists' Association, Hiroshima, Japan
| | - Ayumi Saito
- Oral Health Sciences Major, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Kouji Ohta
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
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23
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Does Masticatory Ability Contribute to Nutritional Status in Older Individuals? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207373. [PMID: 33050275 PMCID: PMC7600781 DOI: 10.3390/ijerph17207373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/17/2020] [Accepted: 09/24/2020] [Indexed: 12/11/2022]
Abstract
Mastication plays a primary role in the process of eating. Hence, compromised masticatory ability may affect the nutrition and quality of life, which are particularly important concerns among older individuals. It remains unclear how is the masticatory ability assessed regarding the nutritional status. We examined the effect of various oral factors on three masticatory ability tests conducted among older individuals. A total of 100 older individuals were enrolled in this study. Body mass index (BMI) as an indicator of nutritional status; and age, sex, and the number of occlusal and molar occlusal supports as clinical attributes were recorded. Three masticatory ability tests (masticatory efficiency, masticatory score, and satisfaction with mastication) were conducted, and tongue pressure, cheek pressure, and occlusal force were assessed as oral functions. A significant but weak correlation was found between masticatory efficiency and the masticatory score, but not between masticatory efficiency and satisfaction score. Objective masticatory efficiency was strongly associated with objective oral factors, whereas subjective assessments of masticatory ability (masticatory score and satisfaction score) were not. Furthermore, BMI was significantly associated with subjective assessments of masticatory ability but not with objective masticatory efficiency. Both subjective and objective assessments of masticatory ability, along with considerations of nutritional formulations, are required for the maintenance and improvement of nutritional status in older individuals.
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24
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Matsubara C, Shirobe M, Furuya J, Watanabe Y, Motokawa K, Edahiro A, Ohara Y, Awata S, Kim H, Fujiwara Y, Obuchi S, Hirano H, Minakuchi S. Effect of oral health intervention on cognitive decline in community-dwelling older adults: A randomized controlled trial. Arch Gerontol Geriatr 2020; 92:104267. [PMID: 33035763 DOI: 10.1016/j.archger.2020.104267] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/16/2020] [Accepted: 09/22/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE The incidence of dementia is rapidly increasing worldwide, especially in developed countries. Little is known regarding the effectiveness of dental intervention to prevent dementia or a decline in cognitive functions among community-dwelling older adults, but a few studies have reported a correlation between the lack of regular dental checkups and dementia. For that reason, this study aimed to investigate the effects of oral health intervention on cognitive functions in community-dwelling subjects with a mild cognitive decline via a randomized controlled trial. PATIENTS AND METHODS Fifty-five community-dwelling older adults with a Mini-Mental State Examination score of ≥21 to ≤26 who had not visited a dental clinic in the previous year were randomized to an intervention group (n = 28) or a control group (n = 29). The intervention group received monthly oral health intervention by dental hygienists for 8 months while the control group did not. Data on demographics, cognitive function and oral parameters were collected before and after the intervention. RESULTS Twenty-five subjects in the intervention group (mean age 77.0 years) and 25 in the control group (mean age 72.8 years) completed the study. Significant improvements were observed in the Trail Making Test (TMT)-A, TMT-B, bleeding on probing rate, oral diadochokinesis, tongue pressure and chewing ability in the intervention group (P < 0.05). There were also significant interactions between the TMT-A and TMT-B scores, oral diadochokinesis, tongue pressure and chewing ability (P < 0.05). CONCLUSION Oral health intervention by dental hygienists may be effective for improving the oral health and executive function of cognitive function assessed via TMT.
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Affiliation(s)
- Chiaki Matsubara
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
| | - Maki Shirobe
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| | - Junichi Furuya
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan.
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan; Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Nishi-7, Kita-13, Kita-ku, Sapporo, 060-8586, Japan.
| | - Keiko Motokawa
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| | - Ayako Edahiro
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| | - Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| | - Shuichi Awata
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| | - Hunkyung Kim
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
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25
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Association between stroke lesions and videofluoroscopic findings in acute stroke patients. J Neurol 2020; 268:1025-1035. [PMID: 32979098 DOI: 10.1007/s00415-020-10244-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/20/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND PURPOSE We aimed to assess stroke lesions, which play a key role in determining swallowing dysfunction, and findings of videofluoroscopy (VF), which provides the most accurate instrumental assessment for evaluating swallowing function, in patients with acute stroke. METHODS We enrolled 342 patients with first-time acute stroke (age 70.4 ± 12.6 years, 142 female). Patients with dementia and altered mental status due to severe stroke were excluded. All patients underwent cranial magnetic resonance imaging to identify the location of stroke lesion, VF, and tongue pressure measurement. RESULTS Aspiration was detected in 45 (13.2%) patients. Multivariate analysis identified parietal lobe lesion and the National Institutes of Health Stroke Scale (NIHSS) score as independent significant factors for aspiration (odds ratio 6.33, 95% confidence interval [CI] 2.25-17.84, p < 0.001; odds ratio 1.12, 95% CI 1.03-1.20, p = 0.004, respectively). Swallowing reflex delay was detected in 58 (17.0%) patients. Multivariate analysis identified habitual drinking, basal ganglia lesion, and the NIHSS score as independent significant factors for swallowing reflex delay (odds ratio 0.51, 95% CI 0.26-0.99, p = 0.047; odds ratio 1.91, 95% CI 1.09-3.67, p = 0.041; odds ratio 1.12, 95% CI 1.05-1.20, p < 0.001, respectively). Additionally, oral cavity and pharyngeal residues were independently associated with tongue pressure. CONCLUSION Parietal lobe lesions are associated with aspiration and basal ganglia lesions with swallowing reflex delay.
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Nakamori M, Imamura E, Fukuta M, Tachiyama K, Kamimura T, Hayashi Y, Matsushima H, Ogawa K, Nishino M, Hirata A, Mizoue T, Wakabayashi S. Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly. PLoS One 2020; 15:e0230224. [PMID: 32764766 PMCID: PMC7413413 DOI: 10.1371/journal.pone.0230224] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 07/11/2020] [Indexed: 11/18/2022] Open
Abstract
The term "oral frailty" reflects the fact that oral health is associated with physical frailty and mortality. The gold standard methods for evaluating the swallowing function have several problems, including the need for specialized equipment, the risk of radiation exposure and aspiration, and general physicians not possessing the requisite training to perform the examination. Hence, several simple and non-invasive techniques have been developed for evaluating swallowing function, such as those for measuring tongue pressure and tongue thickness. The aim of this study was to investigate the relationship between tongue thickness ultrasonography and tongue pressure in the Japanese elderly. We evaluated 254 elderly patients, who underwent tongue ultrasonography and tongue pressure measurement. To determine tongue thickness, we measured the vertical distance from the surface of the mylohyoid muscle to the tongue dorsum using ultrasonography. The results of the analyses revealed that tongue thickness was linearly associated with tongue pressure in both sexes. In male participants, dyslipidemia, lower leg circumference, and tongue pressure were independently and significantly associated with tongue thickness. In female participants, body mass index and tongue pressure were independently and significantly associated with tongue thickness. The optimal cutoff for tongue thickness to predict the tongue pressure of < 20 kPa was 41.3 mm in males, and 39.3 mm in females. In the Japanese elderly, tongue thickness using ultrasonography is associated with tongue pressure. Tongue thickness and tongue pressure, which are sensitive markers for oral frailty, decrease with age. We conclude that tongue ultrasonography provides a less invasive technique for determining tongue thickness and predicts oral frailty for elderly patients.
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Affiliation(s)
- Masahiro Nakamori
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- * E-mail:
| | - Eiji Imamura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Masako Fukuta
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Keisuke Tachiyama
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Teppei Kamimura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yuki Hayashi
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hayato Matsushima
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Kanami Ogawa
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Masami Nishino
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Akiko Hirata
- Department of Clinical Laboratory, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Tatsuya Mizoue
- Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan
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Sunada Y, Magara J, Tsujimura T, Ono K, Inoue M. Endurance measurement of hyoid muscle activity and hyoid-laryngeal position during tongue lift movement. J Oral Rehabil 2020; 47:967-976. [PMID: 32350874 DOI: 10.1111/joor.12988] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/11/2020] [Accepted: 04/16/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Tongue lift movement (TLM) is used as a therapy to improve tongue pressure against the hard palate for dysphagic patients. OBJECTIVE The present study aimed to characterize the time-dependent endurance changes in hyoid muscle activity and hyoid-laryngeal displacement during TLM in different ways. METHODS Sixteen young healthy volunteers were instructed to perform TLM at maximum effort (100%) against the anterior and posterior parts of the hard palate using a balloon-type tongue pressure instrument, followed by a 10-second recording during anterior 80% TLM, anterior 100% TLM, posterior 80% TLM and posterior 100% TLM with visual feedback. Electromyography (EMG) of suprahyoid (S-Hyo) and infrahyoid (I-Hyo) muscles and videofluorography were simultaneously recorded. To evaluate temporal changes, the recording period was divided into three substages: early, middle and late. Tongue pressure, integrated EMG (iEMG), power frequency of EMG burst and hyoid-laryngeal position were compared among the conditions (80% vs 100%, anterior vs posterior and early vs middle vs late). RESULTS Tongue pressure was stably maintained for 10 seconds in all conditions. S-Hyo iEMG and I-Hyo iEMG were significantly greater at 100% than at 80%, while no significant difference was observed between positions. S-Hyo iEMG and I-Hyo iEMG significantly increased at the late stage, while power frequency of EMG burst gradually decreased. Significant temporal changes in laryngeal elevation were observed only in posterior 100% TLM. CONCLUSION The current results suggested that isometric posterior TLM may be more useful compared with anterior TLM in clinical situations for dysphagic patients to elevate the hyolaryngeal complex.
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Affiliation(s)
- Yukako Sunada
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jin Magara
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takanori Tsujimura
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuhiro Ono
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Makoto Inoue
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Miyoshi S, Saito A, Shigeishi H, Sugiyama M. Association of physical performance with oral function in older women participating in community-based health exercise programs. Clin Exp Dent Res 2020; 6:311-317. [PMID: 32558316 PMCID: PMC7301392 DOI: 10.1002/cre2.277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/06/2019] [Accepted: 12/10/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study aimed to clarify the relationship between physical performance and oral function in older women participating in community-based physical and oral exercise programs. MATERIAL AND METHODS We included 163 older women (mean age: 77.4 ± 8.6 years) who participated in weekly health programs in Takehara City, Hiroshima Prefecture, Japan, from August to December 2018. Physical fitness was assessed using a handgrip strength test, a timed up and go test, a one-leg standing time with eyes open test, and a 30-s chair stand test (CS-30). Tongue pressure, oral diadochokinesis, and dysphagia risk assessment for the community-dwelling elderly were used to assess oral function. RESULTS Participants were divided into women aged 65-74 years (younger group) and those aged ≥75 years (older group). There was no significant difference in oral function measures between the groups. A significant correlation was found between CS-30 and oral diadochokinesis for /pa/, /ta/, and /ka/ (Spearman's rank correlation; /pa/: r = .234, p = .009; /ta/: r = .299, p = .001; and /ka/: r = .283, p = .002) in the older group. Multivariable analysis revealed a significant positive relationship between CS-30 and /ta/ repetition in the older group (p = .016). CONCLUSIONS Oral function (i.e., tongue motor function) may be associated with physical performance (i.e., lower leg muscle strength) in women aged ≥75 years. Further study is necessary to clarify sex differences in oral function deterioration.
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Affiliation(s)
- Sanae Miyoshi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
- Takehara‐Toyota Dental Hygienists' AssociationHiroshimaJapan
| | - Ayumi Saito
- Oral Health Sciences, Graduate School of Biomedical & Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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Hironaka S, Kugimiya Y, Watanabe Y, Motokawa K, Hirano H, Kawai H, Kera T, Kojima M, Fujiwara Y, Ihara K, Kim H, Obuchi S, Kakinoki Y. Association between oral, social, and physical frailty in community-dwelling older adults. Arch Gerontol Geriatr 2020; 89:104105. [PMID: 32480111 DOI: 10.1016/j.archger.2020.104105] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 05/06/2020] [Accepted: 05/09/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Oral frailty (OF) has been shown to be a predictor of disability. Therefore, it is important to be able to identify factors associated with OF in order to prevent long-term dependence. The purpose of this study was to clarify the relationships between OF, social frailty (SF), and physical frailty (PF) in community-dwelling older adults, with the overarching aim of informing the future development of effective measures to prevent frailty. METHODS Oral, physical, and social function, nutritional and psychological status, and medical history were examined in 682 community-dwelling individuals (267 men, 415 women) aged ≥ 65 years. Ordinal logistic regression analysis with SF and PF as independent variables was performed with pass analysis to determine the relationship between the different types of frailty. RESULTS Logistic regression analysis revealed significant associations between OF and decline in social function, physical function, and nutritional status, and an increase in the number of medications used. Path analysis showed that SF was directly related to OF and that OF and SF were directly related to PF. CONCLUSIONS These findings suggest that a decline in social function may directly influence a decline in oral and physical function. The results of this study provide initial evidence, that may guide the future development of measures that aim to prevent and manage OF.
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Affiliation(s)
- Sanae Hironaka
- Department of Special Needs and Geriatric Dentistry, Kyushu Dental University, Kitakyushu, Japan; Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yoshihiro Kugimiya
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Yutaka Watanabe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan; Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan.
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan; Department of Oral Surgery and Dentistry, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takeshi Kera
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan; Department of Physical Therapy, Takasaki University of Health and Welfare, Gunma, Japan
| | - Motonaga Kojima
- Department of Physical Therapy, University of Tokyo Health Sciences, Tokyo, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yasuaki Kakinoki
- Department of Special Needs and Geriatric Dentistry, Kyushu Dental University, Kitakyushu, Japan
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Sawaya Y, Ishizaka M, Kubo A, Shiba T, Sato T, Onoda K, Maruyama H, Urano T. Absolute reliability of tongue pressure measurement in young healthy adults and elderly patients with certification of needing long-term care or support. Geriatr Gerontol Int 2020; 20:488-493. [PMID: 32176436 DOI: 10.1111/ggi.13902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/26/2020] [Accepted: 02/19/2020] [Indexed: 11/29/2022]
Abstract
AIM We aimed to determine systematic bias and the range of random error in tongue pressure measurements among young healthy adults and elderly patients with certification of requiring long-term care or support, considering sex, and to establish a measurement method. METHODS Subjects were 226 adults (88 young healthy adults and 138 elderly patients with certification of requiring long-term care or support). Tongue pressure was measured thrice. Bland-Altman analysis was performed for the first and second trials, and second and third trials. RESULTS Fixed bias was revealed for the first and second trials among young healthy adults. Systematic bias was not found for the second and third trials. Fixed bias was revealed for the first and second trials among elderly patients, with a proportional bias with a negative slope for the second and third trials. For young healthy adults, the minimal detectable change was 6.0 and 5.4 kPa in males and females, respectively. For elderly patients, the limit of agreement ranged from -5.9 to 8.6 and from -5.4 to 8.8 kPa in males and females, respectively. CONCLUSIONS There was a difference in systematic bias in tongue pressure measurement between young healthy adults and elderly patients with certification of needing long-term care or support. In young healthy adults, the third trial results showed stability, whereas they decreased in elderly patients. In elderly patients, it was suggested that the number of measurements reduced from three to two when a maximum value was adopted. No differences were observed among sexes in either young or elderly patients. Geriatr Gerontol Int 2020; 20: 488-493.
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Affiliation(s)
- Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan.,Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Otawara, Japan.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Tamae Sato
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan.,Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Otawara, Japan
| | - Ko Onoda
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Hitoshi Maruyama
- Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Otawara, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
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Factors associated with masticatory performance in community-dwelling older adults: A cross-sectional study. J Am Dent Assoc 2020; 151:118-126. [PMID: 32000935 DOI: 10.1016/j.adaj.2019.10.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/29/2019] [Accepted: 10/04/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Decreased masticatory performance leads to deterioration of overall health among older adults. However, maintaining and improving masticatory performance in ways other than maintenance of natural teeth and appropriate prosthodontic treatment remains unclear. If the factors related to the mixing and shearing abilities for masticatory performance are clarified, it may be possible to maintain and improve the masticatory performance of older adults. We aimed to clarify the association among mixing ability, shearing ability, and masticatory performance-related factors. METHODS Of the 707 community-dwelling older adults in Kusatsu Town, Japan, 344 who had been treated for any dental defects were enrolled in this study. Masticatory performance was evaluated on the basis of mixing ability and shearing ability. The number of natural teeth and artificial teeth, occlusal force, tongue pressure, and oral diadochokinesis /ta/ were measured as masticatory performance-related factors. Their relationship with mixing ability, shearing ability, and masticatory performance-related factors was examined by means of Spearman rank correlation coefficient and path analysis. RESULTS Among masticatory performance-related factors, the number of natural teeth, occlusal force, and tongue pressure were directly associated with both mixing ability and shearing ability. Moreover, mixing ability was also directly associated with shearing ability. CONCLUSIONS Tongue pressure, which can be improved by means of training, is a masticatory performance-related factor associated with both mixing and shearing abilities. PRACTICAL IMPLICATIONS Training for tongue pressure after proper prosthetic treatment may provide an effective means of maintaining and improving masticatory performance in older adults.
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Insulin-Like Growth Factor-1 (IGF-1) and Reduced Tongue Pressure in Relation to Atherosclerosis Among Community-Dwelling Elderly Japanese Men: A Cross-Sectional Study. Dysphagia 2020; 35:948-954. [PMID: 32157395 DOI: 10.1007/s00455-020-10096-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 02/17/2020] [Indexed: 10/24/2022]
Abstract
Even though higher serum insulin-like growth factor-1 (IGF-1) levels have a positive effect on preventing reduction in muscle strength, a U-shaped association between IGF-1 and mortality has been reported. Since a recent experimental study revealed that IGF-1 is associated with atherosclerotic lesion formation, the inflammatory status of atherosclerosis could act as a confounding factor on the association between IGF-1 levels and reduced muscle strength. This study aimed to clarify the atherosclerosis-specific association between IGF-1 levels and reduced muscle strength. We conducted a cross-sectional study of 410 elderly men aged 60-89 years. Since a reduction in maximum voluntary tongue pressure against the palate (MTP) is reportedly associated with sarcopenia, we evaluated muscle strength by using MTP and defined reduced MTP as the lowest tertiles of the study population. Among study population, 295 showed no atherosclerosis (carotid intima-media thickness < 1.1 mm). Even though a significant inverse association between IGF-1 and reduced MTP was observed for subjects without atherosclerosis, no such association was detected for subjects with atherosclerosis. The known cardiovascular risk-factor adjusted odds ratio (OR) of a one-standard deviation (SD) increment (28.1 ng/mL) of IGF-1 for reduced MTP was 0.69 (0.51, 0.95) for subjects without atherosclerosis and 1.93 (1.05, 3.52) for subjects with atherosclerosis. IGF-1 was found to be inversely associated with a reduced MTP among elderly men without atherosclerosis but not among those with atherosclerosis. Atherosclerosis can thus act as a powerful confounding factor on the association between IGF-1 levels and a reduced MTP.
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Kugimiya Y, Watanabe Y, Ueda T, Motokawa K, Shirobe M, Igarashi K, Hoshino D, Takano T, Sakurai K, Taniguchi Y, Kitamura A, Shinkai S, Hirano H. Rate of oral frailty and oral hypofunction in rural community‐dwelling older Japanese individuals. Gerodontology 2020; 37:342-352. [DOI: 10.1111/ger.12468] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 02/04/2020] [Accepted: 02/08/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Yoshihiro Kugimiya
- Removable Prosthodontics and Gerodontology Tokyo Dental College Tokyo Japan
| | - Yutaka Watanabe
- Research Team for Promoting Independence and Mental Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
- Gerodontology Department of Oral Health Science Faculty of Dental Medicine Hokkaido University Sapporo Japan
| | - Takayuki Ueda
- Removable Prosthodontics and Gerodontology Tokyo Dental College Tokyo Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Maki Shirobe
- Action Research Center for Community Prevention of Frailty Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Kentaro Igarashi
- Removable Prosthodontics Nihon University School of Dentistry at Matsudo Chiba Japan
| | - Daichi Hoshino
- Special Needs Dentistry Division of Community Based Comprehensive Dentistry School of Dentistry Showa University Tokyo Japan
| | - Tomofumi Takano
- Removable Prosthodontics and Gerodontology Tokyo Dental College Tokyo Japan
| | - Kaoru Sakurai
- Removable Prosthodontics and Gerodontology Tokyo Dental College Tokyo Japan
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research National Institute for Environmental Studies Ibaraki Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Health Promotion Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Shoji Shinkai
- Social Sciences and Human Care Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
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Iwao Y, Shigeishi H, Takahashi S, Uchida S, Kawano S, Sugiyama M. Improvement of physical and oral function in community-dwelling older people after a 3-month long-term care prevention program including physical exercise, oral health instruction, and nutritional guidance. Clin Exp Dent Res 2019; 5:611-619. [PMID: 31890297 PMCID: PMC6934341 DOI: 10.1002/cre2.226] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/14/2019] [Accepted: 07/07/2019] [Indexed: 11/11/2022] Open
Abstract
Objective There is limited evidence about the most appropriate way to improve physical and oral function in older people. The aim of this study was to clarify the effectiveness of a long-term care prevention program combining physical exercise, oral health instruction, and nutritional guidance among community-dwelling older people. Materials and methods We included 43 older people aged at least 65 years (seven men and 23 women; mean age 75.3 years) in Bungotakada City, Japan. The 3-month program involved a weekly intervention. Physical and oral function was investigated on the first day of the program (i.e., baseline) and at the end of the program (i.e., after 3 months). Physical function was examined using measures such as handgrip strength, timed up-and-go test, and one-leg standing time with eyes open. An oral diadochokinesis test was used to assess oral function. Results Mean maximum handgrip strength increased significantly in older people aged ≤74 years (younger participants) and those aged ≥75 years (older participants) after 3 months compared with the baseline. The timed up-and-go test duration was significantly lower in older participants after the program. Repetition of the monosyllables pa and ka and the repetitive saliva swallowing test was significantly improved in both groups. The dysphagia risk assessment for the community-dwelling elderly score was significantly lower in younger participants after 3 months. Conclusion Participation in a 3-month program combining physical exercise, oral health instruction, and nutritional guidance may contribute to improvement or maintenance of oral and physical function in older people.
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Affiliation(s)
- Yoshimi Iwao
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
- Bungotakada City Council of Social WelfareBungotakadaJapan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | | | - Shino Uchida
- Bungotakada City Council of Social WelfareBungotakadaJapan
| | - Shirou Kawano
- Bungotakada City Council of Social WelfareBungotakadaJapan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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Association between tongue and lip motor functions and mixing ability in complete denture wearers. Aging Clin Exp Res 2019; 31:1243-1248. [PMID: 30406919 DOI: 10.1007/s40520-018-1070-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Masticatory performance of elderly complete denture wearers is low, which may lead to restriction on intakes of several foods such as fresh fruit or raw vegetables. AIM The aim of this study was to investigate the relationship between tongue motor function, lip motor function, and mixing ability in complete denture wearers. MATERIALS AND METHODS Participants comprised 54 complete denture wearers with a mean age of 77.1 years. Maximum tongue pressure and oral diadochokinesis were measured to evaluate tongue and lip motor functions. A color-changeable, chewing gum was used to evaluate mixing ability. The relationship between tongue and lip motor functions and mixing ability was assessed using stepwise multiple regression analysis. RESULTS The stepwise multiple regression analysis identified maximum tongue pressure, the number of repetitions of the syllable "ka", and gender as significant predictors for mixing ability among complete denture wearers. DISCUSSION The elderly edentulous individuals mainly used tongue motor function in oral motor functions for mixing color-changeable chewing gums, which might be ascribable to wearing complete dentures. CONCLUSIONS Under the limited conditions of this study, factors relating to tongue motor function, tongue pressure and the number of repetitions of the syllable "/ka"/ significantly contributed to the mixing ability of complete denture wearers. It was suggested that tongue motor function had positive effect on the mixing ability of complete denture wearers.
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Combination of jaw and tongue movement training influences neuroplasticity of corticomotor pathways in humans. Exp Brain Res 2019; 237:2559-2571. [PMID: 31346648 DOI: 10.1007/s00221-019-05610-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 07/18/2019] [Indexed: 01/30/2023]
Abstract
Since humans in daily life perform multiple motor behaviors that often involve the simultaneous activation of both jaw and tongue muscles, it is essential to understand the effects of combined orofacial sensorimotor tasks on plasticity in corticomotor pathways. Moreover, to establish novel rehabilitation programs for patients, it is important to clarify the possible interrelationships in corticomotor excitability between jaw and tongue motor control. The aim of this study was to examine the effect of a combination of a repetitive tooth bite task (TBT) and a repetitive tongue lift task (TLT) on corticomotor excitability of the tongue and jaw muscles as assessed by transcranial magnetic stimulation (TMS). Sixteen healthy individuals participated in three kinds of training tasks consisting of 41-min TBT, 41-min TLT, and 82-min TBT + TLT. Motor-evoked potentials (MEPs) from the tongue muscle, masseter muscle, and first dorsal interosseous muscle were measured before and after the training tasks. The amplitude of tongue MEPs after training with TLT and TLT + TBT, and masseter MEPs after training with TBT and TLT + TBT, were significantly higher than before training (P < 0.05). Tongue MEPs and masseter MEPs were significantly higher after TLT + TBT than after TBT or TLT (P < 0.05). The present results suggest that a task combining both jaw and tongue movement training is associated with a greater degree of neuroplasticity in the corticomotor control of jaw and tongue muscles than either task alone.
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Sugano A, Ofusa W, Sugito H, Matsubayashi N, Hakkaku M, Yamada Y. Development of a novel composite sensor for evaluating lip function. J Oral Rehabil 2019; 46:920-926. [DOI: 10.1111/joor.12825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/16/2019] [Accepted: 05/26/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Aki Sugano
- Department of Dental Hygiene Tokyo Dental Junior College Tokyo Japan
| | - Wataru Ofusa
- Department of Physiology Tokyo Dental College Tokyo Japan
- Department of Geriatric Dentistry Tsurumi University School of Dental Medicine Yokohama Japan
| | - Hiroki Sugito
- Department of Dental Hygiene Tokyo Dental Junior College Tokyo Japan
- Department of Operative Dentistry, Cariology and Pulp Biology Tokyo Dental College Tokyo Japan
| | | | | | - Yoshiaki Yamada
- Department of Dental Hygiene Tokyo Dental Junior College Tokyo Japan
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38
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Kugimiya Y, Ueda T, Watanabe Y, Takano T, Edahiro A, Awata S, Sakurai K. Relationship between mild cognitive decline and oral motor functions in metropolitan community-dwelling older Japanese: The Takashimadaira study. Arch Gerontol Geriatr 2019; 81:53-58. [DOI: 10.1016/j.archger.2018.11.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 10/27/2022]
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Miyoshi S, Shigeishi H, Fukada E, Nosou M, Amano H, Sugiyama M. Association of Oral Function With Long-Term Participation in Community-Based Oral Exercise Programs in Older Japanese Women: A Cross-Sectional Study. J Clin Med Res 2019; 11:165-170. [PMID: 30834038 PMCID: PMC6396783 DOI: 10.14740/jocmr3664] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 10/31/2018] [Indexed: 11/24/2022] Open
Abstract
Background There are several researches demonstrating that community-based educational and exercise programs can improve oral function in older people. However, the relationship between oral function and long-term participation in health programs has not been fully elucidated. The objective of this study was to clarify the oral health status and oral function of older people (≥ 65 years) who had been participating in community-based exercise programs at community salons. Methods We enrolled 108 women (mean age: 77.6 ± 5.7 years) who participated in oral and physical exercise programs once a week at community salons in Takehara throughout May 2017. This cross-sectional pilot study was approved by the Ethical Committee of Hiroshima University and informed consent was obtained from all participants. To assess oral function, the following tests were performed: tongue pressure test, oral diadochokinesis (ODK) measurement, repetitive saliva swallowing test (RSST) and oral wetness measurement. Results A significant negative correlation was found between age and ODK or RSST (Spearman’s rank correlation; P = 0.007 and P = 0.01, respectively). The duration of participation ranged widely from 1 month to 7 years (median: 2.3 years). Although there was no significant difference between participation period and oral function, individuals who had been participating for 3 years or longer did not demonstrate a negative relationship between age and oral wetness. Furthermore, they exhibited a weaker negative relationship between age and oral function (i.e. tongue pressure, ODK and RSST) when compared with individuals who had been participating for less than 3 years. Conclusions Our results suggest that long-term participation in community salon exercise programs may suppress the deterioration of oral function in older people. Further study will be necessary to clarify the significant correlation between oral function and community-based social activities such as oral exercise.
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Affiliation(s)
- Sanae Miyoshi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.,Takehara-Toyota Dental Hygienists' Association, Hiroshima, Japan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Eri Fukada
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Maki Nosou
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideaki Amano
- Department of Maxillofacial Functional Development, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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40
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Shimizu Y, Sato S, Noguchi Y, Koyamatsu J, Yamanashi H, Higashi M, Nagayoshi M, Kawashiri SY, Nagata Y, Takamura N, Maeda T. Association between tongue pressure and subclinical carotid atherosclerosis in relation to platelet levels in hypertensive elderly men: a cross-sectional study. Environ Health Prev Med 2018; 23:31. [PMID: 30021529 PMCID: PMC6052576 DOI: 10.1186/s12199-018-0720-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/13/2018] [Indexed: 12/31/2022] Open
Abstract
Background Age-related low-grade inflammation causing endothelial disruption influences sarcopenia, hypertension, and atherosclerosis. We reported previously that maintenance of muscle strength in elderly hypertensive men with high platelet levels is positively associated with subclinical atherosclerosis but not in those with low platelet levels. Since reduced tongue pressure is related to sarcopenia, tongue pressure may be associated with subclinical carotid atherosclerosis in hypertensive elderly subjects, and platelet levels may function as an indicator of the association between tongue pressure and subclinical carotid atherosclerosis. Methods We conducted a cross-sectional study of 342 hypertensive elderly Japanese men aged 60–89 who participated in an annual health check-up in 2015 and 2016. Subclinical carotid atherosclerosis was defined as a common carotid intima-media thickness (CIMT) of 1.1 mm or more. Results In the overall study population, 171 subjects demonstrated low platelets (< 21.4 × 104/μL). Tongue pressure was significantly inversely associated with subclinical carotid atherosclerosis in these subjects, but not in subjects with high platelets. The known cardiovascular risk factor adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of subclinical carotid atherosclerosis for a 1 standard deviation (SD) increment in tongue pressure (10.4 kPa) were 0.54 (0.35, 0.85) and 1.31 (0.87, 1.96), respectively. Conclusion Tongue pressure is inversely associated with subclinical carotid atherosclerosis in hypertensive elderly men with low platelet levels, but not in those with high levels. This finding may thus constitute an efficient tool for clarifying the background mechanism of age-related diseases such as sarcopenia, hypertension, and atherosclerosis.
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Affiliation(s)
- Yuji Shimizu
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. .,Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.
| | - Shimpei Sato
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuko Noguchi
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Jun Koyamatsu
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hirotomo Yamanashi
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Miho Higashi
- Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mako Nagayoshi
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shin-Ya Kawashiri
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yasuhiro Nagata
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Maeda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Kurabeishi H, Tatsuo R, Makoto N, Kazunori F. Relationship between tongue pressure and maxillofacial morphology in Japanese children based on skeletal classification. J Oral Rehabil 2018; 45:684-691. [PMID: 29908035 DOI: 10.1111/joor.12680] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2018] [Indexed: 11/29/2022]
Abstract
During childhood, perioral muscle function is closely associated with malocclusion. To clarify the effects of tongue function on maxillofacial morphology in children, tongue pressure and maximum lip-closing force (LCF) were measured and the relationship between perioral muscle function and maxillofacial morphology was evaluated according to the skeletal classification. Maximum tongue pressure (MTP) and swallowing tongue pressure (STP) were measured on the anterior palatine rugae in 100 children (Hellman's dental stages IIIA-IIIC) using a balloon-type tongue pressure measurement device. Lip-closing force was measured using an LCF measurement device. Lateral cephalograms were examined to classify subjects into skeletal (S)-I, S-II and S-III groups. Correlations of skeletal classification with tongue pressure and LCF were examined. Correlations of lateral cephalometric measurements with palatal volume (PV), measured using a three-dimensional optical scanner, were evaluated. Maximum tongue pressure was significantly lower in the S-II group than in other groups. Swallowing tongue pressure was significantly lower in the S-II group than in the S-III group. Lip-closing force was significantly higher in the S-III group than in other groups. Swallowing tongue pressure was positively correlated with MTP and PV. Correlations between tongue pressure and anteroposterior skeletal classification indicated the importance of quantitative tongue function assessment.
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Affiliation(s)
- H Kurabeishi
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, Ohu University School of Dentistry, Fukushima, Japan
| | - R Tatsuo
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, Ohu University School of Dentistry, Fukushima, Japan
| | - N Makoto
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, Ohu University School of Dentistry, Fukushima, Japan
| | - F Kazunori
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, Ohu University School of Dentistry, Fukushima, Japan
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Morita K, Mori T, Maruyama M, Hiraoka A, Higa C, Kuroki A, Yoshida M, Tsuga K. Association between buccal mucosa ridging and oral or occlusal status among older people. Oral Dis 2018; 24:778-783. [PMID: 29316022 DOI: 10.1111/odi.12828] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 12/20/2017] [Accepted: 01/05/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVES This study aimed to evaluate the association between buccal mucosa ridging and oral or occlusal statuses among older people. SUBJECTS AND METHODS This cross-sectional study examined 262 independent older people (mean age, 74.2 ± 5.9 years) who participated in the Kyoto Elderly Physical Fitness Measurement Research Project. The predictor variables were oral statuses (number of present teeth and torus palatinus, torus mandibularis, temporomandibular joint noise, clenching, or grinding) and oral functions (occlusal pressure, cheek pressure, oral diadochokinesis, and tongue pressure). The outcome variable was the buccal mucosa ridging status (presence or absence). Additional variables were age, sex, body mass index, grip strength, and wearing dentures. We compared these variables between participants with and without buccal mucosa ridging using a univariate analysis and multiple logistic regression analysis. RESULTS Buccal mucosa ridging was present in 177 (67.6%) people. Multiple logistic regression analysis revealed a close association of buccal mucosa ridging with torus mandibularis, tooth clenching and grinding and occlusal pressure, and cheek pressure. CONCLUSIONS Over 50% of the participants showed buccal mucosa ridging; this was significantly associated with higher cheek pressure, lower occlusal pressure, torus mandibularis, and tooth clenching and grinding.
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Affiliation(s)
- Koji Morita
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takahiro Mori
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mariko Maruyama
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Chiaki Higa
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Azusa Kuroki
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mitsuyoshi Yoshida
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Huckabee ML, McIntosh T, Fuller L, Curry M, Thomas P, Walshe M, McCague E, Battel I, Nogueira D, Frank U, van den Engel-Hoek L, Sella-Weiss O. The Test of Masticating and Swallowing Solids (TOMASS): reliability, validity and international normative data. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:144-156. [PMID: 28677236 DOI: 10.1111/1460-6984.12332] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 04/05/2017] [Accepted: 05/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Clinical swallowing assessment is largely limited to qualitative assessment of behavioural observations. There are limited quantitative data that can be compared with a healthy population for identification of impairment. The Test of Masticating and Swallowing Solids (TOMASS) was developed as a quantitative assessment of solid bolus ingestion. AIMS This research programme investigated test development indices and established normative data for the TOMASS to support translation to clinical dysphagia assessment. METHODS & PROCEDURES A total of 228 healthy adults (ages 20-80+ years) stratified by age and sex participated in one or more of four consecutive studies evaluating test-retest and interrater reliability and validity to instrumental assessment. For each study the test required participants to ingest a commercially available cracker with instructions to 'eat this as quickly as is comfortably possible'. Further averaged measures were derived including the number of masticatory cycles and swallows per bite, and time per bite, masticatory cycle and swallow. Initial analyses identified significant differences on salient measures between two commercially available crackers that are nearly identical in shape, size and ingredients, suggesting the need for separate normative samples for specific regional products. Additional analyses on a single cracker identified that the TOMASS was sensitive at detecting changes in performance based on age and sex. Test-retest reliability across days and interrater reliability between clinicians was high, as was validation of observational measures to instrumental correlates of the same behaviours. Therefore, normative data are provided for the TOMASS from a minimum of 80 healthy controls, stratified by age and sex, for each of seven commercially available crackers from broad regions worldwide. OUTCOMES & RESULTS Analyses on a single cracker identified Arnott's Salada, and that TOMASS measures were sensitive for detecting changes in performance based on age and sex. Interrater and test-retest reliability across days were high, as was validation of observational measures to instrumental correlates of the same behaviours. Significant differences were identified between two commercially available crackers, nearly identical in shape, size and ingredients, thus normative samples for specific regional products were required. Normative data were then acquired for the TOMASS from a minimum of 80 healthy controls, stratified by age and sex, for each of seven commercially available crackers from broad regions worldwide. CONCLUSIONS & IMPLICATIONS The TOMASS is presented as a valid, reliable and broadly normed clinical assessment of solid bolus ingestion. Clinical application may help identify dysphagic patients at bedside and provide a non-invasive, but sensitive, measure of functional change in swallowing.
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Affiliation(s)
- Maggie-Lee Huckabee
- Swallowing Rehabilitation Research Laboratory at the Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
- Department of Communication Disorders, The University of Canterbury, Christchurch, New Zealand
| | - Theresa McIntosh
- Swallowing Rehabilitation Research Laboratory at the Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
- Department of Communication Disorders, The University of Canterbury, Christchurch, New Zealand
| | - Laura Fuller
- Swallowing Rehabilitation Research Laboratory at the Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
- Department of Communication Disorders, The University of Canterbury, Christchurch, New Zealand
| | - Morgan Curry
- Swallowing Rehabilitation Research Laboratory at the Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
- Department of Communication Disorders, The University of Canterbury, Christchurch, New Zealand
| | - Paige Thomas
- Swallowing Rehabilitation Research Laboratory at the Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
- Department of Communication Disorders, The University of Canterbury, Christchurch, New Zealand
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Ellen McCague
- Department of Clinical Speech and Language Studies, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Irene Battel
- Department of Clinical Speech and Language Studies, Trinity College Dublin, University of Dublin, Dublin, Ireland
- Fondazione Ospedale di Neuroriabilitazione IRCCS San Camillo, Venice, Italy
| | - Dalia Nogueira
- Instituto Universitário de Lisboa (ISCTE-IUL), Business Research Unit (BRU-IUL), Lisbon, Portugal
| | - Ulrike Frank
- Department of Cognitive Neurolinguistics, Swallowing Research Lab, University of Potsdam, Potsdam, Germany
| | - Lenie van den Engel-Hoek
- Donders Centre for Neuroscience, Department of Rehabilitation, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Oshrat Sella-Weiss
- Department of Communication Disorders, Ono Academic Collage, Kiryat Ono, Israel
- Department of Communication Disorders, University of Haifa, Haifa, Israel
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Yamanashi H, Shimizu Y, Higashi M, Koyamatsu J, Sato S, Nagayoshi M, Kadota K, Kawashiri S, Tamai M, Takamura N, Maeda T. Validity of maximum isometric tongue pressure as a screening test for physical frailty: Cross-sectional study of Japanese community-dwelling older adults. Geriatr Gerontol Int 2017; 18:240-249. [DOI: 10.1111/ggi.13166] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 06/15/2017] [Accepted: 07/18/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Hirotomo Yamanashi
- Department of Island and Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Goto Japan
- Department of Clinical Medicine, Institute of Tropical Medicine; Nagasaki University; Nagasaki Japan
| | - Yuji Shimizu
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Miho Higashi
- Department of Global Health, Medicine and Welfare; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Jun Koyamatsu
- Department of Island and Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Goto Japan
| | - Shimpei Sato
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Mako Nagayoshi
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Koichiro Kadota
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Shinya Kawashiri
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Mami Tamai
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Takahiro Maeda
- Department of Island and Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Goto Japan
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
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Shimizu Y, Sato S, Koyamatsu J, Yamanashi H, Higashi M, Nagayoshi M, Kadota K, Kawashiri SY, Takamura N, Maeda T. Serum sodium level within the normal range is associated with maximum voluntary tongue pressure against the palate among community-dwelling older Japanese men. Geriatr Gerontol Int 2017; 18:183-186. [PMID: 28836327 DOI: 10.1111/ggi.13152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 06/15/2017] [Accepted: 06/27/2017] [Indexed: 11/28/2022]
Abstract
AIM Recent geriatric studies have focused on maximum voluntary tongue pressure against the palate (MTP) as a diagnostic value for dysphagia, as dysphagia causes aspiration pneumonia. Dysphagia can also cause water intake difficulties, resulting in hypernatremia by indicating the presence of hyperosmotic dehydration. However, no studies have reported on a possible association between reduced MTP and serum sodium levels. METHODS To evaluate hyperosmotic dehydration within the normal range as an indicator of reduced MTP, we carried out a cross-sectional study of 655 older Japanese community-dwelling men (age ≥60 years) who undertook a general health check-up from 2015 to 2016. As a high concentration of glucose influences serum osmolarity, which might act as a strong confounding factor on this association, the additional analysis was limited to individuals without diabetes. Reduced MTP is defined as a tongue pressure at or under the 20th percentile of the study population (≤24.0 kPa). RESULTS Independent of classical cardiovascular risk factors, the adjusted odds ratio of reduced MTP for a 1-standard deviation increment of serum sodium (2.21 mEq/L) was 1.29 (95% confidence interval 1.10-1.52). When the analysis was limited to individuals without diabetes, the association became slightly stronger, with an adjusted corresponding value of 1.59 (95% confidence interval 1.21-2.10). CONCLUSIONS Serum sodium level within the normal range is independently associated with reduced MTP in older Japanese men. This finding suggests that measuring the MTP is clinically relevant for estimating the pathophysiological values (such as dysphagia risks and aspiration pneumonia risks) in daily clinical practice. Geriatr Gerontol Int 2018; 18: 183-186.
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Affiliation(s)
- Yuji Shimizu
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Shimpei Sato
- Research and Clinical Center for Yusho and Dioxin, Kyusyu University, Fukuoka, Japan
| | - Jun Koyamatsu
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hirotomo Yamanashi
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Miho Higashi
- Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mako Nagayoshi
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Koichiro Kadota
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shin-Ya Kawashiri
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Maeda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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46
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Ogawa A, Ishizaki A, Asami T, Kwon H, Fujii K, Kasama K, Tanaka A, Hironaka S. Effectiveness of a mouth rinsing function test for evaluating the oral function of children. PEDIATRIC DENTAL JOURNAL 2017. [DOI: 10.1016/j.pdj.2017.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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47
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Shimizu Y, Sato S, Noguchi Y, Koyamatsu J, Yamanashi H, Higashi M, Nagayoshi M, Kadota K, Kawashiri SY, Nagata Y, Takamura N, Maeda T. Impact of single nucleotide polymorphism on short stature and reduced tongue pressure among community-dwelling elderly Japanese participants: a cross-sectional study. Environ Health Prev Med 2017; 22:62. [PMID: 29165153 PMCID: PMC5664795 DOI: 10.1186/s12199-017-0668-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 07/04/2017] [Indexed: 11/10/2022] Open
Abstract
Background Asian-specific single nucleotide polymorphism (SNPs) (rs3782886) is reported to be associated with myocardial infarction; sarcopenia is reported to be associated with coronary subclinical atherosclerosis. On the other hand, short stature has been revealed as an independent risk factor for cardiovascular disease. However, no studies have reported on the association between sarcopenia and short stature nor on the impact of rs3782886 on this association. Methods Since reduced maximum voluntary tongue pressure against the palate (MTP) reflects one aspect of sarcopenia, we conducted a cross-sectional study of 537 community-dwelling elderly Japanese participants aged 60–89 years who had participated in a general health checkup in 2015. Short stature was defined as values at or under the 25th percentile, and reduced MTP was defined as the lowest tertile of the study population (<158.0 cm and <26.5 kPa for men, <145.0 cm and <24.1 kPa for women). Results Independent of classical cardiovascular risk factors, short stature was revealed to be positively associated with reduced MTP. The adjusted-odds ratio (OR) and 95% confidence interval (CI) of reduced MTP for short stature was 1.87 (1.19, 2.94). We also found that independent of known cardiovascular risk factors, with the non-minor homo of rs3782886 taken as the reference group, the adjusted OR and 95% CI for short stature and reduced MTP of the minor homo allele were 3.06 (1.23, 7.63) and 3.26 (1.33, 8.03), respectively. Conclusion Short stature is independently associated with reduced MTP, with Asian-specific SNPs possibly playing an important role in this association.
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Affiliation(s)
- Yuji Shimizu
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan. .,Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.
| | - Shimpei Sato
- Research and Clinical Center for Yusho and Dioxin, Kyusyu University, Fukuoka, Japan
| | - Yuko Noguchi
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan
| | - Jun Koyamatsu
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hirotomo Yamanashi
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Miho Higashi
- Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mako Nagayoshi
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan
| | - Koichiro Kadota
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan
| | - Shin-Ya Kawashiri
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan
| | - Yasuhiro Nagata
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Maeda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan.,Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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48
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Hiraoka A, Yoshikawa M, Nakamori M, Hosomi N, Nagasaki T, Mori T, Oda M, Maruyama H, Yoshida M, Izumi Y, Matsumoto M, Tsuga K. Maximum Tongue Pressure is Associated with Swallowing Dysfunction in ALS Patients. Dysphagia 2017; 32:542-547. [DOI: 10.1007/s00455-017-9797-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 04/08/2017] [Indexed: 12/11/2022]
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49
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Mori T, Yoshikawa M, Maruyama M, Hiraoka A, Nakamori M, Yoshida M, Tsuga K. Development of a candy-sucking test for evaluating oral function in elderly patients with dementia: A pilot study. Geriatr Gerontol Int 2017; 17:1977-1981. [DOI: 10.1111/ggi.13003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/05/2016] [Accepted: 12/19/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Takahiro Mori
- Department of Advanced Prosthodontics; Hiroshima University Graduate School of Biomedical and Health Sciences; Hiroshima Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics; Hiroshima University Graduate School of Biomedical and Health Sciences; Hiroshima Japan
| | - Mariko Maruyama
- Department of Advanced Prosthodontics; Hiroshima University Graduate School of Biomedical and Health Sciences; Hiroshima Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics; Hiroshima University Graduate School of Biomedical and Health Sciences; Hiroshima Japan
| | - Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics; Hiroshima University Graduate School of Biomedical and Health Sciences; Hiroshima Japan
| | - Mitsuyoshi Yoshida
- Department of Advanced Prosthodontics; Hiroshima University Graduate School of Biomedical and Health Sciences; Hiroshima Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics; Hiroshima University Graduate School of Biomedical and Health Sciences; Hiroshima Japan
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50
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Nakamori M, Hosomi N, Ishikawa K, Imamura E, Shishido T, Ohshita T, Yoshikawa M, Tsuga K, Wakabayashi S, Maruyama H, Matsumoto M. Prediction of Pneumonia in Acute Stroke Patients Using Tongue Pressure Measurements. PLoS One 2016; 11:e0165837. [PMID: 27802333 PMCID: PMC5089549 DOI: 10.1371/journal.pone.0165837] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 10/18/2016] [Indexed: 01/12/2023] Open
Abstract
Swallowing dysfunction caused by stroke is a risk factor for aspiration pneumonia. Tongue pressure measurement is a simple and noninvasive method for evaluating swallowing dysfunction. We have hypothesized that low tongue pressure may be able to predict pneumonia occurrence in acute stroke patients. Tongue pressure was measured using balloon-type equipment in 220 acute stroke patients. The modified Mann Assessment of Swallowing Ability (MASA) score was evaluated independently on the same day. Tongue pressure was measured every week thereafter. An improvement in tongue pressure was observed within the first 2 weeks. Receiver operating curve analysis was performed to determine the ability of tongue pressure to predict modified MASA score <95, which suggests swallowing dysfunction. The optimal cutoff for tongue pressure was 21.6 kPa (χ2 = 45.82, p<0.001, sensitivity 95.9%, specificity 91.8%, area under the curve = 0.97). The tongue pressure was significantly lower in patients with pneumonia than in those without pneumonia. Using a Cox proportional hazard model for pneumonia onset with a cutoff tongue pressure value of 21.6 kPa and adjustment for age, sex, and National Institutes of Health Stroke Scale score at admission, the tongue pressure had additional predictive power for pneumonia onset (hazard ratio, 7.95; 95% confidence interval, 2.09 to 52.11; p = 0.0013). In the group with low tongue pressure, 27 of 95 patients showed improvement of tongue pressure within 2 weeks. Pneumonia occurred frequently in patients without improvement of tongue pressure, but not in patients with improvement (31/68 and 2/27, p<0.001). Tongue pressure is a sensitive indicator for predicting pneumonia occurrence in acute stroke patients.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Naohisa Hosomi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- * E-mail:
| | - Kenichi Ishikawa
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Eiji Imamura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Takeo Shishido
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tomohiko Ohshita
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | | | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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