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Warren A. The relationship between gender differences in dietary habits, neuroinflammation, and Alzheimer's disease. Front Aging Neurosci 2024; 16:1395825. [PMID: 38694261 PMCID: PMC11061392 DOI: 10.3389/fnagi.2024.1395825] [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: 03/04/2024] [Accepted: 04/03/2024] [Indexed: 05/04/2024] Open
Abstract
Neurocognitive decline is one of the foremost dire issues in medicine today. The mechanisms by which dementia pathogenesis ensues are complicated and multifactorial, particularly in the case of Alzheimer's disease (AD). One irrefutable, yet unexplained factor is the gender disparity in AD, in which women are disproportionately affected by AD, both in the rate and severity of the disease. Examining the multifaceted contributing causes along with unique gender dynamics in modifiable risk factors, such as diet, may lend some insight into why this disparity exists and potential paths forward. The aim of this brief narrative review is to summarize the current literature of gender differences in dietary habits and how they may relate to neuroinflammatory states that contribute to AD pathogenesis. As such, the interplay between diet, hormones, and inflammation will be discussed, along with potential interventions to inform care practices.
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Affiliation(s)
- Alison Warren
- The Department of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
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Bakker MH, de Smit MJ, Valentijn A, Visser A. Oral health assessment in institutionalized elderly: a scoping review. BMC Oral Health 2024; 24:272. [PMID: 38402181 PMCID: PMC10893687 DOI: 10.1186/s12903-024-04025-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/14/2024] [Indexed: 02/26/2024] Open
Abstract
When elderly become frail and in need for complex care, they can no longer live independently at home and may be admitted to nursing homes. Various studies have shown that oral health in this population is remarkably poor, which may lead to distressing situations and impacts quality of life. A variety of definitions or descriptions for oral health is used. Without a uniform parameter, it is impossible to determine whether oral health in institutionalized elderly is actually improving or deteriorating over time, as well as the effect of (preventive) interventions. In search for an adequate and clinically applicable parameter to determine oral health in this specific patient group, this scoping review aims to give an overview of the currently used parameters for determining oral health in institutionalized elderly. Ninety different parameters were identified, and 50 parameters were solely used by one study. Only 4 parameters were frequently used (in > 20 studies). The relevance of these parameters for this specific patient group is discussed. To aid the planning and commissioning of future research and patient care, there is an urgent need for an adequate and uniform parameter for oral health determination in institutionalized elderly.
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Affiliation(s)
- M H Bakker
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
| | - M J de Smit
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - A Valentijn
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - A Visser
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
- Department of Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Taira K, Watanabe Y, Okada K, Kondo M, Takeda M, Ito K, Nakajima J, Iwasaki M, Itoda M, Inohara K, Sasaki R, Nishi Y, Furuya J, Watanabe Y, Umemoto G, Kishima M, Tohara T, Sato Y, Yoshida M, Yamazaki Y. Association between denture use and food form in older adults requiring long-term care: A multicenter cross-sectional study. J Prosthodont Res 2022. [PMID: 35989265 DOI: 10.2186/jpr.jpr_d_21_00161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This study aimed to determine whether denture use contributes to maintaining and improving food forms in long-term care facility (LTCFs) residents. METHODS In 888 residents of 37 LTCFs in Japan, the following were investigated: nutritional intake status, food forms, age, sex, Barthel index (BI), clinical dementia rating (CDR), number of teeth present, number of occlusal supports, swallowing function, and use of dentures. Among all residents, those who were well-nourished and had ≤9 occlusal supports were analyzed. Based on standardized criteria, the food forms consumed by the subjects were divided into two groups: dysphagia and normal diet, which were further classified into four levels. Analysis was performed using a generalized estimation equation with the four levels of food forms as dependent variables and age, sex, BI, CDR, presence of dysphagia, number of teeth present, and use of dentures as independent variables. RESULTS The final analysis included 622 (70.0%) residents. Of these, 380 (61.1%) used dentures. The analyses revealed that food form was significantly associated with age (adjusted odds ratio [OR], 0.98), BI (OR, 1.04), number of teeth present (OR, 1.03), presence of dysphagia (OR, 0.44), and use of dentures (OR, 2.82). CONCLUSION Denture use was associated with food forms among Japanese LTCF residents. This indicates that the use of dentures is related to the maintenance of food forms, even in the elderly who participate in few activities of daily living, have reduced cognitive function, and require long-term care.
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Affiliation(s)
- Kenshu Taira
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Kazutaka Okada
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Miyako Kondo
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Maaya Takeda
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Kayoko Ito
- Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Junko Nakajima
- Department of Oral Medicine and Hospital Dentistry, Tokyo Dental College, Chiba, Japan
| | | | - Masataka Itoda
- Department of Oral Rehabilitation Osaka Dental University Hospital, Osaka, Japan
| | - Ken Inohara
- Inohara Dental and Rehabilitation Clinic, Hiroshima, Japan.,Ota Memorial Hospital, Hiroshima, Japan
| | - Rikimaru Sasaki
- Rehabilitation Clinic for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tokyo, Japan
| | - Yasuhiro Nishi
- Department of Oral and Maxillofacial Prosthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Junichi Furuya
- Department of Geriatric Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | | | - George Umemoto
- Swallowing Disorders Center, Fukuoka University Hospital, Fukuoka, Japan
| | | | - Takashi Tohara
- The Nippon Dental University Tama Oral Rehabilitation Clinic, Tokyo, Japan
| | - Yuji Sato
- Department of Geriatric Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Mitsuyohi Yoshida
- Department of Dentistry & Oral-Maxillofacial Surgery Fujita Health University, Aichi, Japan
| | - Yutaka Yamazaki
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
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Malekpour P, Devine A, Dare J, Costello L. Investigating the perspectives of older adults in residential aged care on oral health-related quality of life. Gerodontology 2022; 40:220-230. [PMID: 35581695 DOI: 10.1111/ger.12636] [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: 06/09/2021] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of the study was to explore how older people living in a residential aged care facility perceived that their oral health influenced their food preferences and attitudes towards food, their social interactions and their self-esteem. BACKGROUND Poor oral health can have biological, behavioural and social impacts on quality of life among older adults (aged 65+ years). In terms of biological impacts, oral health impairments may cause older adults to avoid many types of foods. This shift in dietary pattern can lead to malnutrition among older people, undermine general health and negatively impact quality of life (QOL). MATERIALS AND METHODS Using a mixed methods approach, quantitative data from the General Oral Health Assessment Index (GOHAI) were explored and supported by data from semi-structured interviews with 10 older adults from a residential aged care facility in Perth, (Australia) to provide insights into their oral health-related quality of life. Thematic analysis of qualitative data was guided by the conceptual framework informed by Locker. RESULTS The average GOHAI score was 32.9 ± 3.6, which indicated that participants had an average oral health-related quality of life. Participants coped with oral functional problems by adopting personal strategies and seeking organisational assistance. Some participants appeared to have accepted associated changes to their physical appearance, while others reported significant dissatisfaction and low self-esteem. Perceptions differed on their social interactions at the facility, from being self-conscious about their own oral health problems, to distaste at others' eating behaviours. CONCLUSIONS Poor oral health had negative biological, behavioural and social impacts on daily activities and quality of life among some participants. However, changes at the organisation level may help to support participant QOL.
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Affiliation(s)
- Parisa Malekpour
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.,Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Western Australia, Australia
| | - Julie Dare
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Leesa Costello
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.,Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, Western Australia, Australia
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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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Kulvanich S, Ito K, Takei E, Sakai H, Suzumi R, Magara J, Tsujimura T, Inoue M. Impact of Oral and Swallowing Function on the Feeding Status of Older Adults in Nursing Homes. Gerontology 2021; 67:168-176. [PMID: 33454716 DOI: 10.1159/000511912] [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: 06/25/2020] [Accepted: 09/22/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To date, there have been few guidelines proposed for adjustment of the food consistency, particularly to match the oral function of older adults, which will guide clinicians and caregivers in appropriately modifying food. OBJECTIVE We investigated how oral, swallowing, and cognitive conditions of older adults who required daily nursing care in a nursing home were associated with different dietary food consistencies. METHODS Clinical examinations to record dentition status, swallowing, and cognitive functions were performed, and the feeding status, including the food consistencies and need for assistance at lunchtime, was evaluated in 37 older residents in nursing homes. The swallowing function was assessed by performing a modified water-swallowing test, and food swallowing was tested using pudding and rice crackers. The χ2 test was used to determine the relationships among the parameters. RESULTS No participants were able to take cooked rice, nor regular and soft side dishes. There was no significant relationship between dentition status and feeding status. Of the participants, 95% ate pudding without any problems and 49% ate rice crackers without any signs of swallowing difficulty such as coughing or stopping chewing. There was a significant relationship between the food test score using a rice cracker and the level of food consistencies, and between the same test score and the level of mealtime assistance, whereby the better the score of the food test using a rice cracker, the better was the level of food consistencies including use of a thickening agent and the better was the level of mealtime assistance. CONCLUSION The results strongly suggest that the food test using a rice cracker was associated with the level of food consistency and mealtime assistance for older adults in nursing homes.
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Affiliation(s)
- Sirima Kulvanich
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Community Dentistry & Gerodontology, Faculty of Dentistry, Thammasat University, Bangkok, Thailand
| | - Kayoko Ito
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Eri Takei
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Haruka Sakai
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Risa Suzumi
- 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
| | - Makoto Inoue
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
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Medeiros MMD, Pinheiro MA, Figueredo OMC, Oliveira LFS, Wanderley RL, Cavalcanti YW, Rodrigues Garcia RCM. Masticatory function in nursing home residents: Correlation with the nutritional status and oral health–related quality of life. J Oral Rehabil 2020; 47:1511-1520. [DOI: 10.1111/joor.13096] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/25/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022]
Affiliation(s)
| | - Mayara Abreu Pinheiro
- Department of Prosthodontics and Periodontology Piracicaba Dental School University of Campinas São Paulo Brazil
| | - Olívia Maria Costa Figueredo
- Department of Prosthodontics and Periodontology Piracicaba Dental School University of Campinas São Paulo Brazil
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Supplied Food Consistency and Oral Functions of Institutionalized Elderly. Int J Dent 2020; 2020:3463056. [PMID: 32148501 PMCID: PMC7031709 DOI: 10.1155/2020/3463056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/14/2020] [Accepted: 01/21/2020] [Indexed: 12/04/2022] Open
Abstract
Background Maintaining good oral function is one of the goals of dental treatment. The Japanese national insurance system newly introduced the concept of management of oral function according to the life stage. For the application of management of oral functions of the elderly, seven kinds of examination is a must for the diagnosis: xerostomia, oral hygiene status, maximum occlusal pressure, tongue and labium function, tongue pressure, chewing ability, and swallowing function. We analyzed the relationship between oral functions and supplied food consistency. Methods Oral functions and supplied food consistency of sixty-nine institutionalized elderly were investigated. There were 13 men and 56 women, and their mean age was 86.23 ± 7.02. Oral functions were measured and evaluated according to the Japanese insurance system. Data were analyzed by item response theory analysis, ROC analysis, and decision analysis. Results By the item response theory analysis, tongue pressure and swallowing functions had high discrimination ability. The subjects who had malfunction of the tongue and labium all had processed food. The subjects with difficulty in swallowing, even without malfunction of the tongue and labium, all had processed food. Conclusion Supplied food consistency may depend on the oral functions. However, as oral function has some dimension, a systematic evaluation system is necessary to decide the supplied food consistency.
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