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Watanabe D, Yoshida T, Watanabe Y, Yokoyama K, Yamada Y, Kikutani T, Yoshida M, Miyachi M, Kimura M. Oral frailty is associated with mortality independently of physical and psychological frailty among older adults. Exp Gerontol 2024; 191:112446. [PMID: 38679352 DOI: 10.1016/j.exger.2024.112446] [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: 02/13/2024] [Revised: 03/18/2024] [Accepted: 04/25/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Although oral frailty is independently associated with an increased risk of mortality, evidence for the usefulness of screening tools for oral frailty is less than that for physical frailty screening tools. We aimed to investigate the relationship between oral frailty and mortality in older adults. METHODS This prospective cohort study included 11,374 adults aged ≥65 years, who provided valid responses to a baseline mail survey questionnaire from the Kyoto-Kameoka study. Oral frailty status was evaluated using the Oral Frailty Index-8 (range, 0 [best] to 10 [worst]). Participants were classified into four categories according to the Oral Frailty Index-8: robust (score, 0-2), oral pre-frailty (score, 3), oral frailty (score, 4-6), and oral severe frailty (score ≥ 7). Physical and psychological frailty were evaluated using the validated frailty-screening index and defined as a score of ≥3 out of a possible 5 points. Mortality data were collected from 30 July 2011 to 30 November 2016. Hazard ratios (HR) for all-cause mortality were calculated using a multivariable Cox proportional hazards model. RESULTS During the 5.3-year median follow-up period (57,157 person-years), 1184 deaths were recorded. After adjusting for confounders, including physical and psychological frailty, medical history, and lifestyle, in comparison with a robust oral status, oral pre-frailty (HR, 1.29; 95 % confidence interval [CI], 1.02-1.63), oral frailty (HR, 1.22; 95 % CI, 1.01-1.48), and oral severe frailty (HR, 1.43; 95 % CI, 1.16-1.76) were associated with higher HRs of mortality (p for trend = 0.002). CONCLUSION Oral frailty is associated with mortality independent of physical and psychological frailty in older adults. The Oral Frailty Index-8 may be useful for identifying individuals at high risk of mortality.
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Affiliation(s)
- Daiki Watanabe
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan; National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan.
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Senior Citizen's Welfare Section, Kameoka City Government, 8 Nonogami, Yasu-machi, Kameoka-city, Kyoto 621-8501, Japan; National Institute of Biomedical Innovation, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saito-Asagi, Ibaraki-city, Osaka 567-0085, Japan.
| | - Yuya Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Faculty of Sport Study, Biwako Seikei Sport College, 1204 Kitahira, Otsu-city, Shiga 520-0503, Japan.
| | - Keiichi Yokoyama
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan; Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; National Institute of Biomedical Innovation, National Institutes of Biomedical Innovation, Health and Nutrition, 7-6-8 Saito-Asagi, Ibaraki-city, Osaka 567-0085, Japan.
| | - Takeshi Kikutani
- Division of Rehabilitation for Speech and Swallowing Disorders, Nippon Dental University, Tama Oral Rehabilitation Clinic, 4-44-19 Higashi-cho, Koganei-city, Tokyo 184-0011, Japan.
| | - Mitsuyoshi Yoshida
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake-city, Aichi 470-1192, Japan.
| | - Motohiko Miyachi
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan; National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-Shimmachi, Settsu-city, Osaka 566-0002, Japan.
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto-city, Kyoto 602-8566, Japan.
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Zhao H, Wu B, Zhou Y, Yang Z, Zhao H, Tian Z, Jiang M, Huang D. Oral frailty: a concept analysis. BMC Oral Health 2024; 24:594. [PMID: 38778380 PMCID: PMC11112910 DOI: 10.1186/s12903-024-04376-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Oral frailty has become a worldwide problem among older adults. Although researchers have conducted various studies on oral frailty, its definition remains controversial. PURPOSE To clarify the concept of oral frailty. METHODS Online databases PubMed, Web of Science, CINAHL, Cochrane Library, ProQuest, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang database were searched from inception to September 20, 2023. The reference lists of relevant studies were searched manually. Eligible articles, theses, and books were analyzed using Walker & Avant's concept analysis model. RESULTS The attributes of oral frailty were abnormal oral structure and/or decline in multi-faceted oral function and coexisting decline in physical, cognitive and social functions. Its antecedents were aging, social frailty, and severe periodontitis, whereas its consequences were decline in physical health and mental health, social withdrawal, lower quality of life and systemic frailty. CONCLUSION Oral frailty could result in worse conditions among older adults physically, psychologically and socially. Tools based on the concept analysis need to be developed to comprehensively assess oral frailty.
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Affiliation(s)
- Huimin Zhao
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Bei Wu
- Rory Meyers College of Nursing and NYU Aging Incubator, New York University, New York, NY, 10012, USA
| | - Yuqiu Zhou
- Department of Nursing, Harbin Medical University, Harbin, 150081, China
| | - Zhilan Yang
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Hua Zhao
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Ziwei Tian
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Manhong Jiang
- College of Nursing, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Deqin Huang
- School of Nursing, Hangzhou Normal University, Hangzhou, 311121, China.
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Li T, Shen Y, Leng Y, Zeng Y, Li L, Yang Z, Wang S, Jiang Y. The prevalence of oral frailty among older adults: a systematic review and meta‑analysis. Eur Geriatr Med 2024:10.1007/s41999-023-00930-7. [PMID: 38528284 DOI: 10.1007/s41999-023-00930-7] [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: 10/18/2023] [Accepted: 12/29/2023] [Indexed: 03/27/2024]
Abstract
BACKGROUND In recent years, oral frailty was proposed as a new concept regarding dental and oral health in older adults. Poor oral health is linked to preserving general health and has become a geriatric public health problem that deeply affects healthy aging. While in present, evidence on the prevalence associated with oral frailty in older adults remains unclear. OBJECTIVE To systematically evaluate the prevalence of oral frailty among older adults, stratified by relevant factors such as gender, source, study design, region, and the evaluation scales for oral frailty and provide an evidence-based foundation for healthcare professionals and policymakers to formulate relevant measures. METHODS Ten electronic databases were systematically searched from inception to September 2023, including PubMed, Web of Science, Embase, PsycINFO, The Cochrane Library, CINAHL, China National Knowledge Infrastructure Database (CNKI), Chinese Biomedical Database (Sinomed), Weipu Database, and Wanfang database. Based on the Stata 15.0 software package, a random effect model was used to calculate the pooled prevalence of oral frailty among older adults. In addition, sensitivity analysis, subgroup analysis, and meta-regression were conducted based on different study characteristics to detect heterogeneity sources. Funnel plots, Begg's and Egger's tests were used to evaluate the publication bias. RESULTS Eighteen studies with a total of 12,932 older adults were included for meta-analysis. The pooled prevalence of oral frailty and oral pre-frailty was 24% (95% CI: 20-28%) and 57% (95% CI: 52-61%) respectively. Based on different assessment tools of oral frailty, the pooled prevalence of oral frailty was higher when using the OFI-8 scale (44.1%; 95% CI: 35.4-52.8%) than the OFI-6 scale (18.3%; 95% CI: 15.8-20.8%) or OF checklist (22.1%; 95% CI: 17.4-26.7%). The prevalence of oral frailty was higher among older adults in females (23.8%; 95% CI: 18.4-29.2%), hospital settings (31%, 95% CI: 16.6-45.5%), cross-sectional design (26.7%, 95% CI: 19.2-34.2%), and China (45.9%, 95% CI: 34.4-57.3%). CONCLUSIONS Our study showed that oral frailty was common among older adults and various characteristics may affect its prevalence. Thus, healthcare professionals and policymakers should take oral frailty seriously in clinical practice and program planning and develop more preventive measures for oral frailty among older adults.
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Affiliation(s)
- Tao Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Yinli Shen
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Yingjie Leng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - You Zeng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Long Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Zijiang Yang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Siyu Wang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Yunlan Jiang
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
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Yin Y, Zhao Y, Fei Y, Liu Y, Ji Y, Shan E, Niu S, Xing Y, Ding J, Li X. Epidemiology and risk factors of oral frailty among older people: an observational study from China. BMC Oral Health 2024; 24:368. [PMID: 38515048 PMCID: PMC10958975 DOI: 10.1186/s12903-024-04149-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/15/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVES This study aimed to compare the prevalence of oral frailty among community-dwelling older people in Nanjing, China with the usage of different measurements, and to investigate the potential risk factors of oral frailty. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A total of 338 community-dwelling older people in Nanjing, China were recruited. METHODS Oral frailty was measured based on the Oral Frailty Index-8 (OFI-8) scale and other measurement methods including the number of natural teeth (TN), repetitive saliva-swallowing test (RSST), and oral diadochokinesis (ODK). The chi-square test and the binary logistic regression analysis were performed to identify potential risk factors for oral frailty. RESULTS There were 310 participants included in the analysis. Prevalence of oral frailty by using the OFI-8, OFI-8 + TN, OFI-8 + ODK, OFI-8 + TN + ODK and RSST measurement methods were 69.0%, 27.4%, 51.9%, 21.0% and 2.9%, respectively. Passive smoking (OR = 2.04; 95%CI 1.03-4.03), being widowed/unmarried (OR1 = 2.53; 95%CI 1.25-5.10; OR2 = 2.94; 95%CI 1.12-7.77), pre-frailty (OR = 1.76; 95%CI 1.03-3.01), frailty (OR = 3.01; 95%CI 1.39-6.54), and aged 80 years and above (OR = 3.99; 95%CI 1.35-11.81) were found to be risk factors of oral frailty by the usage of the four kinds of measurement methods. CONCLUSIONS AND IMPLICATIONS The definition and diagnostic criteria of oral frailty are strongly needed to be unified in future research. Only subjective assessment is not enough for assessing oral frailty. Among objective indicators, RSST is not suitable as a screening method for oral frailty. In addition, objective indicators including TN and ODK should be valued for early screening and preventive interventions. The risk factors of oral frailty include physical frailty, passive smoking, and being widowed.
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Affiliation(s)
- Yueheng Yin
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Yue Zhao
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Yang Fei
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Ying Liu
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Yun Ji
- Chunhua Community Health Service Centre, Nanjing, 211166, Jiangsu, China
| | - Enfang Shan
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Shuzhen Niu
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Ying Xing
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Jingjing Ding
- Sir Run Run Hospital of Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - XianWen Li
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China.
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Suzuki F, Okamoto S, Nakai S, Miyagi S, Tsujiguchi H, Hara A, Nguyen TTT, Shimizu Y, Hayashi K, Suzuki K, Kasahara T, Nakamura M, Takazawa C, Ogawa A, Shibata A, Kannon T, Tajima A, Tsuboi H, Ogino N, Konoshita T, Takamura T, Sato K, Nakamura H. Association between animal protein intake, oral frailty and calf circumference in middle-aged and older adults: a cross-sectional analysis from the Shika study. BMJ Open 2024; 14:e078129. [PMID: 38365294 PMCID: PMC10875535 DOI: 10.1136/bmjopen-2023-078129] [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: 07/27/2023] [Accepted: 01/03/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE To investigate the relationship between oral frailty (OF), nutrient intake and calf circumference (CC) in middle-aged and older adults. DESIGN Cross-sectional study. SETTING Residents of four model districts of Shika town, Ishikawa Prefecture, Japan, using data from November 2017 to February 2018. PARTICIPANTS One hundred and ninety-four residents aged ≥50 years in four model districts of Shika town. The OF total score ≥3 was defined as OF. Participants were divided into OF and non-OF groups and divided into the low-CC/kg and the high-CC/kg groups. OUTCOME MEASURES The primary outcome is to use a two-way analysis of covariance to analyse the interaction between the two CC/kg groups and the two OF groups on nutrition intake. The secondary outcome is to use multiple regression analysis to investigate the nutrients significantly related to CC/kg when stratified by OF, with age, sex, body mass index, drinking status, smoking status and regular exercise as input covariates. RESULTS A two-way analysis of covariance revealed a significant interaction between the two CC/kg groups and the two OF groups on animal protein intake (p=0.039). Multiple comparisons using the Bonferroni analysis revealed a significantly lower animal protein intake in the OF group than in the non-OF group with a low CC/kg (p=0.033) but not in the group with a high CC/kg. The multiple regression analysis stratified by OF revealed a positive correlation between animal protein intake and CC/kg (p=0.002). CONCLUSIONS The present results revealed a significantly lower animal protein intake in the OF group than in the non-OF group in the low-CC/kg group, but no such difference was observed in the high-CC/kg group. Further longitudinal studies are needed to elucidate this relationship.
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Affiliation(s)
- Fumihiko Suzuki
- Department of Geriatric Dentistry, Ohu University School of Dentistry, Koriyama, Japan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Shigefumi Okamoto
- Laboratory of Medical Microbiology and Microbiome, Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University, Suita, Osaka, Japan
| | - Shingo Nakai
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Akinori Hara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Thao Thi Thu Nguyen
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Viet Nam
| | - Yukari Shimizu
- Faculty of Health Sciences, Department of Nursing, Komatsu University, Komatsu, Japan
| | - Koichiro Hayashi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Keita Suzuki
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Tomoko Kasahara
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Chie Takazawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Aya Ogawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Aki Shibata
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Takayuki Kannon
- Department of Biomedical Data Science, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Atsushi Tajima
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Hirohito Tsuboi
- Graduate School of Human Nursing, The University of Shiga Prefecture, Hikone, Japan
| | - Noriyoshi Ogino
- Department of Environmental Medicine, Faculty of Medicine, Kochi University, Kochi, Japan
- Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tadashi Konoshita
- Division of Diabetes Endocrinology and Metabolism, Yachiyo Medical Center, Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - Toshinari Takamura
- Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kuniko Sato
- Laboratory of Clinical Cognitive Neuroscience, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
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Irie K, Mochida Y, Altanbagana NU, Fuchida S, Yamamoto T. Relationship between risk of oral frailty and awareness of oral frailty among community-dwelling adults: a cross-sectional study. Sci Rep 2024; 14:433. [PMID: 38172224 PMCID: PMC10764834 DOI: 10.1038/s41598-023-50818-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
We aimed to investigate the relationship between the risk of oral frailty and awareness of oral frailty among Japanese adults in an adult dental health field study conducted in Kanagawa Prefecture. Questionnaire data from a total of 5051 individuals (1907 males, 3144 females; mean age; 59.9 years) were used. The risk of oral frailty was assessed using the Oral Frailty Index-8. Of the participants, 1418 (28.1%) had a high risk of oral frailty and 1495 (29.6%) had knowledge of oral frailty. Logistic regression analysis indicated that the risk of oral frailty was significantly associated with awareness of oral frailty. We further found that awareness of oral frailty was significantly related to gender (female), age (20-39 compared to 70-79, ≥ 80), residential areas (Yokohama compared to Kawasaki, Sagamihara), exercise habits (yes), eating a balanced diet (yes), consciousness of oral health (yes), risk of oral frailty (low) and outpatient category (hospital visit). For groups with low levels of awareness obtained from the results of this study, it is necessary to consider the means of accessibility and increase awareness further.
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Affiliation(s)
- Koichiro Irie
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa, 238-8580, Japan
| | - Yuki Mochida
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa, 238-8580, Japan
| | - Nandin Uchral Altanbagana
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa, 238-8580, Japan
| | - Shinya Fuchida
- Department of Education Planning, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa, 238-8580, Japan
| | - Tatsuo Yamamoto
- Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa, 238-8580, Japan.
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7
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Lee S, Lee S, Jo S, Kim KA, Yang YJ, Lee JJ, Kim E, Park Y, Kyong T, Kim JH. Calf Circumference as an Indicator for Cystatin C Testing in Hospitalized Elderly Male Patients for Detecting Hidden Renal Impairment. J Clin Med 2023; 12:6899. [PMID: 37959364 PMCID: PMC10647781 DOI: 10.3390/jcm12216899] [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: 09/25/2023] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Serum creatinine is used to measure the estimated glomerular filtration rate (eGFR); however, it is influenced by muscle mass and may therefore overestimate renal function in patients with sarcopenia. We examined calf circumference (CC) as a convenient muscle mass evaluation tool that can potentially indicate the need to test for cystatin C instead of creatinine in elderly inpatients. We retrospectively reviewed the electronic health record of 271 inpatients aged 65 or over. CC was determined by measuring the thickest part of the nondominant calf. eGFRcys and eGFRcr were calculated using cystatin C and creatinine levels, respectively. We evaluated optimum CC cutoff values using the eGFRcys/eGFRcr ratio for detecting hidden renal impairment (HRI, defined as eGFRcr ≥ 60 mL/min/1.73 m2 but eGFRcys < 60 mL/min/1.73 m2). CC showed a significant positive correlation with the eGFRcys/eGFRcr ratio in both sexes. The areas under the receiver operating characteristic curve were 0.725 and 0.681 for males and females, respectively. CC cutoffs with a sensitivity or specificity of 90% or 95% might be used to detect HRI in males. In conclusion, utilizing the optimum cutoff, CC could be a cost-effective screening tool for detecting HRI in elderly male patients using cystatin C as an add-on test.
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Affiliation(s)
- Sunghwan Lee
- Department of Laboratory Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si 16995, Gyeonggi-do, Republic of Korea; (S.L.); (K.-A.K.)
| | - Seul Lee
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si 16995, Gyeonggi-do, Republic of Korea; (S.L.); (S.J.)
| | - Sunhee Jo
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si 16995, Gyeonggi-do, Republic of Korea; (S.L.); (S.J.)
| | - Kyung-Ah Kim
- Department of Laboratory Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si 16995, Gyeonggi-do, Republic of Korea; (S.L.); (K.-A.K.)
| | - Yu Jin Yang
- Department of Nutrition, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si 16995, Gyeonggi-do, Republic of Korea; (Y.J.Y.); (J.J.L.)
| | - Jung Joo Lee
- Department of Nutrition, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si 16995, Gyeonggi-do, Republic of Korea; (Y.J.Y.); (J.J.L.)
| | - Eunsung Kim
- Department of Inpatient Nursing, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si 16995, Gyeonggi-do, Republic of Korea;
| | - Yongjung Park
- Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul 06273, Republic of Korea;
| | - Taeyoung Kyong
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si 16995, Gyeonggi-do, Republic of Korea; (S.L.); (S.J.)
| | - Jeong-Ho Kim
- Department of Laboratory Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si 16995, Gyeonggi-do, Republic of Korea; (S.L.); (K.-A.K.)
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