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Yang C, Gao Y, An R, Lan Y, Yang Y, Wan Q. Oral frailty: A concept analysis. J Adv Nurs 2024; 80:3134-3145. [PMID: 38214108 DOI: 10.1111/jan.16042] [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: 04/05/2023] [Revised: 11/20/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024]
Abstract
AIM To clarify the concept of oral frailty to provide a clear and standardized conceptual basis for further research in older people. DESIGN Rodgers and Knafl's evolutionary concept analysis approach. METHODS The narrative analysis detailedly extracted and synthesized the attributes of oral frailty, as well as its antecedents, consequences and related terms under the guidance of Rodgers' evolutionary method. DATA SOURCES Multiple databases including Pubmed, CINAHL and Cochrane were searched using selected search terms 'oral frail*', 'oral health' and 'aged' respectively. Articles written between 2013 and 2023 were included, and grey literature was excluded. RESULTS A total of 32 articles were included for further analysis and synthesis. The attributes of oral frailty were hypofunction, predisposing in nature, non-specific and multidimensional. Antecedents of prefrailty were classified into four categories, namely, sociodemographic characteristics, comorbidity, physical function and psychosocial factors. Consequences of oral frailty include three themes: increased risk of adverse outcomes, poor nutritional status and possibility of social withdrawal. Related terms that had shared attributes with oral frailty were oral health, functional dentition, oral hypofunction and deterioration of oral function. CONCLUSIONS Oral frailty is an age-related phenomenon reflected in decreased oral function. The findings of this concept analysis are conducive to understanding and clarifying the oral frailty, which can help clinicians or other healthcare providers to consider how to distinguish oral frailty in older adults and further promote the development of this field. IMPACT Oral frailty is increasingly recognized as an age-related phenomenon reflected in decreased oral function. As it is newly proposed, no consensus has been reached regarding the theoretical and operational concept of it. Through clarifying the concept, this paper will guide future healthcare research on oral frailty regarding the influencing factors, mechanisms and interventions, thus raising the awareness with regard to oral health among older adults. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: In the context of older adults, oral frailty is a concept that requires further research to guide future theoretical development, and the influencing factors, mechanisms and interventions need to be further studied. Raise awareness with regard to oral health among older people and more attention will be paid to the early identification and intervention of oral frailty, so as to further improve the quality of life of older adults.
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Affiliation(s)
- Chengfengyi Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Yajing Gao
- School of Nursing, Peking University, Beijing, China
| | - Ran An
- School of Nursing, Peking University, Beijing, China
| | - Yue Lan
- School of Nursing, Peking University, Beijing, China
| | - Yue Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China
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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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Han X, Bai Z, Mogushi K, Hase T, Takeuchi K, Iida Y, Sumita YI, Wakabayashi N. Machine Learning Prediction of Tongue Pressure in Elderly Patients with Head and Neck Tumor: A Cross-Sectional Study. J Clin Med 2024; 13:2363. [PMID: 38673635 PMCID: PMC11051183 DOI: 10.3390/jcm13082363] [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: 02/28/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
Background: This investigation sought to cross validate the predictors of tongue pressure recovery in elderly patients' post-treatment for head and neck tumors, leveraging advanced machine learning techniques. Methods: By employing logistic regression, support vector regression, random forest, and extreme gradient boosting, the study analyzed an array of variables including patient demographics, surgery types, dental health status, and age, drawn from comprehensive medical records and direct tongue pressure assessments. Results: Among the models, logistic regression emerged as the most effective, demonstrating an accuracy of 0.630 [95% confidence interval (CI): 0.370-0.778], F1 score of 0.688 [95% confidence interval (CI): 0.435-0.853], precision of 0.611 [95% confidence interval (CI): 0.313-0.801], recall of 0.786 [95% confidence interval (CI): 0.413-0.938] and an area under the receiver operating characteristic curve of 0.626 [95% confidence interval (CI): 0.409-0.806]. This model distinctly highlighted the significance of glossectomy (p = 0.039), the presence of functional teeth (p = 0.043), and the patient's age (p = 0.044) as pivotal factors influencing tongue pressure, setting the threshold for statistical significance at p < 0.05. Conclusions: The analysis underscored the critical role of glossectomy, the presence of functional natural teeth, and age as determinants of tongue pressure in logistics regression, with the presence of natural teeth and the tumor site located in the tongue consistently emerging as the key predictors across all computational models employed in this study.
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Affiliation(s)
- Xuewei Han
- Department of Advanced Prosthodontics, Graduate School, Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (X.H.); (Z.B.); (N.W.)
| | - Ziyi Bai
- Department of Advanced Prosthodontics, Graduate School, Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (X.H.); (Z.B.); (N.W.)
| | - Kaoru Mogushi
- Institute of Education, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (K.M.); (T.H.)
| | - Takeshi Hase
- Institute of Education, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (K.M.); (T.H.)
- Faculty of Pharmacy, Keio University, Tokyo 1088345, Japan
- Center for Mathematical Modelling and Data Science, Osaka University, Osaka 5608531, Japan
- The Systems Biology Institute, Tokyo 1410022, Japan
| | - Katsuyuki Takeuchi
- Institute of Education, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (K.M.); (T.H.)
| | - Yoritsugu Iida
- Institute of Education, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (K.M.); (T.H.)
| | - Yuka I. Sumita
- Department of Advanced Prosthodontics, Graduate School, Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (X.H.); (Z.B.); (N.W.)
- Department of Partial and Complete Denture, The Nippon Dental University School of Life Dentistry, Tokyo 1028159, Japan
| | - Noriyuki Wakabayashi
- Department of Advanced Prosthodontics, Graduate School, Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan; (X.H.); (Z.B.); (N.W.)
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Iwai K, Azuma T, Yonenaga T, Sasai Y, Nomura T, Sugiura I, Inagawa Y, Matsumoto Y, Nakashima S, Abe Y, Tomofuji T. Longitudinal association of oral functions and dementia in Japanese older adults. Sci Rep 2024; 14:5858. [PMID: 38467855 PMCID: PMC10928189 DOI: 10.1038/s41598-024-56628-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/08/2024] [Indexed: 03/13/2024] Open
Abstract
The relationship between oral functions and dementia was examined in 7384 older adults (age ≥ 75 years) who visited a dental clinic in Gifu, Japan. Participants without dementia in a baseline survey in April 2018 were followed until March 2021. As oral functions, chewing function, tongue and lip function, and swallowing function were assessed by self-administered questionnaire, by oral diadochokinesis test, and by repetitive saliva swallowing test, respectively. The presence of systemic diseases was based on data obtained from the National Database of Health Insurance of Japan. At follow-up, 415 (6%) participants were diagnosed with dementia. Multivariate logistic regression analyses showed the presence of dementia at follow-up was associated with female (odds ratio [OR] 1.386; 95% confidence interval [CI] 1.117-1.719), age (OR 1.078; CI 1.056-1.101), regular dental checkups (absence; OR 1.452; CI 1.180-1.788), brushing frequency ≥ twice/day (absence; OR 1.510; CI 1.194-1.911), decayed teeth (presence; OR 1.328; CI 1.071-1.648), swallowing function (poor; OR 1.484; CI 1.135-1.939) at baseline. It was found that poor swallowing function was associated with the future onset of dementia.
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Affiliation(s)
- Komei Iwai
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Tetsuji Azuma
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Takatoshi Yonenaga
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Yasuyuki Sasai
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Taketsugu Nomura
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu, 500-8486, Japan
| | - Iwane Sugiura
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu, 500-8486, Japan
| | - Yujo Inagawa
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu, 500-8486, Japan
| | - Yusuke Matsumoto
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu, 500-8486, Japan
| | - Seiji Nakashima
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu, 500-8486, Japan
| | - Yoshikazu Abe
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu, 500-8486, Japan
| | - Takaaki Tomofuji
- Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho, Gifu, 501-0296, Japan.
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Hu S, Li X. An analysis of influencing factors of oral frailty in the elderly in the community. BMC Oral Health 2024; 24:260. [PMID: 38383363 PMCID: PMC10882750 DOI: 10.1186/s12903-024-03946-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: 09/19/2023] [Accepted: 01/27/2024] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE This study aimed to investigate the current situation of oral frailty (OF) in the elderly in the community in China and analyse its influencing factors. METHODS Using convenience sampling, 380 elderly people from three communities in our city were selected as participants in the study. The Oral Frailty Index-8, the Frailty Scale, the Oral Health Assessment Tool, the Mini-nutritional Assessment Scale and the Pittsburgh Sleep Quality Index were used to investigate and analyse OF influencing factors. RESULTS In this study, the 380 elderly participants were categorized into three groups: frailty, pre-frailty, and non-physical frailty, based on their responses to the questionnaires.The influencing factor analysis showed that age, gender, education level, frailty score, frailty stage, number of dentures, dry mouth, subjective chewing difficulty, oral health score and sleep quality were the influencing factors of OF in the elderly in the community (R2 = 0.712, F = 434.73, P < 0.05). The evaluation of the prediction results showed that the frailty score (area under the curve [AUC]: 0.751, 95% confidence interval [CI]: 0.683-0.862), subjective chewing difficulty (AUC: 0.765, 95% CI: 0.655-0.831) and sleep quality (AUC: 0.736, 95% CI: 0.652-0.781) had a higher predictive value for OF. CONCLUSION The main OF influencing factors in the elderly in the community are age, gender, education level, physical frailty (PF) score, PF stage, number of dentures, dry mouth, subjective chewing difficulties, oral health score and sleep quality. Nursing staff should pay attention to the OF of the elderly in the community and take targeted intervention measures in time to reduce and control OF occurrence and progression.
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Affiliation(s)
- Shuying Hu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, 610041, Sichuan Province, China
| | - Xia Li
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, 610041, Sichuan Province, China.
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Parisius KGH, Verhoeff MC, Lobbezoo F, Avivi-Arber L, Duyck J, Hirano H, Iijima K, Janssens B, Kossioni A, Lin CS, McKenna G, Müller F, Schimmel M, Visser A, Watanabe Y, Gobbens RJJ. Towards an operational definition of oral frailty: A e-Delphi study. Arch Gerontol Geriatr 2024; 117:105181. [PMID: 37713933 DOI: 10.1016/j.archger.2023.105181] [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: 07/29/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVES Building upon our recently developed conceptual definition of oral frailty (the age-related functional decline of orofacial structures), this e-Delphi study aims to develop an operational definition of oral frailty by identifying its components. METHODS We used a modified e-Delphi study to reach a consensus among international experts on the components of oral frailty. Twelve out of fifteen invited experts in the field of gerodontology participated. Experts responded to three rounds of an online 5-point scale questionnaire of components to be included or excluded from the operational definition of oral frailty. After each round, scores and rationales were shared with all experts, after which they could revise their position. A consensus was reached when at least 70% of the experts agreed on whether or not a component should be included in the operational definition of oral frailty. RESULTS The experts achieved a high level of agreement (80 - 100%) on including eight components of oral frailty and excluding nineteen. The operational definition of oral frailty should include the following components: 1) difficulty eating hard or tough foods, 2) inability to chew all types of foods, 3) decreased ability to swallow solid foods, 4) decreased ability to swallow liquids, 5) overall poor swallowing function, 6) impaired tongue movement, 7) speech or phonatory disorders, and 8) hyposalivation or xerostomia. CONCLUSION This e-Delphi study provided eight components that make up the operational definition of oral frailty. These components are the foundation for the next stage, which involves developing an oral frailty assessment tool.
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Affiliation(s)
- Karl G H Parisius
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam, The Netherlands; Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, The Netherlands.
| | - Merel C Verhoeff
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam, The Netherlands
| | | | - Joke Duyck
- Department of Oral Health Sciences, KU Leuven, Belgium
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Japan
| | - Katsuya Iijima
- Institute for Future Initiatives, Institute of Gerontology, The University of Tokyo, Japan
| | - Barbara Janssens
- Department of Oral Health Sciences, Gerodontology, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University, Belgium
| | - Anastassia Kossioni
- Division of Gerodontology, Department of Prosthodontics, Dental School, National and Kapodistrian University of Athens, Greece
| | - Chia-Shu Lin
- Department of Dentistry, National Yang Ming Chiao Tung University, Taiwan
| | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Northern Ireland United Kingdom
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthdontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthdontics, University Clinics of Dental Medicine, University of Geneva, Switzerland; Department of Reconstructive Dentistry and Gerodontology, school of Dental Medicine, University of Bern, Switzerland
| | - Anita Visser
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University of Groningen, The Netherlands; University Medical Center Groningen, The Netherlands; Department for Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, The Netherlands; Zonnehuisgroep Amstelland, The Netherlands; Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium; Department of Tranzo Academic Centre for Transformation in Care and Welfare, Faculty of Behavioural and Social Sciences, Tilburg University, The Netherlands
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Castrejón-Pérez RC, Wanyonyi KL, García-Vázquez PE, Cruz-Hervert LP, Ramírez-Aldana R, Borges-Yáñez SA. Frailty index and ten oral conditions in the Coyoacan cohort study: A cross-sectional analysis. Gerodontology 2023; 40:372-381. [PMID: 36358062 DOI: 10.1111/ger.12665] [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: 01/19/2022] [Revised: 10/12/2022] [Accepted: 10/24/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To analyse the relationship between the Frailty Index and 10 oral conditions controlling for nutritional status among Mexican community-dwelling older people. BACKGROUND Studies suggest that the association between frailty and oral conditions are mediated by nutrition. MATERIALS AND METHODS This cross-sectional analysis includes 487 community-dwelling men and women aged ≥70 years old. Interview and clinical examinations were performed at participants' homes. Objective (number of natural teeth, root remnants, dental condition, utilisation and functionality of removable dental prostheses and periodontitis) and subjective (utilisation of dental services, self-rated oral health, chewing difficulties and xerostomia) oral variables were collected by trained personnel. The Frailty Index was calculated considering 35 deficits. Nutritional status measured with the Mini-Nutritional assessment (MNA), age, sex, education, and marital status were included as covariates. We fitted 11 multivariate generalised linear models (one for each oral condition), assuming gamma distribution for Frailty Index as the outcome. RESULTS Participants average age was 78.1 years, 52.1% were women. We observed a higher Frailty Index among those rating their oral health as worse than others their age (5.1%), reporting chewing difficulties often (4.9%) and fairly and very often (7.0%), and xerostomia (4.8%). Age, gender and MNA were consistently associated with the Frailty Index. CONCLUSION Subjective oral conditions are compatible with the Frailty Index after controlling for older people's nutritional status and covariates.
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Affiliation(s)
| | | | - Paola E García-Vázquez
- Postgraduate and Research Studies Division, Dentistry School, National Autonomous University of Mexico, Mexico City, Mexico
| | - Luis Pablo Cruz-Hervert
- Postgraduate and Research Studies Division, Dentistry School, National Autonomous University of Mexico, Mexico City, Mexico
| | - Ricardo Ramírez-Aldana
- Instituto Nacional de Geriatría, National Institutes of Health, Ministry of Health, Mexico City, Mexico
| | - S Aída Borges-Yáñez
- Postgraduate and Research Studies Division, Dentistry School, National Autonomous University of Mexico, Mexico City, Mexico
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Minoura A, Ihara Y, Kato H, Murakami K, Watanabe Y, Hirano K, Ito Y, Kokaze A. Lip Seal Strength and Tongue Pressure among Japanese Male Workers: Comparison of Different Age Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2862. [PMID: 36833558 PMCID: PMC9957075 DOI: 10.3390/ijerph20042862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
Lip seal strength and tongue pressure are related to sarcopenia in older adults and are directly linked to the quality of life of workers after retirement. This study examined lip seal strength and tongue pressure among Japanese male workers by age. A self-administered questionnaire survey including alcohol consumption and smoking was conducted on 454 male workers. Height, weight, lip seal strength, and tongue pressure were also measured and then stratified by age (20s, 30s, 40s, 50s, and 60s and over). The mean (25th, 75th percentiles) lip seal strength and tongue pressure for all workers were 13.7 N (11.6, 16.4) and 41.7 kPa (35.2, 48.2), respectively. Both lip seal strength and tongue pressure were lowest in the 20s, at 12.1 N (9.6, 14.0) and 40.6 kPa (33.4, 47.6), respectively. The multiple regression analysis adjusted for smoking showed a significant positive association between lip seal strength and BMI for the 20s, 50s, and 60s and over, and a significant positive association between tongue pressure and BMI for the 30s, 40s, 50s, and 60s and over. To maintain oral health in older adults, it may be useful to measure workers' lip seal strength and tongue pressure and intervene at an earlier stage.
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Affiliation(s)
- Akira Minoura
- Department of Hygiene, Public Health and Preventive Medicine, School of Medicine, Showa University, Tokyo 142-8555, Japan
| | - Yoshiaki Ihara
- Division of Oral Functional Rehabilitation Medicine, Department of Special Needs Dentistry, School of Dentistry, Showa University, Tokyo 145-8515, Japan
| | - Hirotaka Kato
- Division of Oral Functional Rehabilitation Medicine, Department of Special Needs Dentistry, School of Dentistry, Showa University, Tokyo 145-8515, Japan
| | - Kouzou Murakami
- Department of Radiology, Division of Radiation Oncology, School of Medicine, Showa University, Tokyo 142-8555, Japan
| | - Yoshio Watanabe
- Division of Respiratory Medicine and Allergology, Department of Medicine, School of Medicine, Showa University, Tokyo 142-8555, Japan
| | - Kojiro Hirano
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, Showa University, Tokyo 142-8555, Japan
| | - Yoshinori Ito
- Department of Radiology, Division of Radiation Oncology, School of Medicine, Showa University, Tokyo 142-8555, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, School of Medicine, Showa University, Tokyo 142-8555, Japan
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Iwai K, Azuma T, Yonenaga T, Nomura T, Sugiura I, Inagawa Y, Matsumoto Y, Nakashima S, Abe Y, Tomofuji T. Relationship between Oral Function and Support/Care-Need Certification in Japanese Older People Aged ≥ 75 Years: A Three-Year Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16959. [PMID: 36554840 PMCID: PMC9779451 DOI: 10.3390/ijerph192416959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
The aim was to examine the relationships between oral functions and support/care-need certification in older people aged ≥ 75 years using the National Health Insurance (NHI) database system and data from Kani City, Gifu, Japan. In total, 732 older Japanese people aged ≥ 75 years who did not have support/care-need certification and underwent dental check-ups in Kani City in 2017 were followed up until 2020. Chewing state, tongue and lip function, and swallowing function were assessed by a self-administered questionnaire, an oral diadochokinesis test, and a repetitive saliva-swallowing test, respectively. The presence or absence of systemic diseases and of support/care-need certification was based on data collected by the NHI database. At follow up, 121 (17%) participants had support/care-need certification. The participants with support/care-need certification included more women (p < 0.001) and older people (p < 0.001); and had more hypertension (p = 0.003), musculoskeletal disorders (p < 0.001), pneumonia (p = 0.044), poor chewing state (p < 0.001), and poor swallowing function (p = 0.003) than those without support/care-need certification. Furthermore, the presence of support/care-need certification at follow up was associated with sex (woman: odds ratio [OR], 2.120; 95% confidence interval [CI], 1.354 to 3.317), age (OR, 1.203; CI, 1.139 to 1.270), chewing state (poor: OR, 2.534; CI, 1.409 to 4.557), and swallowing function (poor: OR, 2.372; CI, 1.248 to 4.510) at baseline. However, tongue and lip function were not associated with support/care-need certification. The results indicate that older Japanese people aged ≥ 75 years with a poor chewing state and poor swallowing function at baseline had a higher risk for support/care-need certification after three years.
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Affiliation(s)
- Komei Iwai
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
| | - Tetsuji Azuma
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
| | - Takatoshi Yonenaga
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
| | - Taketsugu Nomura
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Iwane Sugiura
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Yujo Inagawa
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Yusuke Matsumoto
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Seiji Nakashima
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Yoshikazu Abe
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Takaaki Tomofuji
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
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10
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Milagres CS, Tôrres LHDN, de Almeida TB, Neri AL, Antunes JLF, de Sousa MDLR. Self-assessed masticatory function and frailty in Brazilian older adults: the FIBRA Study. Rev Saude Publica 2022; 56:104. [PMID: 36515306 PMCID: PMC9749652 DOI: 10.11606/s1518-8787.2022056004195] [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: 09/02/2021] [Accepted: 01/11/2022] [Indexed: 12/15/2022] Open
Abstract
OBJETIVE To investigate the relationship between the masticatory function and the frailty of older people. METHODS Exploratory cross-sectional study using secondary data from the FIBRA Project on the frailty conditions of older people living in urban areas of six Brazilian municipalities, from 2008 to 2009. The population consisted of older adults aged 65 and over with no cognitive impairment. A single session identification questionnaire and the Mini-Mental State Examination (MMSE) were applied, followed by collecting sociodemographic data and data on the participants' self-assessment of masticatory function, general health, and oral health. RESULTS 2,341 older people (164 frail older adults), of whom 63.2% reported not having seen a dentist in the last year, and approximately 26% of them had three or more functional feeding problems. Older participants (OR = 2.88; 95%CI: 2.01-4.13), who are retired (OR = 2.31; 95%CI: 1.18-5.53), those who were depressed (OR = 2.31; 95%CI: 1.58-3.38), and those who self-assessed their general health as worse compared to others of the same age (OR = 3.91; 95%CI: 2.39-6.40) were at higher risk of frailty. Three or more problems related to the functional aspects of mastication were associated with a greater chance of frailty (OR = 2.06; 95%CI: 1.25-3.41). CONCLUSION This study found an association between masticatory function and a greater chance of frailty among the studied population.
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Affiliation(s)
- Clarice Santana Milagres
- Faculdade São Leopoldo MandicDepartamento de MedicinaArarasSPBrasilFaculdade São Leopoldo Mandic. Departamento de Medicina. Araras, SP, Brasil
| | - Luísa Helena do Nascimento Tôrres
- Universidade Federal de Santa MariaDepartamento de EstomatologiaCentro de Ciências da SaúdeSanta MariaRSBrasilUniversidade Federal de Santa Maria. Centro de Ciências da Saúde. Departamento de Estomatologia. Santa Maria, RS, Brasil
| | - Talita Bonato de Almeida
- Universidade Anhembi MorumbiPiracicabaSPBrasilUniversidade Anhembi Morumbi. Piracicaba, SP, Brasil
| | - Anita Liberalesso Neri
- Universidade Estadual de CampinasFaculdade de EducaçãoDepartamento de Psicologia da EducaçãoCampinasSPBrasilUniversidade Estadual de Campinas. Faculdade de Educação. Departamento de Psicologia da Educação.
Campinas, SP, Brasil
| | - José Leopoldo Ferreira Antunes
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de EpidemiologiaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
| | - Maria da Luz Rosário de Sousa
- Universidade Estadual de CampinasFaculdade de OdontologiaDepartamento de Ciências da Saúde e
Odontologia InfantilPiracicabaSPBrasilUniversidade Estadual de Campinas. Faculdade de Odontologia. Departamento de Ciências da Saúde e
Odontologia Infantil. Piracicaba, SP, Brasil,Correspondence: Maria da Luz Rosário de Sousa Universidade Estadual de Campinas Av. Limeira, 901 - Areião 13414-018 Piracicaba, SP, Brasil E-mail:
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11
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Tani A, Mizutani S, Oku S, Yatsugi H, Chu T, Liu X, Iyota K, Kishimoto H, Kashiwazaki H. Association between oral function and physical pre-frailty in community-dwelling older people: a cross-sectional study. BMC Geriatr 2022; 22:726. [PMID: 36056302 PMCID: PMC9440534 DOI: 10.1186/s12877-022-03409-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have examined the relationship between oral functions and the physical pre-frailty status, classified using physical function tests. This cross-sectional study aimed to clarify this association among community-dwelling older people from the Itoshima Frail Study in Itoshima Fukuoka Prefecture. METHODS Of the 1,555 individuals invited to join the study, 381 (188 males and 193 females) enrolled. Their physical pre-frailty was assessed with a classification system consisting of two physical indicators (fatigue and unintentional weight loss, determined with a questionnaire), two functional components (declined walking speed and muscle weakness, determined using a body function measuring instrument), and declined physical activity (examined using a triaxial accelerometer). Subsequently, the individuals were classified into three groups: robust, pre-frailty, and frailty. Along with the number of teeth remaining, oral functions, such as masticatory performance, tongue pressure strength, and oral diadochokinesis (ODK), were examined. Data regarding social activity and exercise habits were collected, and the individuals' body compositions were measured. Odds ratios (ORs) and 95% confidence intervals (CIs) for the physical pre-frailty were calculated using logistic regression models. RESULTS In this study, 126 (33%) participants presented with physical pre-frailty. The participants in the robust group were younger, had stronger maximum handgrip strength, and walked faster than those in the physical pre-frailty group (p < 0.001). The robust group presented with better oral functions (masticatory performance, p = 0.015; oral ODK /ta/, p = 0.004). The physical pre-frailty status was significantly associated with age (OR, 1.111; 95% CI, 1.048-1.178; p < 0.001), masticatory performance (OR, 0.819; 95% CI, 0.680-0.986; p = 0.035), low ODK/ta/ (OR, 1.864; 95% CI, 1.069-3.250; p = 0.028), and low social activity (OR, 2.273; 95% CI, 1.308-3.951; p = 0.004). CONCLUSION This study indicated that older people with higher age, lower anterior tongue movement, lower masticatory performance, and lower social activity are positively associated with physical pre-frailty.
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Affiliation(s)
- Asuka Tani
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shinsuke Mizutani
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. .,Faculty of Dental Science, Oral Health/Brain Health/Total Health Research Center, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Saori Oku
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Harukaze Yatsugi
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka, 819-0395, Japan
| | - Tianshu Chu
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka, 819-0395, Japan
| | - Xin Liu
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka, 819-0395, Japan
| | - Kiyomi Iyota
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hiro Kishimoto
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka, 819-0395, Japan.,Faculty of Arts and Science, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka, 819-0395, Japan
| | - Haruhiko Kashiwazaki
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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12
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Namiki C, Hara K, Yanagida R, Nakagawa K, Yamaguchi K, Okumura T, Tamai T, Kurosawa Y, Komatsu T, Tohara H. Association between Tongue Pressure and Jaw-Opening Force in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9825. [PMID: 36011461 PMCID: PMC9407805 DOI: 10.3390/ijerph19169825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/28/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Tongue pressure (TP) is used to assess tongue muscle strength and is related to function and frailty. While performing TP, it is necessary to elevate the tongue and oral floor by contracting the suprahyoid muscles. However, the association between TP and suprahyoid muscle strength remains unclear. Accordingly, this study investigated the relationship between TP and jaw-opening force (JOF), an indicator of suprahyoid muscle strength. This cross-sectional study included 88 independent community-dwelling participants aged ≥65 years. Age, sex, and the number of remaining teeth were recorded. Ultrasonography was used to evaluate the cross-sectional area of the tongue and geniohyoid muscle, as representatives of the suprahyoid muscles. Sarcopenia was diagnosed based on appendicular skeletal muscle mass index, handgrip strength, and gait speed. Multiple regression analysis was performed with TP as the dependent variable. TP was significantly associated with JOF (β = 0.371, p = 0.003). This study revealed that decreased TP was associated with a decline in JOF and suprahyoid muscle mass in older adults. Thus, low TP may be associated with decreased JOF. Prevention of the weakness of the suprahyoid muscles and maintaining TP may also contribute to the prevention of frailty associated with TP.
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Affiliation(s)
- Chizuru Namiki
- Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 2388580, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Koji Hara
- Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 2388580, Japan
| | - Ryosuke Yanagida
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Takuma Okumura
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Tomoe Tamai
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Yukiko Kurosawa
- Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 2388580, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Tomoko Komatsu
- Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 2388580, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
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13
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Sakai K, Nakayama E, Yoneoka D, Sakata N, Iijima K, Tanaka T, Hayashi K, Sakuma K, Hoshino E. Association of Oral Function and Dysphagia with Frailty and Sarcopenia in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. Cells 2022; 11:cells11142199. [PMID: 35883642 PMCID: PMC9316124 DOI: 10.3390/cells11142199] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 12/11/2022] Open
Abstract
Studies investigating the associations of oral function and dysphagia with frailty and sarcopenia in community-dwelling older adults are increasing; however, they have not been systematically summarized. We conducted a systematic review to investigate these associations. We searched electronic databases and synthesized relevant data using conventional (frequentist-style) and Bayesian meta-analyses. Twenty-four studies were found to be eligible for our review, including 20 cross-sectional and four prospective cohort studies. Older adults with frailty or sarcopenia had lower tongue pressure, according to the results of conventional meta-analysis (mean difference [95% confidence interval or credible interval]: −6.80 kPa [−10.22 to −3.38] for frailty and −5.40 kPa [−6.62 to −4.17] for sarcopenia) and Bayesian meta-analysis (−6.90 kPa [−9.0 to −4.8] for frailty, −5.35 kPa [−6.78 to −3.89] for sarcopenia). People with frailty had a higher odds ratio (OR) for dysphagia according to the results of conventional meta-analysis (3.99 [2.17 to 7.32]) and Bayesian meta-analysis (1.38 [0.77 to 1.98]). However, the results were inconclusive for people with sarcopenia. A prospective association could not be determined because of the lack of information and the limited number of studies. Decreased oral function and dysphagia can be important characteristics of frailty and sarcopenia in community-dwelling older adults.
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Affiliation(s)
- Kotomi Sakai
- Comprehensive Unit for Health Economic Evidence Review and Decision Support (CHEERS), Research Organization of Science and Technology, Ritsumeikan University, Kyoto 600-8815, Japan;
- Heisei Medical Welfare Group Research Institute, Tokyo 151-0053, Japan;
- Correspondence:
| | - Enri Nakayama
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo 101-8310, Japan;
| | - Daisuke Yoneoka
- Infectious Disease Surveillance Center at the National Institute of Infectious Diseases, Tokyo 162-8640, Japan;
- Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo 160-8582, Japan
- Tokyo Foundation for Policy Research, Tokyo 106-6234, Japan
| | - Nobuo Sakata
- Heisei Medical Welfare Group Research Institute, Tokyo 151-0053, Japan;
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo 113-8654, Japan; (K.I.); (T.T.)
- Institute for Future Initiatives, The University of Tokyo, Tokyo 113-8654, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo 113-8654, Japan; (K.I.); (T.T.)
| | - Kuniyoshi Hayashi
- Institute of Religion and Culture, Kyoto Women’s University, Kyoto 605-8501, Japan;
| | - Kunihiro Sakuma
- Institute for Liberal Arts, Environment and Society, Tokyo Institute of Technology, Tokyo 152-8550, Japan;
| | - Eri Hoshino
- Comprehensive Unit for Health Economic Evidence Review and Decision Support (CHEERS), Research Organization of Science and Technology, Ritsumeikan University, Kyoto 600-8815, Japan;
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14
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Tongue Pressure Declines Early on in Patients with Malocclusion. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
(1) Background: The tongue plays a key role in the stomatognathic system in carrying out oral functions. The aim of this study was to identify the association between tongue pressure and orthodontic parameters. (2) Methods: This study is a cross-sectional multicentered cohort study with IRB approval. During routine orthodontic initial examinations, the following data were recorded: age, sex, angle classification, overjet (OJ), overbite (OB), arch sizes, tongue width, and maximum tongue pressure (MTP). The association between MTP and orthodontic parameters was analyzed using Pearson’s correlation analysis and the Student’s t-test. (3) Results: There is a positive correlation between MTP and age between ages 10 and 20 (R = 0.47, p < 0.01). There is a negative correlation with MTP and age between 20 and 40 (R = −0.30, p < 0.05). There are negative correlations between MTP and OJ (R = −0.278, p < 0.01)) and OB (R = −0.374, p < 0.01). While there is no statistical significance between MTP and tongue width, there is a statistically significant difference between age and tongue width (R = 0.22482, p < 0.05). There is no statistical significance between MTP and sex, angle classification, arch length, intercanine width, and intermolar width. (4) Conclusion: An earlier decline in MTP is observed with patients with malocclusion. This implies that patients with malocclusion should seek early treatment for the malocclusion.
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15
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Effect of decreased tongue pressure on dysphagia and survival rate in elderly people requiring long-term care. J Dent Sci 2022; 17:856-862. [PMID: 35756815 PMCID: PMC9201529 DOI: 10.1016/j.jds.2021.09.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/21/2021] [Indexed: 12/11/2022] Open
Abstract
Background/purpose Tongue pressure plays an important role in swallowing function. The purpose of this study is to investigate whether decreased tongue pressure is associated with dysphagia and the development of pneumonia in the elderly requiring long-term care. Materials and methods Tongue pressure measurement and swallowing videoendoscopic (VE) examination were performed in 60 hospitalized elderly people (33 males and 27 females, with an average age of 84.3 years) to investigate the relationship with the clinical course. Factors related with dysphagia was analyzed by Fisher's exact test and one-way ANOVA, followed by multivariate logistic regression. The relationship between each variable and survival were analyzed by cox regression. Results Twenty-one patients had dysphagia by VE examination. Multivariate analysis showed that smaller BMI and reduced tongue pressure were significantly correlated with dysphagia. Smaller number of remaining teeth and dysphagia were significantly related to pneumonia-related death. No patients with tongue pressure of larger than 20 kpa died by pneumonia within one year, while in those with tongue pressure of smaller than 20 kpa, one-year cumulative survival rate by pneumonia was 44.3%. Conclusion Decreased tongue pressure was significantly associated with dysphagia and may increase the risk of pneumonia-related death in the elderly requiring long-term care.
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16
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Somsak K, Tangwongchai S, Komin O, Maes M. Oral exercises significantly improve oral functions in people with mild and moderate dementia: a randomized controlled study. J Oral Rehabil 2022; 49:616-626. [PMID: 35274344 DOI: 10.1111/joor.13317] [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: 11/10/2021] [Revised: 02/02/2022] [Accepted: 03/06/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND There have been no standard protocols of oral exercises for maintaining and improving oral function for people with dementia. OBJECTIVE This study aimed to determine the effects of home-based oral exercises on the oral function of people with mild to moderate dementia. METHODS Twenty-two participants at King Chulalongkorn Memorial Hospital were randomly assigned to exercise group (n = 11) or control group (n = 11). The exercise group was instructed to do three home-based oral exercises, consisting of tongue-strengthening, oral diadochokinesis (ODK), and mouth-opening exercises, for 3 months, while the control group received advice on oral health care. The maximum tongue pressure (MTP) was the primary outcome. MTP, ODK rates of /pa/, /ta/, /ka/, modified water swallowing test (MWST), and oral moisture were measured at baseline, and after 1, 2, and 3 months of training. The generalized estimating equation analysis was used to evaluate the effects of oral exercises on the oral function. RESULTS The MTP and all ODK rates in the exercise group were significantly increased after 3 months of training. There were significant interaction effects between time and intervention in MTP and all ODK rates. No significant interaction effects between time and intervention in oral moisture were found. The MWST scores in both groups did not change through the end of study and no adverse effects were reported. CONCLUSION Home-based oral exercises were found to be effective for improving tongue strength and tongue-lip motor function in people with mild to moderate dementia.
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Affiliation(s)
- Kwanrutai Somsak
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sookjaroen Tangwongchai
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Orapin Komin
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of Psychiatry, Medical University Plovdiv, Plovdiv, Bulgaria.,IMPACT Research Center, Deakin University, Geelong, Australia
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17
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Dai M, Yue J, Zhang J, Wang H, Wu C. Functional dentition is a modifier of the association between vitamin D and the frailty index among Chinese older adults: a population-based longitudinal study. BMC Geriatr 2022; 22:159. [PMID: 35220949 PMCID: PMC8883641 DOI: 10.1186/s12877-022-02857-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Backgrounds
Although vitamin D and dentition status are each associated with frailty, their combined effects on frailty have not been studied. This study aimed to evaluate the combined effects of vitamin D and dentition status on frailty in old Chinese adults.
Methods
Baseline data were obtained from the 2011–2012 wave of the Chinese Longitudinal Healthy Longevity Survey. A total of 1074 participants ≥65 years who were non-frail or prefrail at baseline were included; follow-up was conducted in the 2014 wave. Frailty was assessed by a 40-item frailty index (FI) and classified into frail (FI > 0.21), prefrail (FI: 0.1–0.21), and non-frail (FI ≤0.1). Vitamin D was assessed by 25-Hydroxyvitamin D (25(OH)D) and categorized into quartiles and dichotomies (normal: ≥50 nmol/L vs. low: < 50 nmol/L). The presence of ≥20 natural teeth was defined as functional dentition, otherwise as non-functional dentition. We used bivariate logistic regression and restricted cubic splines to examine the association between vitamin D, dentition status, and frailty. We created a multiplicative interaction between vitamin D and dentition status to test for their combined effect.
Results
A total of 205 (19.1%) incident frailty were identified during the 3-year follow-up. Participants with the lowest quartile of plasma 25(OH) D were more likely to be frail (odds ratio [OR] 2.45, 95% confidence interval [CI]: 1.38 to 4.35) than those in the highest quartile. Older adults with the lowest quartile of 25(OH) D and non-functional dentition had the highest odds of frailty (OR = 3.67, 95% CI: 1.02 to 13.12). We also observed that a lower vitamin D level was associated with an increased risk of frailty with a threshold of 40.37 nmol/L using restricted cubic spline models. However, vitamin D levels were not significantly associated with frailty among participants with functional dentition.
Conclusions
Low vitamin D levels were associated with an increased risk of frailty in older adults. Functional dentition modified the association of vitamin D with frailty.
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18
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van der Heijden EM, Klüter WJ, van der Maarel-Wierink CD, Gobbens RJJ. Exploring associations between multidimensional frailty and oral health in community-dwelling older people. A pilot study. SPECIAL CARE IN DENTISTRY 2022; 42:361-368. [PMID: 35014046 PMCID: PMC9545350 DOI: 10.1111/scd.12691] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 12/02/2022]
Abstract
Objective To determine the associations between four validated multidimensional self‐report frailty scales and nine indices of oral health in community‐dwelling older persons. Materials and Methods This pilot study was conducted in a sample of 208 older persons aged 70 years and older who visited two dental practices in the Netherlands. Frailty status was measured by four different self‐report frailty questionnaires: Tilburg Frailty Indicator (TFI), Groningen Frailty Indicator (GFI), Sunfrail Checklist (SC), and the Sherbrooke Postal Questionnaire (SPQ). Oral health was assessed by two calibrated examiners. Results The prevalence of frailty according to the four frailty measures TFI, GFI, SC, and SPQ was 32.8%, 31.5%, 24.5%, and 49.7%, respectively. The SC correlated with four oral health variables (DMFT, number of teeth, percentage of occlusal contacts, Plaque Index), the TFI with three (number of teeth, percentage of occlusal contacts, Plaque Index), the GFI only with DPSI, and the SPQ with the number of teeth and the number of occlusal contacts. Conclusion Of the studied multidimensional frailty scales, the SC and TFI were correlated with most oral health variables (four and three, respectively). However, it should be noticed that these correlations were small. Clinical relevance The SC and TFI might help to identify older people with risk of poor oral health so that preventive care can be used to ensure deterioration of oral health and maintenance of quality of life. Vice versa early detection of frailty by oral care professionals could contribute to interprofessional management of frailty.
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Affiliation(s)
| | - Wim J Klüter
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,College of Dental Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Claar D van der Maarel-Wierink
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Robbert J J Gobbens
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, Netherlands.,Zonnehuisgroep Amstelland, Amstelveen, Netherlands.,Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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19
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Relationship between Oral Hypofunction, and Protein Intake: A Cross-Sectional Study in Local Community-Dwelling Adults. Nutrients 2021; 13:nu13124377. [PMID: 34959928 PMCID: PMC8705970 DOI: 10.3390/nu13124377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 01/09/2023] Open
Abstract
Few studies have investigated the relationship between nutritional status and comprehensive assessment of oral hypofunction, especially protein intake-related sarcopenia. Thus, we explored these relationships in a large-scale cross-sectional cohort study using the seven-item evaluation for oral hypofunction and Diet History Questionnaire for nutritional assessment. We used the data from 1004 individuals who participated in the 2019 health survey of the residents of Tarumizu City, Kagoshima Prefecture, Japan for analysis. We found that individuals with oral hypofunction were significantly older with a lower skeletal muscle index. Although there were few foods that had a significant difference between the groups with and without oral hypofunction, the consumption of beans and meats was significantly lower in women and men in the oral hypofunction group, respectively. According to the lower limit of the tentative dietary goal defined in Japan, comprehensive evaluation of oral hypofunction was significantly and independently associated with protein intake in both men and women (odds ratio, 1.70; 95% confidence interval, 1.21-2.35). In conclusion, we found that oral hypofunction was associated with targeted protein intake for sarcopenia and frailty prevention in middle-aged and older community-dwelling adults. Comprehensive evaluation of oral function with intervention in cases of hypofunction could inform clinicians to better prevent sarcopenia.
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Yoshida M, Hiraoka A, Takeda C, Mori T, Maruyama M, Yoshikawa M, Tsuga K. Oral hypofunction and its relation to frailty and sarcopenia in community-dwelling older people. Gerodontology 2021; 39:26-32. [PMID: 34727388 DOI: 10.1111/ger.12603] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/20/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the frequency of oral hypofunction in community-dwelling older people and determine its relationship with frailty and sarcopenia. BACKGROUND Previous studies have shown that frailty and sarcopenia are associated with decreased oral function. However, these studies have only evaluated frailty or sarcopenia alone and have not evaluated their relationship with each other. MATERIALS AND METHODS The participants were community-dwelling independent older people in Kyoto. Their oral function evaluation included seven items (oral hygiene, oral dryness, occlusal force, tongue-lip motor function, tongue pressure, masticatory function and swallowing function). Oral hypofunction was defined as abnormalities in at least three of these items. The frailty status was classified into three categories (robust, pre-frail and frail) according to the frailty phenotype and deficit-accumulation models. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) Consensus. The relationships between oral function and frailty were analysed using logistic regression analyses, after adjusting for sarcopenia. RESULTS Among the 340 participants that were analysed (69 men, 271 women; average age: 75.0 years), 182 (53.5%) had oral hypofunction (40 men, 142 women; average age: 76.8 years). There was a significant relationship between oral hypofunction and deficit-accumulation model-assessed frailty, after adjusting for sarcopenia. CONCLUSION Almost half of the community-dwelling older people have oral hypofunction, which is significantly related to comprehensive frailty and sarcopenia.
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Affiliation(s)
- Mitsuyoshi Yoshida
- Department of Dentistry & Oral-Maxillofacial Surgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Chiho Takeda
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Takahiro Mori
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Mariko Maruyama
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
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21
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Izumi M, Akifusa S. Tongue cleaning in the elderly and its role in the respiratory and swallowing functions: Benefits and medical perspectives. J Oral Rehabil 2021; 48:1395-1403. [PMID: 34612518 DOI: 10.1111/joor.13266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 12/18/2022]
Abstract
Oral dysfunction, including oral uncleanness and decline in tongue motor function, tongue pressure and swallowing function, precedes frailty. The tongue's dorsum is a reservoir of oral microbiota, desquamated epithelial mucosa and leukocytes due to the multi-papillate anatomy, and leads to tongue coating. The tongue coating is frequently found in older adults because of hyposalivation, immunity's hypoactivity, diminished motor function and compromised tongue's pressure with age. Anaerobe-driven volatile sulphur compounds in tongue coating are a major cause of intra-oral malodor. Dysbiosis of the tongue-coating microbiome rather than the amount of microorganisms is associated with a risk of aspiration pneumonia. Daily tongue cleaning with a brush or scraper is an easy way to control tongue coating deposits and quality. Using mouth wash or rinse-containing germicides is also a way to control the microbiota of tongue coating. The tongue function is closely related to swallowing. Tongue and suprahyoid muscles are linked with respiratory muscles through the endothoracic fascia. The mechanical stimulation during the cleaning of the tongue may stimulate the respiratory muscles. An intervention trial revealed that tongue cleaning by mucosal brush improves tongue pressure, swallowing and respiratory function in old residents of nursing homes, suggesting a rehabilitative effect of tongue cleaning on the swallowing and respiratory functions, preventing aspiration pneumonia. This narrative review assesses the tongue-cleaning benefits for respiratory and swallowing functions and the possibility of preventing aspiration pneumonia.
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Affiliation(s)
- Maya Izumi
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
| | - Sumio Akifusa
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Kitakyushu, Japan
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Ogino Y, Suzuki H, Ayukawa Y, Ueno Y, Jinnouchi A, Koyano K. Masticatory performance and other oral functions in community-dwelling elderly patients without posterior occlusal support by natural teeth. J Oral Sci 2021; 63:330-333. [PMID: 34470988 DOI: 10.2334/josnusd.21-0265] [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: 11/01/2022]
Abstract
PURPOSE To evaluate masticatory performance (MP), maximum occlusal force (MOF), maximum tongue pressure (MTP) and oral diadochokinesis (ODK) among community-dwelling elderly patients without posterior occlusal support. METHODS This study enrolled community-dwelling elderly patients (≥65 years old) who belonged to Eichner A, B4, C1, C2, and C3. Each oral function was statistically compared among groups. Correlations between MP and other variables were examined in Eichner B4 and C patients. RESULTS MP and MOF values in Eichner B4 and C patients were significantly lower than in Eichner A patients. There were significant differences in MTP values between Eichner "A and C2, C3", and "B4 and C2, C3". ODK in Eichner C patients showed significantly lower values compared to Eichner A patients in general. Although there were statistically significant correlations of MP with age, the number of remaining teeth and all oral functions were identified, and multiple regression analysis indicated that MOF and MTP were independently related to MP. CONCLUSION Oral functions in Eichner B4 and C patients were lower compared to Eichner A patients. MP was significantly correlated with MOF and MTP in elderly patients without posterior occlusal support, suggesting the importance of rehabilitation of MOF and MTP in MP.
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Affiliation(s)
- Yoichiro Ogino
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Hiroki Suzuki
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University.,Department of Dentistry, Inouekai Medical Corporation Sasaguri Hospital
| | - Yasunori Ayukawa
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University.,Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Yoko Ueno
- Department of Dentistry, Inouekai Medical Corporation Sasaguri Hospital
| | - Akio Jinnouchi
- Department of Dentistry, Inouekai Medical Corporation Sasaguri Hospital
| | - Kiyoshi Koyano
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University
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23
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Clark D, Kotronia E, Ramsay SE. Frailty, aging, and periodontal disease: Basic biologic considerations. Periodontol 2000 2021; 87:143-156. [PMID: 34463998 DOI: 10.1111/prd.12380] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Aging is associated with the development of disease. Periodontal disease is one of the many diseases and conditions that increase in prevalence with age. In addition to the traditional focus on individual age-related conditions, there is now a greater recognition that multisystem conditions such as frailty play an important role in the health of older populations. Frailty is a clinical condition in older adults that increases the risk of adverse health outcomes. Both frailty and periodontal disease are common chronic conditions in older populations and share several risk factors. There is likely a bidirectional relationship between periodontal disease and frailty. Comorbid systemic diseases, poor physical functioning, and limited ability to self-care in frail older people have been implicated as underlying the association between frailty and periodontal disease. In addition, both frailty and periodontal disease also have strong associations with inflammatory dysregulation and other age-related pathophysiologic changes that may similarly underlie their development and progression. Investigating age-related changes in immune cells that regulate inflammation may lead to a better understanding of age-related disease and could lead to therapeutic targets for the improved management of frailty and periodontal disease.
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Affiliation(s)
- Daniel Clark
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Eftychia Kotronia
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Sheena E Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
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Umemoto G, Fujioka S, Arahata H, Sakae N, Sasagasako N, Toda M, Furuya H, Tsuboi Y. Longitudinal Changes of Tongue Thickness and Tongue Pressure in Neuromuscular Disorders. BMC Neurol 2021; 21:302. [PMID: 34353291 PMCID: PMC8340465 DOI: 10.1186/s12883-021-02225-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 05/06/2021] [Indexed: 12/03/2022] Open
Abstract
Background Swallowing dysfunction is related to major cause of adverse events and an indicator of shorter survival among patients with neuromuscular disorders (NMD). It is critical to assess the swallowing function during disease progression, however, there are limited tools that can easily evaluate swallowing function without using videofluoroscopic or videoendoscopic examination. Here, we evaluated the longitudinal changes in tongue thickness (TT) and maximum tongue pressure (MTP) among patients with amyotrophic lateral sclerosis (ALS), myotonic dystrophy type 1 (DM1), and Duchenne muscular dystrophy (DMD). Methods Between 2010 and 2020, TT and MTP were measured from 21 ALS, 30 DM1, and 14 DMD patients (mean ages of 66.9, 44.5, and 21.4 years, respectively) at intervals of more than half a year. TT was measured, by ultrasonography, as the distance from the mylohyoid muscle raphe to the tongue dorsum, and MTP was determined by measuring the maximum compression on a small balloon when pressing the tongue against the palate. Then we examined the relationship between these evaluations and patient background and swallowing function. Results Mean follow-up periods were 24.0 months in the ALS group, 47.2 months in the DM1group, and 61.1 months in the DMD group. The DMD group demonstrated larger first TT than the other groups, while the DM1 group had lower first MTP than the ALS group. The ALS group showed a greater average monthly reduction in mean TT than the DM1 group and greater monthly reductions in mean body weight (BW) and MTP than the other groups. Significant differences between the first and last BW, TT, and MTP measures were found only in the ALS group. Conclusions This study suggests that ALS is associated with more rapid degeneration of tongue function over several years compared to DMD and DM1.
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Affiliation(s)
- George Umemoto
- Swallowing Disorders Center, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. .,Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan.
| | - Shinsuke Fujioka
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hajime Arahata
- Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan
| | - Nobutaka Sakae
- Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan
| | - Naokazu Sasagasako
- Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan
| | - Mine Toda
- Department of Clinical Nutrition & Food services, NHO Omuta National Hospital, Fukuoka, Japan
| | - Hirokazu Furuya
- Department of Neurology, Faculty of Medicine, Kochi University, Kochi, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Dibello V, Zupo R, Sardone R, Lozupone M, Castellana F, Dibello A, Daniele A, De Pergola G, Bortone I, Lampignano L, Giannelli G, Panza F. Oral frailty and its determinants in older age: a systematic review. THE LANCET HEALTHY LONGEVITY 2021; 2:e507-e520. [DOI: 10.1016/s2666-7568(21)00143-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 01/01/2023]
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Slashcheva LD, Karjalahti E, Hassett LC, Smith B, Chamberlain AM. A systematic review and gap analysis of frailty and oral health characteristics in older adults: A call for clinical translation. Gerodontology 2021; 38:338-350. [PMID: 34331353 DOI: 10.1111/ger.12577] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/02/2021] [Accepted: 05/21/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This systematic review updates the evidence for association between oral health characteristics and frailty status, identifying gaps in translational dental research and application of frailty assessment into clinical practice. BACKGROUND Clinicians have little guidance on stage-appropriate dental treatment for medically complex older adults. Oral health characteristics have been associated with frailty status, determined through validated assessment tools representing a concise measure of health. Translation of frailty assessment into dental practice has not been the focus of previous reviews. METHODS Utilising the PRISMA framework for systematic reviews, a comprehensive database search identified articles describing the association of interest. Those included were cross-sectional or longitudinal, in English, included participants aged 50 years or older, used validated frailty assessments and measured clinically relevant oral health outcomes. From 835 screened articles, 26 full-text articles were eligible for quality appraisal and synthesis. RESULTS Frailty prevalence ranged from 8.5% to 66.0%. Most studies utilised the Fried frailty criteria. Qualitative synthesis of 17 cross-sectional and nine longitudinal studies demonstrated significant covariate-adjusted association between frailty status and number of teeth, chewing ability, prosthetic characteristics, dental caries, periodontitis, dental utilisation and oral health-related quality of life factors. Variability in findings reflected study sample diversity based on country of study origin, age at recruitment, sample size, frailty assessment type, use of clinical versus self-reported outcome measures and differences in statistical analysis. CONCLUSION Despite robust evidence of association with oral health characteristics, frailty assessment has yet to be sufficiently applied to translational dental research and clinical practice.
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Affiliation(s)
- Lyubov D Slashcheva
- Department of Dental Specialties, Mayo Clinic, Rochester, MN, USA.,Apple Tree Dental, Rochester, MN, USA
| | - Erika Karjalahti
- Roseman University College of Dental Medicine, Henderson, NV, USA
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Liu HY, Chen JH, Hsu KJ, Yao CT, Chen PH, Hsiao SY, Lin CL. Decreased Tongue Pressure Associated with Aging, Chewing and Swallowing Difficulties of Community-Dwelling Older Adults in Taiwan. J Pers Med 2021; 11:jpm11070653. [PMID: 34357120 PMCID: PMC8303908 DOI: 10.3390/jpm11070653] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/20/2022] Open
Abstract
Personalized tongue pressure (TP) training focuses on improving swallowing. This study aims to establish the TP values of different age levels and compare changes between different swallowing status among community-dwelling elders. In this cross-sectional study, 1000 participants, aged 60 years old and above, were recruited from community care centers. All participants were classified into non chewing and/or swallowing difficulties (NCSD) and with chewing and/or swallowing difficulties (CSD) groups and their diseases and dieting status were recorded using a structured questionnaire. A disposable oral probe was used to measure TP by asking participants to compress it against the hard palate with maximum voluntary effort. Among 1000 elders, 63.10% had CSD and their TP (from 31.76 to 18.20 kPa) was lower than the NCSD group (from 33.56 to 24.51 kPa). Both groups showed the same tendency for TP decline with increasing age. Decline of TP makes CSD elderly have a poor appetite, eat a soft or liquid diet, and take longer to eat a meal (all p < 0.050). The secondary risk factor dominating TP decline for NCSD and CSD elders is having an education level less than primary school and an abnormal eating assessment, respectively. Our results demonstrated that TP decline has a significant relationship with age changes. Education level and an abnormal eating assessment score are closely associated with TP decline. A series of TP values can be used as a reference indicator of personalized medicine during the aging process among community-dwelling older adults.
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Affiliation(s)
- Hsiu-Yueh Liu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Jen-Hao Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (J.-H.C.); (K.-J.H.); (P.-H.C.); (S.-Y.H.)
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Kun-Jung Hsu
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (J.-H.C.); (K.-J.H.); (P.-H.C.); (S.-Y.H.)
- Department of Family Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
| | - Ching-Teng Yao
- Master Program of Long-Term Care in Aging, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Ping-Ho Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (J.-H.C.); (K.-J.H.); (P.-H.C.); (S.-Y.H.)
- Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Szu-Yu Hsiao
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (J.-H.C.); (K.-J.H.); (P.-H.C.); (S.-Y.H.)
- Division of Pediatric Dentistry and Special Needs Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming Chiao-Tung University, Hsinchu 30010, Taiwan
- Correspondence:
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Nakamura M, Hamada T, Tanaka A, Nishi K, Kume K, Goto Y, Beppu M, Hijioka H, Higashi Y, Tabata H, Mori K, Mishima Y, Uchino Y, Yamashiro K, Matsumura Y, Makizako H, Kubozono T, Tabira T, Takenaka T, Ohishi M, Sugiura T. Association of Oral Hypofunction with Frailty, Sarcopenia, and Mild Cognitive Impairment: A Cross-Sectional Study of Community-Dwelling Japanese Older Adults. J Clin Med 2021; 10:jcm10081626. [PMID: 33921265 PMCID: PMC8068799 DOI: 10.3390/jcm10081626] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 01/01/2023] Open
Abstract
Oral hypofunction is a new concept that addresses the oral function of older adults. Few studies have investigated the relationship between oral hypofunction and general health conditions such as frailty, sarcopenia, and mild cognitive impairment. This paper explores these relationships in a large-scale, cross-sectional cohort study. The relationships of oral hypofunction with frailty, sarcopenia, and mild cognitive impairment were examined using data from 832 individuals who participated in the 2018 health survey of the residents of Tarumizu City, Kagoshima Prefecture, Japan. Individuals with frailty, sarcopenia, and mild cognitive impairment had significantly higher rates of oral hypofunction. Frailty was independently associated with deterioration of the swallowing function (odds ratio 2.56; 95% confidence interval, 1.26-5.20), and mild cognitive impairment was independently associated with reduced occlusal force (odds ratio 1.48; 95% confidence interval, 1.05-2.08) and decreased tongue pressure (odds ratio 1.77; 95% confidence interval, 1.28-2.43). There was no independent association found between sarcopenia and oral function. In conclusion, early intervention for related factors such as deterioration of the swallowing function in frailty, reduced occlusal force, and decreased tongue pressure in mild cognitive impairment could lead to the prevention of general hypofunction in older adults.
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Affiliation(s)
- Maya Nakamura
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Tomofumi Hamada
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
- Department of Oral & Maxillofacial Surgery, Hakuaikai Medical Cooperation, Sagara Hospital, Kagoshima 892-0833, Japan
| | - Akihiko Tanaka
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Keitaro Nishi
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Kenichi Kume
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Yuichi Goto
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Mahiro Beppu
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Hiroshi Hijioka
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Yutaro Higashi
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Hiroaki Tabata
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Kazuki Mori
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Yumiko Mishima
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Yoshinori Uchino
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Kouta Yamashiro
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Yoshiaki Matsumura
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-0075, Japan;
| | - Takuro Kubozono
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (T.K.); (M.O.)
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-0085, Japan;
| | - Toshihiro Takenaka
- Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital, Kagoshima 891-2124, Japan;
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (T.K.); (M.O.)
| | - Tsuyoshi Sugiura
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0075, Japan; (M.N.); (T.H.); (A.T.); (K.N.); (K.K.); (Y.G.); (M.B.); (H.H.); (Y.H.); (H.T.); (K.M.); (Y.M.); (Y.U.); (K.Y.); (Y.M.)
- Correspondence: ; Tel.: +81-99-275-6232
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Ma W, Zhang D, Hu M, Wilde PJ, Wu J, Zhao L, Sirguleng, Ma T, Wang X, Chen J. Comparison of oral physiological and salivary rheological properties of Chinese Mongolian and Han young adults. Arch Oral Biol 2020; 123:105033. [PMID: 33429068 DOI: 10.1016/j.archoralbio.2020.105033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Consumers' oral physiology and salivary properties are greatly dependent on dietary backgrounds, and this in turn may impact food perception and preferences. Scarce studies are available on the oral physiology and salivary rheology of Chinese participants with different dietary and ethnic backgrounds. DESIGN This study examined two ethnic groups, Chinese Han and Chinese Mongolian healthy young adults, and explored the differences in oral physiology and salivary rheological properties. Official data suggested that Chinese Mongolians tend to consume more red meat and dairy, and Chinese Han tend to consume more carbohydrates. 200 Han and 104 Mongolian participants were evaluated for the oral physiological and salivary rheological parameters (maximum bite force of incisor and molar teeth, maximum tongue pressure and maximum oral volume; the surface tension, shear viscosity and extensional viscosity of unstimulated and stimulated whole saliva samples). RESULTS Distinct differences between two ethnic groups were found, particularly in their bite forces and salivary physical properties. Chinese Mongolian participants had significantly higher incisor bite force (168 N) than Chinese Han (146 N). In addition, Chinese Han had significantly lower unstimulated whole saliva flow rate than Chinese Mongolians; and significantly higher salivary surface tension, shear viscosity and extensional viscosity, in both unstimulated and stimulated whole saliva samples. CONCLUSIONS Chinese Han and Chinese Mongolian participants exhibited different oral physiological and salivary rheological properties; and considering the dietary differences between the two ethnicities, the findings from this study suggest possible associations between dietary habits and oral physiological & saliva rheological properties.
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Affiliation(s)
- Wenyao Ma
- Laboratory of Food Oral Processing, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, 310018, China
| | - Donghao Zhang
- Laboratory of Food Oral Processing, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, 310018, China
| | - Mengxin Hu
- Laboratory of Food Oral Processing, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, 310018, China
| | - Peter J Wilde
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UQ, United Kingdom
| | - Jing Wu
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot, 010018, China
| | - Liqin Zhao
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot, 010018, China
| | - Sirguleng
- Student Affairs Office, Inner Mongolia Agricultural University, Hohhot, 010018, China
| | - Tian Ma
- Laboratory of Food Oral Processing, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, 310018, China
| | - Xinmiao Wang
- Laboratory of Food Oral Processing, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, 310018, China.
| | - Jianshe Chen
- Laboratory of Food Oral Processing, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, 310018, China
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Fujikawa N, Ogino Y, Koga S, Ueno M, Moroi R, Koyano K. Validation of masticatory function and related factors in maxillectomy patients based on the concept of "oral hypofunction": A retrospective cross-sectional study. J Prosthodont Res 2020; 65:449-454. [PMID: 33390407 DOI: 10.2186/jpr.jpr_d_20_00047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE Although oral functions have been evaluated by various methods in maxillectomy patients, there exists substantial difficulty in the assessment procedures. The purpose of this study was to evaluate masticatory function, maximum occlusal force (MOF), and maximum tongue pressure (MTP) in maxillectomy patients objectively as per the "oral hypofunction" criteria, and examine the factors that correlate with masticatory function. METHODS This retrospective cross-sectional study included 50 maxillectomy patients with maxillofacial prostheses (23 males and 27 females, median age, 72 years; interquartile range (IQR), 63.75-77). The records of masticatory function, MOF, and MTP as per the "oral hypofunction" criteria and their profiles (age, number of occlusal supports, and maxillary defect configuration) were reviewed. The number of patients who exceeded a threshold value of "oral hypofunction" and the effects of occlusal support and defect configuration on masticatory function and MOF were calculated. Multiple regression analysis was performed to assess the associations between masticatory function and other variables. RESULTS The median value of masticatory function (114 mg/dL, IQR: 73-167.5) exceeded a threshold value, but not MOF (229.2 N, IQR: 110.2-419.6) and MTP (25.9 kPa, IQR: 21.4-29.0). The number of patients who exceeded each threshold value was 27 (masticatory function), 8 (MOF), and 12 (MTP), respectively. The influence of the number of occlusal supports, but not the defect configuration, was statistically significant. Multiple regression analysis revealed that MOF was independently related to masticatory function (P=0.042). CONCLUSIONS Within the limitations of this study, the median value of masticatory function in maxillectomy patients could exceed a threshold and MOF might be an independent predictor of masticatory function.
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Affiliation(s)
- Natsue Fujikawa
- Section of Fixed prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Yoichiro Ogino
- Section of Fixed prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Sayuri Koga
- Section of Fixed prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Machiko Ueno
- Department of Medical Technology, Kyushu University Hospital
| | - Ryoji Moroi
- Section of Fixed prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Kiyoshi Koyano
- Section of Fixed prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
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Hayashi C, Tanaka H, Ogata S. Assessing timewise changes over 15 months in life-space mobility among community-dwelling elderly persons. BMC Geriatr 2020; 20:502. [PMID: 33238895 PMCID: PMC7687835 DOI: 10.1186/s12877-020-01882-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine the differences of timewise changes in life-space mobility between elderly people living alone and those living with others among community-dwelling elderly people from a day care facility with a rehabilitation service for seniors. METHODS The present study used a longitudinal design with repeated measures every 3 months. In conformity with our inclusion criteria, this study included 233 community-dwelling elderly users of a day care facility with rehabilitation services for seniors in Japan. We analyzed the life-space assessment (LSA) scores collected at five time points (baseline, 3 months, 6 months, 9 months, and 12 months) using mixed-effects models with random intercepts and slopes over time. In the present study, the explanatory variables of interest were time, and living situation (living alone or with others). As possible confounders, we considered the following: (a) age, (b) sex, (c) social frailty, (d) physical frailty, (e) mild cognitive impairment (MCI), (f) depression, and (g) economic satisfaction. RESULTS The mean age of participants was 78.9 years (SD = 7.7), their mean LSA score was 60.1 points (SD = 25.7), and 42.9% of the participants were men. After adjusting for age, gender, frailty, depression, MCI, and economic satisfaction, the mean LSA score of older adults who lived with others was significantly lower (7.42 points, 95%CI = - 18.30 to - 0.15, p = 0.048) than that older adults who lived alone. DISCUSSION Community-dwelling older adults who used a day care center with rehabilitation services and lived with others had a smaller life-space at baseline than those who lived alone. This suggests that there is a need to pay more attention to social frailty among both older adults who live alone and those who live with others. CONCLUSIONS According to a multilevel analysis growth model, elderly persons who lived with others had significantly lower life-space mobility than those who lived alone.
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Affiliation(s)
- Chisato Hayashi
- University of Hyogo, 13-71 Kitaoji-cho, Akashi, Hyogo 673-8588 Japan
| | - Haruka Tanaka
- Nagoya University, Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-ku, Nahgoya City, Aichi Prefecture 461-8673 Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1, Kishibe - Shimmachi, Suita, Osaka, 564-8565 Japan
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Egashira R, Mizutani S, Yamaguchi M, Kato T, Umezaki Y, Oku S, Tamai K, Obata T, Naito T. Low Tongue Strength and the Number of Teeth Present Are Associated with Cognitive Decline in Older Japanese Dental Outpatients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8700. [PMID: 33238565 PMCID: PMC7700411 DOI: 10.3390/ijerph17228700] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/21/2020] [Accepted: 11/22/2020] [Indexed: 12/13/2022]
Abstract
To mitigate the impact of dementia, initiating early intervention is important. This study aims to investigate the associations between deterioration in oral function and cognitive decline in older outpatients whose oral health was maintained in the dental clinic. This study included 50 outpatients aged ≥65 years. We used the Japanese version of the Montreal Cognitive Assessment (MoCA-J) to assess cognitive decline. Oral function was evaluated by tongue pressure, masticatory performance, and swallowing ability. A full-mouth periodontal examination was conducted, and the occlusal support and number of teeth were recorded. Odds ratios (ORs) and 95% confidence intervals (CIs) for cognitive decline (MoCA-J score ≤ 25 points) were calculated using logistic regression models. The age, number of teeth, tongue pressure, and masticatory performance were significantly correlated with cognitive decline (p < 0.05). Logistic regression analyses revealed that cognitive decline was independently associated with age (OR: 1.25; 95% CI: 1.03-1.52; p = 0.024), number of teeth (OR = 0.83; 95% CI: 0.76-1.00; p = 0.047), and lower tongue pressure (OR: 0.87; 95% CI: 0.77-0.98; p = 0.022). Lower tongue pressure and a small number of remaining teeth may be associated with cognitive decline in Japanese outpatients.
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Affiliation(s)
- Rui Egashira
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan; (R.E.); (M.Y.); (Y.U.); (K.T.); (T.N.)
| | - Shinsuke Mizutani
- OBT Research Center, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
| | - Masahiro Yamaguchi
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan; (R.E.); (M.Y.); (Y.U.); (K.T.); (T.N.)
| | - Tomotaka Kato
- Department of Oral Health Sciences, University of Washington, Seattle, WA 98195, USA;
| | - Yojiro Umezaki
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan; (R.E.); (M.Y.); (Y.U.); (K.T.); (T.N.)
| | - Saori Oku
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
| | - Keiko Tamai
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan; (R.E.); (M.Y.); (Y.U.); (K.T.); (T.N.)
| | | | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan; (R.E.); (M.Y.); (Y.U.); (K.T.); (T.N.)
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Effects of Tongue-Strengthening Self-Exercises in Healthy Older Adults: A Non-Randomized Controlled Trial. Dysphagia 2020; 36:925-935. [PMID: 33215265 PMCID: PMC8464581 DOI: 10.1007/s00455-020-10216-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/10/2020] [Indexed: 12/20/2022]
Abstract
Tongue-strengthening exercises (TSE) using a device have been proposed as an intervention for improving tongue strength and endurance. However, devices for TSE have been expensive and difficult to manipulate and are not commonly used in home or clinical settings. This study therefore aimed to investigate whether tongue-strengthening self-exercises (TSsE) using a tongue-strengthening self-exercise tool at home can improve tongue strength in healthy older adults. This study included 27 participants (exercise group, η = 16, 7 men, 9 women, median age 84.5 years; control group, n = 11, 2 men, 9 women, median age 79.0 years). Exercises in the exercise group consisted of pushing the anterior tongue against the hard palate 30 times, 3 times a day, 5 days a week, for 8 weeks using a tongue-strengthening self-exercise tool. This tool is available in five levels of hardness. The most suitable hardness of the tool for each participant was calculated based on 60% of maximum tongue pressure (MTP) during the first 2 weeks of the training period and 80% of MTP for the remainder of the training period, as assessed using a tongue pressure-measuring device. The exercise group showed a significant improvement of 4.1 kPa in MTP (an 11.53% increase) and 4.53 s in endurance of tongue pressure (ETP) (a 99.86% increase). Furthermore, adherence in the exercise group was 99.2%. In conclusion, performing TSsE for 8 weeks was effective for increasing MTP and ETP in healthy older adults. This indicates that TSsE may be useful in older individuals at home to prevent age-related tongue muscle weakness.
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Arakawa I, Igarashi K, Imamura Y, Müller F, Abou-Ayash S, Schimmel M. Variability in tongue pressure among elderly and young healthy cohorts: A systematic review and meta-analysis. J Oral Rehabil 2020; 48:430-448. [PMID: 32799377 DOI: 10.1111/joor.13076] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/14/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Tongue pressure (TP) is used for the diagnosis of oral hypofunction; however, the impact of several variables on TP is unclear. Therefore, the current systematic review and meta-analysis aimed to analyse the variability in tongue pressure among healthy individuals aged ≥60 years vs <60 years. Secondary outcomes were the influence of gender and the type of measuring device (Iowa Oral Performance Instrument (IOPI) vs JMS tongue pressure measurement device (JMS)). METHODS PubMed and the Japanese database Ichushi-Web were searched systematically by two independent reviewers for studies reporting TP values in healthy populations. Clinical studies published between 1959 and June 2020 with more than 10 participants, written in English, German or Japanese, were included. A random-effects meta-regression for aggregate-level data was applied (α < 0.05). RESULTS Sixty-eight studies reported TP for a total of 13 773 subjects aged <60 years (n = 3265) and ≥60 years (n = 10 508). TP was significantly higher in subjects <60 years (estimated weighted mean (EWM) ± standard error = 51.9 ± 1.28 kPa; 95% CI = 49.4-54.4) relative to those ≥60 (EWM = 34.7 ± 0.94 kPa; 95% CI = 32.8-36.5) (P < .001), men (EWM = 45.9 ± 2.09 kPa; 95% CI = 41.8-50.0) relative to women (EWM = 39.3 ± 1.68 kPa; 95% CI = 36.0-42.6) (P = .015) and when assessed with the IOPI (EWM = 51.9 ± 1.32 kPa; 95% CI = 49.3-54.5) compared to the JMS (EWM = 33.5 ± 0.63 kPa; 95% CI = 32.2-34.7) (P < .001). In terms of gender, there was no significant difference in TP among subjects ≥60 years (P = .282). However, in subjects younger than 60, a significant difference was observed (P = .004). CONCLUSIONS Healthy populations aged <60 years showed significantly higher TP than those aged ≥60 years. TP values ascertained by the IOPI are significantly higher than those obtained with the JMS.
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Affiliation(s)
- Itsuka Arakawa
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Comprehensive Dental Care, The Nippon Dental University Niigata Hospital, Niigata, Japan
| | - Kensuke Igarashi
- Department of Dental Materials Science, School of Life Dentistry at Niigata, The Nippon Dental University, Niigata, Japan
| | - Yoshiki Imamura
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Geriatric Dentistry, School of Dentistry, Showa University, Tokyo, Japan
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Shimazaki Y, Nonoyama T, Tsushita K, Arai H, Matsushita K, Uchibori N. Oral hypofunction and its association with frailty in community‐dwelling older people. Geriatr Gerontol Int 2020; 20:917-926. [DOI: 10.1111/ggi.14015] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/04/2020] [Accepted: 07/28/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health School of Dentistry, Aichi Gakuin University Aichi Japan
| | - Toshiya Nonoyama
- Department of Preventive Dentistry and Dental Public Health School of Dentistry, Aichi Gakuin University Aichi Japan
| | - Kazuyo Tsushita
- Comprehensive Health Science Center Aichi Health Promotion Public Interest Foundation Aichi Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology Aichi Japan
| | - Kenji Matsushita
- Department of Oral Disease Research, National Center for Geriatrics and Gerontology Aichi Japan
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