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Shoji S, Narita M, Murayama H, Kitamura A, Fujiwara Y. Development of a Brief Assessment Tool to Evaluate Early Low Nutrition Risk in Community Elderly. Creation of the tool and examination of its reliability and criterion-related validity. J Epidemiol 2024:JE20240056. [PMID: 39098039 DOI: 10.2188/jea.je20240056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND To date simple assessment tool to evaluate early low nutrition risk in general older population has not been available. This study aimed to create such tool and examined its reliability and criterion-related validity. METHODS 1,192 community elderly with a mean age of 74.7(5.8) years responded to a questionnaire consisting of 48 (Hatoyama) or 34 items (Kusatsu), which have been reported to be associated with nutritional state in older people. Item analysis was conducted on the 34 common items, and items were selected based on the following criteria: adequate pass rates and discriminative power, no gender and regional differences, and a certain level of commonality based on factor analysis. Next, the factor structure of the candidate items was examined through exploratory factor analysis, and confirmatory factor analysis was conducted as the final scale structure. Furthermore, Spearman's partial rank correlation coefficients (sex- and age-adjusted) between the created index and important health indicators were examined to determine the criterion-related validity. RESULTS Finally, we obtained a semantic coherence of 4 factors (named health beliefs, dietary status, physical activity, and food-related quality of life) totaling 13 items; confirmatory factor analysis of the 4-factor solution yielded good model fit values, χ2 (59) =275.4 (p<0.001), CFI=0.930, and RMSEA=0.056. The factor loadings for each factor ranged from 0.43 to 0.82, indicating adequate loadings. The reliability of the index was shown to be high by Good-Poor analysis and Cronbach's α. The index showed statistically significant correlations with all health indicators. CONCLUSIONS We have developed a simple assessment tool to evaluate early low nutrition risk in general older population.
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Affiliation(s)
- Shinkai Shoji
- Kagawa Nutrition University
- Tokyo Metropolitan Institute of Gerontology
| | - Miki Narita
- Tokyo Metropolitan Institute of Gerontology
- Tokyo Online University
| | | | - Akihiko Kitamura
- Tokyo Metropolitan Institute of Gerontology
- Yao City Public Health Center
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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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Kawamura K, Maeda K, Miyahara S, Shimizu A, Ishida Y, Ueshima J, Nagano A, Kagaya H, Matsui Y, Arai H, Mori N. Association between oral frailty and sarcopenia among frailty clinic outpatients: A cross-sectional study. Nutrition 2024; 124:112438. [PMID: 38657417 DOI: 10.1016/j.nut.2024.112438] [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: 12/07/2023] [Revised: 03/03/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES In this study, we aimed to investigate the prevalence of oral frailty and explore its relationship with oral function and sarcopenia among older outpatients. MATERIALS AND METHODS In this cross-sectional study, we retrospectively included older patients who visited a frailty outpatient clinic. We assessed total oral frailty employing, among other measures, oral diadochokinesis (/ta/ sound) for tongue-lip movement and tongue pressure. Patients who did not meet the cut-off values for three or more of these were classified as having oral frailty. Sarcopenia was assessed according to Asian Working Group for Sarcopenia 2019 criteria and analyzed for the relationship with oral function. RESULTS The mean ± standard deviation age of the 111 patients was 77.2 ± 5.7 y; 63 were women (57%). Fifteen patients (14%) had either sarcopenia or dynapenia. The overall prevalence of oral frailty was 38%, with no significant difference in its prevalence between the sarcopenia/dynapenia group (44%) and the robust (no sarcopenia/dynapenia) group (35%). The following oral function assessments significantly differed between the sarcopenia/dynapenia group and the robust group: median (interquartile range) total oral frailty score, 2 (2-4) and 2 (1-3) (P = 0.019); tongue-lip motor function, 5.4 ± 1.2 and 5.9 ± 1.2 times/s (P = 0.049); and tongue pressure, 27.3 ± 8.5 kPa and 31.7 ± 8.0 kPa (P = 0.009). CONCLUSIONS Approximately 40% of patients exhibited a decline in oral function regardless of the presence of sarcopenia. Sarcopenia and dynapenia may particularly affect tongue function. Although assessing patients for sarcopenia is crucial, separate evaluations of oral function should also be considered.
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Affiliation(s)
- Koki Kawamura
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Nutrition Therapy Support Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan; Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
| | - Shuzo Miyahara
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Akio Shimizu
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Department of Health Science, Faculty of Health and Human Development, Nagano University, Nagano-shi, Nagano, Japan
| | - Yuria Ishida
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Department of Nutrition, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Junko Ueshima
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Department of Nutritional Service, NTT Medical Center Tokyo, Tokyo, Japan
| | - Ayano Nagano
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Hyogo, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Palliative Care Center, Aichi Medical University, Nagakute, Aichi, Japan
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Li T, Shen Y, Leng Y, Zeng Y, Li L, Yang Z, Wang S, Jiang Y. The prevalence of oral frailty among older adults: a systematic review and meta‑analysis. Eur Geriatr Med 2024; 15:645-655. [PMID: 38528284 DOI: 10.1007/s41999-023-00930-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/29/2023] [Indexed: 03/27/2024]
Abstract
BACKGROUND In recent years, oral frailty was proposed as a new concept regarding dental and oral health in older adults. Poor oral health is linked to preserving general health and has become a geriatric public health problem that deeply affects healthy aging. While in present, evidence on the prevalence associated with oral frailty in older adults remains unclear. OBJECTIVE To systematically evaluate the prevalence of oral frailty among older adults, stratified by relevant factors such as gender, source, study design, region, and the evaluation scales for oral frailty and provide an evidence-based foundation for healthcare professionals and policymakers to formulate relevant measures. METHODS Ten electronic databases were systematically searched from inception to September 2023, including PubMed, Web of Science, Embase, PsycINFO, The Cochrane Library, CINAHL, China National Knowledge Infrastructure Database (CNKI), Chinese Biomedical Database (Sinomed), Weipu Database, and Wanfang database. Based on the Stata 15.0 software package, a random effect model was used to calculate the pooled prevalence of oral frailty among older adults. In addition, sensitivity analysis, subgroup analysis, and meta-regression were conducted based on different study characteristics to detect heterogeneity sources. Funnel plots, Begg's and Egger's tests were used to evaluate the publication bias. RESULTS Eighteen studies with a total of 12,932 older adults were included for meta-analysis. The pooled prevalence of oral frailty and oral pre-frailty was 24% (95% CI: 20-28%) and 57% (95% CI: 52-61%) respectively. Based on different assessment tools of oral frailty, the pooled prevalence of oral frailty was higher when using the OFI-8 scale (44.1%; 95% CI: 35.4-52.8%) than the OFI-6 scale (18.3%; 95% CI: 15.8-20.8%) or OF checklist (22.1%; 95% CI: 17.4-26.7%). The prevalence of oral frailty was higher among older adults in females (23.8%; 95% CI: 18.4-29.2%), hospital settings (31%, 95% CI: 16.6-45.5%), cross-sectional design (26.7%, 95% CI: 19.2-34.2%), and China (45.9%, 95% CI: 34.4-57.3%). CONCLUSIONS Our study showed that oral frailty was common among older adults and various characteristics may affect its prevalence. Thus, healthcare professionals and policymakers should take oral frailty seriously in clinical practice and program planning and develop more preventive measures for oral frailty among older adults.
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Affiliation(s)
- Tao Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Yinli Shen
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Yingjie Leng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - You Zeng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Long Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Zijiang Yang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Siyu Wang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Yunlan Jiang
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
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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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Hollaar VRY, Naumann E, Haverkort EB, Jerković-Ćosić K, Kok WE, Schueren MAEDVD. Success factors and barriers in interprofessional collaboration between dental hygienists and dietitians in community-dwelling older people: Focus group interviews. Int J Dent Hyg 2024; 22:321-328. [PMID: 37845813 DOI: 10.1111/idh.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/17/2023] [Accepted: 09/19/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION Poor nutritional status can impair oral health while poor oral health can influence the individual's dietary intake, which may result in malnutrition. This interaction between nutritional status and oral health in older age requires attention, coordination and collaboration between healthcare professionals. This qualitative study explores dental hygienists' and dietitians' opinions about current collaboration with the aim of identifying success factors and barriers to this interprofessional collaboration. METHODS Three focus group interviews were held with Dutch dental hygienists and dietitians about nutritional and oral healthcare in community-dwelling older people. RESULTS In total, 9 dietitians and 11 dental hygienists participated in three online focus group interviews. Dental hygienists and dietitians seldom collaborated or consulted with each other. They struggled with the professional boundaries of their field of expertise and experienced limited knowledge about the scope of practice of the other profession, resulting in conflicting information to patients about nutrition and oral health. Interprofessional education was scarce during their professional training. Organizational and network obstacles to collaborate were recognized, such as limitations in time, reimbursement and their professional network that often does not include a dietitian or dental hygienist. CONCLUSION Dental hygienists and dietitians do not collaborate or consult each other about (mal)nutrition or oral health in community-dwelling older people. To establish interprofessional collaboration, they need to gain knowledge and skills about nutrition and oral health to effectively recognize problems in nutritional status and oral health. Interprofessional education for healthcare professionals is needed to stimulate interprofessional collaboration to improve care for older people.
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Affiliation(s)
- Vanessa R Y Hollaar
- Research Group Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Elke Naumann
- Research Group Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Elizabeth B Haverkort
- Research Group Innovations in Preventive Health Care, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Katarina Jerković-Ćosić
- Research Group Innovations in Preventive Health Care, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Wilhelmina E Kok
- Research Group Innovations in Preventive Health Care, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Marian A E de van der Schueren
- Research Group Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
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Min SY, Pang NS, Kim YR, Jeong SA, Jung BY. Factors associated with age-related changes in oral diadochokinesis and masticatory function in healthy old adults. BMC Oral Health 2024; 24:462. [PMID: 38627762 PMCID: PMC11020950 DOI: 10.1186/s12903-024-04214-9] [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: 01/05/2024] [Accepted: 04/01/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND This cross-sectional study aimed to identify factors associated with age-related changes in masticatory performance (MP) and oral diadochokinesis (ODK) and to provide normal values in healthy old adults for the diagnosis of oral frailty. METHODS A total of 385 participants were divided into three age groups (Gr1-3): 20-64 years, 65-74 years, and ≥ 75 years. To investigate tongue-lip motor function, ODK was assessed as the number of repetitions of the monosyllables /pa/ta/ka/. Four questionnaires were used to assess subjective masticatory ability, cognitive ability, and psychological status. MP, bite force, and occlusal area were tested to assess dynamic objective masticatory function, and the number of remaining teeth and functional tooth pairs were determined to assess static objective masticatory function. Handgrip strength (HG), oral dryness, and tongue pressure (TP) were assessed to identify influencing factors. Intergroup differences were evaluated by ANOVA and the Kruskal‒Wallis test, and correlations between ODK and orofacial factors were evaluated. RESULTS This study revealed significant age-related declines in TP, HG, and ODK, especially after 65 years of age. Factors affecting MP were posterior teeth, the Eichner index, bite force, occluding area, the Korean Mini-Mental State Examination (KMMSE) score, and ODK. Each ODK syllable was associated with different factors, but common factors associated with ODK were MP, HG, and PHQ-9 score. For the syllables /pa/ta/, the Eichner Index, TP, and oral dryness were also associated. For the syllable /ka/ in Gr3, MP, TP, HG, oral dryness, and the KMMSE score were associated. CONCLUSIONS These results could provide practical guidelines for oral rehabilitation in old adults and contribute to improving the understanding of age-related changes in oral function and the multidimensional nature of masticatory dynamics.
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Affiliation(s)
- Se-Yeon Min
- Department of Dentistry, Graduate School, Yonsei University, Seoul, 03722, Korea
| | - Nan-Sim Pang
- Department of Advanced General Dentistry College of Dentistry, Yonsei University, 50 Yonseiro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Yu-Ri Kim
- Department of Advanced General Dentistry College of Dentistry, Yonsei University, 50 Yonseiro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Sol-Ah Jeong
- Department of Advanced General Dentistry College of Dentistry, Yonsei University, 50 Yonseiro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Bock-Young Jung
- Department of Advanced General Dentistry College of Dentistry, Yonsei University, 50 Yonseiro, Seodaemun-Gu, Seoul, 03722, South Korea.
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Ishii Y, Iida T, Honda-Sakaki M, Yoshida K, Svensson P, Komiyama O. Comparison of masticatory muscle activity between young adults and elderly participants using a novel standardized bite device. J Dent 2024; 143:104887. [PMID: 38360395 DOI: 10.1016/j.jdent.2024.104887] [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: 10/22/2023] [Revised: 01/22/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVES Standardized bite training is required to prevent oral hypofunction in elderly individuals. We aimed to compare masticatory muscle activity between 24 young adults and 16 pre-elderly individuals during a biting task using a novel standardized bite device (BD). METHODS The BD was made of silicone rubber and included a high-force or low-force plate spring or no plate spring (dummy). The compressive stiffness of the material in each BD was measured using a texture analyzer. All participants performed a biting task 50-times at a rate of 1/s each using the three types of BDs on the right first molar. Electromyographic (EMG) activity was recorded bilaterally from the masseter and temporalis muscles. The variability of each biting training session was calculated as the coefficient of variance (CV) from the EMG activity during each biting task for each muscle. Masticatory muscle fatigue was assessed using a numerical rating scale (NRS). RESULTS Compressive stiffness was significantly different between each BD (P < 0.001). The CV and NRS scores were not significantly different between the groups. The EMG activities during each bite task in all muscles were not significantly different for any measurement item between the age groups. The EMG activities of high- and low-force BDs in the right temporalis (ipsilateral) muscle were significantly higher than those of the dummy BD (P < 0.001). CONCLUSIONS Compressive stiffness of the BD affected EMG activity only in the ipsilateral temporalis muscle, but not in the masseter or contralateral temporalis muscles, without any age effect.
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Affiliation(s)
- Yuki Ishii
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, 2-870-1, Sakaecho-nishi, Matsudo, Chiba 271-8587, Japan; Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Denmark
| | - Takashi Iida
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, 2-870-1, Sakaecho-nishi, Matsudo, Chiba 271-8587, Japan.
| | - Mika Honda-Sakaki
- Department of Anatomy, Nihon University School of Dentistry at Matsudo, Japan
| | - Kazuhiro Yoshida
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, 2-870-1, Sakaecho-nishi, Matsudo, Chiba 271-8587, Japan; Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Denmark
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Denmark; Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark; Faculty of Dentistry, Malmø University, Sweden
| | - Osamu Komiyama
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, 2-870-1, Sakaecho-nishi, Matsudo, Chiba 271-8587, Japan
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Iwasaki M, Shirobe M, Motokawa K, Tanaka T, Ikebe K, Ueda T, Minakuchi S, Akishita M, Arai H, Iijima K, Sasai H, Obuchi S, Hirano H. Prevalence of oral frailty and its association with dietary variety, social engagement, and physical frailty: Results from the Oral Frailty 5-Item Checklist. Geriatr Gerontol Int 2024; 24:371-377. [PMID: 38390632 DOI: 10.1111/ggi.14846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/30/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
AIM This cross-sectional study had two aims: to assess the prevalence of oral frailty (OF), according to the Oral Frailty 5-Item Checklist (OF-5), among community-dwelling older adults; and to examine the associations among oral frailty, dietary variety, social engagement, and physical frailty. METHODS We pooled data from two population-based studies (the Otassha Study and the Itabashi Longitudinal Study on Aging). With the OF-5, OF is characterized by the presence of two or more of the following: (i) fewer teeth, (ii) difficulty in chewing, (iii) difficulty in swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. We calculated the OF prevalence for each sex. We assessed dietary variety, social engagement, and physical frailty. Generalized structural equation modeling was employed to investigate the associations among oral frailty, low dietary variety (dietary variety score ≤3), social isolation (Lubben Social Network Scale score <12), and physical frailty (Japanese version of the Cardiovascular Health Study score ≥3). RESULTS A total of 1206 individuals (626 women and 580 men) with a mean age of 74.7 years were included. The prevalence of OF was 36.7%, and it increased with age; however, there was no significant sex difference. OF was significantly indirectly associated with physical frailty via low dietary variety (odds ratio, 1.43; 95% confidence interval, 1.04-1.97) and social isolation (odds ratio, 1.42; 95% confidence interval, 1.04-1.94). CONCLUSIONS Two of five community-dwelling older adults exhibited OF. Low dietary variety and social isolation are potential underlying mechanisms through which OF is indirectly associated with physical frailty. Geriatr Gerontol Int 2024; 24: 371-377.
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Affiliation(s)
- Masanori Iwasaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Removable Prosthodontics and Gerodontology, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Sasai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Yin Y, Zhao Y, Fei Y, Liu Y, Ji Y, Shan E, Niu S, Xing Y, Ding J, Li X. Epidemiology and risk factors of oral frailty among older people: an observational study from China. BMC Oral Health 2024; 24:368. [PMID: 38515048 PMCID: PMC10958975 DOI: 10.1186/s12903-024-04149-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/15/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVES This study aimed to compare the prevalence of oral frailty among community-dwelling older people in Nanjing, China with the usage of different measurements, and to investigate the potential risk factors of oral frailty. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A total of 338 community-dwelling older people in Nanjing, China were recruited. METHODS Oral frailty was measured based on the Oral Frailty Index-8 (OFI-8) scale and other measurement methods including the number of natural teeth (TN), repetitive saliva-swallowing test (RSST), and oral diadochokinesis (ODK). The chi-square test and the binary logistic regression analysis were performed to identify potential risk factors for oral frailty. RESULTS There were 310 participants included in the analysis. Prevalence of oral frailty by using the OFI-8, OFI-8 + TN, OFI-8 + ODK, OFI-8 + TN + ODK and RSST measurement methods were 69.0%, 27.4%, 51.9%, 21.0% and 2.9%, respectively. Passive smoking (OR = 2.04; 95%CI 1.03-4.03), being widowed/unmarried (OR1 = 2.53; 95%CI 1.25-5.10; OR2 = 2.94; 95%CI 1.12-7.77), pre-frailty (OR = 1.76; 95%CI 1.03-3.01), frailty (OR = 3.01; 95%CI 1.39-6.54), and aged 80 years and above (OR = 3.99; 95%CI 1.35-11.81) were found to be risk factors of oral frailty by the usage of the four kinds of measurement methods. CONCLUSIONS AND IMPLICATIONS The definition and diagnostic criteria of oral frailty are strongly needed to be unified in future research. Only subjective assessment is not enough for assessing oral frailty. Among objective indicators, RSST is not suitable as a screening method for oral frailty. In addition, objective indicators including TN and ODK should be valued for early screening and preventive interventions. The risk factors of oral frailty include physical frailty, passive smoking, and being widowed.
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Affiliation(s)
- Yueheng Yin
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Yue Zhao
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Yang Fei
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Ying Liu
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Yun Ji
- Chunhua Community Health Service Centre, Nanjing, 211166, Jiangsu, China
| | - Enfang Shan
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Shuzhen Niu
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Ying Xing
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Jingjing Ding
- Sir Run Run Hospital of Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - XianWen Li
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China.
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11
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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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12
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Ko H, Cho B, Lim KC, Jang SN, Chang SJ, Yi YM, Cho HR, Ryu SI, Noh EY, Park YH. Changes in the health status and health-related quality of life of community-dwelling older adults living alone: one-year follow-up from a cohort study. Front Public Health 2023; 11:1278008. [PMID: 38192567 PMCID: PMC10772141 DOI: 10.3389/fpubh.2023.1278008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024] Open
Abstract
Background The percentage of older adults living alone is rapidly increasing, improving the health status and health-related quality of life (HRQoL) in this group is becoming a more significant public health issue. This study aimed to examine the changes in the HRQoL of older South Korean adults living alone and identify the factors that affect their HRQoL. Methods A longitudinal study design was followed. Data were collected at baseline and 1-year follow-up. Participants consisting of 789 older adults living alone in S*City aged>65 years completed a cohort survey regarding health status and HRQoL from August 2018 to August 2019. Trained interviewers conducted face-to-face interviews with the participants using a validated questionnaire (physical health, mental health, social health, and HRQoL). Generalized estimating equations were used to assess the change in health status and the interaction effect of time and gender. Then, a stepwise multiple logistic regression analysis was performed to identify factors related to HRQoL. Results Time differences were observed in the subjective evaluation of health status (SEH), IPAQ scores, frailty, nutritional status, and depression. Gender differences were observed in the SEH, IPAQ, frailty, loneliness, depression, and social support. The interaction between time and gender was observed in the IPAQ and HRQoL. At baseline, SEH, depressive symptoms, gender, frailty, and age were associated with HRQoL. After one year, HRQoL was associated with SEH, frailty, depressive symptoms, cost of living, suicidal thoughts, gender, social support, loneliness, and suicide attempts. Conclusion Our results highlight that HRQoL is associated with physical health, mental health, and social support. Future detailed studies are needed to determine whether governments and communities can prevent depression, loneliness, and suicidal thoughts through psychological support and provide economic support to improve the quality of life of older adults living alone.
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Affiliation(s)
- Hana Ko
- College of Nursing, Gachon University, Incheon, Republic of Korea
| | - Belong Cho
- Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Kyung-Choon Lim
- College of Nursing, Sungshin University, Seoul, Republic of Korea
| | - Soong-Nang Jang
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Sun Ju Chang
- College of Nursing, Seoul National University, Seoul, Republic of Korea
- Institute of Nursing Science College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Yu Mi Yi
- College of Nursing, Kyungnam College of Information and Technology, Busan, Republic of Korea
| | - Hye Ryung Cho
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - So Im Ryu
- Department of Nursing, Changwon National University, Changwon-si, Republic of Korea
| | - Eun-Young Noh
- Department of Nursing, Konkuk University, Chungju, Republic of Korea
| | - Yeon-Hwan Park
- College of Nursing, Seoul National University, Seoul, Republic of Korea
- Institute of Nursing Science College of Nursing, Seoul National University, Seoul, Republic of Korea
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13
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Puranen T, Hiltunen K, Kautiainen H, Suominen MH, Salminen K, Mäntylä P, Roitto HM, Pitkälä KH, Saarela RKT. Relationship between oral frailty, health-related quality of life, and survival among long-term care residents. Eur Geriatr Med 2023; 14:1307-1315. [PMID: 37728853 PMCID: PMC10754726 DOI: 10.1007/s41999-023-00859-x] [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: 11/24/2022] [Accepted: 08/28/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE We evaluated oral frailty (OFr) and its association with health-related quality of life (HRQoL), energy and protein intake, and survival among older long-term care residents. METHODS This cross-sectional study with a 3-year follow-up for survival assessed 349 residents in long-term care facilities (73% female, mean age 82 years). We defined OFr with six signs (dry mouth, food residue on oral surfaces, unclear speech, inability to keep mouth open or pain expression during the clinical oral examination, diet pureed/soft) and OFr severity was categorized as Group 1, (mild) = 0-1 signs, Group 2 (moderate) = 2-4 signs, and Group 3 (severe) = 5-6 signs. We measured HRQoL with 15D instrument, and energy and protein intake by a 1- to 2-day food record. Mortality was retrieved from central registers on March 2021. RESULTS Of the residents, 15% had 0-1, 67% 2-4 and 18% 5-6 OFr signs. HRQoL decreased linearly from Group 1 to Group 3. OFr correlated with such dimensions of HRQoL as mobility, eating, speech, excretion, usual activities, mental function, and vitality. We found no association between OFr categories and energy and protein intake. Survival decreased linearly from Group 1 to Group 3. CONCLUSIONS OFr was common among older long-term care residents and OFr severity predicts poorer outcomes. The six oral signs denoting OFr may be used at the bedside to screen residents at risk for OFr.
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Affiliation(s)
- Taija Puranen
- Social Services, Health Care and Rescue Services Division, Development Support, City of Helsinki, P.O. Box 6008, 00099, Helsinki, Finland.
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Merja H Suominen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Karoliina Salminen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Päivi Mäntylä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Hanna-Maria Roitto
- Department of Medicine, University of Helsinki, Helsinki, Finland
- Social Services, Health Care and Rescue Services, Helsinki Hospital, Helsinki, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Riitta K T Saarela
- Social Services, Health Care and Rescue Services Division, Oral Health Care, City of Helsinki, Helsinki, Finland.
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14
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Sawada N, Takeuchi N, Ekuni D, Morita M. Effect of oral health status and oral function on malnutrition in community-dwelling older adult dental patients: A two-year prospective cohort study. Gerodontology 2023. [PMID: 37847782 DOI: 10.1111/ger.12718] [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] [Accepted: 09/26/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES To survey oral status in detail and clarify the factors associated with nutritional status as evaluated by the Mini Nutritional Assessment. BACKGROUND Malnutrition is common in older adults and increases the risk of frailty, sarcopenia, and mortality. However, few longitudinal studies have been performed to investigate the causal effect of oral status on malnutrition in detail, and the information reported in those longitudinal studies has been limited to dentition status and swallowing ability. MATERIALS AND METHODS The participants in this prospective cohort study were patients who visited the Preventive Dentistry Clinic at Okayama University Hospital from November 2017 to January 2021. The number of teeth, periodontal condition, oral function (oral diadochokinesis, masticatory ability, number of bacteria in tongue coating, occlusal force, oral moisture, tongue pressure, swallowing function), nutritional status, the number of comorbidities, and mental health status were examined. These variables were analysed using structural equation modelling (SEM). RESULTS The final analysis included 141 participants (40 males and 101 females; mean age, 73.5 ± 6.3 years; follow-up rate: 79.7%). The results of the SEM revealed that oral status (number of teeth present and swallowing function) was positively associated with nutritional status 2 years later. In addition, age was negatively associated with oral status. CONCLUSION In community-dwelling older adult dental patients (age ≥60 years), oral function at baseline was associated with nutritional status two years later.
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Affiliation(s)
- Nanami Sawada
- Department of Preventive Dentistry, Okayama University Hospital, Okayama, Japan
| | - Noriko Takeuchi
- Department of Preventive Dentistry, Okayama University Hospital, Okayama, Japan
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Manabu Morita
- Department of Oral Health, Takarazuka University of Medical and Health Care, Takarazuka, Japan
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15
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Leandro-Merhi VA, Dos Santos HAV, Almendra AAR, de Aquino JLB. Nutritional indicators' performance in malnutrition diagnosis of hospitalized elderly patients. Exp Gerontol 2023; 181:112286. [PMID: 37683730 DOI: 10.1016/j.exger.2023.112286] [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: 09/24/2022] [Revised: 05/29/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Several nutritional diagnosis methods and their relationship with clinical outcomes have been described. This study investigated malnutrition in hospitalized elderly patients (HEP) using different nutritional indicators and determined criteria to identify malnutrition and explore the variables that discriminate the risk of malnutrition. METHOD Cross-sectional study with 500 HEP; different methods of nutritional diagnosis, their relationship with clinical outcomes and criteria for defining malnutrition were investigated. The GLIM criteria for the diagnosis of malnutrition was applied in this study. In the statistical analysis, the Chi-square test, Fisher's exact test, Mann-Whitney test, univariate and multiple logistic regression and the ROC curve were used. RESULTS Patients aged 65-79 years, at nutritional risk or with malnutrition, had longer hospital stays (p = 0.0099; OR = 1.047; 95% CI = 1.011; 1.084) and lower body mass index (BMI) (p < 0.0001; OR = 0.867 (1153)); 95% CI = 0.813; 0.924 (1085; 1225). Patients aged ≥80 years had a lower BMI (p = 0.0053; OR = 0.779 (1284); 95% CI = 0.653; 0.928 (1078; 1531)). Accuracy was significant in both age groups for BMI (p < 0.0001; 65-79 years and p = 0.001; ≥80 years); for the lymphocyte count (p = 0.0167; 65-79 years and p = 0.0028; ≥80 years), and for the calf circumference (CC) (p < 0.0001; 65-79 years and p = 0.001; ≥80 years). Using the GLIM criteria, 27.78% of patients were considered malnourished. CC showed good accuracy, good specificity, but low sensitivity while BMI was more accurate to detect malnutrition in both age groups. CONCLUSION CC showed good accuracy, good specificity, but low sensitivity to detect malnutrition. BMI was more accurate in both age groups to detect malnutrition.
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16
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Imaoka M, Okuno K, Kobuchi R, Inoue T, Takahashi K. Evaluation of masticatory performance by motion capture analysis of jaw movement. J Oral Rehabil 2023; 50:1020-1029. [PMID: 37323094 DOI: 10.1111/joor.13538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/18/2023] [Accepted: 06/11/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND The assessment of masticatory performance (MP) is conducted in hospitals, but is difficult to perform in nursing facilities that lack specialists in dysphagia. To select the appropriate food textures in nursing practice, a simple method of evaluating the MP should be developed. OBJECTIVE The purpose of this study was to investigate motion parameters that influence MP by motion capture analysis of maxillofacial movement on chewing gummy jelly in healthy adults. METHODS The subjects were 50 healthy adults. The state of chewing gummy jelly was photographed using a high-speed camera. Simultaneously, we evaluated the amount of glucose extracted (AGE) obtained with gummy jelly as a reference value for MP. The subjects were divided into two groups: normal and low masticatory groups (NG and LG, respectively) based on the AGE. The cycle of mastication was classified into three phases: closing phase (CP), transition phase (TP) and opening phase (OP) through motion capture analysis of the video photographed. Parameters of jaw movement and their associations with the AGE were examined. RESULTS The transition phase rate (TR) and opening phase rate (OR) were correlated with the AGE. Furthermore, the TR in the NG was significantly higher than in the LG, whereas the OR was significantly lower than in the LG. The age, TR and opening velocity were significant independent variables. CONCLUSION Motion capture technology facilitated the analysis of jaw movement. The results suggested that MP can be evaluated by analysing the TP and OP rates.
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Affiliation(s)
- Masaaki Imaoka
- Departmet of Geriatric Dentistry, Osaka Dental University Graduate School of Dentistry, Osaka, Japan
| | - Kentaro Okuno
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
| | - Ryuichiro Kobuchi
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
| | - Taro Inoue
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
| | - Kazuya Takahashi
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
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Iwasaki M, Shirobe M, Motokawa K, Hayakawa M, Miura K, Kalantar L, Edahiro A, Kawai H, Fujiwara Y, Ihara K, Watanabe Y, Obuchi S, Hirano H. Validation of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate in community-dwelling older Japanese adults: The Otassha Study. Geriatr Gerontol Int 2023; 23:729-735. [PMID: 37673795 DOI: 10.1111/ggi.14658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/20/2023] [Accepted: 08/22/2023] [Indexed: 09/08/2023]
Abstract
AIM To assess the validity of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate (oral diadochokinesis [oral-DDK]) as a gold standard index for articulatory oral motor skill in community-dwelling older Japanese adults. METHODS This cross-sectional study included 607 Japanese adults (mean age = 73.9 years). A single-item self-report questionnaire for articulatory oral motor skill was developed. Study participants completed a 1-month-interval test-retest protocol to assess reliability of the questionnaire, and the protocol was tested by the kappa statistic. Oral-DDK with /ta/ (i.e., the number of repetitions of the monosyllable /ta/ per second) was measured during the on-site examination. Low oral-DDK performance was defined as <5.2 times/s in men and <5.4 times/s in women. Oral-DDK performance, oral functions other than articulatory oral motor skill, and physical frailty were compared in the groups with and without self-reported low articulatory oral motor skill as determined by the response to the questionnaire. RESULTS Self-reported low articulatory oral motor skill was identified in 18.5% of the study population. The self-report questionnaire had good test-retest reliability, with a kappa statistic of 0.71. Self-reported low articulatory oral motor skill was significantly associated with a lower value of oral-DDK with /ta/ and a higher proportion of low oral-DDK performance, difficulties in chewing and swallowing, dry mouth, and physical frailty. Self-report had high specificity (83.1%) but low sensitivity (42.1%) for detecting low oral-DDK performance. CONCLUSIONS A single-item self-report questionnaire for articulatory oral motor skill had acceptable test-retest reliability and was associated with objectively measured articulatory oral motor skill. Geriatr Gerontol Int 2023; 23: 729-735.
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Affiliation(s)
- Masanori Iwasaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Misato Hayakawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kazuhito Miura
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Lena Kalantar
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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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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Tanaka T, Hirano H, Ikebe K, Ueda T, Iwasaki M, Shirobe M, Minakuchi S, Akishita M, Arai H, Iijima K. Oral frailty five-item checklist to predict adverse health outcomes in community-dwelling older adults: A Kashiwa cohort study. Geriatr Gerontol Int 2023; 23:651-659. [PMID: 37661091 DOI: 10.1111/ggi.14634] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/05/2023] [Accepted: 06/18/2023] [Indexed: 09/05/2023]
Abstract
AIM To enable easy assessment of oral frailty; that is, an overlapping slight decline in multifaceted oral function, in any setting, we developed the oral frailty five-item checklist (OF-5), and examined its predictive validity for increased risks of physical frailty, physical disability and mortality among community-dwelling older adults. METHODS This population-based cohort study randomly selected 2044 residents in Kashiwa, Japan, with no long-term care needs. Baseline data were collected in 2012, and follow-up data were collected in 2013, 2014, 2016, 2018 and 2021. The OF-5 includes five measures: fewer teeth, difficulty in chewing, difficulty in swallowing, dry mouth and low articulatory oral motor skills. Physical frailty was defined according to the Cardiovascular Health Study criteria. Physical disability and mortality determined from the long-term care insurance receipt database were followed for 9 years. RESULTS Of 2031 eligible participants (mean age 73.1 ± 5.6 years; 51.1% women), 39.3% individuals with ≥2 OF-5 points had significantly increased prevalence and new-onset rate of physical frailty. After adjusting for potential confounders, oral frailty, defined as ≥2 OF-5 points, was associated with increased risks of physical disability (adjusted hazard ratio 1.40; 95% confidence interval 1.14-1.72) and mortality (adjusted hazard ratio 1.44; 95% confidence interval 1.11-1.87). The highest adjusted hazard ratios were observed in older adults with coexisting physical and oral frailty. CONCLUSIONS The OF-5 showed strong predictive validity for physical frailty, physical disability and mortality in Japanese older adults. This assessment tool can be implemented in various settings and foster comprehensive prevention through interprofessional collaboration. Geriatr Gerontol Int 2023; 23: 651-659.
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Affiliation(s)
- Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Removable Prosthodontics and Gerodontology, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Masanori Iwasaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
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20
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Kusunoki H, Ekawa K, Kato N, Yamasaki K, Motone M, Shinmura K, Yoshihara F, Shimizu H. Association between oral frailty and cystatin C-related indices-A questionnaire (OFI-8) study in general internal medicine practice. PLoS One 2023; 18:e0283803. [PMID: 37093792 PMCID: PMC10124892 DOI: 10.1371/journal.pone.0283803] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/17/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Cystatin C-related indices such as the ratio of creatinine to cystatin C (Cr/CysC) and the ratio of estimated glomerular filtration rate by cystatin C (eGFRcys) to creatinine eGFRcre (eGFRcys/eGFRcre) levels have been shown to be associated with muscle mass and strength and can be markers of sarcopenia. Oral frailty is defined as an age-related gradual loss of oral functions, accompanied by a decline in cognitive and physical functions. It results in adverse health-related outcomes in older age, including mortality, physical frailty, functional disability, poor quality of life, and increased hospitalization and falls. Therefore, poor oral health among the elderly is an important health concern due to its association with the pathogenesis of systemic frailty, suggesting it to be a multidimensional geriatric syndrome. The Oral Frailty Index-8 (OFI-8) is a questionnaire that can be used for easy screening of oral frailty. This study aimed to investigate whether cystatin C- related indices are different between patients with low to moderate risk of oral frailty and those at high risk of oral frailty, using the OFI-8 in attending a general internal medicine outpatient clinic. MATERIALS AND METHODS This is a cross-sectional study that included 251 patients with a mean age of 77.7±6.6 years and a median age of 77 years (128 men: mean age, 77.1±7.3 years; median age, 77 years and 123 women: mean age, 78.4±5.7 years; median age, 78 years) attending general internal medicine outpatient clinics. OFI-8 scores were tabulated by gender to determine whether there were differences between patients at low to moderate risk of oral frailty (OFI-8 score ≤3 points) and those at high risk (OFI-8 score ≥4 points) in Cr/CysC, eGFRcys/eGFRcre levels, height, weight, grip strength, etc. were examined. RESULTS The OFI-8 score was higher in women than in men, suggesting that oral frailty is more common in women. Cr/CysC, eGFRcys/eGFRcre and grip strength were significantly lower in both men and women in the high-risk group for oral frailty (OFI-8 score ≥ 4). Height, hemoglobin level, red blood cell count, and serum albumin levels were significantly lower in men with an OFI-8 score ≥4. Receiver operating characteristic curve (ROC) analysis also showed that Cr/CysC and eGFRcys/eGFRcre were significantly associated with an OFI-8 score≥4 in both men and women. CONCLUSION Cr/CysC and eGFRcys/eGFRcre were significantly lower in the high-risk group for oral frailty on the OFI-8in both men and women. A relationship exists among cystatin C-related indices, which can effectively screen systemic frailty. Similarly, the OFI-8 score can be used to effectively screen oral frailty. Thus, a collaboration that incorporates both systemic and oral frailty from medical and dental perspectives is required.
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Affiliation(s)
- Hiroshi Kusunoki
- Department of Internal Medicine, Osaka Dental University, Hirakata, Osaka, Japan
- Department of General Internal Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
- Department of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kazumi Ekawa
- Department of Internal Medicine, Osaka Dental University, Hirakata, Osaka, Japan
- Department of Environmental and Preventive Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Nozomi Kato
- Department of Internal Medicine, Osaka Dental University, Hirakata, Osaka, Japan
| | - Keita Yamasaki
- Department of Internal Medicine, Osaka Dental University, Hirakata, Osaka, Japan
- Department of Health and Sports Sciences Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Masaharu Motone
- Department of Internal Medicine, Osaka Dental University, Hirakata, Osaka, Japan
- Faculty of Health Sciences, Osaka Dental University, Hirakata, Osaka, Japan
| | - Ken Shinmura
- Department of General Internal Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Fumiki Yoshihara
- Department of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hideo Shimizu
- Department of Internal Medicine, Osaka Dental University, Hirakata, Osaka, Japan
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21
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Yan GLK, Tan MN, Wong ML, Tay CM, Allen PF. Functional Dentition, Chronic Periodontal Disease and Frailty in Older Adults-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:502. [PMID: 36612820 PMCID: PMC9819030 DOI: 10.3390/ijerph20010502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The likelihood of experiencing the impact of chronic disease rises with age, and cumulative functional deficits over time increase the risk of frailty in older adults. The exact causes of frailty are not clear, and research is needed to identify appropriate intervention measures to reduce risk of developing frailty in old age. OBJECTIVE To review the evidence on the relationship between frailty, dental status and chronic periodontitis and to determine if improvements in oral health of older adults can contribute to reversal of frailty. RESULTS The oral cavity is the entry point to the gastro-intestinal tract, and natural teeth facilitate efficient mastication of food prior to swallowing and subsequent digestion. The loss of natural teeth, which is gradual and cumulative over the life course, is associated with diminished nutritional intake, especially in older adults. Furthermore, chronic periodontitis has been postulated as a risk factor for frailty. The evidence supporting a strong relationship between oral health status and frailty is not clearcut. Cross sectional studies suggest an association with missing teeth and chronic periodontal inflammation. However, there are very few longitudinal studies and accordingly, it is not currently possible to claim a causal relationship. As yet, there is no evidence to suggest that improvements in oral health contribute to reversal of frailty. CONCLUSION Longitudinal studies with robust designs are required to better inform the relationship across functional dentition, chronic periodontitis and frailty in older adults.
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Affiliation(s)
- Gabriel Lee Keng Yan
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
| | - Mei Na Tan
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
| | - Mun Loke Wong
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
| | - Chong Meng Tay
- National University Centre for Oral Health, Singapore 119085, Singapore
| | - Patrick Finbarr Allen
- Faculty of Dentistry, National University of Singapore, Singapore 119085, Singapore
- Department of Restorative Dentistry, Cork Dental School and Hospital, University College Cork, T12 DC4A Cork, Ireland
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22
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Oral Rehabilitation from Oral and Dental Diseases. Healthcare (Basel) 2022; 10:healthcare10102065. [DOI: 10.3390/healthcare10102065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Oral conditions, such as the number of teeth and oral hygiene, are related to oral functions and oral health-related quality of life (QoL) [...]
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23
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Kojima G, Taniguchi Y, Iwasaki M, Aoyama R, Urano T. Associations between self-reported masticatory dysfunction and frailty: A systematic review and meta-analysis. PLoS One 2022; 17:e0273812. [PMID: 36084116 PMCID: PMC9462797 DOI: 10.1371/journal.pone.0273812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
Background Oral health is a key factor of overall health and closely associated with well-being and quality of life. Mastication is one the most important oral functions and may deteriorate with aging. Evidence on association between masticatory dysfunction and frailty in the literature is scarce and not coherent. Methods A search strategy was developed to conduct a systematic review of the literature in PubMed, CINAHL, and AMED in accordance with the PRISMA 2020 guidelines. We searched for studies published in 2000 or later that examined associations between self-reported masticatory dysfunction and frailty risk. The reference lists of the relevant articles were reviewed for additional studies. We calculated pooled odds ratios (OR) of association between self-reported masticatory dysfunction and the risk of frailty by fixed-effects meta-analysis. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess risk of bias. Publication bias was assessed by visually inspecting a funnel plot. Results A total of 285 studies were identified by the literature search. Among 5 studies selected for this review, 4 cross-sectional studies including a total of 7425 individuals were used for meta-analysis. The pooled results by a fixed-effects model showed that there was a significant association between self-reported masticatory dysfunction and frailty risk (pooled OR = 1.83, 95%CI = 1.55–2.18, p<0.00001). There was no evidence of publication bias observed. Conclusions This systematic review and meta-analysis highlighted pooled cross-sectional evidence that community-dwelling older people who report masticatory dysfunction are significantly more likely to be frail than those who do not. The limitations of this study are: inclusion of only cross-sectional studies, no gold standard to measure masticatory functions, self-reported information on masticatory function, and the limited number of included studies. More longitudinal studies are warranted for further understanding of the causal pathways and elucidate underlying mechanisms. Registration: PROSPERO CRD42021277173
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Affiliation(s)
- Gotaro Kojima
- Department of Research, Dr. AGA Clinic, Tokyo, Japan
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | | | - Reijiro Aoyama
- Department of Japanese Studies, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Tomohiko Urano
- Department of Geriatric Medicine, International University of Health and Welfare, Chiba, Japan
- * E-mail:
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24
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Watanabe D, Yoshida T, Yamada Y, Watanabe Y, Yamada M, Fujita H, Miyachi M, Arai H, Kimura M. Combined use of two frailty tools in predicting mortality in older adults. Sci Rep 2022; 12:15042. [PMID: 36057638 PMCID: PMC9440890 DOI: 10.1038/s41598-022-19148-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/24/2022] [Indexed: 12/02/2022] Open
Abstract
We aimed to verify the combined use of two frailty tools in predicting mortality in older adults. We used the data of 10,276 Japanese older adults (aged ≥ 65 years) who provided valid responses to two frailty assessment tools in a mail survey in Japan’s Kyoto‒Kameoka Prospective cohort study. Frailty status was categorized into four groups depending on the validated frailty screening index and Kihon Checklist, respectively: Non-frailty (n = 5960), Physical frailty (n = 223), Comprehensive frailty (n = 2211), and Combination (n = 1882) groups. Mortality data were collected between July 30, 2011, and November 30, 2016. We assessed the relationship between frailty status and all-cause mortality risk using multivariate Cox proportional hazards models. During a median follow-up of 5.3 years, we recorded 1257 deaths. After adjusting for confounders, the Combination group had the highest mortality risk compared with the other groups [Non-frailty: reference; Physical frailty: hazards ratio [HR], 0.99 (95% confidence interval [CI] 0.58 to 1.70); Comprehensive frailty: 1.91 (1.63 to 2.23); Combination: 2.85 (2.44 to 3.22)]. People who are positive for frailty in both instruments have a higher risk of death than those who are positive to one model.
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Affiliation(s)
- Daiki Watanabe
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan. .,National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan. .,Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka, Kyoto, 621-8555, Japan.
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan.,Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka, Kyoto, 621-8555, Japan.,Senior Citizen's Welfare Section, Kameoka City Government, 8 Nonogami, Yasumachi, Kameoka, Kyoto, 621-8501, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan.,Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka, Kyoto, 621-8555, Japan
| | - Yuya Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan.,Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, 150 Tobuki-machi, Hachioji, Tokyo, 192-0001, Japan
| | - Minoru Yamada
- Faculty of Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
| | - Hiroyuki Fujita
- Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka, Kyoto, 621-8555, Japan
| | - Motohiko Miyachi
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan.,National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi, 474-8511, Japan
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka, Kyoto, 621-8555, Japan.,Department of Nursing, Doshisha Women's College of Liberal Arts, 97-1 Minamihokotate, Kodo, Kyotanabe, Kyoto, 610-0395, Japan.,Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
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25
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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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26
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Iwasaki M, Hirano H. Decline in Oral Function and Its Management. Int Dent J 2022; 72:S12-S20. [PMID: 36031320 PMCID: PMC9437811 DOI: 10.1016/j.identj.2022.06.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 01/15/2023] Open
Abstract
With the renewed focus on eating abilities in the ageing population, new concepts referred to as oral frailty and oral hypofunction have been introduced in Japan. We aimed to provide an overview of (i) the evaluation and management of oral function in ageing populations according to oral frailty and oral hypofunction and (ii) recent scientific evidence of the associations of poor oral function with physical function and nutritional status. Both oral frailty and oral hypofunction are multidimensional concepts that describe poor oral function. In epidemiologic and/or clinical settings, they are defined as the accumulation of factors leading to poor oral status. Oral hypofunction is a core component of oral frailty. To date, there are no systematic strategies for addressing oral frailty or oral hypofunction. Nevertheless, recent randomised controlled trials revealed that several components of oral function can be improved through appropriate training. On the other hand, multiple observational studies published in recent years have demonstrated that oral frailty and oral hypofunction are associated with physical function (gait performance, frailty, and sarcopenia) and nutritional status (low protein intake, poor dietary diversity, and malnutrition) in community-dwelling older adults. Moreover, studies have reported a significant association between insufficient participation in social networks and poor oral function. However, most of the studies conducted to date have utilised a cross-sectional design, which does not permit assessment of the temporal association between comprehensive oral function and general health. Maintaining good oral function may be key to longevity. However, evidence is limited thus far, and comprehensive oral function has not been studied in detail; thus, additional high-quality studies are needed.
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27
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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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28
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Suzuki H, Furuya J, Matsubara C, Aoyagi M, Shirobe M, Sato Y, Tohara H, Minakuchi S. Comparison of the Amount of Used and the Ease of Oral Care between Liquid and Gel-Type Oral Moisturizers Used with an Oral Care Simulators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138158. [PMID: 35805817 PMCID: PMC9266061 DOI: 10.3390/ijerph19138158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 11/19/2022]
Abstract
Oral care involving the removal of dry sputum is effective for older patients who require nursing care or hospitalization. However, safe and efficient oral care methods for such patients remain unclear. We aimed to simulate the oral cavity of older adults with dry mouth and elucidate the differences between two moisturization agents, water and gel-like oral moisturizer, and investigate the effect of occupation and experience on the amount of use and the ease of oral care. Using an oral care simulator (MANABOT®, Nissin Dental Products Inc., Kyoto, Japan), 42 students and 48 dental professionals (13 dentists and 35 dental hygienists) performed oral care using moisturization agents to facilitate dry sputum removal. The time required for oral care, amount of water or gel used, amount of pharyngeal inflow, and ease of oral care when using water or gel were compared. The simulations revealed that the amount of use and pharyngeal inflow for gel (2.9 ± 1.6 and 0.3 ± 0.3, respectively) were significantly lower than those for water (6.8 ± 4.1 and 1.2 ± 1.5, respectively) in all participants. Using a gel-like moisturizer might reduce the aspiration risk in older patients requiring nursing care or hospitalization, regardless of occupation and experience.
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Affiliation(s)
- Hiroyuki Suzuki
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (H.S.); (S.M.)
| | - Junichi Furuya
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan; sato-@dent.showa-u.ac.jp
- Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.A.); (H.T.)
- Correspondence: ; Tel.: +81-3-3783-3971
| | - Chiaki Matsubara
- Department of Dental Hygiene, University of Shizuoka, Junior College, 2-2-1 Oshika, Suruga-ku, Shizuoka 422-8021, Japan;
| | - Michiyo Aoyagi
- Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.A.); (H.T.)
| | - Maki Shirobe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan;
| | - Yuji Sato
- Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan; sato-@dent.showa-u.ac.jp
| | - Haruka Tohara
- Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.A.); (H.T.)
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (H.S.); (S.M.)
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Effect of tongue strength on clinical outcomes of patients: A systematic review. Arch Gerontol Geriatr 2022; 102:104749. [PMID: 35724534 DOI: 10.1016/j.archger.2022.104749] [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: 12/29/2021] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Whether decreased tongue strength is associated with poor clinical outcomes is unclear. This systematic review investigated the effect of decreased tongue strength on the clinical outcomes of adults requiring medical treatment. DESIGN Systematic review. SETTING AND PARTICIPANTS Systematic reviews, randomized control trials, intervention studies, and longitudinal observational studies involving patients with decreased tongue strength requiring medical treatment were included. METHODS Articles published between January 2000 and June 2021 were retrieved from MEDLINE, CINAHL, Ichushi-web (in Japanese), Web of Science, ClinicalTrials.gov, UMIN, the Cochrane Library, and Cochrane Central Register of Controlled Trials. Risk of bias was assessed using the Risk of Bias Assessment Tool for Nonrandomized Studies. The study protocol was pre-registered in XXX. RESULTS After screening 3040 articles and excluding duplicates, 74 articles were retrieved; after full-text evaluation of the 74 articles, seven articles (with 787 patients) were found to meet the inclusion criteria. The cut-off values for determining decreased tongue strength ranged from 13.8 to 21.6 kPa. Patients with decreased tongue strength had poorer recovery of their swallowing function, higher incidence of pneumonia, and poorer life expectancy than those with high tongue strength. However, tongue strength in older patients with decreased tongue strength increased when they performed physical exercise interventions and followed strict nutritional management plans. CONCLUSIONS Decreased tongue strength was related to poor clinical outcomes in in- and outpatients. Oral frailty in older patients should be given increased attention in hospitals, and further research is needed to improve the clinical outcomes for older people with reduced tongue strength.
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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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Tanaka T, Son BK, Lyu W, Iijima K. Impact of social engagement on the development of sarcopenia among community-dwelling older adults: A Kashiwa cohort study. Geriatr Gerontol Int 2022; 22:384-391. [PMID: 35322539 DOI: 10.1111/ggi.14372] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/04/2022] [Accepted: 02/13/2022] [Indexed: 12/25/2022]
Abstract
AIM How older adults develop sarcopenia in the community setting is unclear. Focusing on social engagement, we aimed to validate our hypothesized model of sarcopenia development with various contributing factors, such as physical activity, oral function, psychological status and nutritional status. We also clarified direct and indirect effects of social engagement, physical activity, nutritional status, oral function and psychological status on new-onset sarcopenia. METHODS We analyzed 1483 participants' (72.6 ± 5.4 years) longitudinal data from the Kashiwa study. Sarcopenia was assessed in all the surveys in the Kashiwa study. Measures regarding social engagement, physical activity, oral function, psychological status and nutritional status were assessed at baseline. Structural equation modeling was used to analyze the efficiency of the hypothesized model, and calculate direct and indirect effects of factors affecting new-onset sarcopenia. RESULTS Over the follow-up period (median 6 years [interquartile range 4-6 years]), 12% of individuals developed new-onset sarcopenia. Our structural hypothesis model starting from social engagement to new-onset sarcopenia was suitable (root mean square error of approximation = 0.031, goodness-of-fit index = 0.967, adjusted goodness-of-fit index = 0.954, comparative fix index = 0.911, parsimonious comparative fit index = 0.755; all paths were significant), showing direct effects of social engagement on psychological status, physical activity and oral function, and indirect effects on nutritional status through oral function and psychological status. CONCLUSIONS The present results showed that social engagement could potentially decrease new-onset sarcopenia risks by influencing multidimensional factors, such as physical activity, oral function, and psychological and nutritional status. To prevent sarcopenia, it might be essential to promote social engagement through populational approaches. Geriatr Gerontol Int 2022; 22: 384-391.
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Affiliation(s)
- Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Bo-Kyung Son
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan.,Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Weida Lyu
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan.,Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan.,Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
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Oral Factors as Predictors of Frailty in Community-Dwelling Older People: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031145. [PMID: 35162167 PMCID: PMC8834726 DOI: 10.3390/ijerph19031145] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this prospective cohort study was to identify predictors for frailty among possible oral factors in community-dwelling older people. Ninety-seven participants (≥60 years old) without frailty at baseline were included and assigned to either the robust or the frailty group after 2-year follow-up. The frailty was defined using the Japan Cardiovascular Health Study index. The numbers of present and functional teeth and periodontal disease severity were recorded. Bacterial counts on the dorsum of the tongue, oral moisture, tongue pressure, occlusal force, masticatory ability, and the oral diadochokinesis (ODK) rate were measured. Swallowing function, along with psychosocial status, relationships with communities and people, nutritional status, medical history, and comorbidities were evaluated using a questionnaire. The newly identified frailty group at follow-up showed significantly lower values in the number of teeth present, ODK/ta/sound and ODK/ka/sound rates, and clinical attachment level at baseline compared to the robust group. A logistic regression model showed a significantly negative association between the ODK/ta/sound rate at baseline and the incidence of frailty. Articulatory oral motor skill was found to be a predictor of frailty after two years.
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Denture wearing is associated with nutritional status among older adults requiring long-term care: A cross-sectional study. J Dent Sci 2022; 17:500-506. [PMID: 35028076 PMCID: PMC8739738 DOI: 10.1016/j.jds.2021.07.022] [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: 06/18/2021] [Revised: 07/26/2021] [Indexed: 11/20/2022] Open
Abstract
Background/purpose Dentures are important for the reconstruction of occlusal support and masticatory performance for older adults with poor dentition. We aimed to elucidate the oral health factors associated with malnutrition in older adults requiring long-term care, including denture use. Materials and methods This cross-sectional study included 322 older adults (63 men, 259 women; mean age, 86.6 ± 6.9 years) who required long-term care in rural Japan. The participant's nutritional status was assessed using the Mini Nutritional Assessment-Short Form (MNA®-SF). Oral health was assessed using participant's dentition and oral function. Barthel Index (BI) and medical history were measured for assessing general health status. Multiple logistic regression analyses were performed to determine the oral health factors associated with malnutrition. Results The proportion of participants with malnutrition was 17.2%. The BI score (odds ratio [OR], 0.95; 95% confidence interval [CI] 0.93–0.98, p<0.001), having <20 teeth and dentures (OR 0.42; 95%CI 0.18–0.99; p = 0.047), and poor lip-closure ability (OR 2.86; 95%CI 1.32–6.20; p = 0.008) were significantly associated with malnutrition. Conclusion Denture use, lip-closure ability, and activities of daily living were significantly associated with malnutrition in older adults requiring long-term care, suggesting that wearing dentures for tooth loss and maintaining oral function contributes to nutritional status.
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Arenas-Márquez MJ, Tôrres LHDN, Borim FSA, Yassuda MS, Neri AL, Sousa MDLRD. Perda de função mastigatória e risco de fragilidade em idosos vivendo em domicílios familiares no Estado de São Paulo. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2022. [DOI: 10.1590/1981-22562022025.210234.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Verificar se a perda de função mastigatória aumenta o risco de fragilidade em idosos vivendo em domicílios familiares no Estado de São Paulo. Métodos Foi adotado um delineamento de coorte prospectivo sobre a base de dados do estudo FIBRA (Fragilidade em Idosos Brasileiros), com linha de base realizada em 2008-2009 e seguimento em 2016-2018, transcorrendo em média 100,2 ± 9,2 meses. A variável desfecho foi a incidência de fragilidade, a variável de exposição foi a função mastigatória conforme a condição de edentulismo e autorrelato de dificuldade mastigatória. As variáveis de ajuste foram condições sociodemográficas, comportamentais e de saúde geral. Foi utilizado um modelo de regressão de Poisson, com variância robusta, estimando o risco relativo Resultados a incidência acumulada de fragilidade aos oito anos em média foi de 30 casos a cada 100 participantes edêntulos com dificuldade mastigatória, que apresentaram maior risco de desenvolver fragilidade (RR:1,75 IC 95% 1,09-2,81) do que os idosos dentados sem dificuldade mastigatória, independentemente de tabagismo (RR: 1,71 IC 95% 1,07-2,73) e de condição socioeconômica (RR: 1,72 IC 95% 1,13-2,62). Conclusão A perda de função mastigatória aumentou o risco de fragilidade em idosos.Futuras pesquisas deverão estudar se a reabilitação da função mastigatória contribui para diminuir esse risco.
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Arenas-Márquez MJ, Tôrres LHDN, Borim FSA, Yassuda MS, Neri AL, Sousa MDLRD. Masticatory function loss and frailty risk in community-dwelling older people in the State of São Paulo. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2022. [DOI: 10.1590/1981-22562022025.210234.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective To verify if the loss of masticatory function increases the risk of frailty in community-dwelling older people in the state of São Paulo. Methods A prospective cohort design was adopted based on the FIBRA study database (Fragility in Brazilian Elderly), with a baseline performed in 2008-2009 and follow-up in 2016-2018, elapsed on average 100.2 ± 9.2 months. The outcome variable was the incidence of frailty. The exposure variable was masticatory function according to edentulism and self-reported chewing difficulty. Adjustment variables were sociodemographic, behavioral, and general health conditions. A Poisson regression model with robust variance was used to estimate the relative risk. Results the cumulative incidence of frailty over eight years was 30 cases per 100 edentulous participants with chewing difficulties, who had a higher risk of developing frailty (RR: 1.75 95% CI 1.09-2.81) than the dentate elderly without chewing difficulties, regardless of smoking (RR: 1.71 95% CI 1.07-2.73) and socioeconomic status (RR: 1.72 95% CI 1.13-2.62) Conclusion Loss of masticatory function increases the risk of frailty in older people. Future research should study whether the rehabilitation of oral function reduces this risk.
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Sawada N, Takeuchi N, Ekuni D, Morita M. Oral function, nutritional status and physical status in Japanese independent older adults. Gerodontology 2021; 39:359-365. [PMID: 34599786 DOI: 10.1111/ger.12593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/14/2021] [Accepted: 09/22/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To clarify the associations among oral status, nutritional status and physical status in Japanese independent older adults. BACKGROUND It is important to focus on factors affecting physical status associated with life dysfunction, long-term care and mortality. However, there are very few reports of the associations among oral status, nutritional status and physical status. MATERIALS AND METHODS Patients who visited the Preventive Dentistry Clinic at Okayama University Hospital from November 2017 to January 2019 participated in this cross-sectional study. Number of teeth, periodontal condition and oral function were recorded. Bacteria counts in tongue dorsum, oral wettability, tongue pressure, tongue and lip movement function [oral diadochokinesis (ODK)], masticatory ability, bite force and swallowing function were measured. Nutritional status was assessed by the Mini Nutritional Assessment. Physical frailty status and Elderly Status Assessment Set were also evaluated. These variables were analysed by structural equation modelling (SEM). RESULTS Data from 203 patients were analysed (63 males and 140 females). Patients ranged in age from 60 to 93 years. The final model of the path diagram was completed by SEM. ODK was positively associated with nutritional status, and nutritional status was negatively associated with frailty. Age was associated with ODK, nutritional status and frailty. CONCLUSION Based on the associations among age, ODK, nutritional status and frailty, maintaining tongue movement function may contribute to good nutritional status and physical status in Japanese independent older adults.
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Affiliation(s)
- Nanami Sawada
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Noriko Takeuchi
- Department of Preventive Dentistry, Okayama University Hospital, Okayama, Japan
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Manabu Morita
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Prevalence and determinants of frailty in older adult patients with chronic coronary syndrome: a cross-sectional study. BMC Geriatr 2021; 21:519. [PMID: 34592947 PMCID: PMC8482732 DOI: 10.1186/s12877-021-02426-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/23/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Frailty is an expression of vulnerability and decline of physical, mental, and social activities, more commonly found in older adults. It is also closely related to the occurrence and poor prognosis of coronary artery disease (CAD). Little investigation has been conducted on the prevalence and determinants of frailty in older adult patients with chronic coronary syndrome (CCS). METHODS A cross-sectional study was conducted, simple random sampling was used in this study. 218 older adults (age ≥ 60 years) with CCS with an inpatient admission number ending in 6 were randomly selected who hospitalized in Department of Geriatric Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, China, between January and December 2018. For measurement and assessment, we used the 5-item FRAIL scale (fatigue, resistance, ambulation, illnesses, and loss of weight), demographic characteristics, Barthel Index(BI), Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), Mini Nutrition Assessment Shor-Form (MNA-SF), Morse Fall Scale (MFS), Caprini risk assessment, polypharmacy, and Numerical Rating Scale (NRS). Multivariate logistic regression analysis was used to confirme determinants. RESULTS The FRAIL scale showed 30.3% of the subjects suffered from frailty. Determinants were aging (OR1.12; 95% CI 1.04 ~ 1.62), out-of-pocket (OR18.93; 95% CI 1.11 ~ 324.07), hearing dysfunction (OR9.43; 95% CI 1.61 ~ 55.21), MNA-SF score (OR0.71; CI 0.57 ~ 0.89), GDS-15 score (OR1.35; 95% CI 1.11 ~ 1.64), and Caprini score (OR1.34; 95% CI 1.06 ~ 1.70). CONCLUSIONS The FRAIL scale confirmed that the prevalence of frailty in patients with CCS was slightly lower than CAD. Aging, malnutrition, hearing dysfunction, depression, and VTE risk were significantly associated with frail for older adult patients with CCS. A comprehensive assessment of high-risk patients can help identify determinants for frailty progression. In the context of CCS, efforts to identify frailty are needed, as are interventions to limit or reverse frailty status in older CCS patients.
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The Significance of Posterior Occlusal Support of Teeth and Removable Prostheses in Oral Functions and Standing Motion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136776. [PMID: 34202488 PMCID: PMC8297000 DOI: 10.3390/ijerph18136776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 01/19/2023]
Abstract
The purpose of this study was to evaluate the effect of posterior occlusal support of natural teeth and artificial teeth on oral functions and standing motion. Patients who had been treated with removable prostheses were enrolled as the subjects. Their systemic conditions (body mass index (BMI) and skeletal muscle mass index (SMI)) were recorded. The subjects were classified into two groups according to a modified Eichner index: B1-3 (with posterior occlusal support) and B4C (without posterior occlusal support). Maximum occlusal force (MOF), masticatory performance (MP), and standing motion (sway and strength) were evaluated for cases with and without removable prostheses. There were no significant differences in BMI and SMI between the B1-3 group and the B4C group. The subjects with removable prostheses demonstrated significantly higher values in MOF, MP, and sway and strength than the subjects without removable prostheses. The comparison of oral functions between the B1-3 group and the B4C group revealed that the positive effect of posterior occlusal support of natural teeth and removable prostheses and the significant positive effects of posterior occlusal support on standing motion were partly observed in these comparisons. Posterior occlusal support of natural teeth and even of removable prostheses may contribute to the enhancement of oral functions and standing motion.
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Relationship between Oral Hypofunction and Sarcopenia in Community-Dwelling Older Adults: The Otassha Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126666. [PMID: 34205795 PMCID: PMC8296410 DOI: 10.3390/ijerph18126666] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 12/31/2022]
Abstract
Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.
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Komatsu R, Nagai K, Hasegawa Y, Okuda K, Okinaka Y, Wada Y, Tsuji S, Tamaki K, Kusunoki H, Kishimoto H, Shinmura K. Association between Physical Frailty Subdomains and Oral Frailty in Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062931. [PMID: 33809322 PMCID: PMC8001836 DOI: 10.3390/ijerph18062931] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 12/15/2022]
Abstract
This cross-sectional study aimed to demonstrate the association between physical frailty subdomains and oral frailty. This study involved community-dwelling older adults (aged ≥65 years). Physical frailty was assessed with the Japanese version of the Cardiovascular Health Study criteria. Oral frailty was defined as limitations in at least three of six domains. Logistic regression analysis was used to analyze the association between physical frailty risk and oral frailty. In addition, we examined the association between physical frailty subdomains (gait speed, grip strength, exhaustion, low physical activity, and weight loss) and oral frailty. A total of 380 participants were recruited for this study. Overall, 18% and 14% of the participants were at risk of physical frailty and had oral frailty, respectively. Physical frailty risk (odds ratio (OR) = 2.40, 95% confidence interval (CI): 1.22–4.75, p = 0.012) was associated with oral frailty in multivariate analysis. In secondary analysis, among physical frailty subdomains, gait speed (OR = 0.85, 95% CI: 0.73–0.97, p = 0.019) was associated with oral frailty. The present findings suggest that physical frailty is closely related to oral frailty. Among physical frailty subdomains, decreased gait speed in particular is an important indicator related to the development of oral frailty.
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Affiliation(s)
- Ryo Komatsu
- Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo 650-8530, Japan; (R.K.); (K.O.); (Y.O.)
| | - Koutatsu Nagai
- Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo 650-8530, Japan; (R.K.); (K.O.); (Y.O.)
- Correspondence: ; Tel.: +81-78-304-3047; Fax: +81-78-304-2747
| | - Yoko Hasegawa
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan; (Y.H.); (H.K.)
- Division of Comprehensive Prosthodontics, Faculty of Dentistry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| | - Kazuki Okuda
- Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo 650-8530, Japan; (R.K.); (K.O.); (Y.O.)
| | - Yuto Okinaka
- Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo 650-8530, Japan; (R.K.); (K.O.); (Y.O.)
| | - Yosuke Wada
- Department of Rehabilitation, Hyogo College of Medicine Sasayama Medical Center, Sasayama, Hyogo 669-2321, Japan;
| | - Shotaro Tsuji
- Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan;
| | - Kayoko Tamaki
- Department of General Medicine, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo 663-8501, Japan; (K.T.); (H.K.); (K.S.)
| | - Hiroshi Kusunoki
- Department of General Medicine, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo 663-8501, Japan; (K.T.); (H.K.); (K.S.)
| | - Hiromitsu Kishimoto
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan; (Y.H.); (H.K.)
| | - Ken Shinmura
- Department of General Medicine, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo 663-8501, Japan; (K.T.); (H.K.); (K.S.)
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