Shingo Moriya

Factors influencing oral health-related quality of life (OHRQoL) among the frail elderly residing in the community with their family

The purpose of the present study was to identify factors that influence quality of life (QoL) among frail elderly individuals residing in the community, in order to improve the level of home care related to oral health. Participants were 100 pairs comprising elderly individuals requiring care and their family caregivers. Questionnaire items for the family caregivers related to demographic variables, hours spent caregiving per day, and duration of caregiving. Questionnaire items for the elderly recipients of care concerned demographic variables, activities of daily living (ADL), and cognitive status. According to bivariate analysis, oral health-related quality of life (OHRQoL) was significantly related to basic ADL, communication ADL (CADL), dysphagia risk, and duration of caregiving. From multiple regression analysis, dysphagia risk and CADL were extracted as factors influencing OHRQoL. Assessment of OHRQoL will be useful not only to detect oral health needs but also to evaluate the effect of oral health care in the elderly.

Relationships between perceived chewing ability and muscle strength of the body among the elderly

The aim of the present study was to elucidate whether self-assessed masticatory ability (masticatory ability) is significantly related to muscle strength of the body evaluated as handgrip strength and skeletal muscle mass of the whole body (kg) (SMM) after adjusting for confounding variables, including, age, gender, height, weight, employment status, type of household, educational background, social interaction, chronic medical conditions, smoking habit, drinking habits and dentition status among the elderly. A total of 381 persons aged 67-74 years were enrolled. Masticatory ability was classified into one of three categories: ability to chew all kinds of food, ability to chew only slightly hard food or ability to chew only soft or pureed food. Handgrip strength was measured, and bioimpedance analysis was used to estimate SMM. One-way analysis of variance and Bonferroni methods were used to examine differences in handgrip strength and SMM among the three groups of masticatory ability. An ordinal regression model was conducted with masticatory ability as the dependent variable and handgrip strength as the principal independent variable. Handgrip strength was significantly lower in those individuals who could chew only soft or pureed food than in those individuals who could chew all kinds of food. No significant difference in SMM was found among the three groups of masticatory ability. Masticatory ability was significantly related to handgrip strength after adjusting for SMM, dentition status and background factors. Chewing ability may be related to muscle strength of the body evaluated as handgrip strength, but not evaluated as SMM.

Associations between self-assessed masticatory ability and higher brain function among the elderly.

Among the elderly, the quality of higher brain function is a contributing factor in performing activities of daily living. The aim of the study is to elucidate, epidemiologically, associations between mastication and higher brain function. A total of 208 community-dwelling elderly persons, aged 70-74 years, were enrolled. Self-assessed masticatory ability (masticatory ability) was classified into one of three categories: ability to chew all kinds of food, ability to chew only slightly hard food, or ability to chew only soft or pureed food. Brain function was assessed by four neuropsychological tests: Ravens Colored Progressive Matrices (RCPM) test, the Verbal Paired Associates 1 (VerPA) task and the Visual Paired Associates 1 task (from the Wechsler Memory Scale Revised Edition), and the Block Design subtest (from the Wechsler Adult Intelligence Scales-Third Edition). Correlations between masticatory ability and each test were examined using Spearman rank correlation coefficients. Multinominal logistic regression models were conducted with the neuropsychological tests as the dependent variables and masticatory ability as the principal independent variable to adjust for age, gender, educational background, social activity, drinking/smoking habits, chronic medical conditions and dental status. Significant correlations were found between the RCPM test, the VerPA task, the Block Design test and masticatory ability. In multinominal logistic regression models, poor masticatory ability was significantly and independently related to the categories under the mean-s.d. points compared with those of the mean ± s.d. ranges for RCPM test and the VerPA task. Significant associations may exist between mastication and higher brain function among the elderly.

Analysis of moment structures for assessing relationships among perceived chewing ability, dentition status, muscle strength, and balance in community-dwelling older adults

OBJECTIVE The aim of this study was to assess relationships among perceived chewing ability, dentition status, muscle strength and balance in community-dwelling older adults using analysis of moment structures (Amos). BACKGROUND Physical performance parameters such as muscle strength and balance can predict the future onset of disabilities in activities of daily living among older adults. In this context, elucidation of the relationships among oral conditions and physical performance parameters is necessary. MATERIALS AND METHODS Data on occlusal contact patterns of natural teeth (OPNT), self-assessed masticatory ability (mastication), body mass index (BMI), handgrip strength (HG) and one-leg standing time with eyes open (OLST) were collected from 501 independently living adults aged 65-74 years. The relationships among these parameters were analysed using Spearmans rank correlation coefficients and Amos. RESULTS Subjects of both genders showed significant correlations among OPNT, mastication, HG and OLST, evaluated using Spearmans rank correlation coefficients. For each Amos model, the goodness-of-fit statistic indicated a good level of fit. In both men and women, OPNT was significantly related to mastication, and mastication was related to HG but not to OLST. OPNT was related to neither HG nor OLST in women and was related to OLST but not HG in men. CONCLUSION The findings observed in this study present a possible importance of dental status and perceived chewing ability for the onset of disability by influencing physical performance in community-dwelling older adults.

Predictors of eligibility for long‐term care funding for older people in Japan

Aim:  To determine the predictors of Japanese long‐term care insurance system (LTCI) certification.

Self-assessed masticatory ability and hospitalisation costs among the elderly living independently.

The escalating medical costs are a social problem in many countries. Masticatory ability is thought to be related to the general health conditions. The purpose of this study was to show relationships between self-assessed masticatory ability and medical costs among the elderly living independently in community. Data on background factors and self-assessed masticatory ability were collected from 702 Japanese elderly persons by questionnaires. An intra-oral examination was performed to examine the number of remaining teeth. Self-assessed masticatory ability was classified into one of three categories: ability to chew all kinds of food (Good), ability to chew only slightly hard food (Fair) or ability to chew only soft or pureed food (Poor). Data on the annual medical excluding dental costs were obtained from the Japanese National Health Insurance system. The Kruskal-Wallis test was used to examine differences in outpatient costs and hospitalisation costs among the three groups of self-assessed masticatory ability. Univariate unconditional logistic regression models and multivariate logistic regression models were used with medical costs as the dependent variable and self-assessed masticatory ability as the principal independent variable. A significant difference (P=0·039) in hospitalisation costs but not outpatient costs was found among the three groups of self-assessed masticatory ability. The multivariate logistic regression analysis showed that severely impaired masticatory ability (Poor) was significantly related to higher costs of hospitalisation. Self-assessed impairment of masticatory ability may be a significant and independent indicator of higher costs of hospitalisation among community-dwelling elderly persons.

SELF-ASSESSED IMPAIRMENT OF MASTICATORY ABILITY AND LOWER SERUM ALBUMIN LEVELS AMONG COMMUNITY-DWELLING ELDERLY PERSONS

SUMMARY Background: Serum albumin is considered a key nutrient that is significantly related to general health among elderly persons. The aim of the present study was to determine the relationship between masticatory ability and serum albumin levels in the elderly. Methods: A total of 768 persons were enrolled in the study. Data on background factors and the self-assessed masticatory ability were collected by means of questionnaires. An intraoral examination was performed to examine the pattern of occluding pairs of natural teeth, and blood samples were collected from the cutaneous vein to measure serum albumin levels. A forward stepwise multivariate logistic model was constructed with serum albumin levels as the dependent variable and the self-assessed masticatory ability as the principal independent variable, to adjust for potential confounding variables. Results: Sex, current employment status, social interaction, and self-assessed masticatory ability were retained in the final model, and they were significantly associated with serum albumin levels. The odds ratios for lower levels of serum albumin (≤ 40 g/L) were 1.88 for males, 1.70 for non-working status, 1.55 for low social activity status, and 1.43 for the self-assessed impairment of masticatory ability. Conclusion: A weak, statistically significant relationship may exist between self-assessed impairment of masticatory ability and lower levels of serum albumin in the elderly living independently. [International Journal of Gerontology 2010; 4(2): 89–95]

Relationship between subjective assessment of oral health and medical expenses in community-dwelling elderly persons

Objectives The increasing medical expenses of elderly persons in Japan’s rapidly ageing society have become a major concern. It is therefore important to elucidate the factors associated with such escalation. Here, we focused on the relationship between subjective self-assessment of oral health, as an index of general health, and medical expenses (excluding dental repair) under the hypothesis that oral health contributes to general medical expenses. Several studies have shown that oral health status is correlated with general health status among elderly persons. We speculated that oral health status might show a relation with medical costs among elderly persons. However, few studies have investigated this relationship to date. Materials and Methods Participants were 259 elderly subjects (range: 65–84 years; 120 men, 139 women) residing independently. Subjective assessment of oral health was evaluated by their responses (‘Good’, ‘Not good’ and ‘Not at all good’) on a survey questionnaire. The correlation between subjective assessment of oral health and medical expenditure was analysed using Spearman’s rank method, the Mann–Whitney U-test and the Kruskal–Wallis test. Medical expenses were used as the dependent variable in multinomial logistic regression analysis with background and intraoral factors as independent variables. Results A slight yet statistically significant correlation was observed between subjective assessment of oral health and outpatient treatment fees. Conclusion The findings revealed that subjective assessment of oral health is significantly and independently related to the medical expenses of community-dwelling elderly persons after adjusting for social background, living environment and physical factors.

Relationships between Geriatric Oral Health Assessment Index scores and general physical status in community‐dwelling older adults

OBJECTIVE The aim of this study was to investigate the relationships between Geriatric Oral Health Assessment Index (GOHAI) and general physical status among community-dwelling older adults. BACKGROUND Geriatric Oral Health Assessment Index is a patient-centred assessment of oral health for older adults. We hypothesised that GOHAI is a significant indicator of general physical status of older adults. METHODS This study included 354 adults (age, ≥65 years) living independently. Body mass index, handgrip strength and one-leg standing time with eyes open were used to evaluate the general physical status. Spearmans rank correlation coefficients were calculated to examine the relationships between the GOHAI scores, its three subdivided categories (physical function, psychological function and pain and discomfort) and each physical status measurement. A stepwise linear regression model was applied with each physical status measurement as the dependent variable and the GOHAI scores and its subdivisions as the principal independent variable. RESULTS Positive correlations were found between the GOHAI scores, its three subdivided categories and handgrip strength. The physical function category positively correlated with one-leg standing time. The GOHAI and the pain and discomfort category scores were retained in the final models of stepwise regression for handgrip strength, and significant relationships persisted after adjustments for demographic, psychosocial, medical and dental status. CONCLUSION The GOHAI scores and its pain and discomfort category score may be significant indicators of body muscle strength.

Relationship between periodontal status and physical fitness in an elderly population of nonsmokers in Bangladesh.

ACKNOWLEDGMENTS Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this letter. This study was sponsored by the Conselho Nacional de Desenvolvimento Cientı́fico e Tecnológico (CNPq), Brazil (process no. 4708412004-4). Author Contributions: M. Fernanda Lima-Costa: study conceptualization and design, acquisition of subjects and data, analysis and interpretation of data, preparation of manuscript. Sergio V. Peixoto: study conceptualization, analysis, interpretation of data, and preparation of manuscript. Maristela Taufer and Emilio H. Moriguchi: ApoE genotyping and preparation of manuscript. Sponsor’s Role: The sponsor had no influence on the design, methods, subject recruitment, data collection, analysis, or preparation of the letter.