Shuichi Hara

[Relationship between the nutritional status and the oral function among community-dwelling dependent elderly persons].

AIM We herein examined the relationship between the nutritional status and the oral function among community-dwelling dependent elderly persons. METHODS The subjects included 218 community-dwelling dependent elderly persons. The data were collected via questionnaires, including information regarding age, sex, the level of care required, nutritional status and swallowing function. We used the Mini Nutritional Assessment-Short Form (MNA-SF) to measure the nutritional status and the Dysphagia Risk Assessment for the Community-dwelling Elderly (DRACE) to evaluate the swallowing function. The tongue pressure and the labial closure force were measured using a tongue pressure measurement system (JMS Co. Ltd., Hiroshima, Japan) and the Lip de Cum (Cosmo-Instruments Co, Ltd, Tokyo, Japan). RESULTS The mean MNA-SF score was 10.07±2.58. The mean DRACE score was 4.39±3.80. The mean tongue pressure was 23.89±10.61 kPa. The mean labial closure force was 10.17±6.04 N. The results of bivariate regression analyses showed that there was a poor correlation between the MNA-SF and the DRACE, tongue pressure and labial closure force. Furthermore, the multiple regression analysis with the MNA-SF as the dependent variable revealed a correlation between the DRACE and labial closure force (p<0.01, R(2)=0.02). CONCLUSIONS Our results suggest that the nutritional status is significantly related to the swallowing function and labial closure force among community-dwelling dependent elderly persons.

Relationship Between Chewing and Swallowing Functions and Health-Related Quality of Life

Population aging has advanced rapidly in developed countries. In particular, Japan has already become a “Super Aging Society” (MHLW, 2010), and this trend exists in other Asian countries such as South Korea as well (Fig. 1). The increase in life expectancy has led to a decreased ratio between people of working-age and older individuals. At present, the aging problem is most common in developed and mid-developed countries. During the last 6 decades, the types of diseases found in Japan have changed greatly with socio-economic development (Matsuda, 2008). For example, the present major causes of death in Japan are non-communicable diseases (NCD) such as malignant neoplasm, cardiovascular disease, and cerebrovascular disease (WHO, 2011). With an aging population, the need for geriatric dentistry has increased greatly in Japan. Oral health is important in the elderly; it helps maintain the ability to chew, swallow, and speak clearly, which are important for quality of life (QOL) (Pereira et al., 2006; Sonies et al., 1984).

Development of a Masticatory Indicator Using a Checklist of Chewable Food Items for the Community-Dwelling Elderly

The purpose of the present study was to develop a new assessment scale to evaluate masticatory ability among community-dwelling elderly individuals. The study comprised 761 independent elderly subjects residing in the community. We pooled 25 food items with various textures. Based upon the pass rate and nonresponse rate, we extracted 9 food items to be included in the masticatory ability assessment for the community-dwelling elderly (MACE). The reliability of this assessment was determined using Cronbach’s alpha coefficients. We then examined the concurrent validity of the MACE by comparing it with an existing method termed “mastication score.” Additionally, the convergent validity was examined by comparing the correlation coefficients of MACE, general oral health assessment index (GOHAI), and the number of teeth. Cronbach’s alpha coefficient of MACE was 0.89 (), indicating satisfactory reliability. MACE was significantly correlated with the mastication score (), GOHAI (), and the number of teeth (). These results suggest that MACE is a useful tool with sufficient reliability and validity to identify declines in masticatory ability among community-dwelling elderly individuals.