Relationship between Chewing Ability and Nutritional Status in Japanese Older Adults: A Cross-Sectional Study

Objectives: This study aimed to determine the relationship between objective chewing ability and the nutritional status of Japanese community-dwelling elders. Design: A cross-sectional study. Participants: A total of 509 community-dwelling elders living in the Tokyo metropolitan area participated in a comprehensive survey conducted in October 2013. Measurements: The basic characteristics were sex, age, and body mass index. Undernutrition was examined through serum albumin levels. Chewing ability was examined through color-changeable xylitol gum by evaluating the color changes in chewing gum. Nutritional intake was examined using the semi-quantitative food frequency questionnaire. Results: In the poor chewing ability group, all nutrient intake levels were significantly low, except for carbohydrates, and intake levels for all food groups were significantly low, except for cereals, confectionery, sugars, seasonings, and spices. Additionally, after adjusting for covariates for sex, age, Tokyo Metropolitan Institute of Gerontology-Index of Competence (TMIG-IC) score, Mini-Mental State Examination (MMSE) score, body mass index (BMI), stroke, number of functional teeth, energy intake, and protein intake, chewing ability was found to be significantly associated with undernutrition. Conclusion: We concluded that chewing ability was closely associated with nutrient and different food groups’ intake, as well as undernutrition, among Japanese community-dwelling elders. Thus, to ensure comprehensive nutritional management, nutritionists and dentists should collaborate when treating the same patients

The Mini Nutritional Assessment-Short Form as a predictor of nursing home mortality in Japan: A 30-month longitudinal study

Objectives: We examined whether the Mini Nutritional Assessment-Short Form (MNA (R)-SF) predicted mortality in 367 nursing home residents (82% women; mean age = 84.4 +/- 8.5 years) in Japan. Measurements: We examined participants' basic characteristics (sex, age, height, weight, and medical history), the Barthel index (BI), clinical dementia rating (CDR), and six items of the MNA (R)-SF. The association between the MNA (R)-SF and 30-month mortality was assessed using a Cox proportional regression analysis. Results: During the study, 157 (42.8%) participants died. MNA (R)-SF scores in the Survival group were significantly higher than in the Death group (9.4 +/- 2.1 vs. 8.4 +/- 2.3, respectively; p < .001). After adjusting for age, sex, history of aspiration pneumonia, BI, and CDR, MNA (R)-SF scores were significantly associated with 30-month mortality (hazard ratio: 0.89, 95% confidence interval: 0.82-0.97, p = .005). Conclusion: The MNA (R)-SF was an effective predictor of mortality among nursing home residents in Japan, even after adjusting for potential confounders. These results indicate that periodically evaluating nutritional status using the MNA (R)-SF, and nutritional interventions according to status, may result in maintenance and improvement of nutritional status, as well as lead to reduced mortality

Association between decrease in frequency of going out and oral function in older adults living in major urban areas

Aim To examine the association between a decrease in the frequency of going out and oral function in independent older adults living in the urban area of Tokyo. Methods The participants analyzed were 785 older adults from the "Takashimadaira Study" (344 men and 441 women, age 77.0 +/- 4.6 years). This study investigated the following items: decrease in frequency of going out; basic characteristics (sex, age); physical factors, such as oral function (difficulty chewing, difficulty swallowing, dry mouth); body pain; the Japan Science and Technology Agency Index of Competence; physical activities; psychological factors, such as the Geriatric Depression Scale-15 score; and social and environmental factors, such as the presence or absence of participation in organization activities. Results To investigate the factors associated with a decrease in frequency of going out, logistic regression analysis showed an association with age (OR 1.08, 95% CI 1.03-1.13), difficulty chewing (OR 2.41, 95% CI 1.52-3.83), dry mouth (OR 1.68, 95% CI 1.07-2.64), body pain (OR 1.78, 95% CI 1.14-2.78), Japan Science and Technology Agency Index of Competence scores (OR 0.91, 95% CI 0.84-0.99), physical activities (OR 0.99, 95% CI 0.98-1.00), Geriatric Depression Scale-15 scores (OR 1.13, 95% CI 1.05-1.21) and organization activities (OR 1.94, 95% CI 1.22-3.07). Covariance structural analyses showed that both "difficulty chewing" and "dry mouth" significantly affected "decrease in frequency of going out." In addition, decrease in frequency of going out was significantly affected by " Geriatric Depression Scale-15 scores" through oral function. Conclusions The relationship between oral function and decrease in frequency of going out was clarified, after the multifaceted factors were adjusted. Geriatr Gerontol Int 2019; center dot center dot: center dot center dot-center dot center dot

Association between Adherence to the Japanese Food Guide Spinning Top and Sleep Quality in College Students

This study aimed to elucidate the association between adherence to the Japanese Food Guide Spinning Top (Food Guide score) and sleep quality in Japanese college students. We conducted a cross-sectional study of 175 Japanese college students aged 19&#8315;22 years in the eastern part of Gunma Prefecture to examine the association between the Food Guide score and sleep quality. A self-administered diet history questionnaire and the Pittsburgh Sleep Quality Index were used to assess habitual dietary intake and sleep quality, respectively. In the fully adjusted model, the odds ratios for poor sleep quality in the middle and highest tertile categories of the Food Guide score were 0.50 (95% confidence interval, 0.18&#8315;1.37) and 0.30 (95% confidence interval, 0.11&#8315;0.84), respectively, compared with those in the lowest tertile category (p for trend = 0.033). A well-balanced diet may be associated with good sleep quality in Japanese college students

Rate of oral frailty and oral hypofunction in rural community-dwelling older Japanese individuals

Objective To clarify the rate of oral frailty and oral hypofunction in rural community-dwelling older adults in Japan. Background Recently, the oral function of Japanese older adults has been evaluated multilaterally based on two concepts: oral frailty and oral hypofunction. Oral frailty is defined as a decrease in the oral function accompanied by a decrease in mental and physical functions. Oral hypofunction is a disease where the oral function is comprehensively decreased. However, their rates have not yet been elucidated. Materials and methods Oral frailty and oral hypofunction were evaluated in 679 older adults from rural areas. To investigate the differences in occurrence rates due to the evaluation methods, one of the subordinate symptoms of oral hypofunction, the reduced occlusal force, was evaluated based on both the occlusal force (main method) and the number of teeth (alternative method). Results The rate of oral frailty was 22.3% in men and 22.7% in women. The rate of oral hypofunction was 39.0% in men and 46.9% in women. The overall rate of oral hypofunction was 43.6% when the reduced occlusal force of oral hypofunction was evaluated using the main method and 46.4% when evaluated using the alternative method. The proportion of participants with decreased occlusal force, the number of present teeth, oral diadochokinesis, tongue pressure and masticatory performance increased with age in both men and women. Conclusion Among rural community-dwelling older adults, the rate of oral frailty was 22.5% and that of oral hypofunction was 43.6%

Association between oral, social, and physical frailty in community -dwelling older adults

Objectives: Oral frailty (OF) has been shown to be a predictor of disability. Therefore, it is important to be able to identify factors associated with OF in order to prevent long-term dependence. The purpose of this study was to clarify the relationships between OF, social frailty (SF), and physical frailty (PF) in community-dwelling older adults, with the overarching aim of informing the future development of effective measures to prevent frailty. Methods: Oral, physical, and social function, nutritional and psychological status, and medical history were examined in 682 community-dwelling individuals (267 men, 415 women) aged ≥ 65 years. Ordinal logistic regression analysis with SF and PF as independent variables was performed with pass analysis to determine the relationship between the different types of frailty. Results: Logistic regression analysis revealed significant associations between OF and decline in social function, physical function, and nutritional status, and an increase in the number of medications used. Path analysis showed that SF was directly related to OF and that OF and SF were directly related to PF. Conclusions: These findings suggest that a decline in social function may directly influence a decline in oral and physical function. The results of this study provide initial evidence, that may guide the future development of measures that aim to prevent and manage OF

Factors associated with masticatory performance in community-dwelling older adults A cross-sectional study

Background. Decreased masticatory performance leads to deterioration of overall health among older adults. However, maintaining and improving masticatory performance in ways other than maintenance of natural teeth and appropriate prosthodontic treatment remains unclear. If the factors related to the mixing and shearing abilities for masticatory performance are clarified, it may be possible to maintain and improve the masticatory performance of older adults. We aimed to clarify the association among mixing ability, shearing ability, and masticatory performance-related factors. Methods. Of the 707 community-dwelling older adults in Kusatsu Town, Japan, 344 who had been treated for any dental defects were enrolled in this study. Masticatory performance was evaluated on the basis of mixing ability and shearing ability. The number of natural teeth and artificial teeth, occlusal force, tongue pressure, and oral diadochokinesis /ta/ were measured as masticatory performance-related factors. Their relationship with mixing ability, shearing ability, and masticatory performance-related factors was examined by means of Spearman rank correlation coefficient and path analysis. Results. Among masticatory performance-related factors, the number of natural teeth, occlusal force, and tongue pressure were directly associated with both mixing ability and shearing ability. Moreover, mixing ability was also directly associated with shearing ability. Conclusions. Tongue pressure, which can be improved by means of training, is a masticatory performance-related factor associated with both mixing and shearing abilities

A Two-Year Longitudinal Study of the Association between Oral Frailty and Deteriorating Nutritional Status among Community-Dwelling Older Adults

Background: Limited longitudinal studies exist to evaluate whether poor oral health and functions affect the incidence of deteriorating nutritional status. We investigated if there were longitudinal associations between oral frailty, defined as accumulated deficits in oral health, and deteriorating nutritional status among community-dwelling older adults. Methods: The study population consisted of 191 men and 275 women (mean age, 76.4 years) from the Takashimadaira Study. Multifaced oral health assessment was performed at baseline, and oral frailty was defined as having &ge;3 of the following six components: fewer teeth, low masticatory performance, low articulatory oral motor skill, low tongue pressure, and difficulties in chewing and swallowing. Nutritional status assessment was performed at baseline and two-year follow-up using the Mini Nutritional Assessment&reg;-Short Form (MNA&reg;-SF). Deteriorating nutritional status was defined as a decline in the nutritional status categories based on the MNA&reg;-SF score during the study period. The association between oral frailty and deteriorating nutritional status was assessed using logistic regression analyses. Results: Oral frailty was observed in 67 (14.4%) participants at baseline. During the study, 58 (12.4%) participants exhibited deteriorating nutritional status. After adjusting for potential confounders, oral frailty was significantly associated with deteriorating nutritional status (adjusted odds ratio, 2.24; 95% confidence interval, 1.08&ndash;4.63). Conclusion: Community-dwelling older adults with oral frailty had an increased risk of deteriorating nutritional status