歯の状態がｱﾝｹｰﾄ調査および色変わりﾁｭｰｲﾝｸﾞｶﾞﾑを用いた高齢者の咀嚼能力に及ぼす影響

高齢者の栄養障害の要因の一つに口腔状態や摂食の問題があり､食物摂取に直接影響するのは咀嚼能力の低下である｡咀嚼能力を簡便にかつ客観的に測定するために､咀嚼の進行に伴い色が変わるﾁｭｰｲﾝｶﾞﾑが開発されたが､この色変わりﾁｭｰｲﾝｶﾞﾑ(ｶﾞﾑ)を用いて高齢者の咀嚼能力を測定した報告は未だ少ない｡本研究では高齢者の咀嚼能力の実情を知るため､ｱﾝｹｰﾄ調査とｶﾞﾑを用いた咀嚼能力の測定を行い､食品の咀嚼の難易と咀嚼能力との関連性について検討を行うこととした｡対象者は､活動力の高い在宅の高齢者65名とした｡ｱﾝｹｰﾄは年齢､歯の状態､かみ合わせ評価度､また19食品について摂食可能かを尋ね､普通に食べられる食品の割合を示す咀嚼機能ｽｺｱを集計した｡咀嚼後のｶﾞﾑの色は､色彩色差計にて咀嚼能力の程度を示す a* 値を測定した｡活動力の高い在宅者では､｢義歯群｣が53.8%を占めており､｢欠損歯あり｣はいなかった｡｢義歯群｣間では､かみ合わせ評価度､咀嚼機能ｽｺｱおよび a* 値はいずれも個人差が大きく､顕著な差は認められなかった｡咀嚼の難易の程度が高い食品ほど､かみにくいため義歯依存性はより高くなっており､食べられないと答えた食品の数は､義歯の装着部位が多くなると増える傾向にあった｡As one of the factors of nutritional disorders among the elderly, they have problems in their oral cavity conditions or eating. It is a decreased mastication ability that directly influences on their food intake. Although a chewing gum which changes its color according to the progression of mastication has been developed to briefly and objectively measure the mastication ability, still a few studies has been reported to measure the mastication ability of the elderly using this color-changeable chewing gum. In this study, we planed to measure the mastication ability of the elderly by using a questionnaire survey and the gum to know the actual condition of their mastication ability and then to conduct a study on the relationship between the difficulty of food mastication and the mastication ability. Regarding study subjects, we incorporated 65 elderly subjects who consisted of highly active home inhabitants. In the questionnaire survey, we inquired about their age, teeth conditions, assessment score levels of teeth occlusion,and eating availabilities for 19 kinds of foods and we then aggregated mastication function scores which showed the ratio of the foods that they could ordinarily eat. Regarding the color of the chewing gum after mastication, we measured values of a* which showed the degree of the mastication ability with a color difference meter. Among the highly active home inhabitants,“a group of subjects with some dentures”accounted for 53.8% and a“group of subjects with some lost teeth”in a“group of subjects with only natural teeth”was not present. In the mean while, among the“other groups of subjects with some dentures”, no significant difference was noted, because each the assessment score levels of teeth occlusion, the mastication function scores and values of a* had great differences between individuals. When the number of wearing areas of dentures increases, the numbers of foods for which the study subjects answered that they could not eat tended to increase, because a food with a higher difficulty of food mastication required higher degree of dependence on dentures due to more difficult mastication

高齢者の年代､歯の状態および居住形態が咀嚼能力に及ぼす影響

高齢者の年代､歯の状態および居住形態が咀嚼能力にいかなる影響を及ぼすのかを明らかにすることを目的として研究を行った｡咀嚼能力は､ｱﾝｹｰﾄ調査によるかみ合わせ評価度および咀嚼機能ｽｺｱと､色変わりﾁｭｰｲﾝｶﾞﾑを用いた a* 値から検討した｡その結果､年代が増すと咀嚼機能ｽｺｱおよび a* 値はともに低下した｡義歯の装着部分が増すと､また欠損歯を有すると咀嚼機能ｽｺｱおよび a* 値はいずれも低値を示した｡活動力の高い在宅の高齢者の咀嚼機能ｽｺｱおよび a* 値に比し､施設入所および通所の高齢者のそれらの値はともに低かった｡このことから､加齢､義歯数の増加､欠損歯を有することや日頃やわらかいものを食べることの多い食習慣はいずれも咀嚼能力の低下の要因となることが示唆された｡An investigation was made with the elderly to clarify what kinds of influence do teeth status and living style have on the chewing ability. The chewing ability was estimated based on the scores of teeth occlusion and chewing function evaluated through a questionnaire survey, and a* value determined using color-changeable chewing gum. Results of the present survey demonstrated that the scores of chewing function and a* value were both decreased with aging. When an area wearing a denture is increased or a missing teeth is present, the scores of both chewing function and a* value were lowered. The scores of chewing function and a* value were higher for the in-home elderly whose daily activity is high than the elderly living in care service facility or usually visiting it. These findings suggest that aging, an increase of the number of denture / the presence of missing teeth and eating habits to take soft foods might cause a lowering of chewing ability for the elderly

高齢者施設入所者および通所者における歯の状態からみた咀嚼能力

ｹｱﾊｳｽ入所者､ﾃﾞｲｻｰﾋﾞｽ通所者および介護老人福祉施設入所者を対象に､主観的な咀嚼評価としてかみ合わせ評価度および咀嚼機能ｽｺｱをｱﾝｹｰﾄ調査により､客観的な咀嚼能力の評価を色変わりﾁｭｰｲﾝｸﾞｶﾞﾑにより測定し､高齢者の咀嚼能力の実情について検討を行った｡(1)ｱﾝｹｰﾄ調査では､｢義歯群｣間に有意差を認めなかった｡また｢自歯群｣の｢自歯欠損あり｣の評価は個人差が顕著であった｡それに比し､｢自歯群｣の｢自歯欠損なし｣の評価が最も高く個人差は小さかった｡(2)咀嚼能力 a* 値の平均値について､｢義歯群｣では､｢一部｣と｢上下全部｣との間に有意差を認め(p<0.05)､｢上下全部｣の a* 値が低かった｡また｢自歯群｣の｢自歯欠損なし｣の a* 値に比し､｢義歯群｣の｢上全部と一部｣および｢上下全部｣の a* 値はともに有意に低く(p<0.05および p<0.01)､義歯の装着部分が多いと a* 値は低下した｡一方｢自歯群｣では､｢自歯欠損あり｣の a* 値は｢自歯欠損なし｣の a* 値に比し有意に低く(p<0.05)､欠損歯を有すると a* 値は低下した｡A questionnaire survey on food mastication ability and measurement of its mastication ability using color-changeable chewing gum were made with elderly people to clarify actual status of elderly\u27s mastication ability. Elderly persons living in nursing care homes, those receiving day care service as an outpatient and those living in long term care welfare facilities for the elderly were used as the subjects. The results were as follows. (1)There was no significant difference in the degree of dental occlusion among denture-wearing groups. In the own-teeth groups, there were marked individual differences in dental occlusion among persons having some defected teeth. Whereas the degree of dental occlusion was highest in the own-teeth group with no defected own teeth and their individual differences were smallest in the group. (2)In the denture-wearing group, the mean value of mastication ability(a*)was significantly different(p<0.05)between person group whose upper and lower jaws were partly occupied with dentures and that whose jaws were all occupied with dentures, and the value was lower in the latter group than the former. When compared with persons having no defected teeth in the own-teeth group, either of value a* for persons whose upper and lower jaws were all occupied by dentures and that for persons whose upper jaw and a part of lower one were occupied with dentures was significantly lower(p<0.05 and p<0.01). This indicated that the value a* was decreased as an increase in denture-occupied area. On the other hand, the value a* was significantly lower(p<0.05)in persons having some defected teeth than those with no defected ones in the own-teeth group, indicating that the value a* was decreased by the presence of defected teeth