Background: Maximum bite force (MBF) is a common and useful index of masticatory function; it correlates with physical strength in elderly people. Palpation of stiffness in the masseter muscle during forceful biting has been considered to be associated with MBF. However, this assessment method relies on subjective judgments; no study has verified the relationship between MBF and quantitative measurements of masseter muscle stiffness (MMS). Objective:We aimed to verify the association between masseter muscle myotonometric assessment results and MBF. Methods: In total, 117 community-dwelling >65-year-old individuals from the Tokyo metropolitan area were assessed. MMS on the dominant side during forceful biting was measured with a MyotonPRO device. Masseter muscle thickness (MMT) during rest and forceful biting was measured with an ultrasonic diagnostic apparatus, and the difference in MMT (DMMT) between the rest and forceful biting conditions was determined. MBF data were obtained with a pressure-sensitive sheet and an associated device. To determine the independent variables affecting MBF and MMS, multivariate linear regression analyses with adjustments for age, sex and number of teeth were performed. Results:The multivariate analysis revealed that MBF correlated with the number of teeth (β = .489, P < .001) and MMS (β = .259, P = .003) (R 2 = .433). MMS correlated with MBF (β = .308, P = .003) and DMMT (β = .430, P < .001) (R 2 = .326). Conclusion:Masseter muscle stiffness possibly reflects a force generated by the masseter muscle during forceful biting. Therefore, MMS is effective to assess tooth loss as well as an index of masseter muscle strength when evaluating MBF. K E Y W O R D Sbite force, masseter muscle, muscle stiffness, myotonometric assessment, occlusal force | 751 HARA et Al.
<b><i>Introduction:</i></b> The aim of this study was to determine the associations of time spent away from bed with whole-body muscle mass and swallowing function in older adults with low activities of daily living (ADL). <b><i>Methods:</i></b> This cross-sectional study was conducted at Tokyo Medical and Dental University and included adults over 65 years of age who underwent a medical intervention at their residence. Data regarding age, sex, body height and weight, activity status, medical history, time spent away from bed, and Functional Oral Intake Scale (FOIS) were collected. We calculated the body mass index, Charlson Comorbidity Index, whole-body muscle mass, the appendicular skeletal muscle mass index (ASMI), and the trunk muscle mass index (TMI). According to the time spent away from bed, the subjects were grouped as follows: <4 but ≥0 h (S), <6 but ≥4 h (M), and ≥6 h (L). These variables were analyzed using the one-way analysis of variance, the Kruskal-Wallis test, and the χ<sup>2</sup> test, then differences among the three groups were examined. To adjust for confounding factors, we performed multiple regression analysis with ASMI and TMI as the dependent variables and ordinal logistic regression analysis with FOIS as the objective variable. <b><i>Results:</i></b> Ninety subjects (male: <i>n</i> = 42; female: <i>n</i> = 48; mean age = 82.9 ± 8.8 years, and groups S: <i>n</i> = 23; M: <i>n</i> = 30; L: <i>n</i> = 37) were analyzed. Group L had a significantly higher ASMI, TMI, and FOIS score than groups S and M, while group M had a significantly higher ASMI and FOIS score than group S. After adjusting for confounding factors, the significant explanatory factors for ASMI were sex, activity status, time spent away from bed, and TMI. The factors for TMI were activity status, time spent away from bed, ASMI, and FOIS. The factors for FOIS were time spent away from bed and TMI. <b><i>Conclusion:</i></b> Spending 4 or more hours away from the bed is related to appendicular skeletal muscle mass and FOIS, while spending 6 or more hours is related to appendicular skeletal muscle mass, trunk muscle mass, and FOIS in this population. These findings highlight factors that can prevent a decline in swallowing function in the daily life of older adults with low ADL who have difficulty performing exercises to preserve swallowing function.
<b><i>Introduction:</i></b> The aim of this study was to clarify the relationship among swallowing function, activity, and quality of life (QOL) in older adults with low activities of daily living (ADL). <b><i>Materials and Methods:</i></b> We conducted a cross-sectional study. In total, 271 Japanese adults aged over 65 years who underwent medical intervention at their residence (male: <i>n</i> = 107; female: <i>n</i> = 164; mean age = 84.6 ± 8.3 years) participated. We collected data regarding age, sex, body mass index (BMI), residence (their house/nursing home), activity status, consciousness level (eye response), history of aspiration pneumonia, other medical history, number of medication types, frequency of going out, and time spent away from bed. We judged consciousness level (eye response) using the Glasgow Coma Scale (GCS), calculated the Charlson comorbidity index, measured QOL using the short version of the Quality of Life Questionnaire for Dementia (short QOL-D), and assessed swallowing function using the Functional Oral Intake Scale (FOIS). To examine the relationship between scores for the FOIS and the other variables, we used the Spearman rank correlation coefficient and ordinal logistic regression analysis. <b><i>Results:</i></b> The FOIS was strongly correlated with BMI (ρ = 0.47), activity status (ρ = −0.60), GCS (ρ = −0.41), time spent away from bed (ρ = 0.56), scores for the short QOL-D (ρ = 0.40), weakly correlated with history of aspiration pneumonia (ρ = −0.27), and frequency of going out (ρ = 0.39). Results for the ordinal logistic regression analysis showed that the FOIS was associated with activity status, frequency of going out, time spent away from bed, and scores for the short QOL-D. <b><i>Conclusion:</i></b> The swallowing function of older adults with low ADL was related to their QOL and activities, such as time spent away from bed and home. Thus, in rehabilitation programs for swallowing function in older adults, not only functional but also psychological approaches may prove effective.
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