In the present study, we examined the chewing performance of 70 elderly persons. Self-assessment of chewing problems and clinical classification using the modified Eichner index showed little correlation (Kappa value = 0.28; 95% confidence interval (CI) = 0.05-0.51). The sensitivity and specificity were 0.52 and 0.76, respectively. On the other hand, the mastication score determined by evaluation of a questionnaire on food intake and classification using the modified Eichner index showed high agreement (Kappa value = 0.73; 95% CI = 0.50-0.96). The sensitivity and specificity were 0.76 and 0.95, respectively. The mastication score showed significant correlation with other masticatory functions such as maximum biting force, occlusal contact area and the number of missing teeth (P < 0.01). These results suggest that the use of a questionnaire on food intake would be informative for epidemiological surveys of chewing activity in the elderly.
The present study statistically evaluates the relationship between chewing ability and quality of life (QOL) in elderly Japanese residents. We used a subjective evaluation and a mastication score determined by the food intake status to evaluate chewing ability. The PGC morale scale was used to evaluate the QOL level. The mastication score was significantly related to the QOL level in the subject group (P<0.05). The relationship between the subjective evaluation of chewing ability and the score on the PGC morale scale showed a similar tendency. In the section of the PGC morale scale that assesses agitation, attitude towards own aging, and lonely dissatisfaction, chewing ability was correlated with attitude toward own aging in particular (P<0.05). These results have suggested that the chewing ability is closely related to the QOL of the elderly residing in a rural community in Japan.
Brazil has become a country known as having one of the most extreme examples of the consequences of the hospital-based medicalization of delivery care, while a model of humanization of birth was developed in the State of Ceará in the 1970s. The Government of Japan, through the Japanese International Cooperation Agency (JICA), collaborated with the Federal Ministry of Health of Brazil and the Government of the State of Ceará, in implementing the Maternal and Child Health Improvement Project in north-east Brazil (1996-2001). This project focused on 'humanization of childbirth', with training based intervention activities. Behavioral changes among health professionals who received the project's participatory type of training were described using rapid anthropological assessment procedure (RAP) survey results. Changes from 'a culture of dehumanization of childbirth' to 'childbirth as a transformative experience' were observed.
The present study was conducted in order to determine the statistical relationship between chewing activity and activities of daily living (ADL) in the elderly. Subjects which took part were 79 elderly individuals (37 males, 42 females) ranging in age from 65 to 74 years. Based on questionnaires regarding diet, a mastication score was determined to evaluate chewing activity in each subject. This score was scaled from 0 to 100%. ADL levels were determined using two indices: the guidelines of the Ministry of Health and Welfare of Japan and the Tokyo Metropolitan Institute of Gerontology (TMIG) index. The TMIG index is a multidimensional 13-item index of competence in which scores range from 0 to 13 points. According to the guidelines of the Ministry of Health and Welfare, the independence level of each subject was evaluated as independent, home-bound, or bedridden. These independence levels showed a significant correlation with the mastication score (P < 0.01). The mastication score also significantly correlated with the TMIG index, showing a Spearman coefficient of correlation of 0.63 in males (P < 0.01) and 0.71 in females (P < 0.01). These results suggest that chewing activity is related to ADL levels in elderly subjects.
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