Our results confirm that masticatory function was associated with the progression to pre-frailty or frailty among community-dwelling individuals 65 years and older over the 2-year period of this longitudinal study. Of the masticatory function items evaluated, mixing ability and subjective chewing ability were associated with frailty progression.
Aim
Previous studies on the association between intraoral conditions and mortality in community‐dwelling older individuals reported that fewer present teeth (PT) are significant risk factors for mortality. However, how the number of PT relative to the number of functional teeth (FT), including both present and rehabilitated teeth, influences mortality has not been investigated fully. This study examined the impact of the number of FT on mortality among community‐dwelling Japanese older adults.
Methods
This study was a retrospective, observational and population‐based follow‐up study, which examined 1188 older individuals who participated in an annual geriatric health examination from 2009 to 2015. The average follow‐up period was 1697.0 ± 774.5 days. The primary outcome was all‐cause mortality at follow‐up. The numbers of PT and FT of each participant were counted during an oral examination. In addition, demographics, clinical variables, blood nutrient markers, physical functions and perceived masticatory function were measured.
Results
Kaplan–Meier analysis, followed by a log‐rank test, revealed that fewer PT (P < 0.001) and FT (P = 0.002) were significantly associated with a reduced survival rate. Cox's proportional hazard analysis indicated that the number of FT, but not the number of PT, was a significant independent mortality risk factor after adjusting for demographics, clinical variables, nutrient markers and physical functioning (P = 0.036, hazard ratio: 2.089).
Conclusions
Current results suggest that the number of FT more strongly predicts all‐cause mortality than the number of PT among community‐dwelling older adults. Further studies are necessary to consider the confounding of socioeconomic status and disability status. Geriatr Gerontol Int 2020; ••: ••–••.
All three masticatory functions (maximum occlusal force, mixing ability, and self-reported chewing ability) were associated with pre-frailty or frailty in community-dwelling Japanese elderly.
Objective
To measure the occlusal force in the same group of patients with the Dental Prescale 50H type R and the Dental Prescale II, examine the association between them, and determine the reference value for Dental Prescale II that corresponds to the 50H type R 200 N reference value used to make a diagnosis of oral hypofunction.
Background
Reduced occlusal force, a measure of frailty in older persons, was previously determined with Prescale 50H type R pressure‐sensitive film, but it has been replaced by the Prescale II.
Materials and methods
The study participants were 441 men and women aged ≥ 65 (mean, 71.8 ± 5.3) years. The occlusal force was measured with the two different types of pressure‐sensitive film, and their association was examined. Receiver operating characteristic curves for the Prescale II measured values were created with the 200 N reference value used for the 50H type R film as the cut‐off value.
Results
The analysis set included 391 participants for whom measurements were obtained using both the 50H type R and the Prescale II. Linear regression analysis produced regression equations, and a ROC curve analysis provided reference values of 500 N for the Prescale II (without pressure filter) and 350 N for the Prescale II (with pressure filter).
Conclusion
In occlusal force tests for making a diagnosis of oral hypofunction, reference values for the Prescale II (without pressure filter) and for the Prescale II (with pressure filter) were determined. The findings suggested that the Prescale II can be used as a diagnostic examination for oral hypofunction.
Aim
To examine the relationship between the number of present and functional teeth at baseline and future incidence of loss of independence.
Methods
Participants were community‐dwelling older individuals who participated in a comprehensive geriatric health examination conducted in Kusatsu town, Japan, between 2009 and 2015. The primary endpoint was the incidence of loss of independence among participants, defined as the first certification of long‐term care insurance in Japan. The numbers of present and functional teeth at baseline were determined via an oral examination. Demographics, clinical variables (e.g., history of chronic diseases and psychosocial factors), blood nutritional markers, physical functions, and perceived masticatory function were assessed.
Results
This study included 1121 individuals, and 205 individuals suffered from loss of independence during the follow‐up period. Kaplan–Meier estimates of loss of independence for participants with smaller numbers of present and functional teeth were significantly greater than for those with larger numbers of teeth. Cox proportional hazard analyses indicated that a smaller number of present teeth was not a significant risk factor after adjusting for demographic characteristics. However, the number of functional teeth was a significant risk factor after the adjustment (hazard ratio: 1.975 [1.168–3.340]). Additionally, higher hazard ratios were observed in other adjusted models, but they were not statistically significant.
Conclusions
The number of functional teeth may be more closely related to the future incidence of loss of independence than the number of present teeth. This novel finding suggests that prosthodontic rehabilitation for tooth loss possibly prevents the future incidence of this life‐event. Geriatr Gerontol Int 2022; 22: 1032–1039.
As a term indicating the state that the oral function of older adults decreased, both of oral frailty and oral hypofunction are used. Oral hypofunction is a disease whereas oral frailty expresses the state that an oral function decreases. It is reported that decreasing oral function is associated with dementia and decreasing cognitive function. Because the treatment of dementia is not yet established, we should consider the prevention of mild cognitive impairment by the management of oral function in older adults. In this report, we introduce recent reports including our researches about the association between cognitive function and oral function.
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