Maximum Occlusal Force and Incident Functional Disability in Older Adults: The Tsurugaya Project

Abstract

The purpose of the current study was to investigate the association between maximum occlusal force, which is an objective predictor of masticatory performance, and incident functional disability in an elderly Japanese population. A prospective cohort study was conducted targeting 815 (51.7% female) community-dwelling older adults aged ≥70 y residing in the Tsurugaya district, Sendai, Japan. The outcome measurement was incident functional disability, defined as a first certification of long-term care insurance in Japan, which is determined on the basis of a strictly established, uniform, nationwide standard. During a median follow-up of 7.9 y (interquartile range, 4.8-7.9 y), information on long-term care insurance was obtained from the Sendai Municipal Authority. Bilateral maximum occlusal forces of the participants were measured using a horseshoe-shaped pressure-indicating film, and the participants were categorized into quartiles based on occlusal force. Adjusted hazard ratios for functional disability were estimated with Cox proportional hazard models, adjusted for age, sex, body mass index, medical history, smoking status, alcohol consumption, duration of education, depressive symptoms, cognitive impairment, physical functioning, marital status, history of falls, and number of remaining teeth. The multiple-adjusted hazard ratios and 95% confidence intervals (CIs) for incident functional disability compared to the greatest occlusal force quartile were 1.53 (95% CI, 1.02-2.33), 1.64 (95% CI, 1.06-2.55), and 1.64 (95% CI, 1.01-2.68) for the third, second, and first quartiles, respectively (P for trend = 0.011). A lower maximum occlusal force was significantly associated with an increased risk of functional disability independently of possible confounders, including the number of remaining teeth. Occlusal force may be a useful indicator of the relationship between oral function and geriatric health.

Dental Status is Associated With Incident Functional Disability in Community-Dwelling Older Japanese: A Prospective Cohort Study Using Propensity Score Matching

“…According to the previous studies, the variables used for this procedure were age, sex, BMI, medical history (stroke, hypertension, myocardial infarction, cancer, and diabetes), smoking, alcohol consumption, educational attainment, depressive symptoms, cognitive function, physical function, social support, and marital status. 7,9 We confirmed multicollinearity of all the variables about the propensity score matching using the variance inflation factor (VIF). On the logit of the propensity score, we employed caliper widths equal to 0.2 of the standard deviation.…”

“…8 In prospective cohort studies that examined the relationship between the incidence of functional disability and the number of teeth or the occlusal force, the influence of confounding variables has probably not been sufficiently eliminated, since a conventional multivariate analysis was performed. 5,9,10 A previous study actually pointed out that there are many confounding factors in the relationship between oral health status and functional disability; hence, it is necessary to adequately consider the influence of confounding bias. 7 Propensity score matching is a statistical method that can reduce the influence of confounding bias as much as possible and has been applied in many epidemiological studies.…”

Comparison of stud and telescopic crown attachments for mini-implant retained mandibular complete overdentures

“…When values of biting force compared at different follow-up times between both groups, there was no significant difference in these values, this can be explained by the less effect of the attachment type on the level of the biting force as explained in several studies. When values of biting force compared at different follow-up times within each group, There was a significant difference between these values, the highest value was found after 12 months, followed by 6 months, while the lowest value was found at baseline, these results can be explained by the more confidence and adaptation that the patient can gain while using the overdenture along the follow-up period (27,28) .…”

Verification of the criteria for reduced occlusal force to diagnose oral hypofunction in older Japanese people: A prospective cohort study on incident functional disability

“…Complex oral function declines continuously with ageing and/or under the influences of disease and disability. Impaired oral function in later life is associated with degradation of oral health‐related quality of life 1 and with adverse general health outcomes such as malnutrition, frailty, functional disability and mortality 2‐8 …”

“…ROF, one of the seven clinical conditions for making a diagnosis of OHF, is closely associated with decreased masticatory function 11,12 and is certified to predict various adverse health outcomes of older people such as impaired nutritional status, reduced physical function, falls, frailty and functional disability, based on findings of several epidemiological studies 2‐8 . The JSG has recommended directly measuring the maximum occlusal force (MOF) in full dental arches by using pressure‐sensitive film as the primary test method to make a decision of ROF, and setting the threshold of MOF to 200 N, based on a previous study 13 that demonstrated an association between a low MOF (<200 N) and a low (<20 kg/m 2 ) or high (>25 kg/m 2 ) body mass index (BMI).…”