Polypharmacy is associated with malnutrition and activities of daily living disability among daycare facility users: A cross-sectional study.

ABSTRACT: Polypharmacy influences malnutrition and activities of daily living (ADL) in older individuals owing to side effects such as anorexia. This study aimed to examine whether polypharmacy (5 or more drugs) is associated with malnutrition and ADL disability among daycare facility users.This cross-sectional study was performed in a daycare facility specializing in rehabilitation. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition criteria and ADL disability according to the "criteria for determination of the daily life independence level (bedridden level) of elderly with disabilities."In total, 103 of the 134 included individuals were analyzed. Thirty-three (32.0%) participants were malnourished, 46 (44.7%) had ADL disability, 58 (56.3%) qualified as cases of polypharmacy, and 9 (8.7%) experienced loss of appetite. Multivariable logistic regression analysis showed that polypharmacy was independently associated with malnutrition and ADL disability. Separate analyses of each type of drug revealed that proton pump inhibitors (that impair protein absorption and assimilation), anticonstipation drugs, and antihypertensive drugs were associated with malnutrition, whereas proton pump inhibitors, anticonstipation drugs, antidyslipidemia drugs, and antidiabetic drugs were associated with ADL disability. The only factor related to anorexia was the loss of pleasure of eating, which in turn was related to psychological stress.The side effects of polypharmacy among individuals with malnutrition and ADL disability may include impaired protein absorption and assimilation caused by proton pump inhibitors, but not anorexia. Further multicenter prospective studies are required to confirm these findings.

Evaluations of the facial attractiveness of young women with severe maxillary anterior crowding by orthodontists and laypeople with and without orthodontic treatment experience in Japan.

INTRODUCTION: Maxillary anterior crowding (MxAC) has been considered to be an esthetically favorable characteristic of young women in Japan. It has been hypothesized that laypeople and orthodontists have different esthetic preferences; however, to date, this has not been investigated in detail. Therefore, the present study compared the facial attractiveness of women with MxAC and the interpretation of MxAC among orthodontists and laypeople with and without orthodontic treatment experience in Japan. METHODS: Thirty-eight orthodontists, 42 laypeople with orthodontics (patients), and 43 laypeople without orthodontics (laypeople) evaluated the attractiveness of resting and smiling frontal images of 12 women with MxAC (MxAC models; mean age, 21.7 ± 2.6 years) and 12 women with normal occlusion (normal models; mean age, 20.1 ± 0.7 years) using a visual analog scale. In addition, they responded to a questionnaire that asked them to select the terms most closely associated with MxAC. All evaluators and models were Japanese. RESULTS: For all evaluator groups, the facial attractiveness of the MxAC models was significantly lower than that of the normal models for both the resting and smiling images. For MxAC models, orthodontists evaluated resting images more attractive than smiling images, whereas laypeople evaluated smiling images more attractive than resting images. Significantly more patients and laypeople than orthodontists selected "cute" as the term most closely associated with MxAC (P <0.05). CONCLUSIONS: The orthodontists, patients, and laypeople showed a different tendency in their facial attractiveness preferences. Regardless of their orthodontic experience, the laypeople showed more positive interpretations of MxAC than orthodontists. This finding seems to be influenced by Japanese culture, which values irregularity in nature as one form of beauty.