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BACKGROUND: Prevotella bacteria are associated with inherent diseases of the oral cavity, such as periodontal disease, and systemic diseases. Oral frailty (OF) has been associated with nursing necessity and death. However, the relationship between OF and oral microbiota has not been fully clarified. OBJECTIVE: This cross-sectional study investigated the association between OF and Prevotella percentage in the oral microbiota of community-dwelling older adults. METHODS: Oral bacteria species from saliva were identified in 208 community-dwelling older individuals aged ≥60 years in Japan. The proportion of Prevotella in the oral microbiota was classified into three tertile groups, and its relationship with each test item for OF (number of remaining teeth, masticatory performance, oral diadochokinesis, tongue pressure, difficulties eating tough foods, difficulties swallowing tea or soup, number of applicable OF judgement items, and existence of OF) was examined using ordinal logistic regression analysis. RESULTS: The Prevotella proportions were classified into lower, middle and upper groups, comprising 70, 69 and 69 participants, respectively. The three groups showed a significant relationship between the number of remaining teeth (odds ratio [OR]: 0.946, 95% confidence interval [CI]: 0.915-0.977), masticatory performance (OR: 0.897, 95% CI: 0.844-0.953), number of applicable OF judgement items (OR: 1.477, 95% CI: 1.14-1.915), and existence of OF (OR: 4.194, 95% CI: 1.519-11.576). CONCLUSION: The proportion of Prevotella in oral microbiota was high in individuals with OF. Among the older adults, the type of oral microbiota and systemic diseases may be related to the examination and management of oral function decline.
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Fragilidade , Vida Independente , Microbiota , Prevotella , Humanos , Idoso , Masculino , Prevotella/isolamento & purificação , Feminino , Japão , Estudos Transversais , Fragilidade/microbiologia , Microbiota/fisiologia , Pessoa de Meia-Idade , Boca/microbiologia , Saliva/microbiologia , Idoso de 80 Anos ou mais , Mastigação/fisiologia , Saúde BucalRESUMO
OBJECTS: This study aimed to determine the association between annual medical expenses and oral frailty in later-stage older adults (aged ≥ 75 years). No studies have investigated the association between medical costs and oral frailty, which would elucidate the association between oral frailty and the deterioration of mental and overall physical function. MATERIALS AND METHODS: In this cross-sectional study, 2190 adults (860 men and 1330 women aged 75-94 years) covered by the Medical System for the Elderly and residing in Tottori Prefecture, Japan, between April 2016 and March 2019, were included. Participants were classified into three groups: healthy, pre-orally frail or orally frail, based on dental health screening findings. The medical and dental expenses over the years, number of days of consultations and comorbidities were obtained from the Japanese Health Insurance Claims Database. RESULTS: The number of days of medical and dental consultations and annual medical expenses for outpatient care differed among the three study groups. A significant association was observed between oral frailty and high annual expenses for outpatient medical and dental care. Oral frailty was associated with higher medical expenses in participants with poor masticatory function. Higher and lower dental expenses were associated with subjective poor masticatory function and subjective impairment of swallowing function respectively. CONCLUSION: Medical and dental expenses for orally frail older adults are high, indicating that oral frailty may be related to the occurrence and severity of diseases other than oral health issues. Future studies should examine the mechanism by which oral weakness affects physical and mental functions.
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PURPOSE: Survival time after bisphosphonate use has been increasingly recognized to be associated with the incidence of medication-related osteonecrosis of the jaw (MRONJ); however, this has not been elucidated sufficiently in the literature. This study aimed to clarify the incidence of MRONJ and the corresponding survival rate of patients treated with zoledronic acid (ZA) for each type of cancer and obtain useful information for the oral/dental supportive care of cancer patients. METHODS: We evaluated 988 patients who were administered ZA at our hospital; among them, 862 patients with metastatic bone tumors or myeloma were included. RESULTS: The median survival time (MST) after ZA initiation was 35, 34, 8, 41, 12, and 6 months for patients with breast, prostrate, lung, myeloma, renal, and other cancers, respectively. Patients with cancers that had a short survival time (lung and other cancers [MST = 8 and 6 months, respectively] and cancers with MST < 10 months) did not develop MRONJ; this could be attributed to the shorter duration of ZA administration. The cumulative incidence of MRONJ in breast cancer, prostate cancer, and multiple myeloma was related to the frequency of anti-resorptive drug use and the increased risk over time. In renal cancer, the cumulative incidence of MRONJ increased early, although the MST was 12 months. CONCLUSION: For the dentists in charge of dental management, it is essential to be aware of prognosis-related factors, predict MRONJ risk for each cancer treatment, and use risk prediction in dental management planning, particularly for cancers with non-poor prognosis.
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Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Neoplasias Ósseas , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/tratamento farmacológico , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/epidemiologia , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia , Conservadores da Densidade Óssea/efeitos adversos , Neoplasias Ósseas/tratamento farmacológico , Denosumab/uso terapêutico , Difosfonatos/efeitos adversos , Humanos , Incidência , Masculino , Prognóstico , Estudos Retrospectivos , Ácido Zoledrônico/efeitos adversosRESUMO
We examined factors related to dietary intake status (food form) of long-term care facility (LTCF) residents to identify factors related to proper food form choice for older individuals requiring nursing care. We surveyed 888 residents from 37 LTCFs in Japan. We evaluated basic information (age, sex, body mass index [BMI]), food form (swallowing-adjusted diet class), Barthel Index (BI), Clinical Dementia Rating (CDR), simply evaluated eating and swallowing functions, the number of present/functional teeth, oral diadochokinesis, repetitive saliva swallowing test (RSST), and modified water swallowing test. To clarify factors associated with food form, participants who had good nutrition by oral intake were categorized into the dysphagic diet (DD) and normal diet (ND) groups. Multi-level analyses were used to detect oral functions associated with food form status. Among objective assessments, BMI (odds ratio [OR] 0.979, 95% confidence interval [CI] - 0.022- to 0.006, p = 0.001), BI (OR 0.993, 95% CI - 0.007 to - 0.004, p < 0.001), CDR 3.0 (OR 1.002, 95% CI 0.002â0.236, p = 0.046), present teeth (OR 0.993, 95% CI - 0.007 to - 0.001, p = 0.011), functional teeth (OR 0.989, 95% CI - 0.011 to - 0.005, p < 0.001), and RSST (OR 0.960, 95% CI - 0.041 to - 0.007, p = 0.006) were significantly associated with DD vs ND discrimination. Simple evaluations of coughing (OR 1.056, 0.054â0.198, p = 0.001) and rinsing (OR 1.010, 0.010â0.174, p = 0.029) could also discriminate food form status. These simple evaluations provide insight into the discrepancies between food form status and eating abilities of LTCF residents. Periodic evaluations by the nursing caregiver may help to prevent aspiration by older individuals with dysphagia.
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Transtornos de Deglutição , Seguro de Assistência de Longo Prazo , Humanos , Deglutição , Transtornos de Deglutição/diagnóstico , Estado Nutricional , Ingestão de Alimentos , Assistência de Longa DuraçãoRESUMO
OBJECTIVE: To examine the association between oral frailty and oral Candida carriage as a general indicator of deteriorating oral function in older adults. BACKGROUND: Older adults exhibit an elevated risk of oral candidiasis caused by Candida. Although many studies have identified factors associated with oral Candida carriage, none have evaluated its relationship with oral function. MATERIALS AND METHODS: This study included 210 community-dwelling older adults aged ≥60 years who participated in wellness checks. Fungal flora expression in saliva samples was evaluated to identify oral C. albicans and C. glabrata. Participants were categorised by detection of neither strain (group 1), either one of the strains (group 2), or both strains (group 3). The relationship between oral Candida carriage and oral frailty was evaluated by multinomial logistic regression analysis. RESULTS: The participants included 58 men and 152 women with a mean age of 74.2 ± 6.1 years. A total of 88 (41.9%), 94 (44.8%) and 28 (13.3%) participants were assigned to groups 1, 2 and 3 respectively. In the multinomial logistic regression analysis, significant associations were observed between group 1 and group 2 for "Have you choked on your tea or soup recently?" and the number of applicable oral frailty items. Between group 1 and group 3, significant associations were observed for the number of remaining teeth, masticatory performance and the number of applicable oral frailty items. CONCLUSION: We obtained basic data useful for intervention studies aimed at verifying whether oral function management prevents deterioration of the oral bacterial flora.
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Fragilidade , Idoso , Idoso de 80 Anos ou mais , Candida , Estudos Transversais , Feminino , Idoso Fragilizado , Humanos , Vida Independente , Masculino , Saúde BucalRESUMO
BACKGROUND: Zinc is mainly absorbed in the duodenum and proximal jejunum, which are removed during pancreaticoduodenectomy (PD). Little is known about the adverse oral events and skin disorders caused by zinc deficiency after PD. Herein, we reviewed studies on the development of zinc deficiency after PD and reported about a patient with zinc deficiency after PD who required home intravenous zinc replacement. CASE PRESENTATION: A 73-year-old woman with glossitis, taste disorder, and acrodermatitis enteropathica-like eruption on her fingers presented to the Division of Dentistry and Oral Surgery 69 days after PD. Her serum zinc level markedly decreased to 30 µg/dL. Oral zinc administration was inadequate to treat hypozincemia after PD; therefore, multi-trace elements were injected intravenously during readmission. Her serum zinc levels recovered, and her lesions gradually improved. Furthermore, a central venous port was implanted to maintain normal serum zinc levels, and she continued self-injecting zinc at home. CONCLUSIONS: Zinc deficiency after PD rarely occurs. The clinical oncologist community, including dentists responsible for the oral care of cancer patients, should be aware of the oral adverse events, such as dysgeusia, glossitis, and oral pain, associated with zinc deficiency after cancer surgery and that induced by chemotherapy or head and neck radiation therapy.
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Acrodermatite , Pancreaticoduodenectomia , Acrodermatite/tratamento farmacológico , Acrodermatite/etiologia , Acrodermatite/patologia , Idoso , Suplementos Nutricionais , Feminino , Humanos , Pancreaticoduodenectomia/efeitos adversos , ZincoAssuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Neoplasias Ósseas , Mieloma Múltiplo , Osteonecrose , Humanos , Mieloma Múltiplo/tratamento farmacológico , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia , Osteonecrose/induzido quimicamente , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/secundário , Prognóstico , Conservadores da Densidade Óssea/efeitos adversos , DifosfonatosRESUMO
OBJECTIVES: The aim of the present study was to evaluate the effectiveness of platelet-rich fibrin (PRF) as a wound-healing accelerator in patients undergoing oral bisphosphonate therapy and requiring tooth extractions. MATERIALS AND METHODS: A total of 102 patients were divided into a PRF group and control group. The patients received oral bisphosphonate therapy for osteoporosis for an average of 32 months. Blood was collected and PRF was introduced into the socket of the PRF group only. Monitoring of mucosal healing was conducted for 3 months in both groups, and radiographic evaluation in the sockets was performed in the PRF group. Delayed recovery was defined as exposed bone and vulnerable granulation tissue without epithelization after 4 weeks and resolving by 8 weeks. RESULTS: There were no intraoperative complications, and none of the patients exhibited onset of medication-related osteonecrosis of the jaw (MRONJ). Delayed recovery was observed in 9 out of 73 control patients (12%), whereas 29 PRF patients exhibited complete epithelialization of the socket within 1 month. The prevalence of delayed recovery was significantly higher in the control group than the PRF group (P < 0.05). Multivariate logistic regression analysis revealed that risk factors and use of PRF were independent significant factors to relate to delayed recovery (P = 0.02). CONCLUSIONS: Early epithelization was confirmed in all PRF patients. Thus, PRF may reduce the risk of delayed recovery in patients undergoing oral bisphosphonate therapy. CLINICAL RELEVANCE: PRF may be useful in preventing MRONJ in patients receiving oral bisphosphonate (BP).
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Conservadores da Densidade Óssea/administração & dosagem , Difosfonatos/administração & dosagem , Osteoporose/tratamento farmacológico , Fibrina Rica em Plaquetas/fisiologia , Extração Dentária , Cicatrização/fisiologia , Administração Oral , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
We report an advanced case of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in an osteoporotic patient treated with oral risedronate sodium for 2 years. An 80-year-old woman presented to our hospital complaining of pain, swelling and pus discharge in the lower alveolar ridge. Fluorine-18 labeled fluorodeoxyglucose positron emission tomography (FDG-PET) and bone scintigraphy showed definite uptake in the mandible. Under clinical diagnosis of BRONJ, we applied systematic treatments including antibiotic therapy, irrigation, cessation of bisphosphonate, hyperbaric oxygen (HBO) therapy, and debridement of necrotic bone. After pre-operative 20 sessions of HBO therapy, her clinical symptoms disappeared. SUVmax of FDG-PET decreased definitely from 4.5 to 2.5, although magnetic resonance image and bone scintigraphy did not show remarkable changes. After minor surgery with debridement of necrotic bone, she received another ten sessions of HBO therapy. After the treatment, her clinical course was excellent. In conclusion, this report demonstrates FDG-PET may predict the effect of HBO therapy in BRONJ.
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Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/terapia , Oxigenoterapia Hiperbárica , Tomografia por Emissão de Pósitrons/métodos , Idoso de 80 Anos ou mais , Feminino , Fluordesoxiglucose F18 , Humanos , Valor Preditivo dos Testes , Compostos RadiofarmacêuticosRESUMO
BACKGROUND: The activity level of alkaline phosphatase, a zinc-requiring enzyme in the serum, is used to indicate zinc nutritional status; however, it does not correlate with serum zinc levels or subjective symptoms of taste disorder in many cases. Hence, this study focused on the total activity of alkaline phosphatase, a zinc-requiring enzyme. The total alkaline phosphatasa activity level in the saliva was measured before and after zinc supplementation, and the results were compared with serum zinc levels. CASE PRESENTATION: This study included patients with hypozincemia, specifically a patient with zinc-deficient taste disorder (patient 1: a 69-year-old Japanese woman) and a patient with glossodynia with zinc deficiency (patient 2: an 82-year-old Japanese woman). Saliva samples were collected, and blood tests were performed before and after zinc supplementation. Subjective symptoms and serum zinc levels were simultaneously evaluated. Zinc supplementation was performed using zinc acetate hydrate or Polaprezinc. CONCLUSIONS: Total alkaline phosphatase activity levels were found to be associated with serum zinc levels and subjective symptoms. A further study with a higher number of patients is necessary to confirm whether total alkaline phosphatase activity levels more accurately reflect the amounts of zinc in the body than serum zinc levels.
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Fosfatase Alcalina , Zinco , Feminino , Humanos , Idoso , Idoso de 80 Anos ou mais , Saliva/metabolismo , Distúrbios do Paladar/diagnóstico , Acetato de ZincoRESUMO
AIM: Efforts to combat frailty and preserve good health in older adults have highlighted oral frailty as an early indicator of overall frailty. Individuals showing oral frailty are at an elevated risk of insufficient nutritional intake compared with those without oral frailty; however, underlying mechanisms remain poorly explored. In this cross-sectional study, we aimed to examine the link between oral frailty and undernutrition, especially regarding poor appetite and low dietary diversity. METHODS: The analysis included 2727 late-stage older adults (mean age 79.9 ± 4.3 years) who underwent dental checkups in a prefecture in Japan from 2016 to 2020. The examination involved a questionnaire survey (covering basic information, frailty screening index, appetite index: Simplified Nutritional Appetite Questionnaire; and dietary variety: Dietary Variety Score) and a measurement survey (including intraoral confirmation, oral diadochokinesis and masticatory efficiency test). Individuals with three or more indications of poor oral function, identified through oral function assessment, were defined as showing oral frailty. Binomial logistic regression and path analyses examined associations among oral frailty, Simplified Nutritional Appetite Questionnaire and Dietary Variety Score. RESULTS: Among those analyzed, 1208 (44.3%) participants were categorized into the oral frailty group. Binomial logistic regression analysis showed that Simplified Nutritional Appetite Questionnaire (odds ratio for oral frailty per 1-point increase 0.88, 95% confidence interval 0.84-0.93) and Dietary Variety Score (odds ratio 0.95, 95% confidence interval 0.92-0.98) were significantly associated with oral frailty. The path analysis showed individual associations between each examined factor. CONCLUSIONS: Oral frailty was associated with decreased appetite and dietary variety in late-stage older adults. Geriatr Gerontol Int 2024; 24: 626-633.
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Apetite , Idoso Fragilizado , Fragilidade , Avaliação Geriátrica , Humanos , Estudos Transversais , Idoso , Masculino , Feminino , Japão/epidemiologia , Apetite/fisiologia , Idoso de 80 Anos ou mais , Fragilidade/epidemiologia , Avaliação Geriátrica/métodos , Inquéritos e Questionários , Dieta , Desnutrição/epidemiologia , Saúde Bucal , Avaliação Nutricional , Estado NutricionalRESUMO
OBJECTIVE: The aim of the present study was to elucidate relationships between higher-level functional capacity and dental health behaviours in community-dwelling older adults. BACKGROUND: In ageing society, it is necessary to promote oral health in the elderly, because good oral health is a significant contributing factor to good general health. Higher-level functional capacity has been considered a crucial factor for successful independent living in the elderly. We hypothesised that functional capacity is a significant indicator of dental health behaviours. METHODS: Three hundred and thirty-eight adults aged 65 years or older were enrolled in this study. Higher-level functional capacity was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-index). Univariate and multivariate models were constructed with dental health behaviours, such as regular visits to a dentist, brushing frequency and use of extra cleaning devices, as the dependent variable, and the total TMIG-index score and its subcategory scores as the principal independent variable. RESULTS: Univariate logistic regression analysis demonstrated a significant correlation between low TMIG-index and 'intellectual activity' subcategory scores to lack of regular visits to a dentist and not using extra cleaning devices. Using a multivariate model, significant relationships remained after adjusting for a number of variables including demographics, medical status, lifestyle and number of remaining teeth. CONCLUSION: Intellectual activity of higher-level functional capacity may be an accurate indicator of dental health behaviours in community-dwelling older adults. Intellectual activity should be taken into consideration to effectively promote oral health behaviours and oral hygiene in elderly persons living independently.
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Comportamentos Relacionados com a Saúde , Vida Independente , Processos Mentais/fisiologia , Saúde Bucal , Idoso , Doença Crônica , Assistência Odontológica para Idosos , Dispositivos para o Cuidado Bucal Domiciliar , Dentição , Escolaridade , Emprego , Características da Família , Feminino , Avaliação Geriátrica , Promoção da Saúde , Nível de Saúde , Atividade Nervosa Superior/fisiologia , Humanos , Relações Interpessoais , Estilo de Vida , Masculino , Competência Mental , Higiene Bucal , Autocuidado , Escovação DentáriaRESUMO
PURPOSE: This study aimed to determine whether denture use contributes to maintaining and improving food forms in long-term care facility (LTCFs) residents. METHODS: In 888 residents of 37 LTCFs in Japan, the following were investigated: nutritional intake status, food forms, age, sex, Barthel index (BI), clinical dementia rating (CDR), number of teeth present, number of occlusal supports, swallowing function, and use of dentures. Among all residents, those who were well-nourished and had ≤9 occlusal supports were analyzed. Based on standardized criteria, the food forms consumed by the subjects were divided into two groups: dysphagia and normal diet, which were further classified into four levels. Analysis was performed using a generalized estimation equation with the four levels of food forms as dependent variables and age, sex, BI, CDR, presence of dysphagia, number of teeth present, and use of dentures as independent variables. RESULTS: The final analysis included 622 (70.0%) residents. Of these, 380 (61.1%) used dentures. The analyses revealed that food form was significantly associated with age (adjusted odds ratio [OR], 0.98), BI (OR, 1.04), number of teeth present (OR, 1.03), presence of dysphagia (OR, 0.44), and use of dentures (OR, 2.82). CONCLUSIONS: Denture use was associated with food forms among Japanese LTCF residents. This indicates that the use of dentures is related to the maintenance of food forms, even in the elderly who participate in few activities of daily living, have reduced cognitive function, and require long-term care.
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Transtornos de Deglutição , Assistência de Longa Duração , Humanos , Idoso , Estudos Transversais , Transtornos de Deglutição/etiologia , Atividades Cotidianas , DentadurasRESUMO
GOAL OF WORK: Little is known about the effects of professional oral health care (POHC) on the outcome of hematopoietic stem cell transplantation (HSCT). We evaluated the effects of POHC given by dentists and dental hygienists on the development of oral mucositis and febrile neutropenia (FN) after allogeneic bone marrow transplantation (BMT). PATIENTS AND METHODS: We retrospectively studied 140 adult patients who had received allogeneic BMT, with or without POHC, in our hospital consecutively between February 2002 and December 2009. Oral mucositis was evaluated according to the World Health Organization scale. MAIN RESULTS: The incidence of oral mucositis was 66.7% (52/78) in the patients who had received POHC, compared to 93.5% (58/62) in the non-POHC group (P < 0.001). The incidence of FN and the maximal level of CRP were also significantly lower in the POHC group. Multivariate analysis revealed that the POHC was significantly associated with the incidence of oral mucositis (odds ratio, 7.58; 95%CI, 2.45-23.34; P < 0.001). CONCLUSIONS: We concluded that POHC reduced the incidences of oral mucositis and FN by upgrading the overall oral hygiene during HSCT.
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Assistência Odontológica/métodos , Transplante de Células-Tronco Hematopoéticas/métodos , Neutropenia/prevenção & controle , Estomatite/prevenção & controle , Adolescente , Adulto , Idoso , Transplante de Medula Óssea/métodos , Atenção à Saúde , Feminino , Febre/epidemiologia , Febre/etiologia , Febre/prevenção & controle , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias/terapia , Neutropenia/epidemiologia , Neutropenia/etiologia , Saúde Bucal , Estudos Retrospectivos , Estomatite/epidemiologia , Estomatite/etiologia , Transplante Homólogo , Adulto JovemRESUMO
PURPOSE: The present study aimed to measure postsurgical swallowing function in patients 5 years after the surgical treatment of tongue carcinoma. PATIENTS AND METHODS: Using a retrospective cohort study design, the investigators enrolled postsurgical patients treated for tongue carcinomas in Hokkaido University Hospital. The primary outcome variable was oropharyngeal swallow efficiency (OPSE) determined by videofluoroscopic evaluation, and OPSE at follow-up was compared with that at discharge. Other variables included current nutritional status (body mass index, serum albumin), dietary intake, self-rating of current swallowing function, and occurrence of pneumonia. Statistical analysis used the paired t test and the Spearman rank correlation. RESULTS: Swallowing function was assessed in 20 patients (11 men and 9 women) who underwent the surgical treatment of tongue carcinomas; the median age was 70 years (range, 56 to 90 yrs). The mean OPSE values for liquid and paste at follow-up were 26.6 ± 21.2 and 21.9 ± 22.5, respectively. The mean values for the body mass index and serum albumin at presentation were 22.2 ± 3.4 kg/m(2) and 4.5 ± 0.3 g/dL, respectively. All patients had a full oral intake of foods, with a mean self-rated value of 6.4 ± 2.5, a value acceptable to the patients. Pneumonia requiring hospitalization did not occur in these patients. CONCLUSIONS: The long-term follow-up of patients after the surgical treatment of tongue carcinomas showed acceptable levels of oral function and nutritional status despite objective measurements of poor swallowing efficiency assessed using videofluoroscopy.
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Transtornos de Deglutição/etiologia , Transtornos de Deglutição/fisiopatologia , Glossectomia/efeitos adversos , Neoplasias da Língua/cirurgia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Dieta , Feminino , Seguimentos , Glossectomia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Fotofluorografia/métodos , Recuperação de Função Fisiológica , Estudos Retrospectivos , Estatísticas não Paramétricas , Gravação em VídeoRESUMO
We aimed to clarify the relationship between oral function assessments regarding oral hypofunction and sarcopenia in patients who had completed treatment for organic dental problems, including oral pain, removable denture fit, and tooth loss. This cross-sectional study included 269 patients aged ≥65 years (mean age 74.9 ± 6.50 years, 133 men, 136 women) who visited a dental clinic between June 2019 and March 2021. We evaluated oral function and sarcopenia and analyzed their relationship using the Jonckheere-Terpstra test, Mantel-Haenszel trend test, and Poisson regression analysis. We diagnosed 132 (49.07%) patients with oral hypofunction, 30 (11.2%) with sarcopenia, and 24 (8.9%) with severe sarcopenia. The number of oral hypofunction items (prevalence rate ratio [PRR] = 1.39, 95%Wald = 0.11 to 0.56) was significantly associated with sarcopenia. For each of the items, tongue-lip motor function [ta] (PRR = 0.80, 95%Wald = -0.44 to -0.02)] [ka] (PRR = 0.76, 95%Wald = -0.53 to -0.03) and tongue pressure (PRR = 0.95, 95%Wald = -0.09 to -0.02) showed a significant association with sarcopenia. However, no significant association was found for other variables. Dentists should not only treat organic dental problems but also consider the relationship between oral function and sarcopenia.
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Sarcopenia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Masculino , Pressão , Sarcopenia/epidemiologia , LínguaRESUMO
This study aimed to determine the factors associated with the co-infection of Candida albicans and Candida glabrata. This retrospective study conducted between January 2015 and 2020 comprised 131 patients who were diagnosed with oral candidiasis. The factors associated with this condition were analyzed by univariate and multivariate logistic regression. Age and denture use were identified as significant risk factors in the univariate analysis. The multivariate logistic regression analysis revealed that denture use (odds ratio [OR], 8.44 95% confidence interval [CI], 1.99-28.3) and immunosuppressive therapy (OR, 9.20; 95% CI, 1.19-62.0) had significant effects on co-infection with the two Candida species. These findings suggest that immunosuppressive therapy using and dentures is significantly associated with oral candidiasis caused by co-infection of C. albicans and C. glabrata.
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This study examined the association between coronavirus disease 2019 (COVID-19)-related stress, exercise habits, and oral health-related quality of life (OHRQoL) in a sample of 215 community-dwelling older adults in Japan (57 men, 158 women; Mage = 74.2 years, SD = 6.0). Data were collected during wellness checkups in October 2020 and included participants' demographic characteristics, measures of instrumental activities of daily living and depressive tendencies, number of teeth, oral hypofunction, OHRQoL, COVID-19-related stress, and exercise habits. Four mutually exclusive groups were created, using the presence or absence of COVID-19-related stress and lack of exercise habits as risk factors for poor OHRQoL (no COVID-19-related stress and no lack of exercise, COVID-19-related stress only, lack of exercise habits only, and both COVID-19-related stress and lack of exercise habits). Poisson regression with robust standard errors provided the prevalence ratio for poor OHRQoL. The presence of both COVID-19-related stress and lack of exercise habits (adjusted prevalence ratio: 2.20, 95% CI: 1.31- 3.69) was associated with poor OHRQoL. The results indicate that COVID-19-related stress and exercise habits should be considered when designing oral health and public health initiatives.
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COVID-19 , Saúde Bucal , Qualidade de Vida , Idoso , Feminino , Humanos , Masculino , Atividades Cotidianas , COVID-19/epidemiologia , COVID-19/psicologia , Estudos Transversais , Vida Independente , Japão/epidemiologia , Exercício Físico , Estresse PsicológicoRESUMO
This one-year multicenter longitudinal study aimed to assess whether older adult residents of long-term care facilities should switch from a normal to a dysphagia diet. Using the results of our previous cross-sectional study as baseline, older adults were subdivided into those who maintained a normal diet and those who switched to a dysphagia diet. The explanatory variables were age, sex, body mass index (BMI), Barthel Index, clinical dementia rating (CDR), and 13 simple and 5 objective oral assessments (remaining teeth, functional teeth, oral diadochokinesis, modified water swallowing test, and repetitive saliva swallowing test), which were used in binomial logistic regression analysis. Between-group comparison showed a significantly different BMI, Barthel Index, and CDR. Significant differences were also observed in simple assessments for language, drooling, tongue movement, perioral muscle function, and rinsing and in objective assessments. In multi-level analysis, switching from a normal to a dysphagia diet was significantly associated with simple assessments of tongue movement, perioral muscle function, and rinsing and with the objective assessment of the number of functional teeth. The results suggest that simple assessments can be performed regularly to screen for early signs of discrepancies between food form and eating/swallowing functions, which could lead to the provision of more appropriate food forms.
Assuntos
Transtornos de Deglutição , Doenças Musculares , Idoso , Deglutição/fisiologia , Dieta , Humanos , Assistência de Longa Duração , Estudos LongitudinaisRESUMO
PURPOSE: This study aimed to determine the association between home visits by a dentist and regular oral hygiene management by a dental hygienist (regular dental management: RDM) and weight loss among older adults in long-term care facilities. METHODS: A total of 468 older residents from 26 Japanese long-term care facilities participated in two surveys in 2018 and 2019. Participants were divided into two groups based on their diet during the baseline survey (regular diet, n = 256; dysphagia diet, n = 212). Participants with a regular diet were further divided into those who exhibited a weight loss ≥ 5% over 1 year (weight loss group: n = 77) and those with a weight loss < 5% (consistent weight group: n = 179). The explanatory variables were age, sex, baseline weight, Barthel index, and clinical dementia rating, as well as the patients' medical history of pneumonia, stroke, diabetes, and depression (which is reportedly associated with weight). Additionally, a Poisson regression with robust standard error, was carried out to analyze the explanatory variables, namely the prevalence of RDM noted during the study and functional teeth (which seemed to affect weight loss). RESULTS: A multivariate analysis revealed that older residents' lack of RDM, clinical dementia assessment, and their history of pneumonia (prevalence rate ratio: 0.35, 95% confidence interval 0.24-0.95) were all significantly associated with weight loss when on a regular diet. CONCLUSION: Thus, weight loss and RDM were related to each other. Weight loss may be suppressed by incorporating RDMs during the early nursing care for older residents on regular diets.