Impact of the Coronavirus Disease 2019 Pandemic on Dental Visits in Japan.

PURPOSE: This study aimed to clarify the impact of the coronavirus disease 2019 (COVID-19) pandemic on individual dental-visit behaviour and examine the difference between elderly and other individuals regarding the impact on dental visits. MATERIALS AND METHODS: An interrupted time-series analysis was performed to examine the change in data from the national database before and after the first declaration of a state of emergency. RESULTS: The number of patients visiting a dental clinic (NPVDC), number of dental treatment days (NDTD) and dental expenses (DE) during the first declaration of a state of emergency decreased by 22.1%, 17.9%, and 12.5% in the group under 64 years of age and 26.1%, 26.3%, and 20.1% in the group over 65 years of age, respectively, compared with those in the same month of the previous year. Between March and June 2020, the monthly NPVDC and NDTD were significantly reduced (p < 0.001, p = 0.013) in those over 65 years of age. The DE did not change statistically significantly in either the under 64 group or the over 65 group. There was no statistically significant change in the slope of the regression line in the NPVDC, NDTD, and DE before and after the first state-of-emergency declaration. CONCLUSION: The first state of emergency greatly reduced the NPVDC, NDTD, and DE compared to those in the previous year. In people aged over 65 years, it might still be unresolved 2 years after the postponement of dental treatment owing to the first declaration of a state of emergency.

Discordance between hyposalivation and xerostomia among community-dwelling older adults in Japan.

Individuals with an objective decrease in salivary flow (objective dry mouth) may not be aware of subjective dry mouth (xerostomia). However, no clear evidence exists to explain the discordance between subjective and objective dry mouth. Therefore, this cross-sectional study aimed to assess the prevalence of xerostomia and decreased salivary flow among community-dwelling elderly adults. In addition, this study assessed several potential demographic and health status determinants of the discrepancy between xerostomia and reduced salivary flow. The 215 participants in this study were community-dwelling older people aged 70 years and above who underwent dental health examinations between January-February 2019. Symptoms of xerostomia were collected in the form of a questionnaire. The unstimulated salivary flow rate (USFR) was measured by a dentist using visual inspection. The stimulated salivary flow rate (SSFR) was measured using the Saxon test. We identified 19.1% of participants as having mild-severe USFR decline with xerostomia and 19.1% as having mild-severe USFR decline without xerostomia. Additionally, 26.0% of participants had low SSFR and xerostomia, and 40.0% had low SSFR without xerostomia. Except for the age trend, no factors could be associated with the discordance between USFR measurement and xerostomia. Furthermore, no significant factors were associated with the discordance between the SSFR and xerostomia. However, females were significantly associated (OR = 2.608, 95% CI = 1.174-5.791) with low SSFR and xerostomia, as compared to males. Age was a factor that was also significantly associated (OR = 1.105, 95% CI = 1.010-1.209) with low SSFR and xerostomia. Our findings indicate that approximately 20% of the participants had low USFR without xerostomia, and 40% had low SSFR without xerostomia. This study showed that age, sex, and the number of medications may not be factors in the discrepancy between the subjective feeling of dry mouth and reduced salivary flow.

[Relationship between the number of prescribed medications and oral dysfunction in elderly individuals].

Objective　Polypharmacy in elderly individuals may cause reduced flow of saliva and xerostomia. A dry mouth can lead to poor oral function; however, there are no reports on the relationship between polypharmacy and subjective or objective oral dysfunction. The purpose of this study was to clarify the relationship between the number of prescribed medications and subjective and objective oral dysfunction.Methods　The subjects of this study were 215 community-dwelling, elderly individuals, aged 75 years or older, who visited the dental clinic in the Chubu region for a dental health examination from January to February 2019. A medical interview was conducted to assess three items that were related to subjective oral function and record four measurements related to objective oral function. In addition, information was collected on the diseases being treated and prescribed medications. A subject with a decrease in any of the three subjective oral function categories was considered to have subjective oral dysfunction. Objective oral dysfunction was analyzed with respect to two types of oral dysfunction: a decrease in all four objective oral functions and a decrease in two or more of the four objective oral functions. Logistic regression analysis was performed to examine the relationship between subjective and objective oral dysfunction after adjustment for sex, age group, inveterate disease, and the number of prescribed medications.Results　Individuals who had eight or more prescribed medications had lower subjective oral function than those with seven or fewer medications (odds ratio, 95% confidence interval: 2.3, 1.0-5.1; P<0.05). Individuals with eight or more medications had lower scores in all four objective oral functions than those with seven or fewer medications (4.4 : 1.5-12.6, P<0.01). A decrease in two or more of the four objective oral functions was related to 10 or more prescribed medications (4.3 : 1.2-16.2, P<0.05).　In addition, taking eight or more prescribed medications was associated with a decrease in either subjective oral function or all four objective oral functions (8.1 : 2.1-30.8, P<0.01). A decrease in either subjective oral function or two or more objective oral functions was related to taking 10 or more prescribed medications (4.9 : 1.6-15.6, P<0.01).Conclusion　In conclusion, more than eight prescribed pharmaceutical medications in the elderly is associated with subjective or objective oral dysfunction.

Association between daily physical activity and neighborhood environments.

OBJECTIVE: Previous studies on the association between physical activity (PA) and neighborhood environments (NE) focused on either objectively measuring the NE or the residents' perception of NE. Here, we investigate which actual or perceived NE is associated with residents' PA in Japan. METHODS: Two regions with an objectively assessed high and low residential density, land use mix-diversity, and street connectivity, respectively, were identified in one city. The subjects were selected using a stratified random sampling method by sex and age in each region. The NE of the subjects was objectively measured using the Geographic Information System (GIS), and the subjects' perception of the NE was assessed using a questionnaire. The daily total number of walking steps was measured with an accelerometer, and walking and cycling time were assessed by a questionnaire. RESULTS: For the female subjects, the mean cycling time, subjectively assessed as a means of transport, was significantly longer in the group with a high GIS score for the number of land use types, while the score for total number of walking steps was significantly higher among those who were aware of places to walk to, and cycling time for transport was longer for those who perceived an accessibility to post offices, banks/credit unions, gymnasiums/fitness facilities, and amusement facilities in their neighborhood. For the male subjects, the score for walking time for leisure was longer for those who perceived aesthetics and an accessibility to parks, and the score for total walking steps was significantly higher for those who perceived an accessibility to bookstores or rental video stores in their neighborhood. CONCLUSIONS: The results to this study demonstrate that daily PA was high among female subjects living in a NE with land use mix-diversity, and who had an awareness of places to walk to and the accessibility to facilities for daily necessities in their neighborhood. For male subjects, daily PA was high among those who perceived the aesthetics of and accessibility to facilities for pleasure in their neighborhood. Further research is needed to determine the association between PA and NE on the basis of sex differences.

Changes in food intake patterns associated with body weight loss during a 12-week health promotion program and a 9-month follow-up period in a Japanese population.

SUMMARY: Recently, food intake pattern analysis associated with body weight has been conducted instead of traditional dietary analysis focusing on a single nutrient or food group, but there have been few studies examining the association between change in food intake patterns and body weight loss. In this study, short- and long-term relationships between changes in food intake patterns and body weight loss were examined. Subjects were 506 overweight/obese men and women who participated in a 12-week health promotion program and a follow-up check 9 months later. Diet was assessed with a FFQ and food intake patterns named "Plant foods and seafood" and "Sweets, meats, dairy products and alcohol" were derived by cluster analysis using the intake of 17 food groups at the baseline. During the program, body weight loss of the subjects changed pattern from "Sweets, meats, dairy products and alcohol" to "Plant foods and seafood" (SP group) was significantly larger than that of the subjects who showed an opposite pattern change (PS group) or the subjects who maintained "Sweets, meats, dairy products and alcohol" pattern after adjusting for age, sex, body weight at the baseline, changes in energy intake and exercise habit. Body weight loss of the SP group was also significantly greater than that of the PS group during the follow-up period. Changes in food intake patterns were related to body weight loss and changing the pattern from "Sweets, meats, dairy products and alcohol" to "Plant foods and seafood" was most effective for short- and long-term body weight loss.: