Gender differences in the relationship between personality, cognitive function and regular dental visits in Japanese community-dwelling older adults.

OBJECTIVES: Studies have examined the association between personality and health behaviour, but research focusing exclusively on regular dental visits has yet to be conducted. This study examined the association between personality traits and regular dental visits among Japanese community-dwelling older adults. METHODS: The participants in this cross-sectional study included 1,057 community-dwelling older adults aged 65-74 years from Ranzan and Yoshimi towns; data were collected from October to November 2015 and October to November 2016, respectively. Interviews were conducted to obtain sociodemographic, income, occupation and medical data. The Tokyo Metropolitan Institute of Gerontology Index of Competence was used to assess higher-level competence; general intelligence was also evaluated. The 'Big Five' personality traits-openness to experience, consciousness, neuroticism, extraversion and agreeableness-were also examined. A multivariable logistic regression analysis was performed to examine the relationship between regular dental visits and personality traits. RESULTS: Among men, the number of natural teeth, current employment status and conscientiousness were associated with dental care utilization. Among women, the number of natural teeth, current annual income, the intellectual activity domain of the Tokyo Metropolitan Institute of Gerontology Index of Competence and openness were significant. CONCLUSIONS: The factors associated with regular dental visits differed by gender. Overall, work was associated with men's visits, whereas intellectual activity and economic factors were relevant to women. Factors such as personality traits should be considered when addressing barriers to oral health. Understanding personality traits will help practitioners more effectively encourage older adults to make dental visits.

Factors related to removable denture use in independent older people: A cross-sectional study.

BACKGROUND: Denture use for recovery of major tooth loss can reduce the need for care, and thus, it is important for dentists to identify the types of patients who use removable dentures. OBJECTIVE: To identify factors associated with removable denture use in independent older Japanese people. METHODS: This cross-sectional study investigated the oral condition; demographics; lifestyle; dental visit behaviour; and higher-level functional capacity, as assessed using the Tokyo Metropolitan Institute of Gerontology index of competence (TMIG index), of independent older people aged 65-74 years. Participants were divided into four groups based on sex and condition of the posterior occluding pairs (POPs). Multivariate-adjusted logistic regression analyses were performed for each group, with denture use or non-use as the dependent variable and the other items as independent variables. RESULTS: Denture use or non-use was significantly associated with only dental consultation behaviour (regular dental visits and time since the last dental visit) in all groups. Subsequent analyses excluding dental consultation behaviour demonstrated that denture use or non-use was significantly associated with educational background in female participants with decreased POPs, with the type of household in male participants with lost POPs and with the TMIG index (social role) in female participants with lost POPs. CONCLUSIONS: Denture use was associated with dental consultation behaviour. We revealed factors related to denture use or non-use in females with decreased POPs and both males and females with lost POPs.

A case of intra-articular ganglion cysts of the knee joint: correlation between arthroscopic and magnetic resonance imaging.

BACKGROUND: Intra-articular ganglion cysts of the knee are rare. Here we report a case of an arthroscopically confirmed ganglion cyst arising from the posterior cruciate ligament (PCL) along with preoperative magnetic resonance imaging (MRI) findings. CASE PRESENTATION: A 39-year-old female admitted a hospital with left knee pain with flexion and extension. MRI revealed a cystic lesion along the PCL. The lesion exhibited slight but homogeneous hyperintensity on T1 weighted images. Thin septals were visible within the lesion. Arthroscopic examination revealed a mass lesion with a white fibrous capsule, located near the PCL. A gel-like liquid spurted from the mass upon puncture. The lesion was completely resected. Histological examination revealed loose connective tissue and fibroblasts with collagen, thus confirming the diagnosis of a ganglion cyst. CONCLUSION: Many reports have suggested intra-articular ganglion cysts of the knee are rare. In our study, a cystic lesion may have been impinged between the PCL and intercondylar notch, resulting in flexion and extension difficulty in the left knee. Arthroscopic resection is the major treatment of intra-articular ganglion cyst, and preoperative MRI findings can predict the correct arthroscopic approach. We have reported a case in which an intra-articular ganglion attached to the PCL.

[Relationship between the swallowing function and the health-related QOL among community-dwelling dependent elderly persons].

AIM: We examined the relationship between the swallowing function and the health-related QOL (quality of life) among community-dwelling dependent elderly persons. METHODS: The subjects included 191 community-dwelling dependent elderly persons. Data were collected via questionnaires, including information regarding age, gender, the level of care required, post-cerebrovascular disease, the health-related QOL and the swallowing function. We used the SF-8 to measure the health-related QOL and the DRACE (Dysphagia Risk Assessment for the Community-dwelling Elderly) to evaluate the swallowing function. RESULTS: The average DRACE score was 4.29±3.81. In addition, the swallowing risk was found to be related to the SF (social functioning) and MH (mental health) subscales of the SF-8. CONCLUSIONS: Our results suggest that the swallowing function is significantly related to the health-related QOL among community-dwelling dependent elderly persons.

Relationship between masticatory ability and physical performance in community-dwelling edentulous older adults wearing complete dentures.

OBJECTIVE: This study aimed to elucidate the association between masticatory ability and physical performance in community-dwelling edentulous older adults wearing complete dentures. BACKGROUND: Physical performance parameters are significant predictors of decreased activities of daily living. Previous studies have shown the relationships between oral conditions and these parameters. Here, we focused on complete denture wearers. METHODS: Two hundred and ten edentulous adults aged ≥65 years and wearing complete dentures were enrolled. The following oral conditions were examined: masticatory ability measured by colour-changing chewing gum, number of foods considered chewable, pain when using dentures and denture base fit. Handgrip strength (HG) and one-leg standing time with eyes open (OLST) were used to evaluate muscle strength and static balance. Spearman's rank correlation coefficients were calculated to examine the correlations between oral conditions and physical performance. Forward stepwise linear regression models were applied with each physical performance parameters as the dependent variable and oral conditions as the independent variable. RESULTS: The women did not show significant correlations between oral conditions and the physical performance. In men, significant and positive correlations were found between the number of chewable foods and HG, and between the colour scores and OLST. The significant correlation between the colour scores and OLST was still noted in the stepwise liner regression analysis after adjusting for demographic, social and medical conditions, and other oral conditions. CONCLUSION: In Japanese elderly edentulous men wearing complete dentures, masticatory ability evaluated as the mixing ability may be associated with static balance.

Analysis of moment structures for assessing relationships among perceived chewing ability, dentition status, muscle strength, and balance in community-dwelling older adults.

OBJECTIVE: The aim of this study was to assess relationships among perceived chewing ability, dentition status, muscle strength and balance in community-dwelling older adults using analysis of moment structures (Amos). BACKGROUND: Physical performance parameters such as muscle strength and balance can predict the future onset of disabilities in activities of daily living among older adults. In this context, elucidation of the relationships among oral conditions and physical performance parameters is necessary. MATERIALS AND METHODS: Data on occlusal contact patterns of natural teeth (OPNT), self-assessed masticatory ability (mastication), body mass index (BMI), handgrip strength (HG) and one-leg standing time with eyes open (OLST) were collected from 501 independently living adults aged 65-74 years. The relationships among these parameters were analysed using Spearman's rank correlation coefficients and Amos. RESULTS: Subjects of both genders showed significant correlations among OPNT, mastication, HG and OLST, evaluated using Spearman's rank correlation coefficients. For each Amos model, the goodness-of-fit statistic indicated a good level of fit. In both men and women, OPNT was significantly related to mastication, and mastication was related to HG but not to OLST. OPNT was related to neither HG nor OLST in women and was related to OLST but not HG in men. CONCLUSION: The findings observed in this study present a possible importance of dental status and perceived chewing ability for the onset of disability by influencing physical performance in community-dwelling older adults.

Peribronchovascular haze: a frequently observed finding on chest X-rays in the acute phase of Kawasaki disease.

PURPOSE: To evaluate the frequency of peribronchovascular haze on chest X-rays (CXR) in patients with Kawasaki disease (KD), a finding not previously emphasized, and to contrast this finding with clinical, laboratory and echocardiographic findings. METHODS: Sixty-nine patients diagnosed as KD from January 2010 to December 2011 were eligible for this study. The initial CXRs were retrospectively reviewed by two radiologists for the presence of peribronchovascular haze and related findings. Echocardiography was reviewed by one pediatrician for the presence of coronary artery abnormalities. The follow up CXRs and post-remission echocardiograms were also reviewed. Patients' medical records were reviewed for clinical findings. Correlation between CXR findings and clinical findings were assessed. RESULTS: On the initial CXR, peribronchovascular haze was observed in 57/69 patients (82.6 %). Twenty-nine out of 69 patients showed abnormalities on echocardiogram (42.0 %). In the follow-up studies, CXR findings were improved in 25/29 patients (86.2 %). The frequencies of five principal clinical features of KD were from 55.1 to 88.4 %. There was no statistically significant correlation between the CXR finding and clinical findings. CONCLUSION: Peribronchovascular haze on CXR was observed in the acute phase of KD as frequently as the principal clinical features of KD, and more frequently than echocardiographic abnormalities.

Predictors of eligibility for long-term care funding for older people in Japan.

AIM: To determine the predictors of Japanese long-term care insurance system (LTCI) certification. METHODS: Care needs of 784 persons aged 65-84 were followed through LTCI over 5 years. Each participant's score was divided into quartiles according to handgrip strength and one-leg standing time with eyes open. Cox proportional hazard models were conducted for the onset of certification of LTCI. RESULTS: Over the 5-year period 64 women (14%) and 30 men (9%) were certified. Adjusted hazard ratios for certification were significantly higher for those of the lowest groups of one-leg standing time with eyes open at baseline than those in the highest groups, but no significance was found for handgrip strength. Other predictors were age and low social activity for women; and living alone and diabetes for men. CONCLUSIONS: One-leg standing time with eyes open predicts the onset of care-need certification in older people.

Associations between higher-level competence and general intelligence in community-dwelling older adults.

OBJECTIVES: Higher-level competence is crucial for healthy and socially independent living, and general intelligence may underlie heath status. The aim of this study was to elucidate associations between general intelligence and higher-level competence in elderly individuals without dementia. METHODS: A total of 207 community-dwelling elderly persons, aged 70-74 years, were enrolled. A personal interview was performed to obtain data on socio-demographic and medical factors; higher-level competence was evaluated using the Tokyo Metropolitan Institute of Gerontology index of competence (TMIG index). Raven's Coloured Progressive Matrices (RCPM) test was used to assess general intelligence. Correlations between the TMIG index, its subscale scores and the RCPM score were evaluated by Spearman's rank correlation coefficients. Ordinal regression models were conducted with the TMIG index and its subscales as the dependent variables, RCPM as the principal independent variable, and age, sex, type of household, employment status, educational background, chronic medical conditions and number of natural teeth as the potential independent variables. RESULTS: There were significant but weak positive correlations between total score on the TMIG index, scores on the intellectual activity and social role subscales and RCPM score. In ordinal regression models, RCPM and educational background were significantly associated with total score on the TMIG index and the intellectual activity subscale, and only RCPM was associated with the social role subscale score, after adjusting for other potential variables. CONCLUSION: General intelligence may be significantly associated with higher-level competence, especially with intellectual activity and social role subscales, in community-dwelling older adults.

Relationships between higher-level functional capacity and dental health behaviors in community-dwelling older adults.

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.

Relationship between periodontal status and intellectual function among community-dwelling elderly persons.

OBJECTIVE: The aim of this study was to indicate the relationship between periodontal status and intellectual function in the elderly. BACKGROUND: Periodontal status has been shown to be related to demographic, socioeconomic, and psychological status. Intellectual function is a significant indicator of health status. Nevertheless, the relationship between periodontal status and intellectual function has not been elucidated in detail among the elderly. MATERIALS AND METHODS: A total of 152 community-dwelling elderly persons, aged 70-74 years, were enrolled in the study. Periodontal status was evaluated using the WHO Community Periodontal Index of Treatment Needs (CPITN). Intellectual function was assessed by four neuropsychological tests: Raven's Coloured Progressive Matrices (RCPM) test, the Verbal Paired Associates 1 (VerPA) task and the Visual Paired Associates 1 (VirPA) task, extracted from the Wechsler Memory Scale Revised Edition, and the Block Design subtest, extracted from the Wechsler Adult Intelligence Scales, Third Edition. Correlations between CPITN and each test were examined using Spearman rank correlation coefficients. The ordinal regression model was constructed with CPITN as the dependent variable and neuropsychological test as the principal independent variable to adjust for demographic factors, general health, lifestyle and oral health behaviour. RESULTS: Significant correlations were found between the RCPM test, the VerPA task, the Visual Paired Associates 1 and CPITN. In the ordinal regression model, CPITN was significantly related to measures of RCPM after adjusting for demographic factors, general health status, lifestyle and oral health behaviour. CONCLUSION: Intellectual function is considered a significant indicator of periodontal status among community-dwelling elderly persons.

Relationship between subjective assessment of oral health and medical expenses in community-dwelling elderly persons.

OBJECTIVES: The increasing medical expenses of elderly persons in Japan's rapidly ageing society have become a major concern. It is therefore important to elucidate the factors associated with such escalation. Here, we focused on the relationship between subjective self-assessment of oral health, as an index of general health, and medical expenses (excluding dental repair) under the hypothesis that oral health contributes to general medical expenses. Several studies have shown that oral health status is correlated with general health status among elderly persons. We speculated that oral health status might show a relation with medical costs among elderly persons. However, few studies have investigated this relationship to date. MATERIALS AND METHODS: Participants were 259 elderly subjects (range: 65-84 years; 120 men, 139 women) residing independently. Subjective assessment of oral health was evaluated by their responses ('Good', 'Not good' and 'Not at all good') on a survey questionnaire. The correlation between subjective assessment of oral health and medical expenditure was analysed using Spearman's rank method, the Mann-Whitney U-test and the Kruskal-Wallis test. Medical expenses were used as the dependent variable in multinomial logistic regression analysis with background and intraoral factors as independent variables. RESULTS: A slight yet statistically significant correlation was observed between subjective assessment of oral health and outpatient treatment fees. CONCLUSION: The findings revealed that subjective assessment of oral health is significantly and independently related to the medical expenses of community-dwelling elderly persons after adjusting for social background, living environment and physical factors.

Influence of dental treatment on physical performance in community-dwelling elderly persons.

OBJECTIVE: The aim of the study was to investigate the influence of dental treatment on physical performance (muscle strength and balance function) among the elderly. BACKGROUND: Oral conditions have been associated with physical performance. We hypothesised that improved oral conditions by dental treatment would lead to improved physical performance. METHODS: A total of 154 persons aged 65 years or over were judged to be in need of dental treatment as a result of dental examination; of these, 121 persons underwent dental treatment. After 1 year, differences in each parameter of physical performance before and after the intervention were evaluated using the Wilcoxon signed rank sum test. The Spearman rank correlation coefficient was calculated to examine correlations between changes in self-assessed masticatory ability (masticatory ability) and each parameter of physical performance, and multivariate logistic regression analysis was performed using changes in each parameter of physical performance as the dependent variable and changes in masticatory ability as the principal independent variable. RESULTS: Improved physical performance was not observed for the total study population with dental treatment; however, in subjects with improved masticatory ability, one-leg standing times with eyes open increased significantly. A significant correlation was established between changes in masticatory ability and each parameter of physical performance. These relationships were not found in those without dental treatment. A significant relationship was also established for one-leg standing time after adjusting for age, gender, dentition status and needs of dental treatments. CONCLUSION: Chewing ability may be a positive contributing factor to balance function among the elderly.

Relationships between Geriatric Oral Health Assessment Index scores and general physical status in community-dwelling older adults.

OBJECTIVE: The aim of this study was to investigate the relationships between Geriatric Oral Health Assessment Index (GOHAI) and general physical status among community-dwelling older adults. BACKGROUND: Geriatric Oral Health Assessment Index is a patient-centred assessment of oral health for older adults. We hypothesised that GOHAI is a significant indicator of general physical status of older adults. METHODS: This study included 354 adults (age, ≥65 years) living independently. Body mass index, handgrip strength and one-leg standing time with eyes open were used to evaluate the general physical status. Spearman's rank correlation coefficients were calculated to examine the relationships between the GOHAI scores, its three subdivided categories (physical function, psychological function and pain and discomfort) and each physical status measurement. A stepwise linear regression model was applied with each physical status measurement as the dependent variable and the GOHAI scores and its subdivisions as the principal independent variable. RESULTS: Positive correlations were found between the GOHAI scores, its three subdivided categories and handgrip strength. The physical function category positively correlated with one-leg standing time. The GOHAI and the pain and discomfort category scores were retained in the final models of stepwise regression for handgrip strength, and significant relationships persisted after adjustments for demographic, psychosocial, medical and dental status. CONCLUSION: The GOHAI scores and its pain and discomfort category score may be significant indicators of body muscle strength.

Associations between self-assessed masticatory ability and higher brain function among the elderly.

Among the elderly, the quality of higher brain function is a contributing factor in performing activities of daily living. The aim of the study is to elucidate, epidemiologically, associations between mastication and higher brain function. A total of 208 community-dwelling elderly persons, aged 70-74 years, were enrolled. Self-assessed masticatory ability (masticatory ability) was classified into one of three categories: ability to chew all kinds of food, ability to chew only slightly hard food, or ability to chew only soft or pureed food. Brain function was assessed by four neuropsychological tests: Raven's Colored Progressive Matrices (RCPM) test, the Verbal Paired Associates 1 (VerPA) task and the Visual Paired Associates 1 task (from the Wechsler Memory Scale Revised Edition), and the Block Design subtest (from the Wechsler Adult Intelligence Scales-Third Edition). Correlations between masticatory ability and each test were examined using Spearman rank correlation coefficients. Multinominal logistic regression models were conducted with the neuropsychological tests as the dependent variables and masticatory ability as the principal independent variable to adjust for age, gender, educational background, social activity, drinking/smoking habits, chronic medical conditions and dental status. Significant correlations were found between the RCPM test, the VerPA task, the Block Design test and masticatory ability. In multinominal logistic regression models, poor masticatory ability was significantly and independently related to the categories under the mean-s.d. points compared with those of the mean ± s.d. ranges for RCPM test and the VerPA task. Significant associations may exist between mastication and higher brain function among the elderly.

Factors influencing oral health-related quality of life (OHRQoL) among the frail elderly residing in the community with their family.

The purpose of the present study was to identify factors that influence quality of life (QoL) among frail elderly individuals residing in the community, in order to improve the level of home care related to oral health. Participants were 100 pairs comprising elderly individuals requiring care and their family caregivers. Questionnaire items for the family caregivers related to demographic variables, hours spent caregiving per day, and duration of caregiving. Questionnaire items for the elderly recipients of care concerned demographic variables, activities of daily living (ADL), and cognitive status. According to bivariate analysis, oral health-related quality of life (OHRQoL) was significantly related to basic ADL, communication ADL (CADL), dysphagia risk, and duration of caregiving. From multiple regression analysis, dysphagia risk and CADL were extracted as factors influencing OHRQoL. Assessment of OHRQoL will be useful not only to detect oral health needs but also to evaluate the effect of oral health care in the elderly.

Relationships between oral conditions and physical performance in a rural elderly population in Japan.

OBJECTIVES: To show relationships between oral conditions and physical performance in the elderly living independently. METHODS: A total of 821 persons participated. Data on background factors and self-assessed masticatory ability were collected by means of questionnaires. An intraoral examination was performed to examine the pattern of occluding pairs of natural teeth. Handgrip strength and one-leg standing time with eyes open were measured. Step-wise linear regression models were conducted with muscle strength or one-leg standing time as the dependent variables; the pattern of occluding pairs and self-assessed masticatory ability as the principal independent variables. RESULTS: The self-assessed masticatory ability was retained in the final model of the step-wise regression for the handgrip strength, and significant relationships were established in the participants aged 65-74, but the pattern of occluding pairs was not retained. The pattern of occluding pairs, and the self-assessed masticatory ability were retained in the final models for the one-leg standing time, and significant relationships were shown here. CONCLUSION: The self-assessed masticatory ability may be significantly related to muscle strength and static balance function, and the pattern of occluding pairs may be significantly related to the static balance function, particularly in the elderly aged 65-74.