Usefulness of the serum creatinine/cystatin C ratio as a blood biomarker for sarcopenia components among age groups in community-dwelling older people: The SONIC study.

AIM: The serum creatinine/cystatin C ratio (CCR) or sarcopenia index is considered a useful marker of muscle mass. However, its usefulness in late-stage older adults remains unclear. We aimed to determine the usefulness of CCR as an indicator of sarcopenia in community-dwelling Japanese adults aged >75 years. METHODS: Our study recruited participants aged 70, 80, and 90 ± 1 years during the baseline years, and included a 3-year follow-up in the Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians study. From 2015 to 2018, 955 participants were eligible: 367 in their 70s, 304 in their 80s, and 284 in their 90s. The diagnostic components of sarcopenia, including "low muscle mass, plus low muscle strength, and/or low physical performance," were evaluated using the bioelectrical impedance analysis-measured skeletal muscle mass index (SMI), handgrip strength, and short physical performance battery (SPPB) score, respectively, in accordance with the Asia Working Group for Sarcopenia 2019 criteria. Separate analyses were performed between each component and CCR, adjusting for sex, body mass index, and other blood biomarkers in each group. RESULTS: The relationship between CCR and sarcopenia components was significant for handgrip strength (ß = 0.21, 0.13, 0.19, and P < 0.0001, =0.0088, <0.0001, for the 70s, 80s, and 90s age groups, respectively); however, it was limited for SMI (ß = 0.14; P = 0.0022, only for the 90s) and not significant for the SPPB score. CONCLUSION: CCR is a limited indicator of sarcopenia in late-stage older adults. Although its association with muscle strength was significant, its relationship with muscle mass and physical performance was less pronounced. Geriatr Gerontol Int 2024; ••: ••-••.

Exploring the association between number of teeth, food intake, and cognitive function: A 9-year longitudinal study.

OBJECTIVES: This study aimed to investigate the association between the number of teeth, food intake, and cognitive function in Japanese community-dwelling older adults. METHODS: This 9-year longitudinal study included a total of 293 analyzable participants who participated in baseline and follow-up surveys. Dental status (number of teeth and periodontal pocket depth), dietary assessment using the brief-type self-administered diet history questionnaire, cognitive function, and the following confounding factors were evaluated: educational level, financial satisfaction, living situation, smoking and drinking habits, history of chronic diseases, apolipoprotein E-ε4 carrier, body mass index, handgrip strength, instrumental activities of daily living, and depressive symptomatology. The Japanese version of the Montreal Cognitive Assessment was used to evaluate cognitive function. A multinomial logistic regression analysis for the intake level of each food categorized into three groups (low, moderate, high), and a generalized estimating equation (GEE) for cognitive function over nine years were performed. RESULTS: After controlling for confounding factors, the number of teeth was shown to be associated with the intake of green-yellow vegetables and meat. Furthermore, the GEE indicated that the lowest quartile of intake of green-yellow vegetables significantly associated with lower cognitive function (unstandardized regression coefficient [B] = -0.96, 95 % confidence interval [CI]: -1.72 to -0.20), and the lowest quartile of intake of meat significantly associated with lower cognitive function (B = -1.42, 95 % CI: -2.27 to -0.58). CONCLUSIONS: The intake of green and yellow vegetables and meat, which is influenced by the number of teeth, was associated with cognitive function in Japanese community-dwelling older adults. CLINICAL SIGNIFICANCE: There are few studies that have examined the association between oral health, food intake, and cognitive function. This 9-year longitudinal study suggests that it is important to maintain natural teeth to enable the functional means to consume green-yellow vegetables and meat, and thereby help maintain cognitive function.

Clinical Measurements of Force Exerted on Anterior Teeth in Partial Edentulous Distal Extension.

PURPOSE: To determine the influence of partial edentulous distal extension and the use of removable partial dental prostheses in partially edentulous areas on the force exerted on the anterior teeth. MATERIALS AND METHODS: A total of 83 volunteer patients participated in this study. The occlusal force was measured using an occlusal force measuring sheet in the patient's mouth. The occlusal forces and ratios were compared using the Wilcoxon signed-rank test (P < .05). RESULTS: The force exerted on the anterior teeth increased significantly as the number of remaining teeth decreased in an edentulous distal extension. The force exerted on the anterior teeth decreased significantly with the use of a removable partial dental prosthesis. CONCLUSIONS: In a clinical setting, when the number of remaining teeth in a partial edentulous distal extension decreases, the burden on the anterior teeth increases. Our findings suggest that, for patients with partial edentulous distal extension, using a removable partial dental prosthesis is effective in preserving the residual anterior teeth by reducing excessive force.

Prevalence of oral frailty and its association with dietary variety, social engagement, and physical frailty: Results from the Oral Frailty 5-Item Checklist.

AIM: This cross-sectional study had two aims: to assess the prevalence of oral frailty (OF), according to the Oral Frailty 5-Item Checklist (OF-5), among community-dwelling older adults; and to examine the associations among oral frailty, dietary variety, social engagement, and physical frailty. METHODS: We pooled data from two population-based studies (the Otassha Study and the Itabashi Longitudinal Study on Aging). With the OF-5, OF is characterized by the presence of two or more of the following: (i) fewer teeth, (ii) difficulty in chewing, (iii) difficulty in swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. We calculated the OF prevalence for each sex. We assessed dietary variety, social engagement, and physical frailty. Generalized structural equation modeling was employed to investigate the associations among oral frailty, low dietary variety (dietary variety score ≤3), social isolation (Lubben Social Network Scale score <12), and physical frailty (Japanese version of the Cardiovascular Health Study score ≥3). RESULTS: A total of 1206 individuals (626 women and 580 men) with a mean age of 74.7 years were included. The prevalence of OF was 36.7%, and it increased with age; however, there was no significant sex difference. OF was significantly indirectly associated with physical frailty via low dietary variety (odds ratio, 1.43; 95% confidence interval, 1.04-1.97) and social isolation (odds ratio, 1.42; 95% confidence interval, 1.04-1.94). CONCLUSIONS: Two of five community-dwelling older adults exhibited OF. Low dietary variety and social isolation are potential underlying mechanisms through which OF is indirectly associated with physical frailty. Geriatr Gerontol Int 2024; 24: 371-377.

Survival time analysis of remaining teeth following replacement of unilateral free-end missing teeth: A comparison between fixed implant-supported prostheses and removable partial dentures.

OBJECTIVES: This retrospective study aimed to investigate the differences in tooth loss rate between fixed implant-supported prostheses (FISPs) and removable partial dentures (RPDs) in cases of unilateral free-end missing teeth. MATERIALS AND METHODS: The data of 324 patients who underwent treatment with FISPs or RPDs for unilateral free-end missing teeth and satisfied the applicable criteria, were evaluated (47 in the FISPs group and 277 in the RPDs group). After propensity score (PS) matching, which was used to extract patients with similar background factors related to prosthetic selection at baseline, survival time analyses were performed with tooth loss as the endpoint. The adjusted variables were age, sex, number of restored teeth, periodontal status, and the practicing dentist's experience in years. The remaining teeth were classified into subcategories in relation to the missing molars. RESULTS: Overall, 58 patients (29 in each group) selected by PS matching were evaluated in the final analysis. The total number of lost teeth was 35 (FISPs group: n = 10; RPDs group: n = 25). The mean (±SD) period to tooth loss and the 10-year survival rates in the FISPs and RPDs groups were 51.6 (±30.1) months and 42.3 (±29.7) months, 70.5% and 16.4%, respectively. The log-rank test showed that significantly longer survival time in FISPs compared with RPDs. CONCLUSIONS: After adjustments for confounding factors using PS matching, replacing unilateral free-end missing teeth with FISPs may exhibit a lower tooth loss rate in adjacent and contralateral teeth compared to replacing with RPDs.

Mechanical Influence of Edentulous Mandibular Morphology on Peri-implant Bone in Implant Prosthetics: Threedimensional Finite Element Analysis.

PURPOSE: The purpose of this study was to examine the mechanical influence of edentulous mandibular morphology on peri-implant bone in implant prosthetics by finite element analysis. MATERIALS AND METHODS: Computed tomographic data from 25 patients with edentulous mandibles were selected and the radius of mandibular curvature and the height of the mandible at the midline were measured in order to clarify the morphological characteristics of the mandible. From the measurement, two patients with the smallest and largest radii of the mandible were selected. Two types of three-dimensional finite element models consisting of the edentulous mandible (small and large radius), superstructure (a cantilever bridge), implants, and abutments were created. Four implants were inserted between the right and left mental foramina. The upper surface of the mandibular condyle was constrained, and a vertical load of 100 N was applied on the occlusal surface of the right first molar. Three-dimensional finite element analysis of each model was performed to examine the mechanical influence of the edentulous mandibular morphology on the peri-implant bone. RESULTS: Measurement of mandibular morphology in CT images indicated that the lower the mandibular height was, the larger was the radius of the anterior mandibular curvature. Finite element analysis revealed that a higher equivalent stress was generated in the peri-implant bone of the model with a larger radius of curvature than that of the model with a smaller radius of curvature. The highest equivalent stress in the mandible was generated in the distal margin of the peri-implant bone posterior to the loaded side of the large radius of curvature model. CONCLUSIONS: The mandibular morphology had a mechanical influence on the peri-implant bone.

Effect of number of medications on the risk of falls among community-dwelling older adults: A 3-year follow-up of the SONIC study.

AIM: This study examined the association between the number of prescribed medications and falls among community-dwelling older adults. METHODS: We conducted a geriatric comprehensive health-checkup on community-dwelling adults aged 69-91 years who participated in the Septuagenarians, Octogenarians, and Nonagenarians Investigation with Centenarians study. The final analysis of this study included 1,076 participants with complete data. The participants were divided into four groups based on the number of medications at baseline: 0, 1, 2-4, and ≥5. At the 3-year follow-up, the participants were asked whether they had fallen in the past year. Multivariable logistic regression analysis was performed to assess the relationship between the number of medications taken and falls after adjusting for confounding factors. RESULTS: The prevalence rates of falls were 10.5%, 18.2%, 18.3%, and 19.8% in the no-medication, one-medication, comedication, and polypharmacy groups, respectively. In the one-medication prescription group, 59% of prescriptions were for fall-risk-increasing drugs (FRID). Multivariable analysis showed a significantly higher incidence of falls in the one-medication group (adjusted odds ratio [OR], 1.91; 95% confidence interval [CI], 1.04-3.54), co-medication (OR, 1.89; 95% CI, 1.09-3.29), and polypharmacy groups (OR, 1.94; 95% CI, 1.09-3.45) than in the no-medication group. CONCLUSIONS: The study showed that polypharmacy, as well as just taking one medication, can affect the occurrence of falls. This suggests that in addition to the number of medications and polypharmacy, the type of medication, such as FRID, affects the risk of falls. Therefore, pharmacotherapy should consider the risk of falls in older adults when prescribing medications. Geriatr Gerontol Int 2024; 24: 306-310.

Relationship between maximal isometric tongue pressure and limit of fracture force of gels in tongue squeezing.

BACKGROUND: There is no clear objective indicator for selecting soft foods that are required for food bolus formation in older people with impaired oral function. OBJECTIVE: This study aimed to investigate the relationship between maximal isometric tongue pressure (MITP) and the mechanical properties of gels that can be crushed by the tongue. METHODS: This study included 65 healthy participants aged 22-96 (young group; 15 males, 15 females; older dentate group; 7 males, 8 females; older edentulous group; 10 males, 10 females). MITP was measured by the balloon-probe device. Agar gel with 10 different kinds of fracture force from 10N to 100N was used. The limit of fracture force of gels (LFFG) that were crushed by the tongue was measured by the up-and-down method. In the older edentulous group, two items were measured with and without dentures. Spearman's rank correlation coefficient was used to evaluate the relationship between MITP and LFFG in each group (p < .05). RESULTS: There were positive correlations between MITP and LFFG in all groups (overall groups: rs = .66, young group: rs = .46, older dentate group: rs = .61, older edentulous group with dentures: rs = .60, older edentulous group without dentures: rs = .47). CONCLUSION: MITP and LFFG were positively correlated in young, older dentate and older edentulous groups, suggesting that MITP has the potential to be an objective indicator of the range of mechanical properties of soft food that can be crushed by the tongue.

Masseter and digastric muscle activity evaluation using a novel electromyogram that utilizes elastic sheet electrodes.

PURPOSE: To evaluate the reproducibility and reliability of a novel electromyogram (EMG) device with a flexible sheet sensor for measuring muscle activity related to mastication and swallowing. METHODS: We developed a new EMG device made of elastic sheet electrodes to measure the masseter and digastric muscle activities for evaluating mastication and swallowing. To examine the measurement reproducibility of the new EMG device, masseter muscle activity was analyzed using the intraclass correlation coefficient (ICC). Further, we measured the maximum amplitude, duration, integrated value, and signal-to-noise ratio (SNR) using the new EMG device and conventional EMG devices and evaluated the reliability using ICC and Bland-Altman analysis. RESULTS: We confirmed high ICC (1,1) and ICC (2,1) scores (0.92 and 0.88, respectively) while measuring the reproducibility of the new EMG device. When compared to the active electrode EMG device, we found a high correlation for the maximum amplitude (0.90), duration (0.99), integrated values (0.90), and SNR (0.75), with no observation of significant fixed errors. Moreover, the regression coefficient was not significant for any of the evaluation items and no proportional error was observed. Compared with the passive electrode EMG device, the maximum amplitude and duration were highly correlated (0.73 and 0.89). In addition, the SNR exhibited a significant fixed error. In contrast, the regression coefficient was not significant for any of the evaluation items and no proportional error was observed. CONCLUSIONS: Our results suggest that the new EMG device can be used to reliably and reproducibly evaluate muscle activity during mastication and swallowing.

Factors related to subjective evaluation of difficulty in chewing among community-dwelling older adults.

AIM: Awareness of difficulty chewing may limit the diversity of food intake in older adults. However, few studies have clarified which factors are related to subjective difficulty in chewing. The aim was to identify factors related to subjective difficulty in chewing in 70- and 80-year-old Japanese older adults. METHODS: A total of 1680 participants (792 men, 888 women) were surveyed. Difficulty in chewing was assessed with questionnaires regarding food intake, such as rice, apples, beef, and hard rice crackers. The participants were classified into two groups, the "with difficulty" group (participants who answered "cannot eat," "can eat with difficulty," and "can eat if small") and the "without difficulty" group (participants who answered "can eat without problems"), according to their answers to questionnaires for each food. A logistic regression analysis with subjective difficulty in chewing as the dependent variable was performed for each food. RESULTS: Subjective difficulty in chewing was associated with age, occlusal force, and depression for rice; age, number of remaining teeth, occlusal force, and depression for apples; number of remaining teeth, occlusal force, and depression for beef; and number of remaining teeth and occlusal force for hard rice crackers. CONCLUSIONS: Age, number of remaining teeth, and occlusal force, as well as depression, might be related to subjective evaluation of difficulty chewing in community-dwelling Japanese older adults. Geriatr Gerontol Int 2024; 24: 327-333.

Association between prior-night sleep and next-day fatigue in older adults: a daily diary study.

BACKGROUND: Fatigue is known as an element of frailty. Sleep problems (e.g., short sleep duration and low sleep quality) can increase fatigue, but the day-to-day relationship between sleep and fatigue has not been studied well in older adults. Using a daily diary method, this study examined the within- and between-person associations between sleep and fatigue in older adults. METHODS: The study recruited 56 Japanese community dwellers (age: 82-86 years; female: 37.5%). Participants responded to a daily diary questionnaire at the end of each day. Over seven days, time in bed and satisfaction were measured after waking up, whereas fatigue was assessed before going to bed. We included person-level covariates (demographic factors, and physical and mental health) and day-level covariates (time in study, and positive and negative emotions). Multilevel models were estimated to examine within- and between-person associations. RESULTS: At the within-person level, on days following short and long time in bed and days following low levels of sleep satisfaction, individuals felt higher levels of fatigue compared with usual days. At the between-person level, no statistically significant differences in fatigue were observed between individuals with long and short time in bed. CONCLUSIONS: The findings suggest that prior-day sleep is associated with next-day fatigue in older adults. Long and short sleep duration and low sleep quality can lead to fatigue. Considering that sleep is a modifiable health behavior, appropriate management of sleep behavior may reduce fatigue.

Risk factors of cognitive impairment: Impact of decline in oral function.

Cognitive impairment and subsequent dementia are the major causes of disability and need for nursing care among older people in worldwide. The purpose is to review well-known risk factors for cognitive impairment and dementia, focusing on the relationship between decline in oral function and current prevention strategies. Various non-modifiable and modifiable risk factors are related to cognitive impairment. Effects of oral function to cognitive impairment is not yet well recognized in the medical community, although masticatory function, occlusal force, and number of teeth have been reported to be related to cognitive function. Furthermore, occlusal force rather than number of teeth was significantly related to the early stages of cognitive impairment, and that a decline in occlusal force seemed to lead to cognitive impairment directly and indirectly through dietary intake. This relationship was significant only for occlusal force, which may be associated with the early stages of cognitive decline. Nutritional change caused by reduced masticatory function is suggested as a possible explanation. Therefore, rehabilitation or maintenance of oral function should be sought to prevent cognitive impairment.

Age Group Differences in the Association Between Sleep Status and Frailty Among Community-Dwelling Older Adults: The SONIC Study.

Objective: We aimed to determine whether the association of sleep status with frailty differs between age groups of older adults. Method: This cross-sectional study was part of the observational Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. Subjects were community-dwelling older adults in their 70s and 80s. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study criteria (J-CHS). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep status. Poor sleep quality was defined as a PSQI global score ≥6. Sleep duration was categorized as short (<6 hr), normal (6-8), and long (>8). We performed multivariable logistic regression to investigate the association between sleep status and frailty separately for each age group adjusted for multiple covariates. Results: In those in their 70s, long sleep duration and sleep medication use were independently associated with frailty. In those in their 80s, poor sleep quality was independently associated with frailty. Conclusions: The association between sleep status and frailty was different between age groups. The findings underscore the importance of incorporating the evaluation of sleep quantity and non-pharmacological therapies in those in their 70s and the evaluation of sleep quality in those in their 80s to help prevent the onset of frailty.

The relationship between changes in occlusal support and masticatory performance using 6-year longitudinal data from the SONIC study.

OBJECTIVES: Reduced occlusal support is thought to be related to a decline in masticatory performance. However, previous research in this field was based on cross-sectional studies. In this study, we conducted a 6-year longitudinal observation of older adults living in the community and examined the associations of changes in occlusal support with masticatory performance. METHODS: Of the 864 participants aged 72-74 years in the SONIC study, 488 who were followed up (median follow-up period 5.92 years) and had no missing data were included in this study. Participants were divided into three groups according to the number of occlusal support zones in the posterior area: Complete occlusion (four zones), Reduced occlusion (one to three zones), and Collapsed occlusion (no occlusal support zone). Longitudinal analysis of the relationship between occlusal support and masticatory performance was undertaken with linear mixed-effects models. RESULTS: Sex, occlusal force, number of unreplaced missing teeth, aging, and occlusal support change were significantly related to masticatory performance. Furthermore, the interaction term between change in occlusal support and aging was a significant explanatory variable for the decline in masticatory performance. The interaction was strongest in the group that changed from Complete or Reduced occlusion to Collapsed occlusion. This result indicates that the loss of occlusal support is a major factor contributing to declining masticatory performance. CONCLUSIONS: The decline of occlusal support was greatly associated with the deterioration of masticatory performance. Our results suggest that older adults need to prevent the collapse of posterior occlusal support to maintain their masticatory performance. CLINICAL SIGNIFICANCE: Occlusal support is important for preserving masticatory performance in older adults. Preventing the loss of molars and retaining occlusal support may contribute to maintaining food intake diversity and nutritional status, thereby improving quality of life. Dental professionals need to carefully examine dental status to assess the risk of occlusal collapse.

Oral frailty five-item checklist to predict adverse health outcomes in community-dwelling older adults: A Kashiwa cohort study.

AIM: To enable easy assessment of oral frailty; that is, an overlapping slight decline in multifaceted oral function, in any setting, we developed the oral frailty five-item checklist (OF-5), and examined its predictive validity for increased risks of physical frailty, physical disability and mortality among community-dwelling older adults. METHODS: This population-based cohort study randomly selected 2044 residents in Kashiwa, Japan, with no long-term care needs. Baseline data were collected in 2012, and follow-up data were collected in 2013, 2014, 2016, 2018 and 2021. The OF-5 includes five measures: fewer teeth, difficulty in chewing, difficulty in swallowing, dry mouth and low articulatory oral motor skills. Physical frailty was defined according to the Cardiovascular Health Study criteria. Physical disability and mortality determined from the long-term care insurance receipt database were followed for 9 years. RESULTS: Of 2031 eligible participants (mean age 73.1 ± 5.6 years; 51.1% women), 39.3% individuals with ≥2 OF-5 points had significantly increased prevalence and new-onset rate of physical frailty. After adjusting for potential confounders, oral frailty, defined as ≥2 OF-5 points, was associated with increased risks of physical disability (adjusted hazard ratio 1.40; 95% confidence interval 1.14-1.72) and mortality (adjusted hazard ratio 1.44; 95% confidence interval 1.11-1.87). The highest adjusted hazard ratios were observed in older adults with coexisting physical and oral frailty. CONCLUSIONS: The OF-5 showed strong predictive validity for physical frailty, physical disability and mortality in Japanese older adults. This assessment tool can be implemented in various settings and foster comprehensive prevention through interprofessional collaboration. Geriatr Gerontol Int 2023; 23: 651-659.

Relationship between the number of teeth, occlusal force, occlusal contact area, and dietary hardness in older Japanese adults: The SONIC study.

PURPOSE: Individuals with impaired masticatory function tend to prefer soft foods, which results in decreased masticatory muscle activity. This study examined the association between the oral condition (number of teeth, occlusal force, and occlusal contact area) and dietary hardness using a daily dietary questionnaire. METHODS: This cross-sectional study evaluated 1841 participants aged 69-71 and 79-81 years. Registered dentists examined the number of teeth, occlusal force, and occlusal contact area. Dietary hardness was defined as the estimated masticatory muscle activity required for a habitual diet. Habitual diet during the preceding month was assessed using a brief self-administered diet history questionnaire. Confounding factors, such as age, sex, socioeconomic status, smoking habits, history of chronic diseases (hypertension, hyperlipidemia, and diabetes), and cognitive function were also evaluated. Multivariate linear regression analyses were performed to assess the association between dietary hardness and each oral condition. RESULTS: Occlusal force (standardized regression coefficients [ß]=0.08, P < 0.01) and occlusal contact area (ß=0.06, P < 0.01) were significantly associated with dietary hardness after adjusting for the confounding factors. Number of teeth was not significantly associated with dietary hardness. In addition, the associations between dietary hardness, sex, and a history of diabetes were stronger than those between dietary hardness and oral factors. CONCLUSIONS: Occlusal force and contact area were significantly associated with dietary hardness as estimated from the masticatory muscle activity using a daily diet questionnaire.

Factors associated with weight loss by age among community-dwelling older people.

BACKGROUND: Factors associated with weight loss in community-dwelling older people have been reported in several studies, but few studies have examined factors associated with weight loss by age groups. The purpose of this study was to clarify factors associated with weight loss by age in community-dwelling older people through a longitudinal study. METHODS: Participants in the SONIC study (Longitudinal Epidemiological Study of the Elderly) were community-dwelling people aged 70 or older. The participants were divided into two groups: 5% weight loss and maintenance groups, and compared. In addition, we examined factors affecting weight loss by age. The analysis method used was the χ2 test, and the t-test was used for comparison of the two groups. Factors associated with 5% weight loss at 3 years were examined using logistic regression analysis with sex, age, married couple, cognitive function, grip strength, and the serum albumin level as explanatory variables. RESULTS: Of the 1157 subjects, the proportions showing 5% weight loss after 3 years among all subjects, those aged 70 years, 80 years, and 90 years, were 20.5, 13.8, 26.8, and 30.5%, respectively. In logistic regression analysis, factors associated with 5% weight loss at 3 years by age were influenced by BMI of 25 or higher (OR = 1.90, 95%CI = 1.08-3.34, p = 0.026), a married couple (OR = 0.49, 95% = 0.28-0.86, p = 0.013), serum albumin level below 3.8 g/dL (OR = 10.75, 95% = 1.90-60.73, p = 0.007) at age 70, and the grip strength at age 90 (OR = 1.24, 95%CI = 1.02-1.51, p = 0.034), respectively. CONCLUSIONS: The results suggest that factors associated with weight loss by age in community-dwelling older people through a longitudinal study differ by age. In the future, this study will be useful to propose effective interventions to prevent factors associated with weight loss by age in community-dwelling older people.

The Relationship Between Social Interaction and Anxiety Regarding COVID-19 in Japanese Older Adults.

While previous studies suggest that women have higher anxiety than men regarding COVID-19, underlying mechanisms remain unclear. This study tries to explain the mechanisms by gender difference in social interaction based on a theory of social amplification of risk framework (SARF). We surveyed older adults in Japan regarding their anxiety regarding COVID-19, as well as the frequencies of their direct and indirect social interaction in July 2020 (N = 1,587, aged 78-99 years). To explore the way in which gender and anxiety regarding COVID-19 were mediated by these two types of social interactions, MODEL4 of SPSS's Process MACRO was applied to the data. We found that older women interacted more directly and indirectly with others than did older men. And, direct social interaction was negatively and related, but indirect social interaction was positively related to older adults' anxiety regarding COVID-19. Furthermore, direct social interaction was related to older women's low anxiety regarding COVID-19, whereas indirect social interaction was related to older women's high anxiety regarding COVID-19. The findings of our study suggest that the degree of anxiety regarding COVID-19 among older women may be dependent upon the types of social interaction they have with others.

Clinical measurement of force exerted on anterior teeth in partial edentulous distal extension.

PURPOSE: The aim of this clinical study was to determine the influence of partial edentulous distal extension and the use of removable partial dental prostheses in partially edentulous areas on the force exerted on the anterior teeth. MATERIALS AND METHODS: Eighty-three volunteer patients participated in this study. The occlusal force was measured by using an occlusal force measuring sheet in the patient's mouth. The occlusal forces and ratios were compared with the Wilcoxon signed-rank test (p < 0.05). RESULTS: The force exerted on the anterior teeth increased significantly as the number of remaining teeth decreased in an edentulous distal extension. The force exerted on the anterior teeth decreased significantly with the use of a removable partial dental prosthesis. CONCLUSION: When the number of remaining teeth decreases in a partial edentulous distal extension, the burden on the anterior teeth increases in a clinical setting. Our findings suggest that, for patients with partial edentulous distal extension, using a removable partial dental prosthesis is effective in preserving the residual anterior teeth by reducing excessive force. Int J Prosthodont 2023. doi: 10.11607/ijp.8281.

[Relationship between glycemic control and mental health in community-dwelling older people with diabetes mellitus: The SONIC study].

AIM: The purpose of this study was to examine the relationship between glycemic control and mental health in community-dwelling older people with diabetes mellitus (DM) from insights that contribute to the management of diabetes in consideration of quality of life (QOL). METHODS: We used the data of the Septuagenarians, Octogenarians and Nonagenarians Investigation with Centenarians (SONIC) study, a prospective cohort study of community-dwelling older people. The present study included 2,051 older subjects of 70±1 years, 80±1 years and 90±1 years of age. We conducted medical interviews, blood sampling, and the subjects were asked to complete a questionnaire (WHO-5-J) at the venue. Three hundred sixty-eight people were diagnosed with DM. The subjects of this study were 192 people who were undergoing drug therapy for glycemic control. A multiple regression analysis was performed to clarify the relationship between glycemic control (divided as follows: HbA1c<7.0%, good control group; HbA1c≥7.0%, poor control group) and the WHO-5-J score, as the dependent variable, after adjusting for any confounding factors. RESULTS: In subjects of 70 years of age, a negative association was found between glycemic control and the WHO-5-J score, with the good control group showing a significantly lower score (ß: -0.468, p<0.01) in comparison to the poor control group. In detail, we observed a significant difference in the sub-items of WHO-5-J, question item 3, "I have felt active and vigorous" at 70 years of age (good control group, 2.56±1.37; poor control group, 3.21±1.18; p=0.021) and question item 5, "My daily life has been filled with things that interest me" (good control group, 2.44±1.21; poor control group, 3.11±1.11; p=0.009). As for the two questions, the WHO-5-J scores were lower in the good control group. These associations showed no statistical significance at 80 years of age or 90 years of age. CONCLUSION: The results obtained in this study indicated that strict glycemic control management of diabetes mellitus may lead to a lower mental QOL in younger elderly individuals (70 years of age). Therefore, it is important to pay attention to the mental burdens of the management of glycemic control in older people with DM.