A prospective cohort study on factors related to dental care and continuation of care for older adults receiving home medical care.

Information on the effects of dental treatment must be identified and factors that hinder the continuation of dental treatment must be identified to provide appropriate domiciliary dental care (DDC). This study aimed to clarify the treatment outcomes of DDC for older adults and the factors that impede the continuation of such care. This prospective study was conducted at a Japanese clinic specializing in dental care for older adults. The functional status, nutritional status, oral assessment, details of the dental treatment, and outcomes after 6 months of older adults receiving DDC were surveyed. The Oral Health Assessment Tool (OHAT) was used for oral assessment. Cox proportional hazards analysis was used to analyze the factors at the first visit that were associated with treatment continuation. A total of 72 participants (mean age, 85.8 ± 6.9) were included. Twenty-three participants (31.9%) could not continue treatment after 6 months. The most frequently performed procedures were oral care and dysphagia rehabilitation, followed by prosthetic treatment, then tooth extraction. The percentage of participants with teeth that required extraction after 6 months and the total OHAT score decreased significantly. The Barthel Index, Mini Nutritional Assessment Short-Form, and rinsing ability were significantly associated with treatment continuation. Furthermore, instrumental activities of daily living (ADL) and the OHAT "tongue" sub-item were correlated with treatment continuation. In conclusion, DDC improved the oral health status of older adults after 6 months. Factors that impeded treatment continuation were decreased ADL, decreased nutritional status, difficulty in rinsing, and changes in the tongue such as tongue coating.

Problems experienced when swallowing solid oral dosage forms in older Japanese patients with dysphagia: A cross-sectional study.

AIMS: We aimed to assess the difficulty in taking solid oral dosage forms (SODFs) among older people with dysphagia and clarify the relationship between difficulty in swallowing SODFs and swallowing function. METHODS AND RESULTS: Outpatients from a dysphagia clinic aged ≥65 years were asked yes-or-no questions about the applicability of eight items regarding difficulty in taking SODFs. Additionally, a videofluorographic swallowing study (VFSS) was performed to assess their swallowing function. The Kruskal-Wallis test and Spearman's rank correlation coefficient were used to analyze the relationship between difficulty in taking SODFs and swallowing function. RESULTS: Among the 93 participants, the average number of SODFs consumed was 5.8 ± 3.1. In the questionnaire, the average number of "yes" answers was 2.2 ± 2.2, and 65 patients (71.0%) answered "yes" to at least one question. Additionally, no significant relationship was observed between the perceived difficulty in swallowing SODFs and VFSS findings. CONCLUSION: Approximately 70% of participants reported subjective difficulty in taking SODFs, showing that patients uniformly reported perceived difficulty in taking SODFs regardless of actual swallowing function. The results of this study suggest that patients must be questioned thoroughly about their SODFs use, regardless of the objective severity of their dysphagia.

Experimental study on the pressure and pulse wave propagation in viscoelastic vessel tubes-effects of liquid viscosity and tube stiffness.

A pulse wave is the displacement wave which arises because of ejection of blood from the heart and reflection at vascular bed and distal point. The investigation of pressure waves leads to understanding the propagation characteristics of a pulse wave. To investigate the pulse wave behavior, an experimental study was performed using an artificial polymer tube and viscous liquid. A polyurethane tube and glycerin solution were used to simulate a blood vessel and blood, respectively. In the case of the 40 wt% glycerin solution, which corresponds to the viscosity of ordinary blood, the attenuation coefficient of a pressure wave in the tube decreased from 4.3 to 1.6 dB/m because of the tube stiffness (Young's modulus: 60 to 200 kPa). When the viscosity of liquid increased from approximately 4 to 10 mPa·s (the range of human blood viscosity) in the stiff tube, the attenuation coefficient of the pressure wave changed from 1.6 to 3.2 dB/m. The hardening of the blood vessel caused by aging and the increase of blood viscosity caused by illness possibly have opposite effects on the intravascular pressure wave. The effect of the viscosity of a liquid on the amplitude of a pressure wave was then considered using a phantom simulating human blood vessels. As a result, in the typical range of blood viscosity, the amplitude ratio of the waves obtained by the experiments with water and glycerin solution became 1:0.83. In comparison with clinical data, this value is much smaller than that seen from blood vessel hardening. Thus, it can be concluded that the blood viscosity seldom affects the attenuation of a pulse wave.