Abstract
Given that public transportation networks are often worse in rural areas than in urban areas, rural residents who do not drive can find it difficult to access health-promoting goods, services, and resources related to masticatory ability. Moreover, geographical location, assessed by elevation, could modify this association. The aim of this study was to test whether the association between access to transportation and masticatory ability varied by elevation. Data were collected from a cross-sectional study conducted in Mizuho and Iwami counties, Japan. Objective masticatory ability was evaluated using a test gummy jelly and elevation was estimated by the geographic information systems according to the participant’s address. After excluding subjects with missing data, 672 subjects (Mizuho = 401 and Iwami = 271) were analyzed. After adjustment for potential confounders, being a driver was not significantly associated with masticatory ability among elderly people living at low elevation (≤313 m) in Mizuho county. However, after the same adjustment, being a driver remained significantly associated with increased masticatory ability among elderly at high elevations. Similar findings were observed in Iwami county. Accessible transportation was significantly associated with increased mastication ability in elderly people living at high elevations, but not in those living at low elevations.
Highlights
Reduced masticatory disability in elderly people is a cause of reduced quality of life and increased cardiovascular mortality [1,2,3]
To the best of our knowledge, no study has examined the association between accessible transportation, i.e., driving status, and masticatory ability according to the elevation
Our results showed that accessible transportation was significantly associated with masticatory ability in elderly residents of high-elevation areas, but not elderly residents of low-elevation areas
Summary
Reduced masticatory disability in elderly people is a cause of reduced quality of life and increased cardiovascular mortality [1,2,3]. It is important to note that the availability of accessible transportation could be considered as a potential risk factor for masticatory disability in rural areas [7]. We hypothesized that elderly people who do not drive have a lower masticatory ability than those who are drivers. Geographical location, as measured in terms of elevation, could modify the association between access to transportation, i.e., drivers or not and masticatory ability. To the best of our knowledge, previous studies have not investigated the hypothesized associations between masticatory ability, access to transportation, and elevation among elderly residents of rural areas. The aim of this study was to test whether the association between access to transportation and masticatory ability varied by elevation. Masticatory ability was evaluated using a test gummy jelly and access to transportation was assessed in terms of driving status
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