Association between Mixing Ability of Masticatory Functions Measured Using Color-Changing Chewing Gum and Frailty among Japanese Older Adults: The Kyoto-Kameoka Study.

Yasuko Yoshinaka,Tsukasa Yoshida,Yuya Watanabe,Yosuke Yamada,Misaka Kimura,Keiichi Yokoyama,Kyoto-Kameoka Study Group Kyoto-Kameoka Study Group,Daiki Watanabe,Mitsuyoshi Yoshida,Takeshi Kikutani

doi:10.3390/ijerph17124555

Abstract

The relationship between mixing ability of masticatory functions and frailty has not been well evaluated. This study investigated the prevalence of physical and comprehensive frailty and its association with mixing ability in 1106 older adults aged ≥65 years who underwent physical examination as part of the Japanese Kyoto–Kameoka Study. Mixing ability was assessed using color-changing chewing gum (1–5 points, 5 representing the best mixing ability). Participants were divided into four groups (5 points, 4 points, 3 points, and 1 or 2 points). The modified Japanese versions of the Cardiovascular Health Study (mJ-CHS) criteria and the validated Kihon Checklist (KCL) were used to assess physical and comprehensive frailty, respectively. Multivariate logistic regression was used to evaluate the association between frailty and mixing ability. The prevalence of physical and comprehensive frailty was 11.8% and 27.9%, respectively. After adjusting for confounders, the odds ratios of physical and comprehensive frailty comparing the highest to the lowest chewing gum score groups were 3.64 (95% confidence interval (CI): 1.62 to 8.18; p for trend = 0.001) and 2.09 (95% CI: 1.09 to 4.03; p for trend = 0.009), respectively. Mixing-ability tests involving chewing gum may be an indicator associated with both physical and comprehensive frailty.

Highlights

Frailty is a condition in which multiple physiological systems decline in function owing to a loss of homeostasis in response to stress [1,2] and is considered a worldwide public health problem among older adults [3]
We evaluated physical frailty according to the mJ-CHS criteria, which are based on the J-CHS criteria with one question substituted for a question evaluating low activity: (I) Have you lost 2–3 kg or more in weight over the past 6 months without trying? If a participant responded “Yes” to this question, this was defined as “weight loss.” (II) Do you engage in sports, exercise, or keep-fit activities If a participant responded “No” to this question, this was defined as “low activity.”
We investigated the association between the mixing ability of masticatory functions and the prevalence of frailty in a population-based cohort of older adults

Summary

Introduction

Frailty is a condition in which multiple physiological systems decline in function owing to a loss of homeostasis in response to stress [1,2] and is considered a worldwide public health problem among older adults [3]. The Kihon Checklist (KCL) is considered a valid tool for assessment of comprehensive frailty as a multidimensional clinical geriatric syndrome and is widely used in Japan and other countries [4,8,9,10]. The prevalence of oral disease among older adults is high, and the number of people with poor masticatory functions increases with age [15]. A number of previous studies have reported that masticatory functions are positively associated with grip strength [20,21] and gait speed [20], indicating that it could be used to assess physical function in older adults

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