Evaluation of chewing ability and its relationship with activities of daily living, depression, cognitive status and food intake in the community‐dwelling elderly

Abstract

The aim of this study was to assess chewing ability using color-changeable chewing gum and to show the association between chewing ability and geriatric functions, as well as dietary status in the community-dwelling elderly. The study population consisted of 269 community-dwelling elderly aged ≥ 75 living in Tosa, Japan. Assessment of chewing ability was carried out by a dentist using color-changeable chewing gum. Activities of daily living (ADL), depression and subjective quality of life (QOL) were assessed by questionnaire. Cognitive status was assessed by; Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale-Revised (HDS-R) and Frontal Assessment Battery (FAB) during the check-up. Food diversity was assessed using the 11-item Food Diversity Score Kyoto (FDSK-11). Number of teeth was significantly related to chewing ability (P<0.001). The participants with low chewing ability had significantly lower ADL scores in the items of self-maintenance (P=0.029) and intellectual activity (P=0.021). There was a significant association between low chewing ability and depression (P<0.001). Lower cognitive functions were significantly related to low chewing ability; MMSE (P=0.022), HDSR (P=0.017) and FAB (P=0.002). The participants with low chewing ability had lower food variety (P<0.001), and less frequent intake of beans, vegetables, seaweed and nuts, than the participants with high chewing ability. Low chewing ability evaluated by color-changeable gum was associated with lower ADL, lower cognitive functioning, depression and food insufficiency in the community-dwelling elderly. More attention should be paid to assessing chewing ability of elderly persons in community settings.