Good Chewing Ability Research Articles

Modifiable Factors Associated with Mortality among the Oldest Old with Cognitive Impairment: A Longitudinal Study in China

AbstractBackgroundThe oldest old (aged above 80 years) have the highest death rate, and CI (Cognitive Impairment) significantly increases risk of mortality. Studies investigating mortality associated with dementia mostly identified non‐modifiable factors, providing limited practical implications. This study aims to investigating factors associated with mortality among the oldest old with dementia, with particular focus on modifiable factors.MethodOur study included 6,997 older adults aged 80 years above who were diagnosed with CI. Data were from the Chinese Longitudinal Healthy Longevity Study (CLHLS). CI was measured by the Mini‐mental State Examination (MMSE). Cox proportional hazard regression combined with Least Absolute Shrinkage and Selection Operator (LASSO) was applied to select factors and evaluate their association with mortality of the oldest adults with CI.ResultOf the 6,997 participants, 6,451 died with median survival time of 2.2 years. 21 out of the 56 variables were selected from the LASSO‐penalized Cox regression model. Consistent with previous studies, the hazard of mortality increases by 19% with every incremental 10 years of age (95% CI: 12‐27%). The hazard of morality among women was 23% lower than that of men (95% CI: 18%‐29%). History of diabetes also increases the hazard of mortality. In terms of modifiable factors, daily outdoor activities, daily watching TV or listening to the radio, being married, good chewing ability are associated with lower mortality, while smoking and high systolic blood pressure increases the risk of mortality in a dose‐response manner.ConclusionSeveral modifiable factors are associated with mortality among the oldest adults with CI. Analysis suggests that healthy diet, cognitive stimulating leisure activities, marriage, and good chewing ability may contribute to lowering the risk of mortality among this population.

Evaluation by electronic tongue and headspace-GC-IMS analyses of the flavor compounds in dry-cured pork with different salt content

Traditional dry-cured pork, a meat product with a unique flavor and good chewability, occupies an important place in the Chinese market. However, the salt content of dry-cured pork is on the high side and long-term consumption of high-salt meat products is not good for human health. This study determined the role of salt in volatile organic substances and non-volatile taste components of dry-cured pork. Dry-cured pork samples with different salt content (0%, 1%, 3%, 5%, and 7%) were analyzed by electronic tongue for moisture content, pH, salt (NaCl) value, taste activity value, free amino acids, and taste components and by headspace-gas chromatography-ion mobility spectrometry for volatile organic components. The results showed that the moisture content of the tested samples decreased while the salt content increased. The highest amounts of free amino acids were found in dry-cured pork with 3% salt content (P < 0.05). The highest peak area of volatile organic compounds and the maximal taste indexes were found in dry-cured pork with 3% and 5% salt content.

Optimization of The Fermentation Process of Kimchi

This paper focuses on the effects of salt, sugar and temperature on the sensory evaluation of the product. The fermentation process is optimized by single factor experiment and orthogonal experiment. The results showed that salt, sugar and temperature had significant effects on the sensory score of naturally fermented kimchi. The optimum process parameters were: 3% of salt, 2% sugar, 30 °C fermentation temperature and 4 days fermentation time. The kimchi produced by this formula and process has the highest sensory score of 89.0 points. Under the best formula, kimchi has a strong aroma, moderate sweet and sour taste, and has the unique aroma of pickled kimchi. It has a rich aftertaste, good chewability and no roughness.

Association between number of pairs of opposing posterior teeth, metabolic syndrome, and obesity.

We investigated the relationship between the number of pairs of posterior teeth and metabolic syndrome (MetS), abdominal obesity (AO), and obesity, among Japanese adults. In 2005, 2,807 Japanese adults aged 25-74years participated in the Survey of Dental Diseases and the National Health and Nutrition Survey. Based on the survey data, BMI, AO (JAS) determined by the Japan Atherosclerosis Society, AO (IDF) by the International Diabetes Federation, and MetS were assessed. Total functional tooth units (t-FTUs) were scored with pairs of opposing posterior teeth, including artificial teeth. Subjects were divided into three categories of chewing ability based on the score of t-FTUs: Poor (if score ≤ 9), Good (if score = 10-11), and Complete (if score = 12). The relationships between chewing ability and BMI ≥ 25, BMI ≥ 30, AO (JAS), AO (IDF), and MetS were tested using univariate and multivariate logistic regression analysis. The chewing ability was significantly associated with MetS, AO, and obesity in the univariate and multivariate logistic regression analysis. Adjusted OR of "Poor" compared to "Complete" were 1.51 (95% confidence interval (CI), 1.24-1.84) for BMI ≥ 25, 2.10 (95% CI 1.40-3.14) for BMI ≥ 30, 1.31 (95% CI 1.07-1.61) for AO (JAS), 1.40 (95% CI 1.15-1.70) for AO (IDF), and 1.34 (95% CI 1.04-1.72) for MetS. All were statistically significant. Preventing tooth loss and maintaining pairs of good chewing ability may be important factors in preventing MetS, AO, and obesity.

Self-Assessed Kyphosis and Chewing Disorders Predict Disability and Mortality in Community-Dwelling Older Adults

ObjectiveIt is clear that each trend of kyphosis with increased age and the ability to eat firm foods with the back teeth (chewing ability) has a strong influence on both the physical and mental condition of older people. Thus, this study aimed to examine whether the combination of kyphosis and chewing disorders was associated with mortality or the need for care under the new long-term care insurance (LTCI) service requirement, over 3 years in community-dwelling older Japanese adults. DesignA prospective cohort study. Setting and ParticipantsWe analyzed the cohort data for older adults (65 years or older) from a prospective study in Kami town. The response rate was 94.3%, and we followed 5094 older individuals for 3 years. Thus, we analyzed 5083 older adults using multiple imputation to manage missing data. OutcomeThe outcomes were mortality or new certifications for LTCI services in a 3-year period. MeasurementsWe developed 3 groups by asking 2 self-reported questions on both “no kyphosis” and “good chewing ability.” The groups were no kyphosis and good chewing ability (GG), kyphosis and poor chewing ability (BB), and kyphosis and good chewing ability or no kyphosis and poor chewing ability (GB/BG). ResultsThe prevalence of BB, BG/GB, and GG were 8.9%, 40.3%, and 50.8%, respectively, in our survey. During the 3-year follow-up period, 5.2% (n = 262) died and 13.9% (n = 708) individuals were newly certified as needing LTCI services. As determined by multivariate analyses, BG/GB older adults (adjusted hazard ratio: 1.3 [95% CI 1.1–1.6]) and BB older adults (adjusted hazard ratio: 2.0 [95% CI 1.5–2.4]) had a significantly higher risk of needing LTCI services than GG older adults. Similarly, BG/GB older adults (adjusted hazard ratio: 1.5 [95% CI 1.1–2.0]) and BB older adults (adjusted hazard ratio: 2.3 [95% CI 1.5–3.3]) had a significantly higher risk of mortality than GG older adults did. ConclusionThe presence of kyphosis or poor chewing ability was related to mortality and new certifications for LTCI services, and we found an additive effect of these 2 factors related to frailty.

Implant Tooth‐Supported Removable Partial Denture with at Least 15‐Year Long‐Term Follow‐Up

The aim of the present report is to describe the long-term follow-up of cases treated with implant tooth-supported removable partial denture (ITSRPD) after at least 15 years. The study sample comprised 20 consecutively partially edentulous patients treated with ITSRPD. Implants were placed in order to improve unfavorable removable partial denture design resulting from unfavorable teeth distribution and biomechanical considerations, esthetic, or periodontal challenges. All patients were followed up every 6 months for the first 2 years and annually thereafter for at least 15 years. Recall visits for professional cleaning and oral hygiene re-enforcement were scheduled every 3 to 6 mounts. A total of 42 implants were placed in 20 patients and restored with ITSRPD. All implants and prosthetic devices functioned successfully throughout the 15 years of follow-up. Three patients had gone through further implant placement several years after ITSRPD was provided, and a fixed implant-supported restoration was provided on the original and new implants. No implant failure was noted during follow-up, resulting in a rate for implant survival of 100% for the study. Marginal bone loss around implants ranged between 0 and 2 mm (mean 0.64 ± 0.6 mm). During the follow-up period, prosthetic complications were minor and included one rest rupture. All patients answered a questionnaire and were satisfied with the prosthesis. They reported good chewing ability and stability of the prosthetic devices. ITSRPD can be used with predictable long-term results in carefully selected and well-maintained population. Patients should be advised of their role in maintenance, and a comprehensive recall system is mandatory to obtain satisfactory long-term results.

Chewability testing in the development of a chewable tablet for hyperphosphatemia

The official Pharmacopeia does not include a test procedure for the in vitro estimation of the chewability of tablets and publications in the scientific literature on this subject are rare. The purpose of this study was to evaluate a number of different test procedures for assessing chewability, starting from standard breaking force and strength testing and progressing to develop new procedures that simulate the actual chewing action on tablets. A further goal was to apply these test procedures to characterize the chewability of the novel phosphate binder PA21 in comparison with a commercially available phosphate binder chewable tablet product based on lanthanum (Fosrenol®) and a chewable tablet product containing calcium (Calcimagon®) – the latter being used as a standard for its very good chewability. For this purpose, a number of development formulations (different batches of PA21) were tested. The radial or diametrical tablet breaking force offers a poor means of assessing chewability while the axial breaking force was concluded to better reflect the effect of chewing on the tablet. Measurement of tablet behavior upon repeated loading afforded the best simulation of the actual chewing action and was found to have a good discriminating power with respect to chewability of the tested tablets, especially when the tablet was moistened with artificial saliva. The developed tests are shown to be more suitable for evaluating chewing properties of tablets than currently used Pharmacopeial tests. Following ICHQ6, which calls for specification of hardness for chewable tablets, these test procedures enabled the optimal chewability features of PA21 tablets in development to be confirmed whilst still maintaining capabilities for robust production and transportation processes.

Poor Chewing Ability Is Associated with Lower Mucosal Moisture in Elderly Individuals

Oral dryness is common among aging individuals and its objective evaluation is an important issue for improving their oral health. In the present study, we measured the objective mucosal moisture in elderly individuals with a moisture checker and evaluated its relation with laboratory findings and subjective oral status. The subjects were 502 adults (244 men and 258 women), with a mean age of 72.3 +/- 6.7 years, who participated in a regular medical screening program in Nagasaki Prefecture, Japan. We evaluated the moisture of the oral mucosa by measuring the weight percentage of water content in the oral epithelium, subjective oral dryness, self-assessed chewing ability ["good" ("able to chew all foods") or "poor" ("able to chew soft foods only" and "unable to chew any foods")], and laboratory findings. The values obtained with a moisture checker, which represent objective oral mucosal moisture, were significantly lower in women with poor chewing ability than those with good chewing ability (28.2 +/- 2.4% vs. 29.2 +/- 2.0%, p = 0.004) and in all subjects (28.4 +/- 2.4% vs. 29.1 +/- 2.0%, p = 0.004), but not in men (28.6 +/- 2.5% vs. 29.0 +/- 2.0%, p = 0.27). When multiple logistic regression analysis was performed on confounding factors, older age (OR: 1.24, p = 0.015), women (OR: 1.70, p = 0.016), and anemia (OR: 1.96, p = 0.030) were significantly associated with self-assessed chewing ability. Our current study indicates that poor chewing ability is associated with lower mucosal moisture in elderly individuals.

Factors associated with good self-rated health of non-disabled elderly living alone in Japan: a cross-sectional study.

BackgroundSelf-rated health (SRH) is reported as a reliable predictor of disability and mortality in the aged population and has been studied worldwide to enhance the quality of life of the elderly. Nowadays, the elderly living alone, a particular population at great risk of suffering physical and mental health problems, is increasing rapidly in Japan and could potentially make up the majority of the aged population. However, few data are available pertaining to SRH of this population. Given the fact that sufficient healthcare is provided to the disabled elderly whereas there is little support for non-disabled elderly, we designed this population-based survey to investigate SRH of non-disabled elderly living alone and to identify the factors associated with good SRH with the purpose of aiding health promotion for the elderly.MethodsA cross-sectional study was conducted in a metropolitan suburb in Japan. Questionnaires pertaining to SRH and physical conditions, lifestyle factors, psychological status, and social activities, were distributed in October 2005 to individuals aged ≥ 65 years and living alone. Response rate was 75.1%. Among these respondents, a total of 600 male and 2587 female respondents were identified as non-disabled elderly living alone and became our subjects. Multivariate logistic regression was used to identify the factors associated with good SRH and sex-specific effect was tested by stepwise logistic regression.ResultsGood SRH was reported by 69.8% of men and 73.8% of women. Multivariate logistic regression analysis showed that good SRH correlated with, in odds ratio sequence, "can go out alone to distant places", no depression, no weight loss, absence of self-rated chronic disease, good chewing ability, and good visual ability in men; whereas with "can go out alone to distant places", absence of self-rated chronic disease, no weight loss, no depression, no risk of falling, independent IADL, good chewing ability, good visual ability, and social integration (attend) in women.ConclusionFor the non-disabled elderly living alone, sex-appropriate support should be considered by health promotion systems from the view point of SRH. Overall, the ability to go out alone to distant places is crucial to SRH of both men and women.

Life-quality indicators in elderly people are influenced by selenium status

Selenium is of fundamental importance to human health. Our aim was to evaluate the effect of selenium (intake and serum levels) on subjective indicators of quality of life in older people, such as self-perceived health, chewing ability and physical activity. The sample was a cohort of 227 elderly people (93 men and 134 women) residing in 14 nursing homes in Asturias (Spain). Mean age +/- SD was 72.9+/-7.2 y and 76.4+/-5.9 y, for men and women respectively. Information was collected in personal interviews. Dietary intake was recorded by means of a food-frequency questionnaire. Selenium was determined in serum by graphite-furnace atomic absorption spectrometry. Serum selenium was associated with self-perceived health, chewing ability and physical activity in this sample. Subjects in the upper tertile of serum selenium had more than twice as much probability (Odds Ratios, 2.05 to 3.157) of reporting good health status, good chewing ability and of doing more than 60 min of exercise/day. The maintenance of good serum selenium levels is important, since it may affect the self-perception of health, chewing ability, or physical activity and, consequently, the quality of life in elderly people.

Predictors for the onset of functional decline among initially non‐disabled older people living in a community during a 6‐year follow‐up

Background: Predictors for functional decline in basic activities of daily living (BADL) among older people have been extensively studied. However, relatively little is known about predictors for decline in instrumental activities of daily living (IADL).Objectives: To identify predictors for functional decline in IADL as well as predictors for decline in BADL among initially non‐disabled older people living in a community by a longitudinal epidemiological study.Methods: Out of 748 older persons aged 65 years and over who participated in the interview survey and medical examination at baseline in 1992, 601 persons were identified as being independent in both BADL and IADL, and were followed‐up yearly for 6 years until 1998. Outcome events were the onset of IADL disability prior to the onset of BADL disability as well as the onset of BADL disability. A wide range of variables obtained in the baseline survey was entered into the model predicting functional decline in BADL and IADL during the follow‐up period.Results: Common predictors for BADL and IADL disability included: (1) advanced age; (2) lower levels in performance‐based measures; (3) a history of hospitalization in the past year; and (4) poor chewing ability. Longer sleep‐hours, poor intellectual activities, and poor self‐rated health were identified as significant predictors for only IADL disability. Not having an occupation, a history of heart disease, and higher blood β2‐microglobulin level were identified as a significant predictors of BADL disability.Conclusions: Good intellectual activities, good self‐rated health, good chewing ability, and good physical performance are closely associated with remaining independent in IADL for non‐disabled older people. Significance of blood β2‐microglobulin in predicting the onset of functional decline merits further study.

地域老人におけるそしゃく能力の健康状態への影響

The purpose of the present study is to explore relationship of chewing ability to physical health status in the elderly. Subjects were 722 community elderly adults aged 65 years and over (participation rate 88.6%). They were divided into 2 groups according to chewing ability as rated by a questionnaire: good and bad. Results obtained were as follows; 1. Those who had good ability of chewing accounted for 86% of the subjects. The chewing ability was determined by dental status. Those with more natural teeth were better able to chew. 2. Multiple regression analyses controlled by age and sex showed that good chewing ability had significantly positive effect on weight, body mass and length of time for standing on one leg with eyes open.