Self-assessed Chewing Ability Research Articles

Mortality- and Health-Related Factors in a Community-Dwelling of Oldest-Older Adults at the Age of 90: A 10-Year Follow-Up Study

Mortality is obviously intended for epidemiological studies of community-dwelling older adults. There are several health-related factors associated with nutritional status and mortality. The aim of this study was to elucidate the risk factor for mortality in community-dwelling oldest-older adults at the age of 90 and clarify the structure of health-related factors associated with mortality. A 10-year follow-up study was performed for 93 subjects at the age of 90. The mean and median of their survival days were 2373 and 2581 days for women, and 1694 and 1793 days for men. By Cox’s proportional hazards model, health-related factors associated with mortality were self-assessed for chewing ability, activities of daily living (ADLs), serum albumin, total cholesterol, serum creatinine, and gripping power for women but not for men. These factors interacted with each other, and the association of these factors was different in women and men. Self-assessed chewing ability was a powerful risk factor for mortality in women at the age of 90. It acted independently from nutritional status. For older adults, addressing healthy food choices together with improved oral functions is useful. However, risk factors for mortality may depend on the life stage of subjects. To investigate the risk factor for the mortality, the life course approach is necessary.

Impact of the Serum Level of Albumin and Self-Assessed Chewing Ability on Mortality, QOL, and ADLs for Community-Dwelling Older Adults at the Age of 85: A 15 Year Follow up Study.

Quality of life (QOL) and mortality are true endpoints of epidemiological or medical research, especially for community-dwelling older adults. Nutritional status and activities of daily living (ADLs) are associated with QOL and mortality. Good oral health status supports a good nutritional status. The aim of this study was to elucidate the complex structure of these important health-related factors. We surveyed 354 healthy older adults at the age of 85. Nutritional status was evaluated by the serum level of albumin. QOL, ADLs, self-assessed chewing ability, serum albumin level, and mortality during the 15 year follow up period were analyzed. Self-assessed chewing ability was associated with QOL and ADLs. Self-assessed chewing ability for slight-hard foods was associated with mortality in men. However, it was not associated with the serum albumin level. The serum albumin level was associated with mortality in women. These results indicate that maintaining good oral function is not enough. Nutritional instruction in accordance with oral function is indispensable for health promotion in older adults. When planning health promotion strategies for older adults, different strategies are needed for men and women.

Effects of self-assessed chewing ability, tooth loss and serum albumin on mortality in 80-year-old individuals: a 20-year follow-up study

BackgroundThe association between dental status and mortality in community-dwelling older adults has been documented by several studies. The aim of this study was to analyze the contribution of self-assessed chewing ability, number of remaining teeth and serum albumin levels to mortality and the interactions between the three factors.MethodsA 20-year follow-up study was conducted with 666 subjects aged 80 years (from 1996 to 2017) who resided in the 8 areas served by one health center in Iwate Prefecture. Health check-ups including physical fitness measurements were conducted at a meeting place or gymnasium. Medical interview and blood sampling were conducted by physician. Oral examination was examined by dentist. The number of remaining teeth, serum albumin levels, and self-assessed chewing ability were used as predictors of mortality.ResultsAmong the 608 subjects (233 men and 375 women) included in this study, only 12 subjects (1.97%) survived after 20 years of follow-up. For men, dental status and serum levels of albumin were significantly associated with mortality. The hazard ratios of self-assessed chewing ability calculated by item response theory analysis and the inability to chew at least one food adjusted for serum albumin and tooth conditions were statistically significant in men. When adjusted by health status evaluated by blood tests, self-assessed chewing ability was statistically significant in men. According to path analysis, self-assessed chewing ability and serum albumin independently affected mortality in men.ConclusionMasticatory dysfunction may be an important risk factor for mortality in men, even though it was self-assessed. Retaining chewing ability might be a useful predictor of longevity in older male adults.

Dental status and self‐assessed chewing ability in 70‐ and 80‐year‐old subjects in Sweden

The objective was to compare two cohorts of elderly people, 70 and 80 years old, with respect to dental status and self-assessed chewing ability. The hypotheses were as follows: (i) dental status is associated with self-assessed chewing ability; (ii) chewing ability is poorer among the 80- than the 70-year-old subjects. Identical questionnaires were in 2012 sent to all subjects born in 1942 and 1932, living in two Swedish counties. The response rate was 70.1% resulting in samples of 5697 70- and 2922 80-year-old subjects. Answers to questions on self-assessed chewing ability, dental status and some other factors have been analysed. Dental status varied but was in general good; 72% of the 70- and 60% of the 80-year-old subjects reported that they had all or only few missing teeth. Rate of edentulism was 3% and 7%, respectively. Removable partial dentures were reported by 6% and 10%, respectively, implant treatment by 13% in both cohorts. Self-assessed chewing ability was mostly good and correlated with the number of teeth (Spearman rho = 0.46). A majority of the edentulous subjects assessed their chewing ability as very or fairly good. Logistic regression showed that self-assessed chewing ability was significantly associated with a number of dental variables but also with general health. In conclusion, dental status was relatively good at both ages but somewhat poorer in the older cohort. Dental status, some other dental variables and being healthy were in both age groups significantly associated with self-assessed chewing ability.

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.

Dental state, prosthodontic treatment and chewing ability – a study of five cohorts of 70‐year‐old subjects

The aim was to study the relationship between dental state, prosthetic rehabilitation and chewing ability in 70-year-old subjects examined between 1971 and 2001. Five birth cohorts born in 1901/1902 (I), 1906/1907 (II), 1911/1912(III), 1922 (V), and 1930 (VI) were examined at 70 years of age. The number of participants in the odontological cohorts varied between 386 and 583. The prevalence of total edentulism changed from 51% in cohort I to 7% in cohort VI. The proportion of subjects using removable dentures decreased from 76% to 17%, whereas those with >or=20 teeth increased from 13% to 65%. The prevalence of subjects with fixed partial dentures increased from 26% to 58%. Of the 70-year-old subjects examined in 2001, 5% had implant-supported restorations. The self-assessed chewing ability showed only weak associations with dental state, and there was no significant cohort trend. When all cohorts were pooled together, 80% considered their chewing ability good, 16% less good and 4% poor. Among the edentulous subjects, more individuals complained about poor chewing ability in the last two cohorts than in the first three. It was concluded that there were great differences in dental state between the five cohorts of 70-year-old subjects examined from 1971 to 2001. Edentulism and wearing of removable dentures decreased substantially, whereas the proportion of subjects with fixed partial dentures showed a marked increase. In spite of the improved dental state, the self-assessed chewing ability exhibited only minor variation over time.

Relationship between chewing ability and 4‐year mortality in a cohort of 80‐year‐old Japanese people

Poor oral health has been reported to be a risk indicator of mortality, however, few data are available regarding the relationship between chewing ability and mortality. We examined the relationship between self-assessed chewing ability and mortality in elderly subjects. Prospective study. Participating in the study were 697 people (277 males, 420 females) from 1282 individuals (80 years old) residing in Fukuoka Prefecture, Japan. Data on oral and systemic health status through questionnaires, accompanied by physical and laboratory blood examinations were obtained. Chewing ability was assessed based on the number of types of food each subject reported as able to chew by questionnaire. A total of 108 subjects died between 1998 and 2002. Those with the lowest number of chewable foods were associated with higher risk of mortality than those with the ability to chew all of the 15 types of food surveyed [hazard ratio (HR) = 2.38, 95% confidence interval (95% CI) = 1.07-5.29], though other parameters including current smoking, low serum albumin, and poor physical health status were more significant. Further, reduced chewing ability of soft foods increased the risk (HR = 2.65, 95% CI = 1.20-5.87). Chewing ability was associated with mortality in a population of 80-year-old community residents, and may be a predictor for survival rate.

Chewing ability and quality of life in an 80‐year‐old population

As quality of life (QOL) could be influenced by oral status in the elderly, we examined whether chewing ability or number of teeth affected QOL in 80-year olds. A cross-sectional survey included dental examination, chewing self-assessment, and a QOL questionnaire. A total of 823 people who were 80 years old participated in this study. QOL was assessed in terms of satisfaction with physical condition, meals, daily living and social interactions, and with face-scale scores. After adjustment for gender, spouse and activities of daily living, dissatisfaction with social interactions was 3.9 times more prevalent in individuals able to chew four foods or fewer than in those chewing 15. Dissatisfaction with physical condition, meals and daily living, and poor face-scale scores, were 2.7, 2.4, 3.4, and 2.4 times more prevalent, respectively, in subjects chewing four foods or fewer. The number of teeth showed little effect. In conclusion, self-assessed chewing ability but not number of teeth was associated with QOL in 80-year-old subjects.

Association of salivary flow rate with oral function in a sample of community-dwelling older adults in Japan

The purpose of this study was to determine the association of stimulated salivary flow rate with perceived salivary flow and various oral symptoms among a group of independently living elderly persons. The subjects were 351 persons (189 men and 162 women) with a mean age of 66.7 +/- 4.3 years. Stimulated whole saliva was collected with the mastication method. Self-assessed chewing ability and satisfaction with oral function also were evaluated. A multiple logistic regression analysis was used to determine whether an independent variable was statistically significant. Hyposalivation (< 0.5 mL/min) was significantly associated with gender (odds ratio, 1.67; P < .05). Hyposalivation (odds ratio, 3.40; P <.05) and low perceived salivary flow (odds ratio, 5.35; P <.05) were significantly associated with dissatisfaction with tasting. Low perceived salivary flow was also significantly associated with self-assessed chewing ability (odds ratio, 3.32; P <.01). This study suggested that hyposalivation and low perceived salivary flow were related to chewing ability and satisfaction with tasting foods.

Perception of dry mouth in a sample of community-dwelling older adults in Japan.

The purpose of this study was to examine the prevalence of perceived dry mouth among a group of independently-living elderly persons in Japan, and to determine its association with general disease, medication, and dental status, as well as its effect on oral function. The study population consisted of participants of the Senior Citizens' College. The subjective sensations of oral dryness on waking and while eating a meal were measured by a questionnaire. The number of usable questionnaires was 1003 or 77.9%. The mean age of the subjects was 66.3 +/- 4.2 years, and 53.0% were male. More than one-third (37.8%) of the subjects reported oral dryness on waking. Only 9.1% of them noticed a subjective feeling of dry mouth during eating. Persons who had at least one of these symptoms made up 41.0%. A multiple stepwise logistic regression analysis indicated the following results: Perception of dry mouth on waking was more frequent among males (p < 0.001), persons who had a low BMI (p < 0.05), and those taking two or more prescribed drugs (p < 0.01). Sensation of dry mouth when eating was more frequent among subjects with a low BMI (p < 0.001) and those who wore a denture in the maxillary arch (p < 0.05). Perception of dry mouth when eating was associated with self-assessed chewing ability (p < 0.01) and dissatisfaction with speaking clearly (p < 0.05), as well as dental status. However, dissatisfaction with tasting a meal had a significant relationship with the reports of mouth dryness on waking (p < 0.01). Our findings suggest that a substantially higher percentage of persons have the perception of dry mouth on waking than when eating, which was associated with medications, being male, and having a low BMI. This perception may influence oral function, especially the reported dissatisfaction with tasting foods.