A comparison of colorimetric and visual methods for the assessment of masticatory performance with color-changeable chewing gum in older persons

Background/purpose Color-changeable chewing gum is used for the evaluation of masticatory performance. However, it is currently unclear whether colorimetric and visual assessment methods yield consistent results. This study aimed to clarify the consistency between colorimetric and visual methods used for the evaluation of color changes in color-changeable chewing gum. Materials and methods The sample comprised 644 older persons (mean age, 75.4 ± 6.4 years). The chewing gum was masticated 60 times at the participant's own chewing rate and then expectorated. The color of the chewing gum was evaluated with the ΔE values and a∗ values, measured using a colorimeter, and the 10 Color Shades (10CSh) and 5 Color Scales (5CSc), using visual evaluation. Spearman's correlation analysis was performed to examine the correlation between the results obtained by the four methods. The significance level was set at α = 0.05. Results The ΔE values, a∗ values, 10CSh scores, and 5CSc scores were all significantly correlated. The highest correlation coefficient (0.979) was between the ΔE values and a∗ values. The lowest correlation coefficient (0.847) was between the a∗ values and 5CSc scores. Decreased masticatory performance was observed with increased age. Conclusion Significant correlations were found for all four methods used in the assessment of masticatory performance with color-changeable chewing gum. While visually based assessments are valid, colorimetric methods are more sensitive to smaller changes in masticatory performance

Association between Dementia Severity and Oral Hygiene Management Issues in Older Adults with Alzheimer’s Disease: A Cross-Sectional Study

Oral hygiene management issues vary across types and clinical stages of dementia. We aimed to clarify the issues related to oral hygiene management in older adults with Alzheimer’s disease (AD) according to stages defined by the Functional Assessment Staging of Alzheimer’s Disease (FAST). In all, 397 records (45 men and 352 women; average age, 86.8 years; age range, 65–106) from older adults with AD were used for the cross-sectional study. We used data from a cohort of older adults (≥65 years old) who required long-term care and lived in the Omorimachi area of Yokote City, Akita Prefecture, Japan. Multilevel logistic regression analysis was conducted to examine the associations of the FAST stage, set as the exposure variable, with oral hygiene management parameters set as outcome variables. Compared to the reference category (combined FAST stage 1–3), FAST stages 6 and 7 had significantly higher odds ratios for refusal of oral health care, dependence in performing oral health care, and rinsing and gargling disability. FAST stages 4 and 7 were associated with dental plaque accumulation. Oral health care for older adults with AD should be planned appropriately according to dementia severity

The Mini Nutritional Assessment-Short Form as a predictor of nursing home mortality in Japan: A 30-month longitudinal study

Objectives: We examined whether the Mini Nutritional Assessment-Short Form (MNA (R)-SF) predicted mortality in 367 nursing home residents (82% women; mean age = 84.4 +/- 8.5 years) in Japan. Measurements: We examined participants' basic characteristics (sex, age, height, weight, and medical history), the Barthel index (BI), clinical dementia rating (CDR), and six items of the MNA (R)-SF. The association between the MNA (R)-SF and 30-month mortality was assessed using a Cox proportional regression analysis. Results: During the study, 157 (42.8%) participants died. MNA (R)-SF scores in the Survival group were significantly higher than in the Death group (9.4 +/- 2.1 vs. 8.4 +/- 2.3, respectively; p < .001). After adjusting for age, sex, history of aspiration pneumonia, BI, and CDR, MNA (R)-SF scores were significantly associated with 30-month mortality (hazard ratio: 0.89, 95% confidence interval: 0.82-0.97, p = .005). Conclusion: The MNA (R)-SF was an effective predictor of mortality among nursing home residents in Japan, even after adjusting for potential confounders. These results indicate that periodically evaluating nutritional status using the MNA (R)-SF, and nutritional interventions according to status, may result in maintenance and improvement of nutritional status, as well as lead to reduced mortality

Association between decrease in frequency of going out and oral function in older adults living in major urban areas

Aim To examine the association between a decrease in the frequency of going out and oral function in independent older adults living in the urban area of Tokyo. Methods The participants analyzed were 785 older adults from the "Takashimadaira Study" (344 men and 441 women, age 77.0 +/- 4.6 years). This study investigated the following items: decrease in frequency of going out; basic characteristics (sex, age); physical factors, such as oral function (difficulty chewing, difficulty swallowing, dry mouth); body pain; the Japan Science and Technology Agency Index of Competence; physical activities; psychological factors, such as the Geriatric Depression Scale-15 score; and social and environmental factors, such as the presence or absence of participation in organization activities. Results To investigate the factors associated with a decrease in frequency of going out, logistic regression analysis showed an association with age (OR 1.08, 95% CI 1.03-1.13), difficulty chewing (OR 2.41, 95% CI 1.52-3.83), dry mouth (OR 1.68, 95% CI 1.07-2.64), body pain (OR 1.78, 95% CI 1.14-2.78), Japan Science and Technology Agency Index of Competence scores (OR 0.91, 95% CI 0.84-0.99), physical activities (OR 0.99, 95% CI 0.98-1.00), Geriatric Depression Scale-15 scores (OR 1.13, 95% CI 1.05-1.21) and organization activities (OR 1.94, 95% CI 1.22-3.07). Covariance structural analyses showed that both "difficulty chewing" and "dry mouth" significantly affected "decrease in frequency of going out." In addition, decrease in frequency of going out was significantly affected by " Geriatric Depression Scale-15 scores" through oral function. Conclusions The relationship between oral function and decrease in frequency of going out was clarified, after the multifaceted factors were adjusted. Geriatr Gerontol Int 2019; center dot center dot: center dot center dot-center dot center dot

Validation of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate in community-dwelling older Japanese adults : The Otassha Study

Aim: To assess the validity of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate (oral diadochokinesis [oral-DDK]) as a gold standard index for articulatory oral motor skill in community-dwelling older Japanese adults.　Methods: This cross-sectional study included 607 Japanese adults (mean age = 73.9 years). A single-item self-report questionnaire for articulatory oral motor skill was developed. Study participants completed a 1-month-interval test-retest protocol to assess reliability of the questionnaire, and the protocol was tested by the kappa statistic. Oral-DDK with /ta/ (i.e., the number of repetitions of the monosyllable /ta/ per second) was measured during the on-site examination. Low oral-DDK performance was defined as <5.2 times/s in men and <5.4 times/s in women. Oral-DDK performance, oral functions other than articulatory oral motor skill, and physical frailty were compared in the groups with and without self-reported low articulatory oral motor skill as determined by the response to the questionnaire.　Results: Self-reported low articulatory oral motor skill was identified in 18.5% of the study population. The self-report questionnaire had good test-retest reliability, with a kappa statistic of 0.71. Self-reported low articulatory oral motor skill was significantly associated with a lower value of oral-DDK with /ta/ and a higher proportion of low oral-DDK performance, difficulties in chewing and swallowing, dry mouth, and physical frailty. Self-report had high specificity (83.1%) but low sensitivity (42.1%) for detecting low oral-DDK performance.　Conclusions: A single-item self-report questionnaire for articulatory oral motor skill had acceptable test-retest reliability and was associated with objectively measured articulatory oral motor skill

Rate of oral frailty and oral hypofunction in rural community-dwelling older Japanese individuals

Objective To clarify the rate of oral frailty and oral hypofunction in rural community-dwelling older adults in Japan. Background Recently, the oral function of Japanese older adults has been evaluated multilaterally based on two concepts: oral frailty and oral hypofunction. Oral frailty is defined as a decrease in the oral function accompanied by a decrease in mental and physical functions. Oral hypofunction is a disease where the oral function is comprehensively decreased. However, their rates have not yet been elucidated. Materials and methods Oral frailty and oral hypofunction were evaluated in 679 older adults from rural areas. To investigate the differences in occurrence rates due to the evaluation methods, one of the subordinate symptoms of oral hypofunction, the reduced occlusal force, was evaluated based on both the occlusal force (main method) and the number of teeth (alternative method). Results The rate of oral frailty was 22.3% in men and 22.7% in women. The rate of oral hypofunction was 39.0% in men and 46.9% in women. The overall rate of oral hypofunction was 43.6% when the reduced occlusal force of oral hypofunction was evaluated using the main method and 46.4% when evaluated using the alternative method. The proportion of participants with decreased occlusal force, the number of present teeth, oral diadochokinesis, tongue pressure and masticatory performance increased with age in both men and women. Conclusion Among rural community-dwelling older adults, the rate of oral frailty was 22.5% and that of oral hypofunction was 43.6%