Nakanishi N, Hino Y, Ida O, Fukuda H, Shinsho F, Tatara K
Department of Public Health, Osaka University Medical School, Suita-shi, Japan.
Community Dent Oral Epidemiol. 1999 Oct;27(5):366-71. doi: 10.1111/j.1600-0528.1999.tb02033.x.
To examine the relationship between the self-assessed masticatory disability and the health of community-residing older people.
Of 1473 randomly selected people aged 65 years and older living in Settsu, Osaka Prefecture, in October 1992, data on general health status, history of health management, psychosocial conditions, and dental conditions were obtained from 1405 people by interviews made during home visits. Follow-up for 54 months was completed for 1306 subjects (93.0%; 1072 living, 234 deceased).
Being over 75 years of age, having poor general health and poor dental status, not using dental health checks, not using general health checks, not participating in social activities, not feeling that life is worth living (no "ikigai"), and feeling anxious about the future were univariately and significantly associated with self-assessed masticatory disability. Logistic regression analyses indicated that being older than 75 years, having poor general health and poor dental status, not using dental health checks, and not participating in social activities were independently associated with self-assessed masticatory disability. The Cox proportional hazards model showed that being male, over 75 years of age, and in poor general health, as well as not using general health checks, and not participating in social activities were independently associated with mortality. Self-assessed masticatory disability was univariately and significantly related to mortality, but by itself was not a significant risk factor for mortality, because of the potential influence of other variables.
Certain health and psychosocial factors are closely associated with self-assessed masticatory disability among older people. Further investigations are needed to determine whether masticatory disability is a significant risk factor for mortality.
探讨自我评估的咀嚼功能障碍与社区老年人健康状况之间的关系。
1992年10月，在大阪府摄津市随机抽取1473名65岁及以上的老年人，通过家访访谈从1405人那里获取了关于总体健康状况、健康管理史、心理社会状况和牙齿状况的数据。对1306名受试者（93.0%；1072人健在，234人死亡）完成了为期54个月的随访。
75岁以上、总体健康状况差、牙齿状况差、未进行牙齿健康检查、未进行常规健康检查、未参加社交活动、感觉生活无意义（无“生趣”）以及对未来感到焦虑，在单因素分析中均与自我评估的咀嚼功能障碍显著相关。逻辑回归分析表明，75岁以上、总体健康状况差、牙齿状况差、未进行牙齿健康检查以及未参加社交活动与自我评估的咀嚼功能障碍独立相关。Cox比例风险模型显示，男性、75岁以上、总体健康状况差、未进行常规健康检查以及未参加社交活动与死亡率独立相关。自我评估的咀嚼功能障碍在单因素分析中与死亡率显著相关，但由于其他变量的潜在影响，其本身并不是死亡率的显著危险因素。
某些健康和心理社会因素与老年人自我评估的咀嚼功能障碍密切相关。需要进一步研究以确定咀嚼功能障碍是否是死亡率的显著危险因素。
