Ono Takahiro, Hori Kazuhiro, Ikebe Kazunori, Nokubi Takashi, Nago Shotaro, Kumakura Isami
Department of Oromaxillofacial Regeneration, Osaka University Graduate School of Dentistry, Suita, Japan.
Gerodontology. 2003 Jul;20(1):24-31. doi: 10.1111/j.1741-2358.2003.00024.x.
This study was designed to determine the factors influencing eating ability of old in-patients in a rehabilitation hospital.
Cross-sectional investigation.
Forty-six in-patients in the rehabilitation ward of Hashimoto Hospital in Kagawa Prefecture in Japan were investigated using a multidisciplinary approach.
Age, gender, state of dentition, muscle activity of lip, cheek and tongue, biting force, salivary flow rate per a minute (SFR), masticatory ability for gummy jelly, swallowing ability, texture of meal, independency of walking (Functional Independence Measure = FIM) and ability to communicate.
Bivariate analysis for the relationship between surveyed items and masticatory ability (chi-square test) identified that better masticatory ability for gummy jelly was associated with age (< 85years), gender (male),state of dentition (dentate), SFR (high), activity of lip (good), biting force (high), swallowing ability (good) and activity of communication (high). Among these items, SFR (p = 0.001), gender (p = 0.004), ability to communicate (p = 0.005) and age (p = 0.012) were found having an influence on the masticatory ability (logistic regression analysis). On the other hand, age (< 85years), gender (male), SFR (high), activity of lip (good), activity of cheek (good), biting force (high), masticatory ability (good) and swallowing ability (good) had a relationship with normal texture of meal. In regression analysis, only two items, activity of lip (p = 0.003) and swallowing ability (p = 0.024) emerged as factors on texture of meal.
Masticatory ability for gummy jelly was influenced by cognitive function and was excluded from the factors on the state of meal. These results suggested the limitation of evaluation using test food, so dentists should observe eating behaviour of in-patients. In addition, dentists should pay attention to the activity of the lip and swallowing ability as well as dentition and prostheses in the rehabilitation of eating ability. As SFR was the most significant factor on masticatory ability, this emphasizes the necessity of care for dry mouth caused by side effects of multi-medication.
本研究旨在确定影响康复医院老年住院患者进食能力的因素。
横断面调查。
采用多学科方法对日本香川县桥本医院康复病房的46名住院患者进行了调查。
年龄、性别、牙列状况、唇、颊和舌的肌肉活动、咬合力、每分钟唾液流速（SFR）、咀嚼软糖的能力、吞咽能力、食物质地、行走独立性（功能独立性测量=FIM）和沟通能力。
对调查项目与咀嚼能力之间的关系进行双变量分析（卡方检验）发现，咀嚼软糖能力较好与年龄（<85岁）、性别（男性）、牙列状况（有牙）、SFR（高）、唇部活动（良好）、咬合力（高）、吞咽能力（良好）和沟通活动（高）有关。在这些项目中，发现SFR（p=0.001）、性别（p=0.004）、沟通能力（p=0.005）和年龄（p=0.012）对咀嚼能力有影响（逻辑回归分析）。另一方面，年龄（<85岁）、性别（男性）、SFR（高）、唇部活动（良好）、颊部活动（良好）、咬合力（高）、咀嚼能力（良好）和吞咽能力（良好）与正常食物质地有关。在回归分析中，只有唇部活动（p=0.003）和吞咽能力（p=0.024）这两个项目成为影响食物质地的因素。
咀嚼软糖的能力受认知功能影响，被排除在食物状态的影响因素之外。这些结果表明了使用测试食物进行评估的局限性，因此牙医应观察住院患者的进食行为。此外，在进食能力康复过程中，牙医应注意唇部活动、吞咽能力以及牙列和假牙。由于SFR是咀嚼能力的最重要因素，这强调了关注多种药物副作用引起的口干的必要性。
