Suzuki Ryo, Kikutani Takeshi, Yoshida Mitsuyoshi, Yamashita Yoshihisa, Hirayama Yoji
Department of General Medicine and Primary Care, Tokyo Medical University Hospital, Hiroshima, Japan.
Division of Rehabilitation for Speech and Swallowing Disorders, Nippon Dental University Tama Oral Rehabilitation Clinic, Hiroshima, Japan.
Geriatr Gerontol Int. 2015 Aug;15(8):1001-6. doi: 10.1111/ggi.12382. Epub 2014 Oct 10.
The present study examined the relationship between oral function, such as eating/swallowing, and life prognosis among a homebound elderly population, considering physical and mental function.
The participants were 511 homebound older adults aged 65 years or older living in four Japanese prefectures. Sex, age, activities of daily living (ADL), cognitive function, underlying disease, nutritional status as Mini-Nutritional Assessment-Short Form (MNA(®)-SF), swallowing function, dietary modification and occlusal status were examined at baseline. Participants were categorized into poor outcome (died or admitted to hospital or nursing home) and good outcome (still under home care) groups at 1-year follow up, and significant related baseline factors were analyzed. In addition, these groups were compared by the ADL subgroup divided into <60 (lower) and ≥60 (higher) by Barthel Index.
In total, 473 participants were followed up (poor outcome group 177 [37.4%], good outcome group 296 [62.6%]). Sex, age, ADL, MNA(®)-SF, swallowing function, dietary modification and occlusal support were significantly different between these groups. Logistic regression analysis showed that sex and MNA(®)-SF score were significantly related to prognosis in the lower ADL group, and sex, age, Charlson Comorbidity Index and occlusal support were significantly related in the higher ADL group.
ADL was strongly correlated with life prognosis in homebound older adults. Within the higher ADL participants, occlusal support was related to this outcome.
本研究探讨居家老年人群的进食/吞咽等口腔功能与生活预后之间的关系,并考虑身体和心理功能。
研究对象为居住在日本四个县的511名65岁及以上的居家老年人。在基线时检查性别、年龄、日常生活活动能力(ADL)、认知功能、基础疾病、采用微型营养评定简表(MNA(®)-SF)评估的营养状况、吞咽功能、饮食调整和咬合状况。在1年随访时,将参与者分为预后不良(死亡、入院或入住养老院)和预后良好(仍接受家庭护理)两组,并分析显著相关的基线因素。此外,通过Barthel指数将ADL亚组分为<60(较低)和≥60(较高)两组,对这两组进行比较。
共有473名参与者接受了随访(预后不良组177例[37.4%],预后良好组296例[62.6%])。两组之间的性别、年龄、ADL、MNA(®)-SF、吞咽功能、饮食调整和咬合支持存在显著差异。逻辑回归分析显示,在ADL较低的组中,性别和MNA(®)-SF评分与预后显著相关;在ADL较高的组中,性别、年龄、Charlson合并症指数和咬合支持与预后显著相关。
ADL与居家老年人的生活预后密切相关。在ADL较高的参与者中,咬合支持与这一结果相关。