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社区居住的独立老年人群中牙齿缺失与吞咽问题发生的关联:藤原京研究

Association of Tooth Loss With Development of Swallowing Problems in Community-Dwelling Independent Elderly Population: The Fujiwara-kyo Study.

作者信息

Okamoto Nozomi, Morikawa Masayuki, Yanagi Motokazu, Amano Nobuko, Tomioka Kimiko, Hazaki Kan, Harano Akihiro, Kurumatani Norio

机构信息

Department of Community Health and Epidemiology, Nara Medical University, Nara, Japan.

Department of Psychiatry, Mie Prefectural Mental Care Center, Mie, Japan. Department of Psychiatry, Nara Medical University, Nara, Japan.

出版信息

J Gerontol A Biol Sci Med Sci. 2015 Dec;70(12):1548-54. doi: 10.1093/gerona/glv116. Epub 2015 Sep 3.

Abstract

BACKGROUND

Tooth loss induces changes to the anatomy of the oral cavity. We hypothesized that tooth loss may disturb smooth swallowing in healthy elderly people. The purpose of this study was to investigate the effect of tooth loss on the development of swallowing problems in an independent elderly population.

METHODS

This was a 5-year prospective cohort study conducted in Nara, Japan. Included in this analysis were 1,988 community residents aged 65 years or older without swallowing problems at baseline. The participants were classified into quartile groups according to the number of remaining teeth at the baseline survey: 0-12, 13-22, 23-26, and 27-32 teeth. A decrease in the number of teeth during the survey was calculated by subtracting follow-up number from baseline number. Main outcome was the development of swallowing problems at follow-up.

RESULTS

During follow-up, 312 individuals developed swallowing problems. After adjustment for confounding factors by multiple logistic regression analysis, the odds ratios for developing swallowing problems in participants with 13-22 or 0-12 teeth were 2.42 (95% confidence interval [CI], 1.61-3.63) and 2.49 (95% CI, 1.68-3.69), respectively, compared to participants with 27-32 teeth, demonstrating a significant relationship. The odds ratio of per 1 tooth decrease over 5 years was 1.08 (95% CI, 1.02-1.13), showing a significant association.

CONCLUSIONS

Swallowing problems due to aging are more likely to develop in individuals with fewer teeth.

摘要

背景

牙齿缺失会导致口腔解剖结构发生变化。我们推测牙齿缺失可能会干扰健康老年人的顺畅吞咽。本研究的目的是调查牙齿缺失对独立老年人群吞咽问题发展的影响。

方法

这是一项在日本奈良进行的为期5年的前瞻性队列研究。纳入本分析的是1988名65岁及以上、基线时无吞咽问题的社区居民。根据基线调查时剩余牙齿的数量,将参与者分为四分位数组:0 - 12颗牙、13 - 22颗牙、23 - 26颗牙和27 - 32颗牙。通过用基线牙齿数量减去随访牙齿数量来计算调查期间牙齿数量的减少。主要结局是随访时吞咽问题的发生。

结果

在随访期间,312人出现了吞咽问题。通过多因素逻辑回归分析对混杂因素进行调整后,与有27 - 32颗牙的参与者相比,有13 - 22颗牙或0 - 12颗牙的参与者出现吞咽问题的比值比分别为2.42(95%置信区间[CI],1.61 - 3.63)和2.49(95%CI,1.68 - 3.69),显示出显著相关性。每5年牙齿减少1颗的比值比为1.08(95%CI,1.02 - 1.13),显示出显著关联。

结论

牙齿较少的个体因衰老而出现吞咽问题的可能性更大。

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