Inui Akinari, Takahashi Ippei, Kurauchi Sizuka, Soma Yuki, Oyama Toshiaki, Tamura Yoshihiro, Noguchi Takao, Murashita Kouichi, Nakaji Shigeyuki, Kobayashi Wataru
Department of Oral and Maxillofacial Surgery.
Department of Social Medicine.
Clin Interv Aging. 2017 Mar 14;12:515-521. doi: 10.2147/CIA.S132637. eCollection 2017.
Prevention, early detection and effective rehabilitation of dysphagia are important issues to be considered in an aging society. Previous studies have shown conflicting findings regarding the association between dysphagia and its potential risk factors, including age, malnutrition, oral conditions, lifestyle and medical history. Herein, we assessed the prevalence and association of dysphagia with potential risk factors in 50- to 79-year-old adults dwelling in a community in Japan.
In this study, there were 532 participants (185 males and 347 females). Participants who responded positively to the question "Do you sometimes choke on drinks/food such as tea and soup?" or those who presented with abnormal repetitive saliva swallowing test findings were diagnosed with dysphagia. The data collected from these participants included the following: number of teeth, occurrence of oral dryness, age, body mass index, serum albumin concentration, smoking, drinking and exercise habits, presence of diseases, such as diabetes mellitus and hypertension, and questions from the Mini-Mental State Examination.
Dysphagia was observed in 33 males (17.8%) and 76 females (21.9%). To explore the effect of the potential risk factors on the prevalence of dysphagia, a model was built by multivariate logistic regression analysis. Using the forced entry method, oral dryness (odds ratio [OR] =3.683 and =0.003 in males; OR =1.797 and =0.032 in females) and the number of teeth (OR =0.946 and =0.038 in males) were found to be significantly related to dysphagia.
This cross-sectional study demonstrated associations between oral conditions and dysphagia. Factors such as oral dryness and number of teeth may contribute to dysphagia more so than aging, lifestyle and comorbidity in community-dwelling adults over the age of 50.
在老龄化社会中，吞咽困难的预防、早期检测和有效康复是需要考虑的重要问题。先前的研究表明，关于吞咽困难与其潜在风险因素（包括年龄、营养不良、口腔状况、生活方式和病史）之间的关联，研究结果相互矛盾。在此，我们评估了居住在日本某社区的50至79岁成年人中吞咽困难的患病率及其与潜在风险因素的关联。
本研究共有532名参与者（185名男性和347名女性）。对“您是否有时会在喝饮料/吃食物（如茶和汤）时呛到？”这一问题回答为肯定的参与者，或唾液重复吞咽测试结果异常的参与者被诊断为吞咽困难。从这些参与者收集的数据包括：牙齿数量、口干的发生情况、年龄、体重指数、血清白蛋白浓度、吸烟、饮酒和运动习惯、是否存在疾病（如糖尿病和高血压）以及简易精神状态检查表中的问题。
33名男性（17.8%）和76名女性（21.9%）被观察到有吞咽困难。为了探究潜在风险因素对吞咽困难患病率的影响，通过多因素逻辑回归分析建立了一个模型。采用强制进入法，发现口干（男性的比值比[OR]=3.683，P=0.003；女性的OR=1.797，P=0.032）和牙齿数量（男性的OR=0.946，P=0.038）与吞咽困难显著相关。
这项横断面研究表明口腔状况与吞咽困难之间存在关联。在50岁以上的社区居住成年人中，口干和牙齿数量等因素可能比衰老、生活方式和合并症更易导致吞咽困难。
