Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Health Science, Kyoto Koka Women's University, Kyoto, Japan.
J Am Med Dir Assoc. 2017 Jun 1;18(6):550.e1-550.e6. doi: 10.1016/j.jamda.2017.02.012. Epub 2017 Apr 11.
It is clear that each trend of kyphosis with increased age and the ability to eat firm foods with the back teeth (chewing ability) has a strong influence on both the physical and mental condition of older people. Thus, this study aimed to examine whether the combination of kyphosis and chewing disorders was associated with mortality or the need for care under the new long-term care insurance (LTCI) service requirement, over 3 years in community-dwelling older Japanese adults.
A prospective cohort study.
We analyzed the cohort data for older adults (65 years or older) from a prospective study in Kami town. The response rate was 94.3%, and we followed 5094 older individuals for 3 years. Thus, we analyzed 5083 older adults using multiple imputation to manage missing data.
The outcomes were mortality or new certifications for LTCI services in a 3-year period.
We developed 3 groups by asking 2 self-reported questions on both "no kyphosis" and "good chewing ability." The groups were no kyphosis and good chewing ability (GG), kyphosis and poor chewing ability (BB), and kyphosis and good chewing ability or no kyphosis and poor chewing ability (GB/BG).
The prevalence of BB, BG/GB, and GG were 8.9%, 40.3%, and 50.8%, respectively, in our survey. During the 3-year follow-up period, 5.2% (n = 262) died and 13.9% (n = 708) individuals were newly certified as needing LTCI services. As determined by multivariate analyses, BG/GB older adults (adjusted hazard ratio: 1.3 [95% CI 1.1-1.6]) and BB older adults (adjusted hazard ratio: 2.0 [95% CI 1.5-2.4]) had a significantly higher risk of needing LTCI services than GG older adults. Similarly, BG/GB older adults (adjusted hazard ratio: 1.5 [95% CI 1.1-2.0]) and BB older adults (adjusted hazard ratio: 2.3 [95% CI 1.5-3.3]) had a significantly higher risk of mortality than GG older adults did.
The presence of kyphosis or poor chewing ability was related to mortality and new certifications for LTCI services, and we found an additive effect of these 2 factors related to frailty.
随着年龄的增长，每个脊柱后凸趋势和使用后牙（咀嚼能力）进食固体食物的能力都对老年人的身心健康有很大影响。因此，本研究旨在探讨脊柱后凸与咀嚼障碍相结合是否与社区居住的日本老年人在新的长期护理保险（LTCI）服务要求下 3 年内的死亡率或护理需求有关。
前瞻性队列研究。
我们分析了神户镇一项前瞻性研究中老年人（65 岁或以上）的队列数据。应答率为 94.3%，我们对 5094 名老年人进行了 3 年的随访。因此，我们使用多重插补法对 5083 名老年人进行了分析，以处理缺失数据。
3 年内的结局是死亡率或新的 LTCI 服务认证。
我们通过询问 2 个关于“无脊柱后凸”和“良好咀嚼能力”的自我报告问题，将老年人分为 3 组。这些组分别是无脊柱后凸和良好咀嚼能力（GG）、脊柱后凸和差的咀嚼能力（BB）以及脊柱后凸和良好咀嚼能力或无脊柱后凸和差的咀嚼能力（GB/BG）。
在我们的调查中，BB、BG/GB 和 GG 的患病率分别为 8.9%、40.3%和 50.8%。在 3 年的随访期间，5.2%（n=262）死亡，13.9%（n=708）的人新被认定需要 LTCI 服务。多变量分析结果表明，与 GG 老年人相比，BG/GB 老年人（调整后的危险比：1.3[95%可信区间 1.1-1.6]）和 BB 老年人（调整后的危险比：2.0[95%可信区间 1.5-2.4]）有更高的 LTCI 服务需求风险。同样，BG/GB 老年人（调整后的危险比：1.5[95%可信区间 1.1-2.0]）和 BB 老年人（调整后的危险比：2.3[95%可信区间 1.5-3.3]）的死亡率也显著高于 GG 老年人。
脊柱后凸或差的咀嚼能力与死亡率和 LTCI 服务的新认证有关，我们发现这两个与虚弱相关的因素存在相加效应。
