Iwasaki M, Yoshihara A, Sato N, Sato M, Minagawa K, Shimada M, Nishimuta M, Ansai T, Yoshitake Y, Ono T, Miyazaki H
Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Division of Community Oral Health Development, Kyushu Dental University, Kitakyushu, Japan.
J Oral Rehabil. 2018 Jan;45(1):17-24. doi: 10.1111/joor.12578. Epub 2017 Oct 13.
To determine whether maximum bite force (MBF), an objective measure of oral function, is associated with development of frailty in community-dwelling older adults. This prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Baseline MBF was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up examinations, including physical fitness and anthropometric evaluation and structured questionnaires, were administered annually over a 5-year period to determine the incidence of frailty, which was defined by the presence of 3 or more of the following 5 components derived from the Cardiovascular Health Study: low level of mobility, low physical activity level, weakness, shrinking and poor endurance and energy. Adjusted hazard ratios (HRs) of incidence of frailty according to sex-stratified tertiles of baseline MBF were calculated using Cox proportional hazards regression models. During the follow-up, 49 participants (15.2%) developed frailty. Participants in the lower tertile of MBF exhibited a significantly greater risk of frailty than those in the upper tertile. After adjustment for sex, depression, diabetes and Eichner index, the adjusted HRs for frailty in the upper through lower tertiles of MBF were 1.00 (reference), 1.27 (95% confidence interval [CI]: 0.50-3.20) and 2.78 (95% CI: 1.15-6.72), respectively (P for trend = .01). Poor oral function, as indicated by low MBF, increases the risk of development of frailty among elderly men and women.
为了确定最大咬合力（MBF）这一口腔功能的客观指标是否与社区居住的老年人衰弱的发生有关。这项前瞻性队列研究纳入了基线时年龄为75岁的社区居住日本成年人（n = 322）。使用电子记录设备（咬合力计GM10）测量基线MBF。在5年期间每年进行随访检查，包括体能和人体测量评估以及结构化问卷调查，以确定衰弱的发生率，衰弱的定义为存在源自心血管健康研究的以下5个组成部分中的3个或更多：低活动水平、低体力活动水平、虚弱、消瘦以及耐力和精力差。使用Cox比例风险回归模型计算根据基线MBF的性别分层三分位数划分的衰弱发生率的调整风险比（HR）。在随访期间，49名参与者（15.2%）出现衰弱。MBF处于较低三分位数的参与者比处于较高三分位数的参与者表现出显著更高的衰弱风险。在对性别、抑郁、糖尿病和艾希纳指数进行调整后，MBF从高到低三分位数的衰弱调整HR分别为1.00（参照）、1.27（95%置信区间[CI]：0.50 - 3.20）和2.78（95%CI：1.15 - 6.72）（趋势P值 = 0.01）。MBF低表明口腔功能差，这会增加老年男性和女性发生衰弱的风险。
