Murakami M, Watanabe Y, Edahiro A, Ohara Y, Obuchi S, Kawai H, Kim H, Fujiwara Y, Ihara K, Murakami M, Hirano H
Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Tokyo Medical and Dental University, Tokyo, Japan.
J Oral Rehabil. 2018 Aug;45(8):598-604. doi: 10.1111/joor.12650. Epub 2018 Jun 29.
Clinicians' evaluations of older adults sometimes reveal inconsistencies between objective and subjective dental status. This study investigated which factors contribute both to good objective masticatory function (OMF) and the poor subjective masticatory function (SMF) that often becomes a clinical issue. Study participants included 635 elderly community-dwelling Japanese adults who underwent a comprehensive geriatric health examination in 2012. SMF was assessed with a question from the Kihon Checklist on eating difficulties (poor or good). OMF was assessed by a colour-changing gum (poor or good). Also investigated were age, sex, depressive symptoms, instrumental activities of daily living (I-ADLs), number of people who joined the participant at dinner, grip strength, usual walking speed, number of remaining teeth, number of functional teeth and their occlusal force. The group with good OMF and good SMF, defined as group 1, and the group with good OMF but poor SMF, group 2, were compared. Logistic regression analyses confirmed that the number of remaining and functional teeth participants had was statistically unrelated to differences between OMF and SMF. Instead, differences were related to stronger depressive symptoms (OR = 1.67, CI = 1.14-2.44), less ability to conduct I-ADL activities (OR = 0.73, CI = 0.59-0.91), slower usual walking speeds (OR = 0.18, CI = 0.06-0.58) and less occlusal force (OR = 0.99, CI = 0.99-1.00). Depressive symptoms, I-ADLs, and physical function are shown to be significantly related to divergence between objective and subjective masticatory function in elderly Japanese. This suggests that dissociations between objective and subjective dental evaluations of elderly adults indicate need for assessment of their mental and physical function.
临床医生对老年人的评估有时会发现客观和主观牙齿状况之间存在不一致。本研究调查了哪些因素既导致良好的客观咀嚼功能（OMF），又导致经常成为临床问题的较差主观咀嚼功能（SMF）。研究参与者包括635名居住在社区的日本老年人，他们于2012年接受了全面的老年健康检查。通过《基本检查表》中关于进食困难的问题（差或好）评估SMF。通过变色口香糖评估OMF（差或好）。还调查了年龄、性别、抑郁症状、日常生活工具性活动（I-ADL）、晚餐时与参与者一起用餐的人数、握力、通常步行速度、剩余牙齿数量、功能牙数量及其咬合力。将OMF良好且SMF良好的组定义为第1组，将OMF良好但SMF较差的组定义为第2组，并进行比较。逻辑回归分析证实，参与者的剩余牙齿数量和功能牙数量与OMF和SMF之间的差异在统计学上无关。相反，差异与更强的抑郁症状（OR = 1.67，CI = 1.14 - 2.44）、进行I-ADL活动的能力较低（OR = 0.73，CI = 0.59 - 0.91）、通常步行速度较慢（OR = 0.18，CI = 0.06 - 0.58）和咬合力较小（OR = 0.99，CI = 0.99 - 1.00）有关。抑郁症状、I-ADL和身体功能被证明与日本老年人客观和主观咀嚼功能之间的差异显著相关。这表明老年人客观和主观牙齿评估之间的分离表明需要评估他们的心理和身体功能。
