Morita Ichizo, Morioka Hisayoshi, Abe Yoshikazu, Nomura Taketsugu, Inagawa Yujo, Kondo Yuka, Kameyama Chisato, Kondo Kanae, Kobayashi Naoji
Japanese Red Cross Toyota College of Nursing.
Department of Public Health, The University of Tokushima Graduate School, Institute of Health Biosciences.
Nihon Koshu Eisei Zasshi. 2021 Mar 30;68(3):167-179. doi: 10.11236/jph.20-062. Epub 2021 Jan 15.
Objective Polypharmacy in elderly individuals may cause reduced flow of saliva and xerostomia. A dry mouth can lead to poor oral function; however, there are no reports on the relationship between polypharmacy and subjective or objective oral dysfunction. The purpose of this study was to clarify the relationship between the number of prescribed medications and subjective and objective oral dysfunction.Methods The subjects of this study were 215 community-dwelling, elderly individuals, aged 75 years or older, who visited the dental clinic in the Chubu region for a dental health examination from January to February 2019. A medical interview was conducted to assess three items that were related to subjective oral function and record four measurements related to objective oral function. In addition, information was collected on the diseases being treated and prescribed medications. A subject with a decrease in any of the three subjective oral function categories was considered to have subjective oral dysfunction. Objective oral dysfunction was analyzed with respect to two types of oral dysfunction: a decrease in all four objective oral functions and a decrease in two or more of the four objective oral functions. Logistic regression analysis was performed to examine the relationship between subjective and objective oral dysfunction after adjustment for sex, age group, inveterate disease, and the number of prescribed medications.Results Individuals who had eight or more prescribed medications had lower subjective oral function than those with seven or fewer medications (odds ratio, 95% confidence interval: 2.3, 1.0-5.1; P<0.05). Individuals with eight or more medications had lower scores in all four objective oral functions than those with seven or fewer medications (4.4 : 1.5-12.6, P<0.01). A decrease in two or more of the four objective oral functions was related to 10 or more prescribed medications (4.3 : 1.2-16.2, P<0.05). In addition, taking eight or more prescribed medications was associated with a decrease in either subjective oral function or all four objective oral functions (8.1 : 2.1-30.8, P<0.01). A decrease in either subjective oral function or two or more objective oral functions was related to taking 10 or more prescribed medications (4.9 : 1.6-15.6, P<0.01).Conclusion In conclusion, more than eight prescribed pharmaceutical medications in the elderly is associated with subjective or objective oral dysfunction.
老年人多重用药可能导致唾液分泌减少和口干症。口干会导致口腔功能不佳；然而，关于多重用药与主观或客观口腔功能障碍之间的关系尚无报道。本研究的目的是阐明处方药数量与主观和客观口腔功能障碍之间的关系。
本研究的受试者为215名居住在社区的75岁及以上老年人，他们于2019年1月至2月前往中部地区的牙科诊所进行口腔健康检查。进行了一次医学访谈，以评估与主观口腔功能相关的三个项目，并记录与客观口腔功能相关的四项测量值。此外，收集了正在治疗的疾病和处方药的信息。在三个主观口腔功能类别中任何一项出现下降的受试者被认为患有主观口腔功能障碍。针对两种类型的口腔功能障碍分析客观口腔功能障碍：四项客观口腔功能全部下降以及四项客观口腔功能中的两项或更多项下降。在对性别、年龄组、慢性病和处方药数量进行调整后，进行逻辑回归分析以检验主观和客观口腔功能障碍之间的关系。
服用八种或更多处方药的个体的主观口腔功能低于服用七种或更少药物的个体（优势比，95%置信区间：2.3，1.0 - 5.1；P<0.05）。服用八种或更多药物的个体在所有四项客观口腔功能方面的得分均低于服用七种或更少药物的个体（4.4 : 1.5 - 12.6，P<0.01）。四项客观口腔功能中的两项或更多项下降与服用十种或更多处方药有关（4.3 : 1.2 - 16.2，P<0.05）。此外，服用八种或更多处方药与主观口腔功能或所有四项客观口腔功能下降有关（8.1 : 2.1 - 30.8，P<0.01）。主观口腔功能或两项或更多客观口腔功能下降与服用十种或更多处方药有关（4.9 : 1.6 - 15.6，P<0.01）。
总之，老年人服用八种以上处方药与主观或客观口腔功能障碍有关。
