Department of Research, Dr. AGA Clinic, Tokyo, Japan.
Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan.
PLoS One. 2022 Sep 9;17(9):e0273812. doi: 10.1371/journal.pone.0273812. eCollection 2022.
Oral health is a key factor of overall health and closely associated with well-being and quality of life. Mastication is one the most important oral functions and may deteriorate with aging. Evidence on association between masticatory dysfunction and frailty in the literature is scarce and not coherent.
A search strategy was developed to conduct a systematic review of the literature in PubMed, CINAHL, and AMED in accordance with the PRISMA 2020 guidelines. We searched for studies published in 2000 or later that examined associations between self-reported masticatory dysfunction and frailty risk. The reference lists of the relevant articles were reviewed for additional studies. We calculated pooled odds ratios (OR) of association between self-reported masticatory dysfunction and the risk of frailty by fixed-effects meta-analysis. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess risk of bias. Publication bias was assessed by visually inspecting a funnel plot.
A total of 285 studies were identified by the literature search. Among 5 studies selected for this review, 4 cross-sectional studies including a total of 7425 individuals were used for meta-analysis. The pooled results by a fixed-effects model showed that there was a significant association between self-reported masticatory dysfunction and frailty risk (pooled OR = 1.83, 95%CI = 1.55-2.18, p<0.00001). There was no evidence of publication bias observed.
This systematic review and meta-analysis highlighted pooled cross-sectional evidence that community-dwelling older people who report masticatory dysfunction are significantly more likely to be frail than those who do not. The limitations of this study are: inclusion of only cross-sectional studies, no gold standard to measure masticatory functions, self-reported information on masticatory function, and the limited number of included studies. More longitudinal studies are warranted for further understanding of the causal pathways and elucidate underlying mechanisms. Registration: PROSPERO CRD42021277173.
口腔健康是整体健康的关键因素，与幸福感和生活质量密切相关。咀嚼是最重要的口腔功能之一，随着年龄的增长可能会恶化。文献中关于咀嚼功能障碍与虚弱之间关联的证据很少且不一致。
按照 PRISMA 2020 指南制定了检索策略，以在 PubMed、CINAHL 和 AMED 中进行系统文献检索。我们检索了 2000 年或之后发表的研究，这些研究检查了自我报告的咀嚼功能障碍与虚弱风险之间的关联。对相关文章的参考文献进行了审查，以寻找其他研究。我们通过固定效应荟萃分析计算了自我报告的咀嚼功能障碍与虚弱风险之间关联的汇总优势比 (OR)。使用 Joanna Briggs 研究所批判性评估清单评估偏倚风险。通过视觉检查漏斗图评估发表偏倚。
通过文献检索共确定了 285 项研究。在纳入本综述的 5 项研究中，有 4 项横断面研究共纳入了 7425 人，用于荟萃分析。固定效应模型的汇总结果表明，自我报告的咀嚼功能障碍与虚弱风险之间存在显著关联（汇总 OR=1.83，95%CI=1.55-2.18，p<0.00001）。未观察到发表偏倚的证据。
本系统综述和荟萃分析强调了汇总的横断面证据，即报告有咀嚼功能障碍的社区居住老年人比没有咀嚼功能障碍的老年人更容易虚弱。本研究的局限性在于：纳入的仅为横断面研究、没有测量咀嚼功能的金标准、自我报告的咀嚼功能信息、以及纳入研究的数量有限。需要进行更多的纵向研究，以进一步了解因果关系并阐明潜在机制。注册：PROSPERO CRD42021277173。
