Sato So, Sasabuchi Yusuke, Okada Akira, Yasunaga Hideo
Department of Clinical Epidemiology and Health Economics, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 1130033, Japan.
Department of Real-World Evidence, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Geroscience. 2024 Aug 30. doi: 10.1007/s11357-024-01325-7.
Oral frailty can contribute to physical and mental health disorders. Previous research has shown an association between frailty and self-reported difficulty in chewing or swallowing. However, their combined assessment has obscured their specific impact on frailty-related outcomes. To investigate the independent associations between difficulty in chewing or swallowing and 1-year frailty outcomes, while also examining their interactions. This retrospective cohort study utilized the DeSC database to identify older adults aged ≥ 75 years who underwent health checkups between April 2014 and November 2022. Multivariate Cox regression analyses were conducted to assess the association between self-reported difficulty in chewing or swallowing and outcomes, including hospitalization due to aspiration pneumonia, all-cause hospitalization, and all-cause mortality within 1 year. Interactions between chewing and swallowing difficulties were also evaluated. Among 359,111 older adults, 39.0% reported oral function difficulties. Swallowing difficulty alone lacked significant outcome association. However, chewing difficulty alone was significantly associated with higher risks of hospitalization due to aspiration pneumonia (hazard ratio (HR), 1.35; 95% confidence interval (CI), 1.15-1.58; P < 0.001), all-cause hospitalization (HR, 1.08; 95% CI, 1.05-1.11; P < 0.001), and all-cause mortality (HR, 1.28; 95% CI, 1.14-1.44; P < 0.001) compared with no self-reported difficulty. A significant positive interaction between self-reported difficulty in chewing and swallowing was observed for all-cause mortality (P = 0.009). Self-reported difficulty in chewing was significantly associated with higher risks of hospitalization due to aspiration pneumonia, all-cause hospitalization, and all-cause mortality among older adults. Chewing and swallowing difficulties showed a synergistic effect, significantly increasing all-cause mortality risk.
口腔功能衰退会导致身心健康问题。先前的研究表明，身体衰弱与自我报告的咀嚼或吞咽困难之间存在关联。然而，对它们的综合评估掩盖了它们对衰弱相关结果的具体影响。为了研究咀嚼或吞咽困难与1年衰弱结果之间的独立关联，同时也研究它们之间的相互作用。这项回顾性队列研究利用DeSC数据库，确定了2014年4月至2022年11月期间接受健康检查的75岁及以上老年人。进行多变量Cox回归分析，以评估自我报告的咀嚼或吞咽困难与结果之间的关联，包括因吸入性肺炎住院、全因住院以及1年内的全因死亡率。还评估了咀嚼和吞咽困难之间的相互作用。在359,111名老年人中，39.0%报告有口腔功能困难。单独的吞咽困难与结果之间缺乏显著关联。然而，与没有自我报告困难的情况相比，单独的咀嚼困难与因吸入性肺炎住院（风险比（HR），1.35；95%置信区间（CI），1.15 - 1.58；P < 0.001）、全因住院（HR，1.08；95% CI，1.05 - 1.11；P < 0.001）和全因死亡率（HR，1.28；95% CI，1.14 - 1.44；P < 0.001）的较高风险显著相关。在全因死亡率方面，观察到自我报告的咀嚼和吞咽困难之间存在显著的正向相互作用（P = 0.009）。自我报告的咀嚼困难与老年人因吸入性肺炎住院、全因住院和全因死亡率的较高风险显著相关。咀嚼和吞咽困难显示出协同作用，显著增加全因死亡风险。
