Won Chang Won, Shin Seung-Yun, Kim Miji, Ko Min Jung, Seo Seongwoo, So Jong Seob, Jung Hoi-In, Kho Hong-Seop, Kang Kyung Lhi, Ha Seung-Ryong, Kim Nam-Hee, Linton Jina Lee, Kang Jeong-Hyun
Department of Family Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Department of Periodontology, Kyung Hee University College of Dentistry, Seoul, Republic of Korea.
Gerodontology. 2025 Sep;42(3):386-395. doi: 10.1111/ger.12806. Epub 2024 Dec 18.
This study evaluated the impact of masticatory difficulty on the development and progression of malnutrition, frailty, sarcopenia, and disability in community-dwelling adults, using data from the Korean Frailty and Aging Cohort Study.
Participants were categorised by presence of masticatory difficulty. The Fried frailty phenotype, mini-nutritional assessments, and diagnostic criteria proposed by Asian Working Group on Sarcopenia were adopted to diagnose frailty, malnutrition, and sarcopenia respectively. Physical disabilities were measured using the Korean activities of daily living (ADL) and Korean instrumental activities of daily living (IADL) scales.
A total of, 3010 participants were initially enrolled, 2864 participants remained in the study after 2 years, reflecting a 95.1% retention compliance. At baseline, the prevalence of frailty (28.0% vs. 18.1%), malnutrition (1.5% vs. 0.8%), IADL disability (10.1% vs. 7.7%), and ADL disability (10.8% vs. 8.0%) was higher among those experiencing masticatory difficulty than in those without. After 2 years, baseline masticatory difficulty was associated with the incidence of malnutrition (OR, 2.62; 95% CI, 0.99-6.90; p = 0.042) after full adjustment for confounders. However, no associations were found between baseline masticatory difficulty and the incidence of frailty, sarcopenia or physical disability over 2 years after adjustment. Additionally, masticatory difficulty did not affect the persistence or remission of malnutrition, frailty, sarcopenia, IADL disability, and ADL disability in individuals who already had these conditions at baseline.
Restoring chewing function and masticatory satisfaction improves not only oral health but also contributes to overall health and promotes healthy aging in older individuals.
本研究利用韩国衰弱与老龄化队列研究的数据,评估咀嚼困难对社区居住成年人营养不良、衰弱、肌肉减少症和残疾的发生及进展的影响。
根据是否存在咀嚼困难对参与者进行分类。分别采用Fried衰弱表型、微型营养评定法以及亚洲肌少症工作组提出的诊断标准来诊断衰弱、营养不良和肌少症。使用韩国日常生活活动(ADL)量表和韩国工具性日常生活活动(IADL)量表测量身体残疾情况。
最初共纳入3010名参与者,2年后有2864名参与者仍留在研究中,留存率为95.1%。在基线时,有咀嚼困难者的衰弱患病率(28.0%对18.1%)、营养不良患病率(1.5%对0.8%)、IADL残疾率(10.1%对7.7%)和ADL残疾率(10.8%对8.0%)均高于无咀嚼困难者。2年后,在对混杂因素进行充分调整后,基线咀嚼困难与营养不良的发生率相关(比值比,2.62;95%置信区间,0.99 - 6.90;p = 0.042)。然而,在调整后,未发现基线咀嚼困难与2年内衰弱、肌少症或身体残疾的发生率之间存在关联。此外,咀嚼困难对基线时已患有这些疾病的个体的营养不良、衰弱、肌少症、IADL残疾和ADL残疾的持续或缓解没有影响。
恢复咀嚼功能和咀嚼满意度不仅能改善口腔健康,还有助于整体健康,并促进老年人的健康老龄化。