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Factors Associated with Food Form in Long-Term Care Insurance Facilities

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Abstract

We examined factors related to dietary intake status (food form) of long-term care facility (LTCF) residents to identify factors related to proper food form choice for older individuals requiring nursing care. We surveyed 888 residents from 37 LTCFs in Japan. We evaluated basic information (age, sex, body mass index [BMI]), food form (swallowing-adjusted diet class), Barthel Index (BI), Clinical Dementia Rating (CDR), simply evaluated eating and swallowing functions, the number of present/functional teeth, oral diadochokinesis, repetitive saliva swallowing test (RSST), and modified water swallowing test. To clarify factors associated with food form, participants who had good nutrition by oral intake were categorized into the dysphagic diet (DD) and normal diet (ND) groups. Multi-level analyses were used to detect oral functions associated with food form status. Among objective assessments, BMI (odds ratio [OR] 0.979, 95% confidence interval [CI] − 0.022- to 0.006, p = 0.001), BI (OR 0.993, 95% CI − 0.007 to − 0.004, p < 0.001), CDR 3.0 (OR 1.002, 95% CI 0.002‒0.236, p = 0.046), present teeth (OR 0.993, 95% CI − 0.007 to − 0.001, p = 0.011), functional teeth (OR 0.989, 95% CI − 0.011 to − 0.005, p < 0.001), and RSST (OR 0.960, 95% CI − 0.041 to − 0.007, p = 0.006) were significantly associated with DD vs ND discrimination. Simple evaluations of coughing (OR 1.056, 0.054‒0.198, p = 0.001) and rinsing (OR 1.010, 0.010‒0.174, p = 0.029) could also discriminate food form status. These simple evaluations provide insight into the discrepancies between food form status and eating abilities of LTCF residents. Periodic evaluations by the nursing caregiver may help to prevent aspiration by older individuals with dysphagia.

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Data Availability

The data presented in this study are available on request from the corresponding author. The data are not publicly available due to ethico-legal restrictions imposed by the Ethics Committee at the Japanese Society of Gerodontology.

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Acknowledgements

We would like to thank the members of the Special Committee of the Japanese Society for Geriatrics and Gerontology, as well as the staff members of the cooperating institutions and the older individuals requiring long-term care who had cooperated in this research. The authors would like to thank Editage (www.editage.com) for English language editing and publication support.

Funding

This work was supported by the Japan Ministry of Health, Labor and Welfare, and JSPS KAKENHI (Grant Nos. 20H03873, 20H03899).

Author information

Authors and Affiliations

  1. Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Kita 13 Nishi 7, Kita-ku, Sapporo City, Hokkaido, 060-8586, Japan

    Maaya Takeda, Kazutaka Okada, Miyako Kondo, Kenshu Taira, Yutaka Watanabe & Yutaka Yamazaki

  2. Oral Rehabilitation, Niigata University Medical and Dental Hospital, 754 Ichibancho, Asahimachi-dori, Chuo-ku, Niigata City,, Niigata Prefecture, 951-8520, Japan

    Kayoko Ito

  3. Department of Oral Medicine and Hospital Dentistry, Tokyo Dental College, 5-11-13 Sugano, Ichikawa City, Chiba Prefecture, 272-8513, Japan

    Junko Nakajima

  4. Dental Clinic Maruozaki, 15-36, Nishinoguchi-cho, Beppu City, Oita Prefecture, 874-0931, Japan

    Yoshie Ozaki

  5. Rehabilitation Clinic for Speech and Swallowing Disorders, The Nippon Dental University Hospital, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8158, Japan

    Rikimaru Sasaki

  6. Department of Oral and Maxillofacial Prosthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima Prefecture, 890-8544, Japan

    Yasuhiro Nishi

  7. Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku,, Ohta-ku, Tokyo, 145-8515, Japan

    Junichi Furuya & Yuji Sato

  8. Public Health Office, Health & Welfare Bureau, Kita 1-jo Nishi 2-chome, Chuo-ku, Sapporo City, Hokkaido, 060-0001, Japan

    Kenichi Akino

  9. Ohta Dental Clinic, 2-24-14 Kamoike, Kagoshima City, Kagoshima Prefecture, 890-0063, Japan

    Hiromi Ohta

  10. Hamamatsu City Rehabilitation Hospital, 1-6-1 Wago Kita, Naka-ku, Hamamatsu City, Shizuoka Prefecture, 433-8127, Japan

    Tomohisa Ohno

  11. Japan Dental Association, 4-1-20, Kudan-kita, Chiyoda-ku, Tokyo, 102-0073, Japan

    Tsuyoshi Kodama

  12. Ryouhoku Hospital, 315 Nishi Terakata-cho, Hachioji City, Tokyo, 192-0153, Japan

    Hideo Sakaguchi

  13. Hanagata Dental Clinic, 3-5-22, Tiduka 3-chome, Kofu City, Yamanashi Prefecture, 400-0074, Japan

    Tetsuo Hanagata

  14. Departments of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Japan

    Mitsuyoshi Yoshida

Authors
  1. Maaya Takeda
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  2. Kazutaka Okada
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  8. Yoshie Ozaki
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  18. Yuji Sato
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  19. Mitsuyoshi Yoshida
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  20. Yutaka Yamazaki
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Contributions

Conceptualization: MT, YW, YY, and MY; formal analysis: MT, YW, KO, MK, KT, and YY; investigation: MT, YW, KO, MK, KT, KI, JN, YO, RS, YN, JF, KA, HO, TO, TK, HS, TH, YS, MY, and YY; data curation: MT, YW, KO, MK, KT, KI, JN, YO, RS, YN, JF, HO, TO, TK, HS, TH, and MY; writing—original draft preparation: MT, YW, and YY; writing—review and editing: MT, YW, KO, MK, KT, KI, JN, YO, RS, YN, JF, KA, HO, TO, TK, HS, TH, YS, MY, and YY; supervision: YS, MY, and YY; project administration: YW, KO, JN, RS, KA, MY, and YY; funding acquisition: YW, MY, and YS. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Yutaka Watanabe.

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The authors declare no conflict of interest.

Ethical Approval

This study was conducted with approval of the Ethics Committee of the Japanese Society of Gerodontology (2018–1) and the Ethics Committee of the Graduate School of Dentistry, Hokkaido University (No. 2020–4).

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Written informed consent was obtained from patients and their families.

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Takeda, M., Okada, K., Kondo, M. et al. Factors Associated with Food Form in Long-Term Care Insurance Facilities. Dysphagia 37, 1757–1768 (2022). https://doi.org/10.1007/s00455-022-10440-6

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