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Association between Oral Frailty and Dietary Variety among Community-Dwelling Older Persons: A Cross-Sectional Study

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The journal of nutrition, health & aging

Abstract

Objective

To examine the association between the severity of oral frailty (OF), which is one of the comprehensive oral functions evaluated, and dietary variety in community-dwelling older persons.

Design

Cross-sectional study.

Setting

Community-based.

Participants A total of 769 community-dwelling older persons aged 65 and over

Interventions

We examined basic demographic information, functional status, cognitive status, depressive symptoms, medical history, and oral functions of the participants.

Measurements

OF was defined by 1–2 and 3 or more of 6 items of oral function evaluation in the pre-oral frailty and oral frailty groups, respectively. Dietary variety was assessed using the dietary variety score (DVS). The participants were categorized into 3 groups for evaluation: those with a low score (0–2), medium score (3–5), and high score (≥6). Ordinal logistic regression analysis was performed to examine the association between OF and DVS.

Results

The rate of OF in the participants was 21.6%, and its severity was significantly associated with DVS after adjusting for potential confounders (Pre-OF; adjusted odds ratio [OR] = 1.687, 95% confidence interval [CI] = 1.219–2.335, OF; adjusted OR = 2.857, 95% CI = 1.489–5.484).

Conclusion

The severity of OF was significantly associated with DVS in community-dwelling older persons. This suggests that DVS may be useful in understanding the effects of OF on the nutritional status. Further longitudinal studies are needed to elucidate the association between OF and DVS.

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References

  1. Yokoyama Y, Nishi M, Murayama H, Amano H, Taniguchi Y, Nofuji Y, Narita M, Matsuo E, Seino S, Kawano Y, Shinkai S. Association of dietary variety with body composition and physical function in community-dwelling elderly Japanese. J Nutr Health Aging 2016;20:691–696. https://doi.org/10.1007/s12603-015-0632-7.

    Article  CAS  Google Scholar 

  2. Motokawa K, Watanabe Y, Edahiro A, Shirobe M, Murakami M, Kera T, Kawai H, Obuchi S, Fujiwara Y, Ihara K, Tanaka Y, Hirano H. Frailty severity and dietary variety in Japanese older persons: a cross-sectional study. J Nutr Health Aging 2018;22:451–456. doi:https://doi.org/10.1007/s12603-018-1000-1.

    Article  CAS  Google Scholar 

  3. Otsuka R, Nishita Y, Tange C, Tomida M, Kato Y, Nakamoto M, Imai T, Ando F, Shimokata H. Dietary diversity decreases the risk of cognitive decline among Japanese older adults. Geriatr Gerontol Int 2017;17:937–944. doi: https://doi.org/10.1111/ggi.12817.

    Article  Google Scholar 

  4. Zhu K, Devine A, Suleska A, Tan CY, Toh CZ, Kerr D, Prince RL. Adequacy and change in nutrient and food intakes with aging in a seven-year cohort study in elderly women. J Nutr Health Aging 2010;14:723–729. doi:https://doi.org/10.1007/s12603-010-0324-2.

    Article  CAS  Google Scholar 

  5. Zhu Y, Hollis JH. Tooth loss and its association with dietary intake and diet quality in American adults. J Dent 2014;42:1428–1435. doi:https://doi.org/10.1016/j.jdent.2014.08.012.

    Article  CAS  Google Scholar 

  6. Kwon J, Suzuki T, Kumagai S, Shinkai S, Yukawa H. Risk factors for dietary variety decline among Japanese elderly in a rural community: a 8-year follow-up study from TMIG-LISA. Eur J Clin Nutr 2006;60:305–311. doi:https://doi.org/10.1038/sj.ejcn.1602314.

    Article  CAS  Google Scholar 

  7. Kagawa R, Ikebe K, Inomata C, Okada T, Takeshita H, Kurushima Y, Kibi M, Maeda Y. Effect of dental status and masticatory ability on decreased frequency of fruit and vegetable intake in elderly Japanese subjects. Int J Prosthodont 2012;25:368–375.

    PubMed  Google Scholar 

  8. Iwasaki M, Borgnakke WS, Ogawa H, Yamaga T, Sato M, Minagawa K, Ansai T, Yoshihara A, Miyazaki H. Effect of lifestyle on 6-year periodontitis incidence or progression and tooth loss in older adults. J Clin Periodontol 2018;45:896–908. doi:https://doi.org/10.1111/jcpe.12920.

    Article  Google Scholar 

  9. Mann T, Heuberger R, Wong H. The association between chewing and swallowing difficulties and nutritional status in older adults. Aust Dent J 2013;58:200–206. doi:https://doi.org/10.1111/adj.12064.

    Article  CAS  Google Scholar 

  10. Yoshihara A, Watanabe R, Nishimuta M, Hanada N, Miyazaki H. The relationship between dietary intake and the number of teeth in elderly Japanese subjects. Gerodontology 2005;22:211–218.

    Article  Google Scholar 

  11. Volpi E, Kobayashi H, Sheffield-Moore M, Mittendorfer B, Wolfe RR. Essential amino acids are primarily responsible for the amino acid stimulation of muscle protein anabolism in healthy elderly adults. Am J Clin Nutr 2003;78:250–258.

    Article  CAS  Google Scholar 

  12. Lim H, Choue R. Impact of nutritional status and dietary quality on stroke: do we need specific recommendations. Eur J Clin Nutr 2013;67:548–554. doi:https://doi.org/10.1038/ejcn.2013.30.

    Article  CAS  Google Scholar 

  13. Lee MS, Huang YC, Su HH, Lee MZ, Wahlqvist ML. A simple food quality index predicts mortality in elderly Taiwanese. J Nutr Health Aging 2011;15:815–821. doi:https://doi.org/10.1007/s12603-011-0081-x.

    Article  Google Scholar 

  14. Sagawa K, Furuya H, Ohara Y, Yoshida M, Hirano H, Iijima K, Kikutani T. Tongue function is important for masticatory performance in the healthy elderly: a cross-sectional survey of community-dwelling elderly. J Prosthodont Res 2019;63:31–34. doi:https://doi.org/10.1016/j.jpor.2018.03.006.

    Article  Google Scholar 

  15. Okamoto N, Tomioka K, Saeki K, Iwamoto J, Morikawa M, Harano A, Kurumatani N. Relationship between swallowing problems and tooth loss in community-dwelling independent elderly adults: the Fujiwara-kyo study. J Am Geriatr Soc 2012;60:849–853. doi:https://doi.org/10.1111/j.1532-5415.2012.03935.x.

    Article  Google Scholar 

  16. Morita K, Tsuka H, Kato K, Mori T, Nishimura R, Yoshida M, Tsuga K. Factors related to masticatory performance in healthy elderly individuals. J Prosthodont Res 2018;62:432–435. doi:https://doi.org/10.1016/j.jpor.2018.03.007.

    Article  Google Scholar 

  17. Palmer JB, Rudin NJ, Lara G, Crompton AW. Coordination of mastication and swallowing. Dysphagia 1992;7:187–200. doi:https://doi.org/10.1007/BF02493469.

    Article  CAS  Google Scholar 

  18. Kugimiya Y, Watanabe Y, Ueda T, Motokawa K, Shirobe M, Igarashi K, Hoshino D, Takano T, Sakurai K, Taniguchi Y, Kitamura A, Shinkai S, Hirano H. Rate of oral frailty and oral hypofunction in rural community-dwelling older Japanese individuals. Gerodontology 2020: doi:https://doi.org/10.1111/ger.12468.

  19. Tanaka T, Takahashi K, Hirano H, Kikutani T, Watanabe Y, Ohara Y, Furuya H, Tetsuo T, Akishita M, Iijima K. Oral frailty as a risk factor for physical frailty and mortality in community-dwelling elderly. J Gerontol A Biol Sci Med Sci 2018;73:1661–1667. doi:https://doi.org/10.1093/gerona/glx225.

    Article  Google Scholar 

  20. Kojima G, Taniguchi Y, Kitamura A, Shinkai S. Are the Kihon checklist and the Kaigo-yobo checklist compatible with the frailty index. J Am Med Dir Assoc 2018;19:797–800.e2. doi:https://doi.org/10.1016/j.jamda.2018.05.012.

    Article  Google Scholar 

  21. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12:189–198.

    Article  CAS  Google Scholar 

  22. Tsoi KK, Chan JY, Hirai HW, Wong SY, Kwok TC. Cognitive tests to detect dementia: a systematic review and meta-analysis. JAMA Intern Med 2015; 175:1450–1458. doi:https://doi.org/10.1001/jamainternmed.2015.2152

    Article  Google Scholar 

  23. Tsuga K, Maruyama M, Yoshikawa M, Yoshida M, Akagawa Y. Manometric evaluation of oral function with a hand-held balloon probe. J Oral Rehabil 2011;38:680–685. doi:https://doi.org/10.1111/j.1365-2842.2011.02202.x.

    Article  CAS  Google Scholar 

  24. Yamada A, Kanazawa M, Komagamine Y, Minakuchi S. Association between tongue and lip functions and masticatory performance in young dentate adults. J Oral Rehabil 2015; 42:833–839. DOI 10.1111/joor.12319.

    Article  CAS  Google Scholar 

  25. Satake S, Senda K, Hong YJ, Miura H, Endo H, Sakurai T, Kondo I, Toba K. Validity of the Kihon Checklist for assessing frailty status. Geriatr Gerontol Int 2016; 16:709–715. doi:https://doi.org/10.1111/ggi.12543.

    Article  Google Scholar 

  26. Kumagai S, Watanabe S, Shibata H, Amano H, Fujiwara Y, Shinkai S, Yoshida H, Suzuki T, Yukawa H, Yasumura S, Haga H. Effects of dietary variety on declines in high-level functional capacity in elderly people living in a community. Nihon Koshu Eisei Zasshi 2003;50:1117–1124.

    PubMed  Google Scholar 

  27. Koyano W, Shibata H, Nakazato K, Haga H, Suyama Y. Measurement of competence: reliability and validity of the TMIG Index of Competence. Arch Gerontol Geriatr 1991;13:103–116.

    Article  CAS  Google Scholar 

  28. Schreiner AS, Hayakawa H, Morimoto T, Kakuma T. Screening for late life depression: cut-off scores for the Geriatric Depression Scale and the Cornell Scale for Depression in Dementia among Japanese subjects. Int J Geriatr Psychiatry 2003;18:498–505. doi:https://doi.org/10.1002/gps.880

    Article  Google Scholar 

  29. Shinkai S, Watanabe N, Yoshida H, Fujiwara Y, Amano H, Lee S, Nishi M, Tsuchiya Y. Research on screening for frailty: development of “the Kaigo-Yobo Checklist”. Nihon Koshu Eisei Zasshi 2010;57:345–354. doi:https://doi.org/10.11236/jph.57.5_345.

    PubMed  Google Scholar 

  30. Fukuda Y, Ishikawa M, Yokoyama T, Hayashi T, Nakaya T, Takemi Y, Kusama K, Yoshiike N, Nozue M, Yoshiba K, Murayama N. Physical and social determinants of dietary variety among older adults living alone in Japan. Geriatr Gerontol Int 2017; 17:2232–2238. doi: https://doi.org/10.1111/ggi.13004.

    Article  Google Scholar 

  31. Kimura Y, Wada T, Ishine M, Ishimoto Y, Kasahara Y, Konno A, Nakatsuka M, Sakamoto R, Okumiya K, Fujisawa M, Otsuka K, Matsubayashi K. Food diversity is closely associated with activities of daily living, depression, and quality of life in community-dwelling elderly people. J Am Geriatr Soc 2009;57:922–924. doi:https://doi.org/10.1111/J.1532-5415.2009.02235.X.

    Article  Google Scholar 

  32. Iwasaki M, Taylor GW, Manz MC, Yoshihara A, Sato M, Muramatsu K, Watanabe R, Miyazaki H. Oral health status: relationship to nutrient and food intake among 80-year-old Japanese adults. Community Dent Oral Epidemiol 2014;42:441–450. doi:https://doi.org/10.1111/cdoe.12100.

    Article  Google Scholar 

  33. Suthuvoravut U, Takahashi K, Murayama H, Tanaka T, Akishita M, Iijima K. Association between traditional Japanese diet Washoku and sarcopenia in community-dwelling older adults: findings from the Kashiwa study. J Nutr Health Aging 2020;24:282–289. doi: https://doi.org/10.1007/s12603-020-1318-3.

    Article  CAS  Google Scholar 

  34. Murakami K, Livingstone MBE, Sasaki S. Thirteen-Year Trends in Dietary Patterns among Japanese Adults in the National Health and Nutrition Survey 2003–2015: Continuous Westernization of the Japanese Diet. Nutrients. 2018; 10:994 doi: https://doi.org/10.3390/nu10080994.

    Article  Google Scholar 

  35. Hiza HA, Casavale KO, Guenther PM, Davis CA. Diet quality of Americans differs by age, sex, race/ethnicity, income, and education level. J Acad Nutr Diet 2013;113:297–306. doi:https://doi.org/10.1016/j.jand.2012.08.011.

    Article  Google Scholar 

  36. Alkerwi A, Baydarlioglu B, Sauvageot N, Stranges S, Lemmens P, Shivappa N, Hébert JR. Smoking status is inversely associated with overall diet quality: Findings from the ORISCAV-LUX study. Clin Nutr 2017;36:1275–1282. doi: https://doi.org/10.1016/j.clnu.2016.08.013.

    Article  Google Scholar 

  37. Suzuki H, Kanazawa M, Komagamine Y, Iwaki M, Jo A, Amagai N, Minakuchi S. The effect of new complete denture fabrication and simplified dietary advice on nutrient intake and masticatory function of edentulous elderly: A randomized-controlled trial. Clin Nutr 2018;37:1441–1447. doi:https://doi.org/10.1016/j.clnu.2017.07.022.

    Article  Google Scholar 

  38. Kimura M, Moriyasu A, Kumagai S, Furuna T, Akita S, Kimura S, Suzuki T. Community-based intervention to improve dietary habits and promote physical activity among older adults: a cluster randomized trial. BMC Geriatr 2013; 13:8. doi:https://doi.org/10.1186/1471-2318-13-8.

    Article  Google Scholar 

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Acknowledgments

We would like to thank the staff of the department of Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology, for their tremendous support. This study was supported by grants from the Tokyo Metropolitan Government, Tokyo Metropolitan Institute of Gerontology, and AMED under Grant Number JP18dk0110019h0003, research funding for Longevity Sciences (29–42) from the National Center for Geriatrics and Gerontology (NCGG), and JSPS KAKENHI (grant number: JP16K11908, JP17K13239, JP20K23207).

Author information

Authors and Affiliations

  1. Department of Special Needs Dentistry, Division of Community Based Comprehensive Dentistry, School of Dentistry, Showa University, Tokyo, 145-8515, Japan

    Daichi Hoshino & Y. Maruoka

  2. Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan

    Daichi Hoshino, H. Hirano, A. Edahiro, K. Motokawa, Y. Watanabe, Y. Motohashi, Y. Ohara & M. Iwasaki

  3. Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan

    H. Hirano

  4. The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan

    M. Shirobe

  5. Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan

    Y. Watanabe

  6. Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan

    Y. Yokoyama, M. Narita, S. Shinkai & A. Kitamura

  7. Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Ibaraki, Japan

    Y. Taniguchi

  8. Kagawa Nutrition University, Saitama, Japan

    S. Shinkai

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  1. Daichi Hoshino
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  2. H. Hirano
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Correspondence to Daichi Hoshino.

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Conflict of Interest: None of the authors have any conflicts of interest to declare.

Ethical standards: This study was approved by the Ethical Committee of the Tokyo Metropolitan Institute of Gerontology.

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Hoshino, D., Hirano, H., Edahiro, A. et al. Association between Oral Frailty and Dietary Variety among Community-Dwelling Older Persons: A Cross-Sectional Study. J Nutr Health Aging 25, 361–368 (2021). https://doi.org/10.1007/s12603-020-1538-6

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  • DOI: https://doi.org/10.1007/s12603-020-1538-6

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