Association between objectively measured chewing ability and frailty: A cross‐sectional study in central Thailand

Iwasaki, Masanori; Kimura, Yumi; Sasiwongsaroj, Kwanchit; Kettratad-Pruksapong, Matana; Suksudaj, Sutee; Ishimoto, Yasuko; Chang, Nai-Yuan; Sakamoto, Ryota; Songpaisan, Yupin; Miyazaki, Hideo

doi:10.1111/ggi.13264

Cited by 34 publications

(54 citation statements)

References 24 publications

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“…Given the small number of longitudinal studies on oral health/ frailty relationship, it is worth noting that findings from several cross‐sectional studies were consistent with the conclusion of this review. Number of teeth, indicators of oral function, and self‐reported oral health were associated with frailty assessed by Fried's frailty phenotype in cross‐sectional studies. Another cross‐sectional study that used the Japanese checklist for defining frailty found an association between oral function indicators and frailty …”

Section: Discussionmentioning

confidence: 99%

Association between oral health and frailty: A systematic review of longitudinal studies

2019

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Objective To systematically review longitudinal studies on the association between oral health and frailty indicated by any validated scale or index. Background Frailty and poor oral health are common among ageing populations; however, evidence from longitudinal studies is scarce. Methods Three databases (MEDLINE, EMBASE and LILACS) were searched for published literature up to July 2018 using prespecified search strategy. Grey literature was searched using OpenGrey and Google Scholar. Quality of included studies was checked using the Newcastle‐Ottawa Quality Assessment Scale (NOS) for longitudinal studies. Results Five longitudinal studies from three countries (Mexico, Japan, and UK) that examined the association between oral health and frailty were identified. All studies used Fried's frailty phenotype criteria for measuring frailty. Oral health indicators were number of teeth, periodontal disease, oral functions (functional dentition with occluding pairs and maximum bite force), use of removable dentures, accumulation of oral health problems and dry mouth symptoms. The studies showed significant association of number of teeth (two studies), oral functions (two studies), accumulation of oral health problems and number of dry mouth symptoms with frailty incidence, whereas periodontal disease showed inconsistent associations. Conclusion This systematic review identified significant longitudinal associations between oral health indicators and frailty that highlight the importance of oral health as a predictor of frailty in older age. There is a need for further research exploring the role of nutrition as a mediator of the relationship between oral health and frailty.

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Section: Discussionmentioning

confidence: 99%

Association between oral health and frailty: A systematic review of longitudinal studies

2019

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“…By using linear analysis, a cohort study in Mexico suggested that each additional tooth was associated with a lower probability of developing frailty 12. However, two cross-sectional studies performed in Mexico16 and Thailand15 and one cohort study in Denmark10 did not find a significant association between the number of teeth and frailty. Collectively, current evidence supports that the relationship between frailty and tooth number exists in the older population in Brazil, the USA, Japan, Mexico and China, but does not exist in Danish and Thai older adults.…”

Section: Discussionmentioning

confidence: 99%

“…Until now, the proposed risk factors for frailty include physiological changes with ageing, inflammation, sarcopenia, polypharmacy, social isolation and malnutrition 9. Notably, emerging research has shown that frailty is significantly associated with oral health and functions, including tooth number,10–12 functional dentition,13 chewing ability,14 15 periodontitis,12 utilisation of dental services11 16 17 and self-perception of oral health 14 16. More teeth were significantly associated with a lower risk of developing frailty11–13 17 because tooth loss might be caused by severe periodontal diseases, which can trigger higher levels of inflammatory markers and contribute to the development of frailty 14.…”

Section: Introductionmentioning

confidence: 99%

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Association between the number of teeth and frailty among Chinese older adults: a nationwide cross-sectional study

Bai

et al. 2019

BMJ Open

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ObjectivesTo explore the association between the number of teeth and frailty among older Chinese adults using a nationally representative sample.DesignCross-sectional analysis was carried out using the 2014 wave data from the Chinese Longitudinal Healthy Longevity Survey, which used a targeted random-sampling design.SettingThis research was conducted in communities from nearly half of the counties and cities in 22 out of 31 provinces throughout China.ParticipantsOf the 6934 interviewees aged ≥65 years, the final analysis included 3635 older adults who had completed the 2014 wave survey on the variables included in the study.Primary and secondary outcome measuresOutcome variables included frailty, measured by the Frailty Index, and number of teeth. Covariates included demographic characteristics (ie, age, sex, co-residence, marital status, years of education and financial support), body mass index (BMI) and health behaviours (ie, smoking, drinking and exercise). A univariate logistic regression was used to test the factors associated with frailty. A multiple logistic regression model was used, using the frailty score as the dependent variable and the number of teeth together with significant covariates as the independent variables.ResultsThe prevalence of frailty was 27.68%. The mean number of teeth present was 9.23 (SD=10.03). The multiple logistic regression showed that older adults’ demographic variables, health behaviours, BMI, tooth number and chewing pain were significantly associated with frailty. After adjusting for the covariates, older adults with fewer teeth had significantly higher odds of frailty than those with 20 or more teeth (no teeth: OR=2.07, 95% CI 1.53 to 2.80; 1 to 10 teeth: OR=1.77, 95% CI 1.31 to 2.38), except for older adults with 11 to 20 teeth (OR=1.30, 95% CI 0.93 to 1.82).ConclusionsThe presence of fewer teeth is significantly associated with frailty status among older Chinese adults. Future studies are needed to explain the specific mechanisms underlying how oral health status is associated with frailty.

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“…In the Chianti cohort study, a daily energy intake ≤21 kcal/kg was significantly associated with the risk of frailty among older individuals [ 41 ]. In addition, caloric intake was positively associated with chewing ability in older individuals [ 42 ], which was more common in frail than pre-frail or non-frail older individuals [ 43 ]. The present study also demonstrated that frail older individuals had lower energy intake and poorer chewing ability than non-frail individuals.…”

Section: Discussionmentioning

confidence: 99%

Association between the Dietary Inflammatory Index and Risk of Frailty in Older Individuals with Poor Nutritional Status

Kim

Park

2018

Nutrients

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Both inflammation and poor nutritional status are major risk factors of frailty, and the dietary inflammatory index (DII) has been suggested as being associated with the risk of frailty. The present study aimed to investigate whether DII scores were positively associated with the risk of frailty in older individuals, particularly those with poor nutritional status. In total, 321 community-dwelling older individuals aged 70–85 years were recruited and categorized as non-frail, pre-frail, and frail according to the Cardiovascular Health Study index. DII scores were calculated based on 24-h dietary recall, and nutritional status was assessed using the Mini Nutritional Assessment. Multinomial logistic regression analysis showed that DII scores were positively associated with the risk of frailty in older individuals (odds ratio, OR 1.64, 95% confidence interval, 95% CI 1.25–2.17), particularly those with poor nutritional status (OR 1.68, 95% CI 1.21–2.34). Among the frailty criteria, weight loss (OR 1.29, 95% CI 1.03–1.60), low walking speed (OR 1.33, 95% CI 1.10–1.61), and low grip strength (OR 1.34, 95% CI 1.13–1.60) were associated with DII scores. In addition, the optimal DII cut-off score for frailty was ≥0.93 (sensitivity 71%; specificity: 72%; area under the receiver operating characteristic curve, AUC = 0.792). The present study showed that a pro-inflammatory diet was associated with increased risk of frailty, particularly in older individuals with poor nutritional status. Future randomized controlled trials with a low DII diet for the prevention of frailty are needed to confirm our finding.

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Association between objectively measured chewing ability and frailty: A cross‐sectional study in central Thailand

Abstract: Objectively measured chewing ability was significantly associated with frailty in community-dwelling older Thai adults. Geriatr Gerontol Int 2018; 18: 860-866.

Cited by 34 publications

References 24 publications

Association between oral health and frailty: A systematic review of longitudinal studies

Association between oral health and frailty: A systematic review of longitudinal studies

Association between the number of teeth and frailty among Chinese older adults: a nationwide cross-sectional study

Association between the Dietary Inflammatory Index and Risk of Frailty in Older Individuals with Poor Nutritional Status

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