Does Oral Hypofunction Promote Social Withdrawal in the Older Adults? A Longitudinal Survey of Elderly Subjects in Rural Japan

Abstract

It is often assumed that oral hypofunction is associated with social withdrawal in older adults because decreased motor function is related to decreased oral function. However, few studies have examined the relationship between social withdrawal in older adults and oral function. This longitudinal study aimed to clarify the relationship between changes in the level of social withdrawal and oral function in independent older adults. Participants were 427 older adults aged 65 years or older who took part in a self-administered questionnaire from 2016 to 2017 (baseline), and again two years later (follow-up). At baseline, 17 items related to oral function and confounding factors related to withdrawal, physical condition, physical function, and cognitive function were evaluated. A Cox proportional hazard model was used to examine the oral functions that negatively impact social withdrawal. The following factors were significantly associated with the worsening of social withdrawal: the number of remaining teeth, gingival condition, occlusal force, masticatory efficiency, and items related to swallowing and dry mouth. Older adults with cognitive issues who walk slowly and have a weak knee extension muscle were also significantly more likely to have oral frailty. Those who were found to have oral frailty at baseline were 1.8 times more likely to develop withdrawal compared to those with robust oral function. The results indicated that the worsening of withdrawal was associated with oral hypofunction at baseline. Since oral hypofunction was associated with the worsening of social withdrawal in older adults, it is important to maintain older adults’ oral function.

Masticatory dysfunction in older adults: A scoping review

“…Maximum occlusal force was the second most preferred method 5,10,16,21,23,24,29,33,37,38,42,45,48,52,53,62,65,68–73 . This involves a pressure indicating film (e.g.…”

“…66 Maximum occlusal force was the second most preferred meth od . 5,10,16,21,23,24,29,33,37,38,42,45,48,52,53,62,65,[68][69][70][71][72][73] Film) designed to register force during clenching. 74 Studies which assessed musculoskeletal risk factors such as sarcopenia and frailty often utilised this objective measure; whereby participants were instructed to bite on the pressure film for a designated time period with occlusal force measurements being recorded anteriorly and posteriorly.…”

“…Ageing is strongly linked to a decline in oral‐health‐related quality of life with older adults experiencing more oral pain and difficulties in chewing food 3 . This decline in oral function can compound the management of chronic diseases by negatively affecting food selection and nutritional intake, which can lead to malnutrition, 4 as well as social activities that are necessary for good general health outcomes and quality of life 5 . While it is understood that the lack of occluding teeth in the dentition is strongly associated with low masticatory ability across all ages, 6 there is still a limited availability of evidence regarding additional risk factors that lead to impaired masticatory ability in older adults.…”

Association between Physical Frailty Subdomains and Oral Frailty in Community-Dwelling Older Adults

“…Participants were instructed to chew a piece of test gummy jelly (UHA Mikakuto Co., Ltd., Osaka, Japan) freely 30 times; subsequently, the pieces of gummy jelly were objectively evaluated by a visual scoring method (on a scale from 0–9 points). The cutoff value for low masticatory performance was a score of ≤2 points [ 22 ]. Articulatory oral motor skills (pronunciation of the “ta” sound) were assessed using oral diadochokinesis (“ta”).…”

Patients with mild cognitive impairment diagnosed at dementia clinic display decreased maximum occlusal force: a cross-sectional study

“…Moreover, previous research indicates that exercise habits and employment status are associated with cognitive function [ 39 , 40 ]. In contrast, the decline in social participation represented by these exercise habits and employment status is also reportedly associated with the decline in oral function [ 47 , 48 ]. In light of these reports, in this study, exercise habits and employment status were not included as independent variables in the logistic regression analysis.…”