Number of teeth and masticatory function are associated with sarcopenia and diabetes mellitus status among community-dwelling older adults: A Shimane CoHRE study

Abstract

Objectives We aimed to examine the number of teeth and masticatory function as oral health indices and clarify their roles in the pathogenesis of sarcopenia and diabetes mellitus in community-dwelling older adults. Subjects and methods This cross-sectional study was conducted with 635 older adults in Ohnan, Shimane Prefecture, in rural Japan. The number of teeth and masticatory function (measured by the number of gummy jelly pieces collected after chewing) were evaluated by dental hygienists. Sarcopenia status was assessed using handgrip strength, skeletal muscle index, calf circumference, and a possible sarcopenia diagnosis based on the Asian Working Group for Sarcopenia 2019. Diabetes mellitus status was defined as a hemoglobin A1c level ≥6.5% or self-reported diabetes. A multivariable logistic regression model was used to analyze the association between oral health, sarcopenia, and diabetes mellitus after adjusting for confounders. Results After adjusting for all confounders, logistic regression analysis showed that the number of remaining teeth was negatively associated with a low level of handgrip strength (odds ratio [OR], 0.961; 95% confidence interval [CI], 0.932–0.992) and possible sarcopenia (OR, 0.949; 95% CI, 0.907–0.992). Higher levels of masticatory function were also negatively associated with a low level of handgrip strength (OR, 0.965; 95% CI, 0.941–0.990) and possible sarcopenia (OR, 0.941; 95% CI, 0.904–0.979). Logistic regression analysis showed that the number of remaining teeth and a higher level of masticatory function were negatively associated with diabetes mellitus (OR, 0.978; 95% CI, 0.957–0.999; OR, 0.976; 95% CI, 0.960–0.992, respectively). Conclusion Our findings suggest that improvement in oral health, including the maintenance of masticatory function and remaining teeth, may contribute to the prevention of sarcopenia and diabetes mellitus in older adults.

Screening for a Decreased Masticatory Function by a Color-changeable Chewing Gum Test in Patients with Metabolic Disease

“…Cross-sectional studies have demonstrated a correlation between these clinical characteristics and a decreased masticatory function (28)(29)(30). Recent studies also suggest a close relationship between a decreased masticatory function and frailty or sarcopenia (31,32). A decline in gait Intern Med 61: 781-787, 2022 DOI: 10.2169/internalmedicine.8082-21 speed and handgrip strength are well-known markers of frailty and sarcopenia (22,33).…”

Effect of Multimorbidity on Fragility Fractures in Community-Dwelling Older Adults: Shimane CoHRE Study

“…Thus, osteoporosis is expected to accelerate the process of bone loss in chronic periodontitis. Moreover, we found significant association between loss of teeth and sarcopenia in our very recent study [ 53 ]. Taken together, further study is necessary to elucidate whether periodontitis or loss of teeth may increase the risk of falls and fractures.…”

Tooth Loss Related with Prevalence of Metabolic Syndrome in a General Urban Japanese Population: The Suita Study

“…The results of the present study demonstrate that there is an association between tooth loss and MetS, as well as MetS components (hyperglycemia, low HDL cholesterol, and high triglycerides) in the general urban Japanese 40 year and older population, suggesting that the number of teeth of 20 or less could be a surrogate marker in assessing the MetS risk due to decreased masticatory function. Decreased number of teeth could lead to decreased masticatory performance [ 5 , 23 ], and it might result in the group with decreased masticatory ability avoiding chewy foods and preferring soft foods [ 1 , 2 , 3 , 24 ], and resulting decrease in dietary fiber and Vitamins A and C intake and increase in the intake of carbohydrate [ 25 ]. These changes in nutritional intake affect the components of MetS, such as lipid and carbohydrate metabolism and blood pressure [ 26 ].…”

“…Occlusal force and masticatory performance are known to depend on the number of teeth, and a decrease in the number of teeth has often been used as a surrogate marker for decreased masticatory function [ 5 ]. The Japanese Society of Gerodontology allows the use of fewer than 20 teeth (normally, the number of permanent teeth is 28 teeth, excluding wisdom teeth) in the diagnosis of decreased occlusal force [ 6 ], which is one of the sub-symptoms of oral hypofunction, in the absence of an occlusal force test device.…”