学位研究紹介

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学 位 研 究 紹 介

日本における地域在住 90 歳高齢者の口腔衛生と栄養摂取に関する横断研究
Oral Health and Nutrition among
90-Year-Old Japanese People

nutrients thought to be connected to oral health9, thenutrients chosen for the data analysis were determined.
The TMIG-IC is a 13-item questionnaire with threedomains: social role, intellectual activity, and講師
Department of Community Dentistry
Faculty of Dentistry, Mahidol University, THAILAND

instrumental activity of daily life. The TMIG-IC scoreindicates dependency, cognitive function, and social
health in addition to physical function4.

Raksanan Karawekpanyawong

The oral health assessment consisted of a dental
examination, a masticatory performance test, and astimulated salivary flow（SSF）test. Univariate and【Introduction】

multivariate linear regression analyses were conducted.
Detailed information on the methods has been

Good oral health is essential in eating, speaking,described in our previously published article10.

socializing, and protecting our body from external【Results】

pathogens1. Older adults' decline in oral health conditions
2

can affect eating, resulting in altered nutritional intake

and inferior quality of life3. This study aimed to examine

After adjustment for sex, education, higher-level

the association between three elements of oral healthfunctional capacity（TMIG-IC）, and undernutrition（dentition, mastication, and salivation）and nutritionaltendency（BMI ≤20 kg/m 2）, as shown in Table1,intake in 90-year-old Japanese adults.

multivariable linear regression analyses found apositive association between masticatory performance【Materials and Methods】

and vitamin A intake. Participants with a masticatory
performance of ＜173 mg/dL consumed less folic acid,

In 2018, we asked 90-year-old adults who wereiron, and vitamin A than those with a masticatory

participants of the Niigata Cohort Study to come toperformance ofthe survey sites at community halls. Eighty-eightassociated with the consumption of vitamin A, B2, n-6participants（41 men and 47 women）participated infatty acids, and γ-tocopherol, but adversely associatedthe survey. We used questionnaires to gather data on

with the consumption of carbohydrates. The higher

demographic information, nutritional intake, andconsumption of folic acid, beta-carotene, and vitamin C

higher-level functional capacity. Nutritional intake waswas associated with an increasing number ofassessed using the Brief-Type Self-Administered Diet

remaining teeth.

4History Questionnaire（BDHQ）. Higher-level

173 mg/dL. SSF was positively【Discussion】

functional capacity was measured using the Tokyo
Metropolitan Institute of Gerontology Index ofC o m p e t e n c e （ T M I G - I C ）5 . O r a l e x a m i n a t i o n s ,We focused on 90-year-old participants, for whommasticatory performance tests, saliva tests, blood tests,

there are few studies on dietary consumption and oral

and body measurements were conducted.

health. Additionally, we employed validated techniques
to objectively quantify masticatory performance andBDHQ is a food frequency questionnaire developed

used clinical measures for all oral health indices.

to examine dietary intake estimates for 58 food andFinally, we included the less-studied component of oral

beverage items in the previous month6,7. Based on ahealth, such as salivary flow rate. The cross-sectional

8

review of nutrients important for older adults anddesign, limited sample size, incomplete dimensions of－ 39 －新潟歯学会誌8852（2）：2022

oral health, and the omission of the interaction among

history questionnaires for individuals. Research

the three oral health parameters are the limitations offor evaluation methods of nutrition and dietary

the present study.

lifestyle programs held on Healthy Japan 21
Summary report 2004: 10-44.

【Conclusion】５）Koyano W, Shibata H, Nakazato K, Haga H,
Suyama Y. Measurement of competence:

The intake of various micronutrients, including

reliability and validity of the TMIG Index ofvitamin A, beta-carotene, and folic acids, was lower inCompetence. Arch Gerontol Geriatr 1991; 13（2）:Japanese people who were older because of worse

103–16.

masticatory ability, reduced SSF, and fewer teeth. In６）Kobayashi S, Murakami K, Sasaki S, et al.

older adults with impaired mastication, dry mouth, andComparison of relative validity of food group

significant tooth loss, oral health professionals should

intakes estimated by comprehensive and brieftype self-administered diet history questionnaires

pay close attention to their nutritional intake.

against 16 d dietary records in Japanese adults.

【References】

Public Health Nutr 2011; 14（7）: 1200-11.
７）Kobayashi S, Honda S, Murakami K, et al. Both１）Ogawa H, McKenna G, Kettratad-Pruksapong M.

comprehensive and brief self-administered dietPrevention of Oral Functional Decline.

history questionnaires satisfactorily rank

International Dental Journal 2022; 72（4,nutrient intakes in Japanese adults. J EpidemiolSupplement）: S21-S6.

2012; 22（2）: 151-9.

２）Tada A, Miura H. Systematic review of the８）Bernstein M. Nutritional needs of the older

association of mastication with food and nutrient

adult. Phys Med Rehabil Clin N Am 2017; 28（4）:intake in the independent elderly. Arch Gerontol

747–66.

Geriatr 2014; 59（3）: 497–505.

９）Henshaw MM, Calabrese JM. Oral health and３）Petersen PE, Yamamoto T. Improving the oral
health of older people: the approach of the WHO

nutrition in the elderly. Nutr Clin Care 2001; 4（1）: 34–42.

Global Oral Health Programme. Community10）Karawekpanyawong R, Nohno K, Kubota Y,

Dentistry and Oral Epidemiology 2005; 33（2）:Ogawa H. Oral Health and Nutritional Intake in81-92.

Community-Dwelling 90-Year-Old Japanese４）Sasaki S. Development and evaluation of dietaryassessment methods using biomarkers and dietPeople: A Cross-Sectional Study. Gerodontology
2022.

Table 1. Summary of the main findings
Nutrient*

MP（mg/dL）

Presence oflower MP（<173mg/dL）

SSF（ml/3 min）

Vitamin A+++++

Variable

Folic acid

++

Iron+

Hyposalivation

Number of teeth（teeth）+

Carbohydrate-γ-tocopherol+

Vitamin B2+

N-6 fatty acids+

β-carotene++

Vitamin C+

MP: masticatory performance; SSF: stimulated salivary flow rate
Hyposalivation: SSF ≤ 0.7mL/min*List of nutrients with p < 0.05（two-sided）and q（minimal false discovery rate）< 0.05++: Positive association with a large effect size（the absolute value of unstandardized correlation coefficient（B）more than 10 asrelatively compared within the study); +: Positive association; -: Negative association－ 40 －