Maximum Occlusal Force and Physical Performance in the Oldest Old: The Tokyo Oldest Old Survey on Total Health

  • Toshimitsu Iinuma
    Department of Complete Denture Prosthodontics
  • Yasumichi Arai
    Department of Internal Medicine Division of Geriatric Medicine
  • Motoko Fukumoto
    Department of Complete Denture Prosthodontics
  • Michiyo Takayama
    Department of Internal Medicine Division of Geriatric Medicine
  • Yukiko Abe
    Department of Internal Medicine Division of Geriatric Medicine
  • Keiko Asakura
    Department of Preventive Medicine and Public Health Keio University School of Medicine Tokyo Japan
  • Yuji Nishiwaki
    Department of Preventive Medicine and Public Health Keio University School of Medicine Tokyo Japan
  • Toru Takebayashi
    Department of Preventive Medicine and Public Health Keio University School of Medicine Tokyo Japan
  • Takashi Iwase
    Department of Pathology Nihon University School of Dentistry Tokyo Japan
  • Kazuo Komiyama
    Department of Pathology Nihon University School of Dentistry Tokyo Japan
  • Nobuhito Gionhaku
    Department of Complete Denture Prosthodontics
  • Nobuyoshi Hirose
    Department of Internal Medicine Division of Geriatric Medicine

抄録

<jats:sec><jats:title>Objectives</jats:title><jats:p>To elucidate the independent relationship between masticatory and physical performance in community‐living oldest old people (mean age ± standard deviation 87.8 ± 2.2, range 85–102).</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Cross‐sectional analysis<jats:bold>.</jats:bold></jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>University research center or home‐based examination.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>Four hundred eighty‐nine community‐living individuals (219 men, 270 women) aged 85 and older.</jats:p></jats:sec><jats:sec><jats:title>Measurements</jats:title><jats:p>Maximum occlusal force (<jats:styled-content style="fixed-case">MOF</jats:styled-content>) was measured using an occlusal force measuring device. Sociodemographic and functional factors, oral health, comorbidities, blood chemistry, lower extremity performance, and handgrip strength were assessed. Blood chemistry analyses included serum albumin, C‐reactive protein, interleukin (<jats:styled-content style="fixed-case">IL</jats:styled-content>)‐6, and total and free testosterone.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p><jats:styled-content style="fixed-case">MOF</jats:styled-content> was significantly associated with age, body mass index, and cognitive impairment in men but not in women. Comorbidities and blood chemistry were not associated with <jats:styled-content style="fixed-case">MOF</jats:styled-content> except for a significant association with <jats:styled-content style="fixed-case">IL</jats:styled-content>‐6 concentration in women. In a multivariate model adjusted for various confounders, lower <jats:styled-content style="fixed-case">MOF</jats:styled-content> was associated with greater risk for poor performance on the timed up and go (<jats:styled-content style="fixed-case">TUG</jats:styled-content>) test in men and women (men: odds ratio (<jats:styled-content style="fixed-case">OR</jats:styled-content>)=2.34, 95% confidence interval (<jats:styled-content style="fixed-case">CI</jats:styled-content>)=1.02–5.38; women: <jats:styled-content style="fixed-case">OR</jats:styled-content>=2.44, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content>=1.12–5.33). <jats:styled-content style="fixed-case">MOF</jats:styled-content> was similarly associated with performance in chair standing, one‐leg standing, and handgrip strength only in men. These associations remained after adjustment for number of natural teeth.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p><jats:styled-content style="fixed-case">MOF</jats:styled-content> was strongly and independently associated with all measures of physical performance in men and with the <jats:styled-content style="fixed-case">TUG</jats:styled-content> test in women after adjustment for various confounders, suggesting that age‐related declines in masticatory and skeletal muscle functions share common mechanistic pathways in older age, particularly in men.</jats:p></jats:sec>

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