研究者詳細 - 葭原　明弘

Malnutrition and Oral Disease in the Elderly––Is There Any Bidirectional Relationship?

Masanori Iwasaki, Misuzu Sato, Akihiro Yoshihara, Hideo Miyazaki

Current Oral Health Reports 4 ( 2 ) 70 - 78 2017年4月

地域高齢者における平衡機能と口腔機能の関連

小田島あゆ子, 葭原明弘, 石上和男, 笹嶋真嵩, 野々村絢子, 宮崎秀夫

口腔衛生学会雑誌 67 ( 増刊 ) 117 - 117 2017年4月

地域在住高齢者における健康習慣と歯の喪失・歯周病リスクの関連

岩崎正則, 葭原明弘, 佐藤美寿々, 安細敏弘, 宮崎秀夫

口腔衛生学会雑誌 67 ( 増刊 ) 116 - 116 2017年4月

知的障害者における歯の喪失状況および義歯使用と日常生活動作との関連査読

米澤大輔, 石川裕子, 葭原明弘

日本歯科衛生学会雑誌 11 ( 2 ) 32 - 39 2017年2月

Association between tooth loss and medical costs related to stroke in healthy older adults aged over 75 years in Japan

Masanori Iwasaki, Misuzu Sato, Akihiro Yoshihara, Toshihiro Ansai, Hideo Miyazaki

GERIATRICS & GERONTOLOGY INTERNATIONAL 17 ( 2 ) 202 - 210 2017年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY

AimGrowing evidence suggests that tooth loss is associated with increased risk of stroke. In the current study, we investigated cumulative medical costs related to stroke using data from the Advanced Elderly Medical Service System. We hypothesized that tooth loss was associated with an increase in medical costs related to stroke among older Japanese adults.
MethodsA total of 273 Japanese adults aged 80 years were enrolled in the current study. Baseline medical and dental examinations were carried out in June 2008. Medical care use and costs were monitored by linkage with National Health Insurance claim files from baseline to the end of February 2011. Medical costs related to stroke per month were calculated and examined for any association with the baseline number of remaining teeth using a linear regression model with robust standard errors.
ResultsA total of 19 individuals were admitted to hospital for stroke during the follow-up period. A significant negative association was found between the number of teeth and medical costs related to stroke per month. The regression coefficients of the number of teeth in relation to medical costs related to stroke was -248 (95% CI -438 to -58, P=0.011) in the crude model and -226 (95% CI -413 to -38, P=0.018) after adjusting for other confounders.
ConclusionWithin the limitations of the present study, the reported findings suggest an independent relationship of tooth loss with increase in medical cost related to stroke among older Japanese adults. Further studies are necessary to substantiate these findings. Geriatr Gerontol Int 2017; 17: 202-210.

DOI： 10.1111/ggi.12687

現在歯数20本以上の75歳高齢者は「健康な食事パターン」を満たしているか？

Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. 査読

NCD Risk Factor Collaboration, NCD-RisC

Lancet (London, England) 389 ( 10064 ) 37 - 55 2017年1月

Malnutrition and oral disease in the elderly – is there any bidirectional relationship? 招待査読

Masanori Iwasaki, Misuzu Sato, Akihiro Yoshihara, Hideo Miyazaki

Current Oral Health Reports 4 ( 2 ) 70 - 78 2017年

木村秀喜, 渡邊智子, 鈴木亜夕帆, 岩﨑正則, 葭原明弘, 小川祐司, 宮﨑秀夫

口腔衛生学会雑誌 67 ( 3 ) 172 - 180 2017年

記述言語：日本語出版者・発行元：一般社団法人口腔衛生学会

<p> 高齢者の歯・口腔の健康は摂食と構音を良好に保つために重要であり，生活の質（QOL）の向上にも大きく寄与するとされている．歯を20本以上有することは，口腔の機能を維持し，さらには全身の健康に寄与する一つの基準とされている．厚生労働省は日本人の長寿を支える「健康な食事」を示している．そこで本研究は，現在歯数20本以上の75歳高齢者が「健康な食事パターン」を満たしているか検討した．対象は2003年新潟市高齢者コホートスタディに参加し，口腔内診査，健康診査，簡易型自記式食事歴法質問票（BDHQ）調査等に協力が得られた75 歳高齢者338人とした．「健康な食事パターン」は「健康な食事」を参考にした．「健康な食事」は料理区分を主食，主菜，副菜とし，1食の上限および下限値を定めている．本研究は，下限値の3倍量を主食，主菜，副菜の下限量／日と定めた．3料理区分すべてを満たしている食事パターンを充足群，それ以外を不足群とした．対象者を現在歯数20本以上，未満の2群に分け，現在歯数と「健康な食事パターン」の関連について多重ロジスティック回帰分析を用いて評価した．結果として，現在歯数を20本以上有する群の「健康な食事パターン」充足に対する調整オッズ比は1.7（95% 信頼区間=1.1-2.6）であり，統計的に有意だった．結論として，地域在住高齢者において現在歯を20本以上有することと食事パターンの間に関連があることが示された．</p>

DOI： 10.5834/jdh.67.3_172

CiNii Article

CiNii Books

その他リンク： http://search.jamas.or.jp/link/ui/2017356870

Oral health and depression in older Japanese people

Tomoya Takiguchi, Akihiro Yoshihara, Naoko Takano, Hideo Miyazaki

GERODONTOLOGY 33 ( 4 ) 439 - 446 2016年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY-BLACKWELL

ObjectiveThe aim of this study was to investigate the relationship between oral dysfunction and depressive symptoms in Japanese community-dwelling seniors.
Materials and methodsParticipants included 351 community-dwelling seniors (189 men, 162 women) aged 77years. During dental examination, teeth and periodontal condition, including number of teeth, number of dental caries, pocket depth and clinical attachment level, were assessed, and unstimulated and stimulated salivary flow rates were measured. The General Health Questionnaire 30 (GHQ-30) was used to assess depression. The Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence was used to assess activities of daily living.
ResultsMultiple logistic regression analysis revealed that gender (odds ratio [OR] = 2.3), low unstimulated salivary flow rate (OR = 2.1), Complaint of mouth pain' (OR = 2.4), Complaint of physical disorders' (OR = 2.1), and the total TMIG Index of Competence score (OR = 2.0) were positively associated with the high GHQ-30 score.
ConclusionSubjective and objective oral dryness and oral pain are associated with depressive symptoms.

DOI： 10.1111/ger.12177

Longitudinal association of dentition status with dietary intake in Japanese adults aged 75 to 80 years 査読

M. Iwasaki, A. Yoshihara, H. Ogawa, M. Sato, K. Muramatsu, R. Watanabe, T. Ansai, H. Miyazaki

JOURNAL OF ORAL REHABILITATION 43 ( 10 ) 737 - 744 2016年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY-BLACKWELL

Limited information is available on the temporal association between dentition status and dietary intake. The aim of this 5-year prospective cohort study was to investigate whether impaired dentition was associated with subsequent decline in dietary intake in older Japanese adults. Two hundred and eighty-six community-dwelling Japanese individuals, all aged 75 years at baseline, were included in the study. Functional tooth units (FTUs), defined as a pair of opposing natural or prosthetic teeth excluding third molars (range: 0-14), were counted on the basis of baseline dental examinations. Individuals with 5 FTUs were defined as having impaired dentition. Dietary intake was assessed at baseline and 5 years later, using a validated dietary questionnaire. Robust regression analyses were used to evaluate the differences in change in dietary intake between participants with and without impaired functional dentition, after adjustment for potential confounders. Sixty-one study participants (213 %) were defined as having impaired dentition. Overall, mean values for all estimated dietary variables (energy, nutrients and food groups) declined over time. Notably, individuals with impaired dentition demonstrated a significantly (P < 005) greater degree of decline in the intake of multiple nutrients (protein, sodium, potassium, calcium, vitamin A, vitamin E and dietary fibre) and food groups (vegetable and meat) than those without impaired dentition, after adjusting for potential confounders. The results of this study describe the temporal association of impaired dentition with the decline in selected nutrient and food group intake among older Japanese adults.

DOI： 10.1111/joor.12427

Longitudinal relationship of severe periodontitis with cognitive decline in older Japanese 査読

M. Iwasaki, A. Yoshihara, Y. Kimura, M. Sato, T. Wada, R. Sakamoto, Y. Ishimoto, E. Fukutomi, W. Chen, H. Imai, M. Fujisawa, K. Okumiya, G. W. Taylor, T. Ansai, H. Miyazaki, K. Matsubayashi

JOURNAL OF PERIODONTAL RESEARCH 51 ( 5 ) 681 - 688 2016年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY-BLACKWELL

Background and Objective: Epidemiologic data examining the longitudinal relationship between periodontitis and cognitive status are very limited, especially in Asian populations. The present study examined the longitudinal relationship of periodontitis with cognitive decline in 85 Japanese community-dwelling individuals (average age: 79.3 years) for whom data were available from comprehensive health examinations conducted in 2010 and 2013.
Material and Methods: Based on a baseline full-mouth periodontal examination, severe periodontitis was defined using a Centers for Disease Control and Prevention/American Academy of Periodontology definition. Cognitive decline during the 3-year study period was defined using the results of the Mini-Mental State Examination (MMSE). Information on age, gender, education, depression, body mass index, smoking status, alcohol use, exercise, hypertension, diabetes, history of cardiovascular disease and stroke, and baseline MMSE scores were obtained and tested as potential confounders in the statistical models.
Results: Among 85 study participants, 21 (24.7%) were defined as having severe periodontitis. Multivariable Poisson regression analyses revealed that severe periodontitis was significantly associated with an increased risk of cognitive decline [adjusted relative risk = 2.2; 95% confidence interval (95% CI): 1.1-4.5]. Furthermore, multivariable linear regression analyses revealed that participants with severe periodontitis had a 1.8-point greater decrease (95% CI: -3.3 to -0.2) in MMSE score than those without severe periodontitis.
Conclusion: Within the limitations related to its small sample size, the findings of the present study suggest that severe periodontitis is significantly associated with future decline in cognitive function among community-dwelling older Japanese subjects.

DOI： 10.1111/jre.12348

Cystatin C-based estimated glomerular filtration rate and periodontitis

Masanori Iwasaki, George W. Taylor, Misuzu Sato, Kazutoshi Nakamura, Akihiro Yoshihara, Hideo Miyazaki

GERODONTOLOGY 33 ( 3 ) 328 - 334 2016年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY-BLACKWELL

Background and ObjectiveAccumulating evidence suggests that decreased kidney function characterised by low estimated glomerular filtration rate (eGFR) may be associated with periodontitis. Recent studies have suggested that the use of cystatin C strengthens the association between the eGFR and the risks of adverse outcomes in decreased kidney function. The aim of this cross-sectional study was to investigate the association of cystatin C-based eGFR (eGFRcys) and creatinine-based eGFR (eGFRcreat), the commonly used method to assess kidney function, with periodontitis in 502 Japanese women (average age, 68.6years).
Materials and MethodsGFR was estimated from serum cystatin C and serum creatinine, respectively, using the Japanese equation for GFR. Participants were classified into five groups according to their eGFRcys and eGFRcreat values. Poisson regression models with robust error variance assessed the associations of eGFRcys and eGFRcreat with periodontitis. Tests for trends were performed by fitting the five-category eGFR variables in their continuous form to the regression models.
ResultsParticipants with eGFRcys<50ml/min/1.73 m(2) were at significantly higher risk of periodontitis compared with the reference group (90ml/min/1.73m(2)) (adjusted relative risk = 2.12, 95% confidence interval = 1.12 to 4.02). Additionally, there was a trend towards a higher risk of periodontitis among participants with lower eGFRcys values (p for trend in the multivariable model = 0.008). In contrast, eGFRcreat did not show a significant association with periodontitis.
ConclusionThe findings of this study of Japanese older women showed that eGFRcys had a stronger and more linear association with periodontitis than eGFRcreat.

DOI： 10.1111/ger.12159

Bidirectional relationship between renal function and periodontal disease in older Japanese women

Akihiro Yoshihara, Masanori Iwasaki, Hideo Miyazaki, Kazutoshi Nakamura

JOURNAL OF CLINICAL PERIODONTOLOGY 43 ( 9 ) 720 - 726 2016年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：WILEY-BLACKWELL

ObjectivesThe purpose of this study was to evaluate the reciprocal effects of chronic kidney disease (CKD) and periodontal disease.
Material and MethodsA total of 332 postmenopausal never smoking women were enrolled, and their serum high-sensitivity C-reactive protein, serum osteocalcin and serum cystatin C levels were measured. Poor renal function was defined as serum cystatin C>0.91mg/l. Periodontal disease markers, including clinical attachment level and the periodontal inflamed surface area (PISA), were also evaluated. Logistic regression analysis was conducted to evaluate the relationships between renal function and periodontal disease markers, serum osteocalcin level and hsCRP level. The prevalence-rate ratios (PRRs) on multiple Poisson regression analyses were determined to evaluate the relationships between periodontal disease markers and serum osteocalcin, serum cystatin C and serum hsCRP levels.
ResultsOn logistic regression analysis, PISA was significantly associated with serum cystatin C level. The odds ratio for serum cystatin C level was 2.44 (p=0.011). The PRR between serum cystatin C level and periodontal disease markers such as number of sites with clinical attachment level 6mm was significantly positive (3.12, p<0.001). Similar tendencies were shown for serum osteocalcin level.
ConclusionThis study suggests that CKD and periodontal disease can have reciprocal effects.

DOI： 10.1111/jcpe.12576

Maximum bite force at age 70 years predicts all-cause mortality during the following 13 years in Japanese men 査読

M. Iwasaki, A. Yoshihara, N. Sato, M. Sato, G. W. Taylor, T. Ansai, T. Ono, H. Miyazaki

Journal of Oral Rehabilitation 43 ( 8 ) 565 - 574 2016年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Blackwell Publishing Ltd

There is limited information on the impact of oral function on mortality among older adults. The aim of this prospective cohort study was to examine whether an objective measure of oral function, maximum bite force (MBF), is associated with mortality in older adults during a 13-year follow-up period. Five hundred and fifty-nine community-dwelling Japanese (282 men and 277 women) aged 70 years at baseline were included in the study. Medical and dental examinations and a questionnaire survey were conducted at baseline. Maximum bite force was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up investigation to ascertain vital status was conducted 13 years after baseline examinations. Survival rates among MBF tertiles were compared using Cox proportional hazards regression models stratified by sex. There were a total of 111 deaths (82 events for men and 29 for women). Univariable analysis revealed that male participants in the lower MBF tertile had increased risk of all-cause mortality [hazard ratio (HR) = 1·94, 95% confidence interval (CI) = 1·13–3·34] compared with those in the upper MBF tertile. This association remained significant after adjustment for confounders (adjusted HR = 1·84, 95% CI = 1·07–3·19). Conversely, no association between MBF and all-cause mortality was observed in female participants. Maximum bite force was independently associated with all-cause mortality in older Japanese male adults. These data provide additional evidence for the association between oral function and geriatric health.

DOI： 10.1111/joor.12401

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