記述言語：日本語   出版者・発行元：(公社)日本歯科医師会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

© 2017 Japan Geriatrics Society Aim: To examine the longitudinal association between dentition status and incidence of frailty in older adults. Methods: The present prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Dental examinations, biochemical blood examinations, physical performance and anthropometric measurements, and structured questionnaires were carried out at baseline. The presence of ≥20 teeth with nine or more occluding pairs of teeth was defined as functional dentition. Annual follow-up examinations, including physical performance, anthropometric measurements and structured questionnaires, were carried out over a 5-year period to determine the incidence of frailty, defined as three or more of the following five components derived from the Cardiovascular Health Study: weight loss, weakness, slowness, poor energy and low physical activity level. Adjusted hazard ratios of frailty incidence according to dentition status were calculated from Cox proportional hazards regression analyses. Results: At baseline, 118 participants (36.6%) were defined as having functional dentition. During the follow up, 48 participants (14.9%) developed frailty. The adjusted hazard ratio for frailty in participants with functional dentition was 0.50 (95% confidence interval 0.25–0.98) compared with participants without functional dentition, after adjusting for sex, income, education, smoking status, body mass index, serum biomarkers and comorbidities. Conclusions: Functional dentition was significantly associated with a lower risk of frailty defined by the Cardiovascular Health Study frailty index in older Japanese adults. These results suggest that maintaining healthy and functional dentition into later life is important for frailty prevention. Geriatr Gerontol Int 2018; 18: 256–262.

DOI： 10.1111/ggi.13170

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

© 2019 American Academy of Periodontology. BACKGROUND: People with chronic kidney disease (CKD) may have an increased risk of periodontal disease, but longitudinal evidence is sparse. METHODS: This 4-year cohort study assessed the association between CKD and changes in periodontal health status, defined by attachment loss (AL) progression, among older adults. Participants were 388 community-dwelling Japanese adults who were 70 years old at baseline with 7053 teeth. Estimated glomerular filtration rate (eGFR) was calculated by using baseline serum creatinine concentration. AL at six sites for every tooth was recorded at baseline and follow-up examinations. Multilevel logistic regression models estimated the tooth-specific risk of AL progression (≥1 site exhibiting a ≥3 mm increase in AL) with baseline CKD (eGFR < 60 mL/min/1.73 m2 ) as the principal exposure. RESULTS: At baseline, 27.8% of the study population (108/388 participants) had CKD. After 4 years, 21.8% of the studied teeth (1537/7053 teeth) exhibited AL progression. After applying inverse probability weighting and adjusting for potential confounders, including sex, use of devices for interdental cleaning, smoking, diabetes, tooth location, abutment for a removable denture, and highest AL, CKD was associated with significantly higher odds of AL progression (adjusted odds ratio: 1.73; 95% confidence interval: 1.15-2.60). CONCLUSIONS: The results suggest that CKD increases the risk of periodontal disease progression in older community-dwelling Japanese adults. Additional studies with more complete information, as well as in other geographic areas and age groups, are necessary to further generalize the findings.

DOI： 10.1002/JPER.18-0464

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

© 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd Objective: To evaluate the association of salivary flow rate with all-cause mortality among older Japanese adults. We hypothesised that hyposalivation would be a marker for mortality. Background: Hyposalivation, which is an objectively measurable decrease in salivary flow, is highly prevalent among older adults. It is associated with malnutrition and poor general health. Methods: The study population comprised 600 community-dwelling Japanese adults (306 men and 294 women), who were 70 years old at baseline. They underwent stimulated salivary flow rate (SSFR) measurements and were followed up during a 10-year study period. After stratification by sex, the hazard ratios of all-cause mortality were estimated using Cox proportional hazards regression analysis comparing groups with and without hyposalivation (ie, SSFR < 0.7 mL/min). Results: The baseline prevalence of hyposalivation was 27.8% (85/306) among men and 47.3% (139/294) among women. During a mean (standard deviation) follow-up period of 104 (27) months, 80 deaths occurred: 60 (75.0%) deaths among men and 20 (25.0%) deaths among women. After adjusting for the number of remaining teeth, smoking status, exercise, hypoalbuminemia, diabetes and cardiovascular disease, hyposalivation at baseline was significantly associated with all-cause mortality among men (adjusted hazard ratio, 1.71; 95% confidence interval, 1.01-2.89). In contrast, no association between SSFR and all-cause mortality existed among women. Conclusion: Hyposalivation could be a marker for all-cause mortality among older community-dwelling Japanese men. Future studies investigating the association between SSFR and cause-specific mortality are warranted.

DOI： 10.1111/ger.12319

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掲載種別：研究論文（学術雑誌）  

© 2017 John Wiley & Sons Ltd To determine whether maximum bite force (MBF), an objective measure of oral function, is associated with development of frailty in community-dwelling older adults. This prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Baseline MBF was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up examinations, including physical fitness and anthropometric evaluation and structured questionnaires, were administered annually over a 5-year period to determine the incidence of frailty, which was defined by the presence of 3 or more of the following 5 components derived from the Cardiovascular Health Study: low level of mobility, low physical activity level, weakness, shrinking and poor endurance and energy. Adjusted hazard ratios (HRs) of incidence of frailty according to sex-stratified tertiles of baseline MBF were calculated using Cox proportional hazards regression models. During the follow-up, 49 participants (15.2%) developed frailty. Participants in the lower tertile of MBF exhibited a significantly greater risk of frailty than those in the upper tertile. After adjustment for sex, depression, diabetes and Eichner index, the adjusted HRs for frailty in the upper through lower tertiles of MBF were 1.00 (reference), 1.27 (95% confidence interval [CI]: 0.50-3.20) and 2.78 (95% CI: 1.15-6.72), respectively (P for trend =.01). Poor oral function, as indicated by low MBF, increases the risk of development of frailty among elderly men and women.

DOI： 10.1111/joor.12578

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

© 2018 John Wiley & Sons A/S. Aim: To evaluate the longitudinal association of combined healthy lifestyle factors with incidence or progression of periodontitis and tooth loss in older adults. Materials and methods: This 6-year study included 374 Japanese 70-year olds with 7,157 teeth, from a source eligible baseline population of 554 individuals. Four lifestyle factors—cigarette smoking, physical activity, relative weight, and dietary quality— were scored as healthy (1 point) or unhealthy (0 point). Adding the individual scores generated the “healthy lifestyle score” (0–4 points). Multilevel mixed-effects logistic regression models were applied to evaluate tooth-specific associations between the baseline healthy lifestyle score and the incidence or progression of periodontitis (increase in clinical attachment loss ≥3 mm) and tooth loss. Results: After 6 years, 19.0% of the teeth exhibited periodontitis incidence or progression and 8.2% were lost. Compared with a healthy lifestyle score of 0–1 (least healthy), the highest score (4 points) was associated with a significantly lower tooth-specific risk of periodontitis (adjusted odds ratio = 0.32; 95% confidence interval: 0.16–0.62) and tooth loss (adjusted odds ratio = 0.42; 95% confidence interval: 0.23–0.77). Conclusions: Simultaneous adherence to multiple healthy lifestyle factors significantly lowers the risk of incidence or progression of periodontitis and tooth loss in older adults.

DOI： 10.1111/jcpe.12920

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

© 2014 John Wiley & Sons AS and The Gerodontology Association. Published by John Wiley & Sons Ltd. Background and Objective Potentially significant associations between metabolic syndrome (MetS) and periodontal disease have been reported in recent studies; however, there is a dearth of literature regarding the relationship of MetS with serum antibody levels to periodontal pathogens. The aim of this cross-sectional study was to investigate the association between MetS and serum antibody to the periodontal pathogen Porphyromonas gingivalis (P. gingivalis) in 216 Japanese individuals aged 79 years. Materials and Methods Serum antibody levels to P. gingivalis were measured by enzyme-linked immunosorbent assay. An elevated serum antibody response was defined as the upper quartile and was considered as the outcome variable. A multivariable logistic regression model was used to evaluate the association of MetS defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria with an elevated antibody status. Adjustments for gender, income, education, smoking status, dental-care utilisation patterns and brushing frequency were considered. Results The prevalence of MetS was 22.2% (n = 48). Study participants with MetS were 2.9 times more likely to have an elevated serum antibody to P. gingivalis (adjusted odds ratio = 2.91, 95% confidence interval = 1.24-6.85) after simultaneous adjustment for other covariates. Conclusion Our findings suggest an independent relationship between MetS and serum antibody levels to P. gingivalis in the Japanese elderly. Additional longitudinal epidemiologic studies with larger, more diversified samples and more complete information are needed to substantiate our findings.

DOI： 10.1111/ger.12135

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

© 2016 Japan Geriatrics Society. Aim: Saliva is important for maintaining oral function and regulating oral health. Reduced saliva flow rate, which is common among older adults, has been reported to be associated with perceived chewing and swallowing difficulties; however, its relationship to actual nutrient intake is unclear. The aim of the present cross-sectional study was to evaluate the relationship between hyposalivation and nutrient intake among older Japanese adults. Methods: The participants were 352 community-based Japanese aged 80 years. A stimulated salivary flow rate <0.5mL/min was defined as hyposalivation. Multivariable analysis of differences in nutrient and food intake outcome variables, which were collected through a validated food frequency questionnaire, between groups with/without hyposalivation was carried out using general linear models. Models included adjustment for number of teeth, denture use, sex, income, education, body mass index, smoking status, alcohol use, diabetes, medication, activities of daily living, depression and total calorie intake. Results: The hyposalivation group had significantly lower intake of n-3 polyunsaturated fatty acid, potassium, vitamin D, vitamin E, vitamin B6 and folate than the group without hyposalivation (P<0.05) after adjusting for confounders. Vegetable, fish and shellfish consumption was significantly lower in the hyposalivation group (P<0.05). Conclusions: Dietary intake was poorer in those with hyposalivation than among those without. A decrease in stimulated salivary flow rate could have negative effects on geriatric nutrition.

DOI： 10.1111/ggi.12500

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

© 2014, The Society of The Nippon Dental University. The present study aims to investigate the correlation between SNP genotype patterns and periodontitis severity in Japanese type II diabetic patients. A cross-sectional study in 43 Japanese diabetic patients with periodontitis was performed. Blood samples were drawn for single nucleotide polymorphism (SNP) analyses and periodontal index (probing pocket depth and clinical attachment level) was subsequently recorded. Twelve functional genes with SNPs that had been shown to be associated with diabetes and/or inflammation were genotyped using a nuclease-mediated SNP-specific ligation method. Subjects with two or more sites with clinical attachment level ≥6 mm and who additionally had one or more sites with pocket depth ≥5 mm were classified as having severe periodontitis. Proportions of risk genotypes/non-risk genotypes between severe and non-severe periodontitis were subsequently compared. A high frequency (21/43 participants, 49 %) of adiponectin gene polymorphism (ADIPOQ 45T > G) homozygous risk genotype (TT genotype) was observed in the participants. The frequency of TGF-β1 SNP (29C > T) risk genotype (TT genotype) in severe periodontitis (34 %, n = 11) was significantly higher than in non-severe periodontitis (0 %, n = 0) (p = 0.04). Our study suggests that TGF-β1 SNPs (29C > T) may be used as one of the risk indicators for severe periodontitis in Japanese diabetic patients.

DOI： 10.1007/s10266-014-0171-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: There has been little evaluation in longitudinal epidemiologic studies of the effect of metabolic syndrome (MetS) on periodontal status. The specific aim of this longitudinal study is to investigate whether MetS in the Japanese population could be a risk factor for periodontal disease. Methods: A total of 125 older adults from Japan for whom data were available for the years 2003 to 2006 were selected for the current study. Full-mouth periodontal status, measured as clinical attachment level (CAL), was recorded at baseline and in follow-up examinations. Development of periodontal disease was considered to be ≥2 teeth demonstrating a longitudinal loss of proximal attachment of ≥3 mm at the follow-up dental examination. A multivariable Poisson regression model with robust error variance was used to evaluate the association of MetS defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria with development of periodontal disease. Adjustments for sex, income, education, smoking status, number of teeth at baseline, mean CAL at baseline, pattern of visits to a dentist, and brushing frequency were considered. Results: The prevalence of MetS was 21.6% (27/125). Study participants with MetS were approximately 2.6 times more likely to develop periodontal disease (adjusted relative risk 2.58, 95% confidence interval 1.17 to 5.67) after simultaneous adjustment for other covariates. Conclusions: These findings support the hypothesis that MetS may be a risk factor for periodontal disease in older Japanese individuals. Additional studies with larger, more diverse populations and more complete information are needed to substantiate the findings.

DOI： 10.1902/jop.2015.140398

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The association between adipokines and inflammatory periodontal diseases has been studied over the last two decades. This review was intended to explore the observation that periodontal therapy may lead to an improvement of adipokines in diabetic patients. In summary, substantial evidence suggests that diabetes is associated with increased prevalence, extent and severity of periodontitis. Numerous mechanisms have been elucidated to explain the impact of diabetes on the periodontium. However, current knowledge concerning the role of major adipokines indicates only some of their associations with the pathogenesis of periodontitis in type 2 diabetes. Conversely, treatment of periodontal disease and reduction of oral inflammation may have positive effects on the diabetic condition, although evidence for this remains somewhat equivocal.

DOI： 10.4239/wjd.v5.i6.924

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

本研究の目的は地域在住高齢者における歯数の加齢に伴う変化の軌跡(加齢変化パターン)を類型化し、生命予後との関連を明らかにすることである。70歳から80歳までの10年間に毎年実施した調査に参加した、ベースライン時点で20歯以上を有する299名(男性154名・女性145名)のデータを用いた。70歳から80歳までの歯数の変化に対して、異なる関数形の軌跡をもつグループに分割することを目的に集団軌跡モデルを適応した。その後、歯数の加齢変化パターンと生命予後の関連を評価することを目的にCox比例ハザードモデルによる生存解析を実施した。追跡期間(70歳から85歳)中の総死亡をアウトカムとし、加齢変化パターンごとのハザード比(HR)を算出した。歯数の加齢変化は3つ(28歯維持群、中間-減少群、少ない-減少群)に類型化された。生存解析の結果、少ない-減少群と比較して28歯維持群は総死亡リスクが有意に低いことがわかった(adjusted HR=0.50、95%信頼区間=0.28-0.89)。結論として70歳で20歯以上を有する地域在住高齢者において、その後10年間の歯数の加齢変化は一様でなく、生命予後の観点からはできる限り多くの歯を維持することが重要であり、28歯を維持できれば最も望ましいことが本研究から示唆された。(著者抄録)

DOI： 10.5834/jdh.69.3_131

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

高齢化が進み、有病者への対応や医療連携体制の必要性が高まる現在、診療所は一次医療機関として、多岐にわたる患者への対応および地域における多職種連携等が求められている。本調査の目的は、新潟県の診療所に勤務する各業種の従事状況と、診療所で担える診療内容の関連について評価することである。平成24年8月1日現在、新潟県で開設されている県内すべての歯科診療所(1,186施設)を対象に調査を行い、平成24年7月の1ヵ月間の実施状況について、質問紙による調査で回答を得た。欠損値のない950施設を分析対象とした。診療所に勤務している歯科医師数あるいは歯科衛生士数を説明変数とし、歯科業務補助者数、技工士数、事務職数を共変量に在宅歯科医療サービスの実施状況についてロジスティック回帰分析、障害者および摂食嚥下指導への対応状況については順序ロジスティック回帰分析を行った。その結果、歯科衛生士数のみと関連がみられたのは在宅歯科医療サービス、施設への歯科訪問診療、訪問歯科衛生指導、障害者への対応(それぞれ調整済オッズ比[95%信頼区間]=1.12[1.03-1.23]、1.11[1.01-1.23]、1.31[1.16-1.47]、1.27[1.16-1.40])であった。一方、摂食嚥下指導への対応については歯科医師数(1.24[1.04-1.48])とのみ関連がみられた。診療所の多岐にわたる患者への対応や病診連携を推進するには、まずは歯科医師の意識向上が前提であり、それを基に診療所における歯科医師および歯科衛生士の人材確保が必要である。(著者抄録)

DOI： 10.5834/jdh.69.1_10

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

健康の評価方法として、歯科保健の分野においても主観的評価による健康度を評価指標にした調査が報告されている。しかし、主観的健康観についての調査対象は高齢者が多く、65歳未満の者を対象とした調査はほとんど行われていない。そのため本研究は、一般地域住民を対象に、歯や歯肉の健康状態と全身健康状態との関連を主観的健康観により明らかにすることを目的とした。全国から20〜79歳の5,000人を抽出し、質問紙による調査で回答を得た2,465人(有効回収率49.3%)の中から、分析に用いる変数に欠損値のない1,972人を分析対象者とした。対象者を年齢によって壮年(20〜39歳)・中年(40〜59歳)・高年(60〜79歳)の3区分に分け、それぞれの群において歯や歯肉の健康状態と全身健康状態の主観的健康観の回答をそれぞれカテゴリー化した後、相互の関連を順序ロジスティック回帰分析を用いて分析した。共変量として、現在歯数、性別、仕事の有無、主観的経済状況、就学年数、治療中の疾患の有無、相談相手の有無、BMIを使用した。その結果、すべての年齢群において歯や歯肉の健康状態が良いと回答した者は全身的な健康状態がより良好であると回答していた(調整済オッズ比[95%信頼区間]=壮年期12.41[7.22-21.34]、中年期11.77[7.50-18.48]、老年期10.07[6.55-15.50])。一般住民において属性や関連要因を調整した分析で、いずれの年代においても主観的な歯や歯肉の健康状態と全身健康状態との間には明確な関連性が認められた。(著者抄録)

DOI： 10.5834/jdh.68.4_198

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

フレイルと歯・口腔の健康との関連は疫学的に十分に解明されていない。今回われわれは、地域在住高齢者における現在歯数および義歯の使用状況・主観的評価とフレイルとの関連を明らかにすることを目的とする横断研究を実施した。79歳高齢者344人を解析対象とした。フレイルは、Study of Osteoporotic Fracture Criteria for Frailtyを一部改変したものを用いて定義し、目的変数とした。説明変数には現在歯数および義歯の使用状況・主観的評価を用いた。そして両者の関連を性別、体格、および精神健康状態を共変量とするロジスティック回帰分析を用いて評価した。解析対象者におけるフレイルの頻度は8.4%であった。現在歯数(1本増加ごとの調整済オッズ比[OR]=0.94、95%信頼区間[CI]=0.90-0.99)、現在歯数20本以上有すること(20本未満と比較した調整済OR=0.39、95%CI=0.15-0.97)、義歯不使用(義歯使用者と比較した調整済OR=17.89、95%CI=5.00-64.32)、主観的に義歯不具合の訴えがあること(訴えなしと比較した調整済OR=3.38、95%CI=1.01-11.27)はフレイルと有意に関連していた。本研究結果から、地域在住高齢者において現在歯数および義歯の使用状況・主観的評価はフレイルと有意に関連していることが示された。(著者抄録)

DOI： 10.5834/jdh.68.2_68

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

認知症に影響する口腔関連の要因には、歯周組織の慢性炎症状態、口腔への刺激および咀嚼運動による脳への刺激、口腔機能の低下による低栄養、長期間にわたるバランスの良い食事スタイル、生活習慣病および社会交流が挙げられる。これらのエビデンスとして国内外での多くの縦断または介入研究において、認知機能の低下・認知症の発症と口腔健康状態との間で有意な関連が報告されている。したがって、口腔保健は認知症予防に寄与する蓋然性が高いと考えられ、口腔保健に従事する関係者は、このことを念頭に置いて一次〜三次予防(口腔疾患の予防、早期発見・早期治療による歯の喪失の予防、喪失部位に対する補綴治療)を系統的に今後進めていく必要がある。また、口腔保健からのアプローチは他職種との連携を通して行われる必要がある。加えて、政策面においては高齢者における介護予防プログラムへの歯科保健の導入を一層促進すべきであり、研究面においては認知機能の低下・認知症の発症に及ぼす口腔保健の効果についてエビデンスをさらに積み重ね、認知症予防に向けた認知症施策の推進と評価に資する根拠と実践を図ることが必要である(図)。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本有病者歯科医療学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：有限責任中間法人日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：新潟歯学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔衛生学会  

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