We prototyped a new device with a soft and flexible pressure sensor to measure the force to close the mandible with or without occlusal support (jaw-closing force, JCF). This study aimed to clarify the practicality of this instrument. Healthy young and older adults with occlusal support were recruited. Intra- and inter-rater reliability of the JCF meter was examined using data from younger participants. Data regarding age, sex, body mass index, remaining teeth, and dentures of the older adults were obtained. Furthermore, the right and left JCFs were measured using a JCF meter; occlusal force was measured using an existing occlusal force-measuring device. Intra- and inter-rater correlation coefficients were significantly reproducible (0.691–0.811, p < 0.05). JCF was correlated with occlusal force (p < 0.05). Multiple regression analysis revealed that factors significantly associated with JCF included denture status (p < 0.001), age (p = 0.038), and occlusal force (p = 0.043). The prototyped JCF meter can measure JCF with high reproducibility, reliability, and validity. Further, association with occlusal force, which is an existing index, was observed. This device could be used to measure the JCF with or without occlusal support as a new method of evaluating oral function in older adults.
Gerstmann-Sträussler-Scheinker disease (GSS) is a genetic prion disease. Swallowing function evaluation in patients with GSS remains unclear. Here, we describe a case of videofluoroscopic examination of swallowing (VF) to facilitate continued oral ingestion in a patient with P105L GSS. A 67-year-old woman developed gait disturbance and Parkinsonism symptoms at the age of 54 years. Since her family wanted her to continue oral ingestion, we performed VF, which revealed impairment and preservation of the oral and pharyngeal phases, respectively. Moreover, the impairment of the oral phase was improved by adjusting the patient’s posture and food consistency. A swallowing function evaluation based on the condition of a patient with GSS may facilitate continued oral ingestion.
In clinical practice, we encounter cases wherein older adults lacking occlusal support consume foods requiring mastication and adequate swallowing function. This study investigated the relationship between jaw-closing force (JCF) and dietary form in older adults without occlusal support requiring nursing care. This prospective cross-sectional study included 123 older adults requiring nursing care who lost their molar occlusal support and consumed food orally without dentures. JCF was defined as the force required for crushing food with the edentulous ridges or with the tooth and edentulous ridge while closing the mouth. Participants were classified into four groups based on the International Dysphagia Diet Standardization Initiative framework for recommended dietary forms. Basic information was collected, and tongue pressure and JCF were measured. Differences in JCF were analyzed using one-way analysis of variance, while factors related to dietary form were evaluated using ordinal logistic regression analysis. Significant differences in JCF were observed among the four groups. Factors such as the Barthel Index, tongue pressure, and JCF were dietary form-related. Our findings suggest that older adults requiring nursing care tend to have higher JCF when consuming meals requiring mastication. Therefore, JCF could serve as an index for determining appropriate dietary forms in this population.
Physical performance shows approximately 30% diurnal variation; however, diurnal variation in oral function remains unclear. This study aimed to determine the diurnal variation in oral and swallowing function in older adults requiring long-term care. The participants included 13 adults aged >60 years (3 men and 10 women, mean age: 77.2 ± 6.3 years, age range: 62–90 years) requiring long-term care. Tongue strength (TS) and oral mucosal moisture were measured as indices of oral and swallowing function, while hand grip strength was measured as an index of general muscle strength. The patients were asked to participate in a “test” after breakfast, lunch, and dinner on the same day. Multilevel linear regression analysis was used to examine diurnal differences in each item. Multilevel linear regression analysis with adjustment for age and sex revealed that TS was significantly higher at noon (p = 0.001) than in the morning. Therefore, caregivers who provide support during meals to older people requiring long-term care should consider the possibility of swallowing function differing according to the time of the day. In conclusion, it may be beneficial to establish a nutritional therapy that accounts for the diurnal variation in TS.
Background/Objectives: Direct and indirect training are well established in dysphagia rehabilitation, but the role of brief psychosocial interactions in home-based care remains unclear. This retrospective cohort study examined whether provider-based exposure to “Ippatsu-gei” was associated with spontaneous activity and adverse events during home-visit dysphagia rehabilitation. Methods: Clinical records were reviewed for patients who received at least one session between January and June 2019. Exposure was defined as care from dentists who routinely incorporated Ippatsu-gei into patient communication. Spontaneous-activity analysis required complete 180-day follow-up (N = 148); adverse-event analysis included patients with complete follow-up or a predefined event within 180 days (N = 150). Results: Spontaneous activity was documented in 18 of 148 patients (12.2%). Ippatsu-gei exposure was associated with higher odds of spontaneous activity (adjusted odds ratio 5.42; 95% confidence interval 1.62–18.18; p = 0.006), although the estimate remained imprecise. Adverse events occurred in 31 of 150 patients (20.7%) and were not significantly associated with Ippatsu-gei exposure (adjusted odds ratio 0.53; 95% confidence interval 0.20–1.39; p = 0.195). Conclusions: Provider-based Ippatsu-gei exposure was associated with retrospectively documented spontaneous activity, but causal interpretation is limited by temporal uncertainty, provider-related effects, and residual confounding. No statistically significant association with adverse events was observed.