• 치위생과학회지
• /
• 제23권4호
• /
• pp.378-388
• /
• 2023

Background: With increasing interest in health in old age, aspects of oral aging are being considered. The Korean Academy of Geriatric Dentistry recently proposed the diagnostic criteria for oral frailty in older adults in Korea. This study aimed to conduct a cross-sectional survey of factors related to oral frailty among community-dwelling older adults and identify differences in oral frailty status according to age and sex. Methods: Among 217 older adults aged ≥60 years who visited a senior center in Wonju, 206 completed all tests for oral frailty. Among them, data from those with a Korean Version of the Modified Barthel Index score ≥90 were used in the final analysis. After evaluating oral frailty diagnostic factors such as chewing ability, occlusal force, tongue pressure, oral dryness, oral cleanliness, and swallowing function, oral hypofunction was determined according to the oral frailty diagnostic criteria. Subsequently, the evaluation results were compared based on sex and age. Results: Significant differences in chewing ability, maximum occlusal pressure, and maximum tongue pressure were observed between sexes. However, these differences did not affect oral frailty diagnosis. All diagnostic factors of oral frailty, except for the risk of oral dryness and swallowing dysfunction, showed significant differences with age. However, no significant difference was observed in the prevalence of oral frailty. Additionally, this study found no relationship between sex and oral frailty factors using the oral frailty diagnostic criteria. However, it also found that age plays a significant role as an oral frailty diagnostic indicator, in addition to oral dryness and swallowing function. Conclusion: Sex and age did not affect oral frailty diagnosis. However, patients' chewing ability, occlusal force, and tongue pressure were affected by sex and age. Therefore, sex and age should be considered when diagnosing and intervening in oral frailty in the future.

• 치위생과학회지
• /
• 제24권1호
• /
• pp.1-8
• /
• 2024

Background: Oral frailty is defined as the functional decline of the oral function due to aging, and it is associated with frailty and chronic disease. Most of the frailty intervention is for adults aged 65 years and older. However, early intervention for preventive disorder is most important. The objective of this study was to identify the age at which oral frailty surpass the "normal" range. Methods: This cross-sectional study included 719 adults (aged 30~89 years) residing in Gangwon province in May 2023. Risk of oral frailty was assessed using criteria from The Korean Academy of Geriatric Dentistry including oral function such as swallowing and mastication, and frailty. Frailty was assessed using the Kihon Checklist. To determine when oral frailty surpass the "normal" status, statistical analysis including chi-squared tests and multiple logistic regression analysis were performed using R (ver. 4.3.1). Results: There were 388 (54.0%) individuals who had a "normal" status risk of oral frailty. The risk of oral frailty was higher in the 50~54 age group compared to the 30~34 age group (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28~0.91), after adjusting for gender, education, income, occupation, and frailty (OR 0.46, 95% CI 0.22~0.94). This means that from 50~54 years old, regardless of gender, education, income, occupation, or frailty condition, there is a distinction from the "normal" status. Conclusion: We found that intervention for oral frailty is needed starting from age 50 years. This is the stage where early indications of oral frailty become apparent. Early intervention for oral frailty can lead to a decrease in the prevalence of diseases and medical expenditure. Therefore, early intervention in middle-aged adults of oral frailty is necessary to improve the quality of life related to oral health.

• 한국치위생학회지
• /
• 제20권3호
• /
• pp.347-357
• /
• 2020

Objectives: The purpose of the study was to investigate the relationship between frailty and oral health among some elderly community residents. Methods: A self-reported questionnaire was completed by 240 elderly in the Gwangju-Jeonnam area from October 1, 2019, to November 30, 2019, based on convenience sampling. The questionnaire consisted of general characteristics of the subjects, frailty level (Kihon checklist), and Geriatric Oral Health Assessment Index. Results: There were 66 (27.5%) frail elderly, and the GOHAI group with a score less than 45 constituted 187 (77.9%), which was higher than the group with a score of 45 or higher. The distribution of the frail elderly was indicated to be higher in the people with older age (p<0.05), lower educational level (p<0.01), current economic inactivity (p<0.05), living alone (p<0.01), more chronic diseases (p<0.01), and GOHAI score below 45 (p<0.01). Compared to those with a good oral health-related quality of life, those with a poor quality of life showed a 3.03 times higher risk of frailty (95% CI=1.291-7.107)(p<0.05). Conclusions: By recognizing the need for oral health care of the elderly through these results and by identifying the relationship between frailty and oral health, it is possible to consider oral health as a predictor of frailty.

• 치위생과학회지
• /
• 제23권4호
• /
• pp.320-329
• /
• 2023

Background: Oral frailty has garnered considerable interest following its identification as a risk factor for physical frailty. The Korean oral frailty diagnosis criteria have emphasized the need for extensive research on oral frailty diagnostic items and interventions. Our study performed an in-depth analysis of the tongue-palate pressure patterns in healthy community-dwelling older adults. Methods: Of the 217 older adults aged ≥60 years who visited a senior center in Wonju, 205 participants who completed tongue pressure measurement were included in the final analysis. Pressure changes over time were recorded by instructing the participants to press their tongue against the hard palate with for 7 seconds per cycle. The participants were divided into the normal and abnormal tongue pressure (NTP and ATP, respectively) groups based on whether they achieved the target tongue pressure at least once; tongue pressure patterns were compared between the groups. Furthermore, the average time taken to achieve the standard tongue pressure value was calculated for the participants in the NTP group and used to evaluate the decrease in tongue pressure in the ATP group. Results: Among the 205 participants, 40.5% had ATP. The tongue pressure graph revealed a gentle and consistent incline that was maintained even after achieving standard tongue pressure in the NTP group. The graph was more extreme in the ATP group, and the changes in the pressure type varied across individuals; the tongue pressure was only 48.4%, 40.7%, 31.9%, and 22.6% of the NTP in the participants in their 60s, 70s, 80s, and ≥90s, respectively (p<0.05). Conclusion: Tongue pressure weakness was observed in 40.5% of the healthy community-dwelling older adults. Furthermore, ATP graphs were observed in the patients with tongue pressure weakness. Thus, activities improving the oral function in community-dwelling older adults and systematic oral rehabilitation programs should be devised to promote normal swallowing.

• 한국치위생학회지
• /
• 제24권2호
• /
• pp.109-119
• /
• 2024

연구목적: 본 연구는 노인들의 구강노쇠 실태를 파악하고 구강노쇠와 건강관련 삶의 질(HINT-8)의 관련성을 확인하는 것이다. 연구방법: 제8기 1차 국민건강영양조사 원시자료를 이용하여 65세 이상 노인의 구강노쇠와 건강관련 삶의 질(HINT-8)의 관련성을 확인하고자 복합표본 교차분석과 일반선형모형, 복합표본 로지스틱 회귀분석을 시행하였다. 연구결과: 건강관련 삶의 질(HINT-8)은 저작불편이 있는 사람은 1.183배, 말하기 불편이 있는 사람은 1.236배, 현존치아 수가 19개 이하인 사람은 1.153배, 칫솔질 평균횟수가 2회 이하인 사람은 1.043배 낮았다(p<0.05). 저작불편이 있는 사람은 저작불편이 없는 사람보다 신체적 건강영역의 삶의 질은 1.246배 낮았고, 사회적 건강영역의 삶의 질은 1.324배 낮았으며, 정신적 건강영역의 삶의 질은 1.089배 낮았다(p<0.05). 말하기 불편이 있는 사람은 말하기 불편이 없는 사람보다 신체적 건강영역의 삶의 질은 1.275배 낮았고, 사회적 건강영역의 삶의 질은 1.449배 낮았으며, 정신적 건강영역의 삶의 질은 1.175배 낮았다(p<0.05). 현존치아 수가 19개 이하인 사람은 현존치아 수가 20개 이상인 사람보다 신체적 건강영역의 삶의 질은 1.331배 낮았고, 사회적 건강영역의 삶의 질은 1.530배 낮았다(p<0.05). 칫솔질 평균횟수 2회 이하인 사람은 칫솔질 평균횟수 3회 이상인 사람보다 긍정적 건강영역의 삶의 질이 1.128배 낮았고, 구강위생용품을 사용하지 않는 사람은 사용하는 사람보다 사회적 건강영역의 삶의 질이 1.242배 낮았다(p<0.05). 결론: 노인의 구강노쇠는 건강관련 삶의 질을 저하시키고 있다는 것이 입증되었다. 노인의 약 55%에서 구강노쇠 증상을 경험하고 있는 것으로 나타나 노인들의 구강노쇠 관리를 할 수 있는 정책 마련과 함께 구강노쇠 관리 전문프로그램 개발이 필요할것 으로 사료된다.

• 한국융합학회논문지
• /
• 제13권2호
• /
• pp.47-54
• /
• 2022

본 연구는 노인의 저작 능력이 노쇠에 미치는 영향을 분석하고자 하였다. 65세 이상의 노인 224명을 대상으로 일반적 특성, 주관적 및 객관적 저작 능력, 노쇠수준을 조사하였다. 연구 결과는 다음과 같다. 첫째, 저작 능력은 연령, 교육 수준, 경제활동 여부, 거주 형태, 틀니 장착 여부에 따라 차이가 있었다. 둘째, 비노쇠 노인의 저작 능력은 노쇠 노인에 비해 통계적으로 유의하게 높았다. 셋째, 저작 능력이 좋은 대상자에 비해 저작 능력이 좋지 못한 대상자에서 노쇠가 있을 위험비는 2.33배 높았으며, 연령을 보정한 결과 저작 능력이 좋은 그룹에 비해 좋지 못한 그룹에서 노쇠가 있을 위험비는 2.30배 높게 나타났다. 이를 통해 노인의 저작 능력이 노쇠의 예측요인 중의 하나이며, 지역사회 차원의 구강건강 관리를 통해 노쇠를 예방하여 건강한 노화를 달성하는 노력이 필요할 것으로 생각한다.

• 치위생과학회지
• /
• 제23권4호
• /
• pp.302-311
• /
• 2023

Background: Oral health is an important element of well aging. And oral health also affects overall health, mental health, and quality of life. In this study, we sought to identify oral health influencing factors and research trends for well-aging through text analysis of research on well-aging and oral health over the past 12 years. Methods: The research data was analyzed based on English literature published in PubMed from 2012 to 2023. Aging well and oral health were used as search terms, and 115 final papers were selected. Network text analysis included keyword frequency analysis, centrality analysis, and cohesion structure analysis using the Net-Miner 4.0 program. Results: Excluding general characteristics, the most frequent keywords in 115 articles, 520 keywords (Mesh terms) were psychology, dental prosthesis and Alzheimer's disease, Dental caries, cognition, cognitive dysfunction, and bacteria. Research keywords with high degree centrality were Dental caries (0.864), Quality of life (0.833), Tooth loss (0.818), Health status (0.727), and Life expectancy (0.712). As a result of community analysis, it consisted of 4 groups. Group 1 consisted of chewing and nutrition, Group 2 consisted oral diseases, systemic diseases and management, Group 3 consisted oral health and mental health, Group 4 consisted oral frailty symptoms and quality of life. Conclusion: In an aging society, oral dysfunction affects mental health and quality of life. Preventing oral diseases for well-aging can have a positive impact on mental health and quality of life. Therefore, efforts are needed to prevent oral frailty in a super-aging society by developing and educating systematic oral care programs for each life cycle.

• 정신신체의학
• /
• 제32권1호
• /
• pp.1-9
• /
• 2024

노쇠는 스트레스 요인에 대한 취약성이 증가하여 생리적인 예비능력이 감소되고 항상성을 유지하는 능력이 저하되는 증후군으로 입원, 장애 및 사망의 위험을 증가시킨다. 노쇠는 다양한 원인에 의해 발생하며 다차원적인 접근이 필요하고 조기에 발견해서 관리하는 것이 중요하다. 노쇠는 통증이나 우울증과 같은 신경정신과적 문제와도 깊은 관련이 있다. 노쇠를 평가하는데 있어서 질병, 영양, 움직임, 감각기능 등의 신체적 영역뿐만 아니라 심리사회적인 영역까지 포괄적으로 고려하는 것이 바람직하며, 대표적인 척도로 Fried의 신체적 노쇠 기준과 Rockwood의 노쇠 척도를 들 수 있다. 노쇠 관리를 위해서는 신체적 활동과 적절한 단백질 섭취가 중요하며, 부적절한 약물 사용을 줄이고 구강관리, 인지기능, 낙상에도 유의해야한다. 노쇠와 통증은 서로 영향을 미칠 수 있으며 통증이 노쇠를 촉진시킬 수 있다. 노쇠와 통증 연구 분야에서 호르몬과 단백질의 이상, 면역체계 활성과 염증반응, 그리고 후성 유전학의 기전이 공통적으로 작용하고 있다는 증거들이 발표되고 있다. 향후 좀 더 광범위하고 수준 높은 연구가 이루어져야 할 것이며, 그 결과를 노쇠와 통증의 억제와 치료에 적용한다면 삶의 질이 높아질 것이다.

• 지역사회간호학회지
• /
• 제27권1호
• /
• pp.51-59
• /
• 2016

Purpose: The purpose of this study is to provide a disease management, nutrition education, and group exercise program for three months to the moderately frail elderly whose physical functions have deteriorated, and to investigate its effects in order to develop an intervention program. Methods: As a quasi-experiment, this study was conducted based on non-equivalence studies designed as a similar experiment. The milk intake group and calcium intake group participated in the disease education, individual nutrition education, and group exercise program for three months, and the control group was visited once in the three months by a nurse who provided disease education, nutrition education, and oral instruction of exercise, and asked them to exercise on their own every day. For the data analysis, ${\chi}^2$-test, ANOVA and $Scheff{\acute{e}}$ test were used. Results: After three months of intervention, there was a significant difference in the frailty level (p=.029) and bone density (p=.001) between the groups. Conclusion: The comprehensive intervention program had an effect on the bone density and the frailty level of the socially-vulnerable and moderately frail elderly, suggesting that the program can be used as a nursing intervention to prevent functional deterioration and damage of the moderately frail elderly.

• Journal of Korean Dental Science
• /
• 제16권2호
• /
• pp.128-148
• /
• 2023

Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.