老年人口腔衰弱与跌倒关系的研究进展

doi:10.3969/j.issn.1003-9198.2024.09.004

摘要/Abstract

摘要： 口腔衰弱(oral fraility, OF)是指在衰老过程中与增龄相关的口腔功能衰退,跌倒是我国60岁以上老年人意外伤害的病因之首。本文总结了老年人OF的诊断、评估、危险因素、发病机制以及干预措施,发现OF主要通过影响咀嚼功能、平衡感知、营养摄取等因素增加跌倒风险,且心理因素是OF共病跌倒的重要因素。本研究据此提出了义齿与口腔功能训练、运动和身体活动、营养支持等干预措施来降低OF共病跌倒的发生风险,以期为我国老年人OF及跌倒的防治提供参考。

中图分类号:

R787
R473

李毛毛, 张飞, 沈鑫, 李洁华. 老年人口腔衰弱与跌倒关系的研究进展[J]. 实用老年医学, 2024, 38(9): 876-879.

参考文献

[1] 国家统计局.第七次全国人口普查公报解读[EB/OL]. (2021-05-12)[2024-05-20]. https://proapi.jingjiribao.cn/detail.html?id=339961.
[2] LI T, SHEN Y, LENG Y, et al. The prevalence of oral frailty among older adults: a systematic review and meta-analysis[J]. Eur Geriatr Med, 2024,Online ahead of print.
[3] ZHANG J F, LIU C, LUO Z, et al. Comment on the prevalence of oral frailty among older adults: a systematic review and meta-analysis[J]. Eur Geriatr Med, 2024, Online ahead of print.
[4] DIBELLO V, ZUPO R, SARDONE R, et al. Oral frailty and its determinants in older age: a systematic review[J]. Lancet Healthy Longev, 2021, 2(8): e507-e520.
[5] YANG C, GAO Y, AN R, et al. Oral frailty: a concept analysis[J]. J Adv Nurs, 2024, 80(8):3134-3145.
[6] World Health Organization. Falls[R].World Health Organization,2021.
[7] World Health Organization. WHO global report on falls prevention in older age[R].World Health Organization,2008.
[8] XU Q, OU X, LI J. The risk of falls among the aging population: a systematic review and meta-analysis[J]. Front Public Health, 2022, 10: 902599.
[9] TANAKA T, TAKAHASHI K, HIRANO H, et al. Oral frailty as a risk factor for physical frailty and mortality in community-dwelling elderly[J]. J Gerontol A Biol Sci Med Sci, 2018, 73(12): 1661-1667.
[10] CHOI J H, KANG J H, KOH S B, et al. Development of an oral and maxillofacial frailty index: a preliminary study[J]. J Oral Rehabil, 2020, 47(2): 187-195.
[11] TANAKA T, HIRANO H, OHARA Y, et al. Oral Frailty Index-8 in the risk assessment of new-onset oral frailty and functional disability among community-dwelling older adults[J]. Arch Gerontol Geriatr, 2021, 94: 104340.
[12] BELAFSKY P C, MOUADEB D A, REES C J, et al. Validity and reliability of the Eating Assessment Tool (EAT-10)[J]. Ann Otol Rhinol Laryngol, 2008, 117(12): 919-924.
[13] SCHINDLER A, DE FÁTIMA LAGO ALVITE M, ROBLES-RODRIGUEZ W G, et al. History and science behind the Eating Assessment Tool-10 (Eat-10): lessons learned[J]. J Nutr Health Aging, 2023, 27(8): 597-606.
[14] BUSH L A, HORENKAMP N, MORLEY J E, et al. D-E-N-T-A-L: a rapid self-administered screening instrument to promote referrals for further evaluation in older adults[J]. J Am Geriatr Soc, 1996, 44(8): 979-981.
[15] HIDAKA R, MASUDA Y, OGAWA K, et al. Impact of the Comprehensive Awareness Modification of Mouth, Chewing and Meal (CAMCAM) Program on the attitude and behavior towards oral health and eating habits as well as the condition of oral frailty: a pilot study[J]. J Nutr Health Aging, 2023, 27(5): 340-347.
[16] 王志燕, 高欢玲, 张红梅, 等. Kihon老年衰弱筛查量表的汉化及信效度检验[J]. 护理学杂志, 2021, 36(3): 10-13.
[17] 陈宗梅, 谭莹, 梁远俊, 等. 老年人口腔衰弱筛查量表的汉化及信效度检验[J]. 护理研究, 2023, 37(21): 3808-3812.
[18] GANZ D A, LATHAM N K. Prevention of falls in community-dwelling older adults[J]. N Engl J Med, 2020, 382(8): 734-743.
[19] IWASAKI M, WATANABE Y, MOTOKAWA K, et al. Oral frailty and gait performance in community-dwelling older adults: findings from the Takashimadaira study[J]. J Prosthodont Res, 2021, 65(4): 467-473.
[20] KIMBLE R, MCLELLAN G, LENNON L T, et al. Association between oral health markers and decline in muscle strength and physical performance in later life: longitudinal analyses of two prospective cohorts from the UK and the USA[J]. Lancet Healthy Longev, 2022, 3(11): e777-e788.
[21] LIN W Q, XIAO T, FANG Y Y, et al. The association of malnutrition and health-related factors among 474,467 older community-dwellers: a population-based data mining study in Guangzhou, China[J]. Nutrients, 2024, 16(9):1338.
[22] IWASAKI M, MOTOKAWA K, WATANABE Y, et al. Oral hypofunction and malnutrition among community-dwelling older adults: evidence from the Otassha study[J]. Gerodontology, 2022, 39(1): 17-25.
[23] BALLY E L S, YE L, VAN GRIEKEN A, et al. Factors associated with falls among hospitalized and community-dwelling older adults: the APPCARE study[J]. Front Public Health, 2023, 11: 1180914.
[24] CHEN T Y, RAJAN S I, SAITO Y. Nutritional status predicts injurious falls among community-dwelling older adults: does sex matter?[J]. J Appl Gerontol, 2023, 42(11): 2207-2218.
[25] KARAWEKPANYAWONG R, NOHNO K, KUBOTA Y, et al. Oral health and nutritional intake in community-dwelling 90-year-old Japanese people: a cross-sectional study[J]. Gerodontology, 2023, 40(1): 100-111.
[26] NISHI K, KANOUCHI H, TANAKA A, et al. Relationship between oral hypofunction, and protein intake: a cross-sectional study in local community-dwelling adults[J]. Nutrients, 2021, 13(12):4377.
[27] IWASAKI M, TAYLOR G W, MANZ M C, et al. Oral health status: relationship to nutrient and food intake among 80-year-old Japanese adults[J]. Community Dent Oral Epidemiol, 2014, 42(5): 441-450.
[28] JO A R, PARK M J, LEE B G, et al. Association between falls and nutritional status of community-dwelling elderly people in Korea[J]. Korean J Fam Med, 2020, 41(2): 111-118.
[29] SONG H, WEI Y, WANG Y, et al. The mediating effect of nutrition on oral frailty and fall risk in community-dwelling elderly people[J]. BMC Geriatr, 2024, 24(1): 273.
[30] AKEMA S, MAMENO T, NAKAGAWA T, et al. Relationship between occlusal force and psychological frailty in Japanese community-dwelling older adults: the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study[J]. J Am Geriatr Soc, 2023, 71(6): 1819-1828.
[31] SURI A, HUBBARD Z L, VANSWEARINGEN J, et al. Fear of falling in community-dwelling older adults: what their gait acceleration pattern reveals[J]. Comput Methods Programs Biomed, 2024, 244: 108001.
[32] LIN Y C, HUANG S S, YEN C W, et al. Physical frailty and oral frailty associated with late-life depression in community-dwelling older adults[J]. J Pers Med, 2022, 12(3):459.
[33] YAMAMOTO T, KONDO K, MISAWA J, et al. Dental status and incident falls among older Japanese: a prospective cohort study[J]. BMJ Open, 2012, 2(4): e001262.
[34] ZHANG J, XU G, XU L. Number of teeth and denture use are associated with frailty among Chinese older adults: a cohort study based on the CLHLS from 2008 to 2018[J]. J Nutr Health Aging, 2023, 27(11): 972-979.
[35] HU S, LI X. An analysis of influencing factors of oral frailty in the elderly in the community[J]. BMC Oral Health, 2024, 24(1): 260.
[36] SHIROBE M, WATANABE Y, TANAKA T, et al. Effect of an oral frailty measures program on community-dwelling elderly people: a cluster-randomized controlled trial[J]. Gerontology, 2022, 68(4): 377-386.
[37] IYOTA K, MIZUTANI S, KISHIMOTO H, et al. Effect of isometric tongue lifting exercise on oral function, physical function, and body composition in community-dwelling older individuals: a pilot study[J]. Gerontology, 2022, 68(6): 644-654.
[38] MONTERO-ODASSO M, VAN DER VELDE N, MARTIN F C, et al. World guidelines for falls prevention and management for older adults: a global initiative[J]. Age Ageing, 2022, 51(9): afac205.
[39] FREIRE I, SEIXAS A. Effectiveness of a sensorimotor exercise program on proprioception, balance, muscle strength, functional mobility and risk of falls in older people[J]. Front Physiol, 2024, 15: 1309161.
[40] ABD EL-KAFY E M, ALAYAT M S, SUBAHI M S, et al. C-Mill virtual reality/augmented reality treadmill training for reducing risk of fall in the elderly: a randomized controlled trial[J]. Games Health J, 2024, Online ahead of print.
[41] MCCRUM C, BHATT T S, GERARDS M H G, et al. Perturbation-based balance training: principles, mechanisms and implementation in clinical practice[J]. Front Sports Act Living, 2022, 4: 1015394.
[42] RIEGER M M, PAPEGAAIJ S, STEENBRINK F, et al. Effects of perturbation-based treadmill training on balance performance, daily life gait, and falls in older adults: REACT randomized controlled trial[J]. Phys Ther, 2024, 104(1) :pzad136.