title: Chewing problems and mortality in older adults in home care: results from the Aged in Home Care study.
abstract: OBJECTIVE
  To assess the association between chewing problems and risk of mortality in an older population receiving home care in Europe.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Eleven European countries.
  
  
  METHODS
  Two thousand seven hundred fifty-five older adults (mean age+/-standard deviation 82.2+/-7.2) in home care.
  
  
  METHODS
  Data were collected using the Minimum Data Set for Home Care. Study personnel recorded chewing problems (inability to chew food easily and without pain or difficulties, regardless of cause) that presented in the last 3 days before baseline assessment. Data on mortality were collected over a 1-year period.
  
  
  RESULTS
  Three hundred ninety-five participants (14.3%) presented with chewing problems. One-year mortality differed significantly according to presence of chewing problems; 303 of 2,361 (12.8%) without chewing problems (crude incident rate per person-year (p-y)=0.15) and 80 of 394 (20.3%) participants with chewing problems (crude incident rate per p-y=0.24) died during follow-up. After adjusting for potential confounders, the risk of death was significantly higher for participants with chewing problems (adjusted hazard ratio (HR)=1.45, 95% confidence intervals (CI)=1.05-1.99). This association remained after exclusion of participants with cognitive impairment (adjusted HR=1.50, 95% CI=1.03-2.20) and those with unintended weight loss (adjusted HR=1.62, 95% CI=1.12-2.34).
  
  
  CONCLUSIONS
  In older adults in home care in Europe, chewing problems are associated with greater risk of mortality.
authors.affiliation: Department of Gerontology, Catholic University Sacred Heart, Rome, Italy. graziano_onder@rm.unicatt.it
authors.forename: Graziano
authors.initials: G
authors.lastname: Onder
authors.forename: Rosa
authors.initials: R
authors.lastname: Liperoti
authors.forename: Manuel
authors.initials: M
authors.lastname: Soldato
authors.forename: Maria Camilla
authors.initials: MC
authors.lastname: Cipriani
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
authors.forename: Francesco
authors.initials: F
authors.lastname: Landi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005060:Europe / Q000453:epidemiology; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008409:Mastication / Q000502:physiology*; D009026:Mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors