title: Evaluation of chewing ability and its relationship with activities of daily living, depression, cognitive status and food intake in the community-dwelling elderly.
abstract: OBJECTIVE
  The aim of this study was to assess chewing ability using color-changeable chewing gum and to show the association between chewing ability and geriatric functions, as well as dietary status in the community-dwelling elderly.
  
  
  METHODS
  The study population consisted of 269 community-dwelling elderly aged ≥ 75 living in Tosa, Japan. Assessment of chewing ability was carried out by a dentist using color-changeable chewing gum. Activities of daily living (ADL), depression and subjective quality of life (QOL) were assessed by questionnaire. Cognitive status was assessed by; Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale-Revised (HDS-R) and Frontal Assessment Battery (FAB) during the check-up. Food diversity was assessed using the 11-item Food Diversity Score Kyoto (FDSK-11).
  
  
  RESULTS
  Number of teeth was significantly related to chewing ability (P<0.001). The participants with low chewing ability had significantly lower ADL scores in the items of self-maintenance (P=0.029) and intellectual activity (P=0.021). There was a significant association between low chewing ability and depression (P<0.001). Lower cognitive functions were significantly related to low chewing ability; MMSE (P=0.022), HDSR (P=0.017) and FAB (P=0.002). The participants with low chewing ability had lower food variety (P<0.001), and less frequent intake of beans, vegetables, seaweed and nuts, than the participants with high chewing ability.
  
  
  CONCLUSIONS
  Low chewing ability evaluated by color-changeable gum was associated with lower ADL, lower cognitive functioning, depression and food insufficiency in the community-dwelling elderly. More attention should be paid to assessing chewing ability of elderly persons in community settings.
authors.affiliation: Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan. yumi@cseas.kyoto-u.ac.jp
authors.forename: Yumi
authors.initials: Y
authors.lastname: Kimura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yoshihara
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yamaga
authors.forename: Tomoya
authors.initials: T
authors.lastname: Takiguchi
authors.forename: Taizo
authors.initials: T
authors.lastname: Wada
authors.forename: Ryota
authors.initials: R
authors.lastname: Sakamoto
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Ishimoto
authors.forename: Eriko
authors.initials: E
authors.lastname: Fukutomi
authors.forename: Wenling
authors.initials: W
authors.lastname: Chen
authors.forename: Michiko
authors.initials: M
authors.lastname: Fujisawa
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Okumiya
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Otsuka
authors.forename: Hideo
authors.initials: H
authors.lastname: Miyazaki
authors.forename: Kozo
authors.initials: K
authors.lastname: Matsubayashi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D004435:Eating / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D049690:History, Ancient; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008409:Mastication / Q000502:physiology*; D011788:Quality of Life; D012189:Retrospective Studies
keywords: activities of daily living; chewing ability; cognitive function; depression; dietary intake