title: Prognosis-related factors concerning oral and general conditions for homebound older adults in Japan.
abstract: OBJECTIVE
  The present study examined the relationship between oral function, such as eating/swallowing, and life prognosis among a homebound elderly population, considering physical and mental function.
  
  
  METHODS
  The participants were 511 homebound older adults aged 65 years or older living in four Japanese prefectures. Sex, age, activities of daily living (ADL), cognitive function, underlying disease, nutritional status as Mini-Nutritional Assessment-Short Form (MNA(®)-SF), swallowing function, dietary modification and occlusal status were examined at baseline. Participants were categorized into poor outcome (died or admitted to hospital or nursing home) and good outcome (still under home care) groups at 1-year follow up, and significant related baseline factors were analyzed. In addition, these groups were compared by the ADL subgroup divided into <60 (lower) and ≥60 (higher) by Barthel Index.
  
  
  RESULTS
  In total, 473 participants were followed up (poor outcome group 177 [37.4%], good outcome group 296 [62.6%]). Sex, age, ADL, MNA(®)-SF, swallowing function, dietary modification and occlusal support were significantly different between these groups. Logistic regression analysis showed that sex and MNA(®)-SF score were significantly related to prognosis in the lower ADL group, and sex, age, Charlson Comorbidity Index and occlusal support were significantly related in the higher ADL group.
  
  
  CONCLUSIONS
  ADL was strongly correlated with life prognosis in homebound older adults. Within the higher ADL participants, occlusal support was related to this outcome.
authors.affiliation: Department of General Medicine and Primary Care, Tokyo Medical University Hospital, Hiroshima, Japan.|Division of Rehabilitation for Speech and Swallowing Disorders, Nippon Dental University Tama Oral Rehabilitation Clinic, Hiroshima, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Division of Rehabilitation for Speech and Swallowing Disorders, Nippon Dental University Tama Oral Rehabilitation Clinic, Hiroshima, Japan.|Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry at Tokyo, Hiroshima, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kikutani
authors.affiliation: Dental Department, Hiroshima City Rehabilitation Hospital, Hiroshima, Japan.
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department of General Medicine and Primary Care, Tokyo Medical University Hospital, Hiroshima, Japan.|Department of General Medicine, Tokyo Medical University, Tokyo, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Hirayama
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology / Q000503:physiopathology*; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000453:epidemiology / Q000503:physiopathology*; D004032:Diet; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D018577:Homebound Persons / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D008297:Male; D015596:Nutrition Assessment; D009909:Oral Health; D011379:Prognosis; D018570:Risk Assessment; D018709:Statistics, Nonparametric
keywords: activities of daily living; elderly; nutrition; occlusion; prognosis