title: Perceived swallowing problems and mortality risk in very elderly people ≥85 years old: Results of the Tokyo Oldest Old Survey on Total Health study.
abstract: OBJECTIVE
  The aim of this study was to clarify whether perceived swallowing problems affect the life expectancy of very elderly individuals.
  
  
  BACKGROUND
  In an ageing society, oral function affects health status. In particular, a decline in swallowing function may increase the risk of various diseases, morbidity and malnutrition.
  
  
  METHODS
  We evaluated 526 elderly individuals aged ≥85 years. All participants completed a questionnaire and underwent oral, physical and mental health examinations. The comprehensive oral health assessment comprised a face-to-face interview that included a questionnaire on swallowing function. We estimated hazard ratios and 95% confidence intervals using the Cox proportional hazards model, adjusting for potential confounders between perceived swallowing problems and all-cause mortality over a 3-year period.
  
  
  RESULTS
  Over a 3-year follow-up period, 88 of 526 participants died and 68 participants complained of perceived swallowing problems. Perceived swallowing problems had statistically significant associations with physical status and function and nutrition. In the univariate analysis, perceived swallowing problems had statistically significant associations with an approximately 1.9-fold higher risk of all-cause mortality during the 3-year period (HR: 1.89, 95% CI: 1.14-3.14). In the multivariate analysis, the statistically significant association between perceived swallowing problems and all-cause mortality remained after adjusting for various confounding factors (HR: 1.73, 95% CI: 1.03-2.92).
  
  
  CONCLUSIONS
  Perceived swallowing disorders should be verified by a clinical examination, as they are associated with other health outcomes and increased all-cause mortality.
authors.affiliation: Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Iinuma
authors.affiliation: Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Hirata
authors.affiliation: Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yasumichi
authors.initials: Y
authors.lastname: Arai
authors.affiliation: Center for Preventive Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Michiyo
authors.initials: M
authors.lastname: Takayama
authors.affiliation: Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan.
authors.forename: Motoko
authors.initials: M
authors.lastname: Fukumoto
authors.affiliation: Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Fukui
authors.affiliation: Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan.
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Gionhaku
mesh_terms: D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000401:mortality*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008017:Life Expectancy; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014041:Tokyo / Q000453:epidemiology
keywords: elderly; mortality; oral function; oral health