2023 Volume 27 Issue 1 Pages 16-24
Decreased oral function in older adults requiring long-term care and associated dietary restrictions are thought to increase the risk of developing fever and pneumonia through malnutrition and decreased immune function. We conducted a cohort survey for approximately 1.5 years using oral care assessment sheets for older adults who were capable of oral ingestion and who required nursing care in a facility. The purpose of this study was to clarify the factors related to the onset of fever.
A statistical analysis was performed on 259 subjects for whom the presence or absence of fever could be confirmed for 1 year. Significant associations were found between the onset of fever and the staple food form, difficulty in mouth-opening, difficulty in protruding the tongue, difficulty in swallowing, lack of spontaneity in oral care, difficulty in keeping the mouth open, and difficulty in holding water in the mouth. Furthermore, without limiting the observation period, Cox hazard analysis was performed on the relationship between these items and the onset of fever in 279 subjects for whom data were available. It was found that there was a significant relationship between difficulty in mouth-opening, difficulty in protruding the tongue, difficulty in swallowing, lack of spontaneity in oral care, difficulty in keeping the mouth open, and difficulty in holding water in the mouth. Older age and lower body mass index were associated with a higher risk of the onset of fever, and the risk of the onset of fever was higher in men than in women.
These results suggest that a marked decline in oral functions such as mouth-opening, tongue protrusion, swallowing, and holding water in the mouth could predict the onset of fever.
