Abstract
Oral functional improvement is very important as a preventative approach in long-term care. The aim of this study was to perform factorial analysis of the feeding/swallowing function during meals, and to issue guidelines for the maintenance of the oral function in the elderly needing care in facilities. The subjects were 95 elderly residents at a long-term care insurance facility for the elderly in Tokyo and at a geriatric medical facility in Shizuoka Prefecture. The subjects' feeding/swallowing dysfunction during lunch time was observed and evaluated. Three dentists and a speech-pathologist who specialized in feeding/swallowing rehabilitation evaluated the function by observational assessment. From the feeding/swallowing items, nine items that we hypothesized to relate to food drooling were analyzed. The items were; type of the meal, propriety of type of the meal, posture at meals, size of bowl of spoon, independence of eating, meal time duration with assumption of 30 minutes as a cut-off value, disorder of anticipatory stage, lip closing function and masticatory movements. The results showed 1. Food drooling was revealed to be related to the following five items by Chi-squared test: type of the meal, meal time duration, disorder of anticipatory stage, lip closing function and masticatory movements (p<0.05), 2. Multiplex logistic analysis was conducted with the above five items as a covariate, and food drooling as a dependent variable. As a result, lip closing function and masticatory movements showed significant correlations with food drooling (p<0.05). This study suggested that it is necessary to improve the feeding/swallowing function by educating the subjects on the feeding environment, by treatment of oral conditions, and by training of muscles related to the oral function.
