Ronen Shika Igaku

Oral care is important since elders such as stroke patients easily suffer from aspiration pneumonia because of dysphagia. It is very important to understand oral microbial flora in order to maintain oral hygiene. In the present study samples from the dorsal tongues of 30 elderly stroke patients (17 men and 13 women, average age: 70.1±6.9 years) and from the dorsal tongues and the pharynxes of 32 healthy elders (7 men and 25 women, average age: 78.4±7.6 years) were cultivated for Candida and aerobic bacteria detection. The quantative change and the change of normal microflora were investigated from the viewpoint of oral hygiene. Candida isolation rate was 47% from the dorsal tongue in the stroke patients group and 59% from the dorsal tongue in the healthy elders group, which shwed no significance between the two groups. When compared among the positive (more than 10E+5CFU/mL) subjects at the dorsal tongue, however, the rate was 47% in the stroke patients and 12.5% in the healthy elders. The number of positive subjects in the stroke patients was significantly higer (p<0.01: Fisher's exact probability test) than that in the healthy elders. P.aeruginosa was more frequently positive isolated both from the dorsal tongue of the stroke patients and from the dorsal tongue and the pharynx of the healthy elders as a result of aerobic bacterial culture.
But, the difference wasn't recognized between health elders group and elderly stroke patients group in the positive rate of P.aeruginosa, and the isolation of P. aeruginosa wasn't characteristic in stroke patients.It could think that Candida was isolated the positivity (more than 10 E+5 CFU/mL) to be characteristic in stroke patients, and thought that Candida positivity of the dorsal tongue was useful as a reference item in the oral microbial inspection.

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It is well known that whether the dependent elderly can use dentures or not depends on the degree of both their physical and mental capacities. However, we have observed several cases where two eldely persons having with similar levels of activities of daily living (ADL), a similar degree of independence in daily living, and a similar degree of dementia, differed significantly in their ability to use dentures properly.
From these cases, it can be hypothesized that the ability of the dependent elderly to use dentures properly depends not only on their actual oral condition and ADL, but also on various events in their lives such as the number of their admissions to the hospital since they started wearing dentures. In other words, the cumulative effect of various major life events influences the usage of dentures by the elderly.
Therefore, we conducted a survey designed to investigate the contributing factors that divide those elderly who wear dentures properly from those who do not .
The study participants were the edentulous individuals (71 in total; 16 males, 55 females. Average age: 85.0±5.9 years) who are residents in a geriatric hospital or in a facility of the health care servicesfor the elderly in Tokushima prefecture .
A survey was conducted on the above participants regarding their use of complete dentures, their ADL, their degree of independence for daily living, their degree of dementia, etc.
The results can be summarized as follows:
1 . The frequency of complete denture usage declined as the participant's levels of ADL, independence and dementia worsened, but this decline did not have any relationship to the times of theiradmissions to the hospital/facility or the numbers of members in their family.
2. It was suggested that, among the elderly who have a dementia and mild to low levels of ADL, their ability to wear/remove dentures and to clean the dentures by themselves relates significantly to the frequency of their denture usage .

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In Japan, the population is aging faster than in any other country. The eldertly aged ≥65 years accounted for 17.2% of the total population in 1999, and this protprtion is expected to increase to 27.4% in 2025 and 32.3%. in 2050. With an increase in the elderly, the number of those with care needs will also increase. To practice evidence-based medicine in such a situation, evaluation of the situation and clarification of problems are necessary .
Therefore, as a model of rapidly aging society in the future in Japan, we evaluated the living and oral conditions in the elderly with care need in Goka-mura, Oki-gun, Shimane Prefecture, an area with a rapidly aging population. The elderly with care needs were classified into those with physical disabitity and those with dementia. The characteristics of each group were analyzed, and the results were discussed.The problems were clarified, their measures were evaluated, and some conclusions were obtained.

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