Objectives: The purpose of this study was to clarify factors related to a history of suffocation accidents in the elderlyneeding care at home.
Methods: The subjects were 308 volunteers (90 men; mean age, 78.4±8.4 years and 218 women; 83.4±7.3 years) who required day-care services. We conducted a questionnaire survey of thesubjects about any episode of suffocation, and analyzed the results by comparing associated factors such as age, sex, height & weight, ability to perform theactivities of daily life, cognitive function, underlying disease, medication, type of food, help with eating, occlusal status, swallowing function, and tongue motor function.
Results and discussion: Thirty-six (11.7%: 12 men and 24 women; mean age 81.3±8.9 years) of 308 subjects hada past history of suffocation. Univariate logistic regression analysis demonstrated that statistically significant riskfactors among the factors included in the questionnaire were: 1) taking medication that may cause side effects on theoropharyngeal function, 2) type of food, 3) help with eating, 4) swallowing function, and 5) tongue motor function. As aresult of logistic regression analysis, the following factors were adopted as significant variables: history ofcerebrovascular disorder (p<0.01) and swallowing disorder (p<0.05).
Conclusions: It was suggested that individuals with a history of cerebrovascular disorder, swallowing disorder, thatmay cause side effects on the oropharyngeal function have a high risk of suffocation accidents, and therefore, shouldreceive careful attention while eating meals.

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In the present study, the relationships between the counts of putative periodontopathic bacteria in saliva and theoral and general status of the elderly in nursing homes were investigated. The subjects were 37 residents (13 men and 24 women; mean age, 82.1 years) of six nursing homes. Saliva samples were collected from subjects, who providedconsent. Bacterial counts per 10, μl of saliva were measured using the PCR-Invader method for the following species: Aggregatibacter actinomycetemcomitans (A. a), Prevotella intermedia (P. i), Porphyromonas gingivalis (P. g), Tannerella forsythia (T.f) , and Treponema denticola (T.d) . The relationships between the measured bacterial countsand the following subject characteristics were investigated: age, gender, care level, BMI, periodontal parameters, amount of tongue coating, and amount of food residue. The severe periodontal disease group had significantly highercounts of P.g, T.f, and T. d than the mild or moderate group (p<0.05, p<0.05, and p<0.01, respectively), while nosignificant relationships to bacterial counts were observed for care level, BMI, and amount of food residue. Theseresults suggest that the periodontopathic bacteria detected in saliva are primarily related to the severity ofperiodontitis of the elderly and are independent of their general status.

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The purpose of this study was to elucidate the occlusal condition, feeding function and nutritional status of elderlypersons needing long-term care at home, and to create a database in order to reduce the need for nursing care.
The subjects were 213 people (52 men and 161 women; mean age, 85.0±5.2 year) who required daycare services inTokyo. We evaluated the subjects' natural teeth and the condition of wearing dentures, in accordance with the Eichner occlusal support region, by dividing them into three groups: 1) Occlusal support maintenance group, 2) Occlusalsupport maintenance by dentures group, and 3) No occlusal support group.The swallowing function was evaluated byrepetitive saliva-swallowing test, and the feeding dysfunction was evaluated by observation of eating meals. Thenutritional status was evaluated by measuring the boundary length of the upper posterior arm and the thickness ofsubcutaneous fat over the triceps, and the boundary length of the brachial muscle was calculated. These values wereexpressed as physical measurement percentiles based on the median values of each age group and sex in the NewJapanese Physical Measurement Standard (JARD 2001).
We obtained following results: 1) Eighty percent of subjects had no occlusal support in the molar region, and 20% ofthem did not have any dental prosthesis. 2) Twenty-two percent of the subjects had swallowing disorders; most of thisgroup had worse occlusal support. 3) Subjects with swallowing disorder or feeding dysfunction showed poornutritional status. 4) Subjects who had no occlusal support showed poor nutritional status.
These finding showed that elderly people needing slight but long-term care had decreased occlusal support andfeeding/swallowing functions, and these factors were suggested to be correlated with nutritional status.

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[in Japanese]

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[in Japanese]

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Objective: It is reported that among the elderly requiring case most aspirations are not caused by the function ofpharyngeal stage but the preparatory stage, though aspiration indeed occurs in the pharyngeal stage. Thus it is important to evaluate the function of bolus preparation for reducing the risk of aspiration. The purpose of this studyas to establish a method to evaluate the function of bolus preparation for swallowing using videoendoscopy.
Methods: Ten dentulous healthy adults participated in this study. Rice and cookies were used as examination foods.We made up bicolor foods to evaluate the degree of bolus preparation, that is, white rice and green rice, yellow cookiesand green cookies. The subjects were instructed to eat mouthfuls of the same kind of foods with different colors in twodifferent ways: in the usual manner and with proper mastication. We evaluated the function of bolus preparation in thepharynx, using videoendoscopy, from the viewpoint of the degree of grindability, cohesiveness and mixing.
Results: Rice; The bolus made by chewing normally had poor degrees of grindability and cohesiveness. Thedegrees of grindability and cohesiveness of the bolus made by chewing well were higher than with the bolus made bychewing normally. Cookie; The bolus made in both ways had high degrees of mixing, grindability and cohesiveness.
Conclusion: These results indicated that it is possible to evaluate the bolus preparation function for swallowingusing videoendoscopy, although it is not qualitative but quantitative.

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[in Japanese]

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