85歳における口腔内気体のVSCおよびその関連口腔内診査所見とADLおよびQOLの測定指標との関連について [in Japanese] ADL and QOL Scales Relating to Volatile Sulfur Compounds in Mouth Air and Oral Health Status in the Elderly [in Japanese]
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岩手県盛岡保健所管内11市町村において, 2002年度に実施された85歳の口腔と全身の状態に関する調査結果より, 口腔内気体の揮発性硫黄化合物(VSC)濃度およびその関連口腔内診査所見〔舌苔の付着状態の視診(舌苔スコア), CPI重度歯数〕と日常生活動作能力(ADL)および生活の質(QOL)の測定指標との関連について検討した.参加者349名のうち168名を対象に舌苔スコアと口腔内気体のVSC濃度測定を行った.VSC濃度測定には口臭測定器OralChroma^<TM>を使用した.有歯顎者に対しては, 歯周組織の状態も診査した.ADLおよびQOLに関するアンケートは, 面接聞き取り調査法により行った.前者は「老研式活動能力指標」を, 後者は「地域高齢者のための簡便なQOL質問表」(以下, QOL質問表)を使用した.その結果, 「老研式活動能力指標」の下位尺度は, VSC濃度およびその関連口腔内診査所見と関連はみられなかった.「QOL質問表」の下位尺度では, 経済的ゆとり満足感と精神的活力がH_2S濃度の嗅覚閾値(26ppb)との間に, それぞれ有意なオッズ比0.30, 0.55を示し, これらのQOLが高いとH_2S濃度は嗅覚閾値未満になりやすいという関連が認められた.また, 精神的活力は舌苔スコアとの間に有意なオッズ比0.69を示し, このQOLが高いと舌苔スコアは0または1になりやすいという関連が認められた.これらのことから, H_2S濃度と「QOL質問表」の一部下位尺度では, H_2Sの原因の1つである舌苔を通して関連している可能性が示唆された.
The objective of this study was to examine whether volatile sulfur compounds (VSC) in mouth air and the related oral health status, such as tongue coating and periodontal diseases, were related to activities of daily living (ADL) and quality of life (QOL) in the elderly. In 2002, a health examination survey for people aged 85 years was conducted in Iwate prefecture with 349 individuals participating in the survey. Tongue coating score and VSC concentrations in mouth air were assessed in the 168 subjects who were sampled. The concentrations of each subject were measured with a VSC monitor (OralChroma^<TM>). Periodontal conditions, CPI Codes 3 and 4 recording teeth, were assessed for dentulous subjects. The participants were interviewed about ADL and QOL using questionnaires. ADL was assessed by the TMIG index of competence. The questionnaire consisted of 13 questions. The questions were of the alternative-choice type. The questions were classified into 3 subscales (instrumental self-maintenance, intellectual activity and social role). QOL was assessed by the QOL questionnaire for elderly subjects living in a community. The questionnaire consisted of 19 alternative-choice type questions. The questions were classified into 6 subscales (daily activity, satisfaction with health, satisfaction with human support, satisfaction with economic state, symptom of depression and positive mental attitude). The results were as follows. 1. ADL subscales were not related to objectionable levels of VSC (hydrogen sulfide (H_2S)≧112 ppb, methyl mercaptan (CH_3SH)≧26 ppb) and the related oral health status. 2. There was a significant relation between objectionable level of H_2S and score of satisfaction with economic state (odds ratio 0.30, p<0.05), and score of positive mental attitude (odds ratio 0.55, p<0.05). The subjects who had high scores in these QOL subscales were found to have a nonobjectionable level of H_2S. 3. There was a significant relation between score of positive mental attitude and tongue coating score (odds ratio 0.69, p<0.05). The subjects who had high score in the QOL subscale were found to have tongue coating score 0 or 1. It was suggested that the QOL subscales in the elderly were indirectly associated with an objectionable level of H_2S in mouth air, and that H_2S produced mainly from tongue coating.
- JOURNAL OF DENTAL HEALTH
JOURNAL OF DENTAL HEALTH 55(3), 153-158, 2005
Japanese Society for Oral Health