高齢者の口腔衛生と全身の健康との関連  [in Japanese] Association between oral condition and general health status in the elderly  [in Japanese]

Access this Article

Search this Article

Abstract

近年の寿命の延長は人口の高齢化をもたらし,先進国,とりわけわが国では複雑かつ重大な問題に直面している。障害や全身疾患により介護・医療を要する高齢者の発生を防止し,高齢者の日常生活活動や生活の質を高い水準に維持することが求められる一方で,人口の高齢化に伴う高齢者の医療費の増加も看過できない。高齢者における口腔機能の低下は,食の楽しみや味わい,栄養状態,他者との会話などに悪影響を及ぼすので,健康に関する生活の質を議論するときには,口腔の健康や疾患に注意を払う必要がある。最近は,冠状動脈疾患,脳卒中などの全身疾患のリスクや死亡率に歯の喪失や歯周病などの口腔因子が影響することから,口腔内状況が全身の健康にとって重要であると認識されようになった。誤嚥性肺炎のリスクも,口腔衛生が不良な高齢者や摂食・嚥下障害のある高齢者において顕著である。認知症(痴呆)は,口腔衛生を悪化させることは明らかであるが,歯の喪失により認知機能障害が惹起されるという動物実験の結果によれば,歯の喪失が認知症のリスクファクターになる可能性も否定できない。また,うつ状態の人では口腔内状況は悪いが,無歯顎とうつ状態に関連があるとする報告もある。本稿は,高齢者における口腔状態と全身の健康に関する論文のレビューである。これらの多くは横断的研究でありサンプル数も十分ではないので,口腔と全身の健康の因果関係を明らかにするには,大規模な縦断的研究が実施される必要がある。総説

As a result of the increased life span, the aging of the population has become a complex and important issue in industrialized countries, especially in Japan, during the last few decades. It is therefore necessary to maintain the activities of daily living and quality of life at a high level to prevent these independent elderly from requiring health care services due to poor health or systemic diseases. Medical expenditures for the elderly, which have increased with the aging of population, must be also taken into consideration. Oral health and oral diseases for the elderly should be discussed when assessing health-related quality of life, since declined oral function affects pleasant eating and tasting of food, nutritional outcomes and conversation with others. Recently, oral conditions, including tooth loss and periodontal disease, have become considered important to general health status, since these factors affect the risk for systemic diseases, such as coronary heart disease and stroke, and mortality in the elderly. The risk of aspiration pneumonia is remarkable in the elderly with both poor oral hygiene and swallowing or feeding problems. While patients with dementia obviously appear to promote a compromised oral health status, tooth loss might inversely be a risk factor for dementia when considering the fact that, in some animal experiments, tooth loss caused impairment of cognitive function. It has been also reported that individuals with more depressive symptoms exhibited worse oral quality of life and that depressive symptoms were directly associated with edentulousness. This paper reviews original articles, focusing on the associations between oral conditions and general health status in the elderly. Most of the studies regarding this association have been cross-sectional studies with relatively small sample sizes. Therefore, longitudinal studies in large populations should be conducted to clearly demonstrate the causal relationship between oral and systemic health.

Journal

  • 東北大学歯学雑誌

    東北大学歯学雑誌 25(2), 51-64, 2006-12

    東北大学歯学会

Cited by:  2

Codes

  • NII Article ID (NAID)
    110006606544
  • NII NACSIS-CAT ID (NCID)
    AN00081101
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    0287-3915
  • Data Source
    CJPref  NII-ELS  IR 
Page Top