Researcher Profile and Settings

Master

Affiliation (Master)

• Faculty of Dental Medicine　Division of Dental Medicine　Department of Health Science

Affiliation (Master)

• Faculty of Dental Medicine　Division of Dental Medicine　Department of Health Science

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Profile and Settings

Affiliation

• Hokkaido University

Profile and Settings

• Contact Point

  iwasakiden.hokudai.ac.jp

• Name (Japanese)

  Masanori

• Name (Kana)

  Iwasaki

• Name

  201001094709049490

Affiliation

• Hokkaido University

Achievement

Research Interests

• 口腔衛生学   予防歯科学   老年歯科医学   

Research Areas

• Life sciences / Community dentistry

Research Experience

• 2023/04 - Today 東京都健康長寿医療センター研究所 自立促進と精神保健研究チーム 非常勤研究員
• 2023/04 - Today Hokkaido University
• 2020/04 - Today 九州歯科大学 客員教授
• 2022/04 - 2023/03 Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
• 2020/03 - 2022/03 Tokyo Metropolitan Institute of Gerontology Research Team for Promoting Independence and Mental Health
• 2014/10 - 2020/02 Kyushu Dental University Associate Professor
• 2010/06 - 2014/09 Niigata University Medical & Dental Hospital Assistant Professor
• 2010/04 - 2010/05 Niigata University Graduate School of Medical and Dental Sciences
• 2009/11 - 2010/03 University of Michigan Visiting Scholar
• 2008/11 - 2009/03 University of Michigan Visiting Scholar

Education

•        - 2010  Niigata University
•        - 2006  Hokkaido University  School of Dental Medicine

Awards

• 2024/08 Gerodontology The Robin Heath Citation Award 2024
  
• 2023/06 日本老年医学会 Geriatrics & Gerontology International Best reviewer award 2022
  
• 2019/06 日本老年歯科医学会 優秀奨励論文賞（ライオンアワード）
   

  受賞者: 岩﨑 正則
• 2018 日本口腔衛生学会 学術賞 LION AWARD
   

  受賞者: 岩﨑 正則
• 2012 日本口腔衛生学会 論文奨励賞
   

  受賞者: 岩﨑 正則
• 2010 JADR Young Investigator Award of JADR
   

  受賞者: Iwasaki Masanori

Published Papers

• Is urinary taurine associated with protein intake? Itabashi Longitudinal Study on Aging.

  Keiko Motokawa, Maki Shirobe, Masanori Iwasaki, Yosuke Komatsu, Takuya Shibasaki, Yasuaki Wada, Yurie Mikami, Misato Hayakawa, Takashi Shida, Hiroyuki Sasai, Tsuyoshi Okamura, Hirohiko Hirano, Shuichi Awata

  Geriatrics & gerontology international 2024/08/13
• General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants

  Bin Zhou, James E Bennett, Aidan P Wickham, Rosie K Singleton, Anu Mishra, Rodrigo M Carrillo-Larco, Nayu Ikeda, Lakshya Jain, Ana Barradas-Pires, Rachel A Heap, Victor PF Lhoste, Kate E Sheffer, Nowell H Phelps, Archie W Rayner, Edward W Gregg, Mark Woodward, Gretchen A Stevens, Maria LC Iurilli, Goodarz Danaei, Mariachiara Di Cesare, Carlos A Aguilar-Salinas, Noor Ani Ahmad, Pascal Bovet, Zhengming Chen, Albertino Damasceno, Sarah L Filippi, Imre Janszky, Andre P Kengne, Young-Ho Khang, Kamlesh Khunti, Avula Laxmaiah, Lee-Ling Lim, Lauren Lissner, Paula Margozzini, Jean Claude N Mbanya, Stephen T McGarvey, Jonathan E Shaw, Stefan Söderberg, Luis Adrián Soto-Mota, Junyang Wang, Francesco Zaccardi, Leandra Abarca-Gómez, Mohsen Abbasi-Kangevari, Shynar Abdrakhmanova, Suhaila Abdul Ghaffar, Hanan F Abdul Rahim, Zulfiya Abdurrahmonova, Niveen M Abu-Rmeileh, Benjamin Acosta-Cazares, Ishag Adam, Marzena Adamczyk, Wichai Aekplakorn, Imelda A Agdeppa, Javad Aghazadeh-Attari, Charles Agyemang, Mohamad Hasnan Ahmad, Ali Ahmadi, Naser Ahmadi, Nastaran Ahmadi, Soheir H Ahmed, Wolfgang Ahrens, Gulmira Aitmurzaeva, Kamel Ajlouni, Hazzaa M Al-Hazzaa, Halima Al-Hinai, Jawad A Al-Lawati, Rajaa Al-Raddadi, Deena Al Asfoor, Huda M Al Hourani, Monira Alarouj, Fadia AlBuhairan, Shahla AlDhukair, Mohamed M Ali, Anna V Alieva, Abdullah Alkandari, Buthaina M Alkhatib, Eman Aly, Deepak N Amarapurkar, Pilar Amiano Etxezarreta, Norbert Amougou, Lars Bo Andersen, Sigmund A Anderssen, Odysseas Androutsos, Ranjit Mohan Anjana, Alireza Ansari-Moghaddam, Elena Anufrieva, Hajer Aounallah-Skhiri, Tahir Aris, Raphael E Arku, Nimmathota Arlappa, Krishna K Aryal, Felix K Assah, Batyrbek Assembekov, Maria Cecília F Assunção, Juha Auvinen, Mária Avdičová, Kishwar Azad, Ana Azevedo, Mohsen Azimi-Nezhad, Fereidoun Azizi, Flora Bacopoulou, Suhad Bahijri, Izet Bajramovic, Nagalla Balakrishna, Mohamed Bamoshmoosh, Maciej Banach, Piotr Bandosz, José R Banegas, Rafał Baran, Carlo M Barbagallo, Valter Barbosa Filho, Alberto Barceló, Maja Baretić, Joaquin Barnoya, Lena Barrera, Aluisio JD Barros, Mauro Virgílio Gomes Barros, Abdul Basit, Joao Luiz Bastos, Anwar M Batieha, Aline P Batista, Rosangela L Batista, Zhamilya Battakova, Louise A Baur, Pascal M Bayauli, Silvia Bel-Serrat, Antonisamy Belavendra, Habiba Ben Romdhane, Theodora Benedek, Judith Benedics, Mikhail Benet, Gilda Estela Benitez Rolandi, Michaela Benzeval, Elling Bere, Nicolas Berger, Ingunn Holden Bergh, Salim Berkinbayev, Antonio Bernabe-Ortiz, Heloísa Bettiol, Augustin F Beybey, Jorge Bezerra, Aroor Bhagyalaxmi, Santosh K Bhargava, Elysée Claude Bika Lele, Mukharram M Bikbov, Bihungum Bista, Dusko J Bjelica, Peter Bjerregaard, Espen Bjertness, Marius B Bjertness, Cecilia Björkelund, Katia V Bloch, Anneke Blokstra, Simona Bo, Martin Bobak, Lynne M Boddy, Bernhard O Boehm, Jose G Boggia, Elena Bogova, Marialaura Bonaccio, Alice Bonilla-Vargas, Herman Borghs, Steve Botomba, Rupert Bourne, Khadichamo Boymatova, Lutgart Braeckman, Tasanee Braithwaite, Imperia Brajkovich, Francesco Branca, Hermann Brenner, Lizzy M Brewster, Yajaira Briceño, Lacramioara Brinduse, Bettina Bringolf-Isler, Miguel Brito, Johannes Brug, Anna Bugge, Frank Buntinx, Marta Buoncristiano, Con Burns, Antonio Cabrera de León, Roberta B Caixeta, Tilema Cama, Günay Can, Ana Paula C Cândido, Felicia Cañete, Mario V Capanzana, Naděžda Čapková, Eduardo Capuano, Rocco Capuano, Vincenzo Capuano, Viviane C Cardoso, Axel C Carlsson, Felipe F Casanueva, Maribel Casas, Laura Censi, Marvin Cervantes‐Loaiza, Parinya Chamnan, Snehalatha Chamukuttan, Queenie Chan, Nish Chaturvedi, Fangfang Chen, Huashuai Chen, Long-Sheng Chen, Yiling J Cheng, Bahman Cheraghian, Angela Chetrit, Ekaterina Chikova-Iscener, Mai JM Chinapaw, Anne Chinnock, Arnaud Chiolero, Adela Chirita-Emandi, María-Dolores Chirlaque, Chean Lin Chong, Diego G Christofaro, Jerzy Chudek, Renata Cifkova, Massimo Cirillo, Frank Claessens, Philip Clare, Emmanuel Cohen, Susana C Confortin, Tara C Coppinger, Lilia Yadira Cortés, Cojocaru R Cosmin, Simona Costanzo, Melanie J Cowan, Chris Cowell, Amelia C Crampin, Amanda J Cross, Ana B Crujeiras, Juan J Cruz, Alexandra M Cucu, Felipe V Cureau, Sarah Cuschieri, Graziella D'Arrigo, Eleonora d'Orsi, Haroldo da Silva-Ferreira, Christina C Dahm, Jean Dallongeville, Rachel Dankner, Kairat Davletov, Francisco de Assis Guedes de Vasconcelos, Maria Alice Altenburg de Assis, Dirk De Bacquer, Jaco De Bacquer, Jeroen de Bont, Amalia De Curtis, Patrícia de Fragas Hinnig, Giovanni de Gaetano, Stefaan De Henauw, Pilar De Miguel-Etayo, Paula Duarte de Oliveira, Karina Mary de Paiva, Karin De Ridder, Marco Aurélio de Valois Correia Júnior, Mohan Deepa, Vincent Jr DeGennaro, Stefaan Demarest, Elaine Dennison, Valérie Deschamps, Meghnath Dhimal, María Pilar Díez Ripollés, Zivka Dika, Shirin Djalalinia, Liria Dominguez, Maria Benedetta Donati, Chiara Donfrancesco, Guanghui Dong, Silvana P Donoso, Maria Dorobantu, Marcus Dörr, Nico Dragano, Wojciech Drygas, Shufa Du, Charmaine A Duante, Priscilla Duboz, Rosemary B Duda, Vesselka L Duleva, Anar Dushpanova, Azhar Dyussupova, Elzbieta Dziankowska-Zaborszczyk, Narges Ebrahimi, Guadalupe Echeverría, Ricky Eddie, Ebrahim Eftekhar, Vasiliki Efthymiou, Eruke E Egbagbe, Sareh Eghtesad, Ulf Ekelund, Mohammad El-Khateeb, Jalila El Ati, Roberto Elosua, Ofem Enang, Rajiv T Erasmus, Cihangir Erem, Gul Ergor, Louise Eriksen, Johan G Eriksson, Jorge Escobedo-de la Peña, Ali Esmaeili, Roger G Evans, Ildar Fakhradiyev, Albina A Fakhretdinova, Caroline H Fall, Elnaz Faramarzi, Mojtaba Farjam, Farshad Farzadfar, Yosef Farzi, Mohammad Reza Fattahi, Asher Fawwad, Francisco J Felix-Redondo, Trevor S Ferguson, Romulo A Fernandes, Daniel Fernández-Bergés, Desha R Fernando, Daniel Ferrante, Gerson Ferrari, Marika Ferrari, Catterina Ferreccio, Eldridge Ferrer, Thamara Hubler Figueiró, Anna Fijalkowska, Günther Fink, Mauro Fisberg, Maria Forsner, Edward F Fottrell, Heba M Fouad, Damian K Francis, Guillermo Frontera, Flavio D Fuchs, Sandra C Fuchs, Viktoriya Furdela, Takuro Furusawa, Stefan Adela Gabriela, Zbigniew Gaciong, Manuel Galán Cuesta, Andrzej Galbarczyk, Sonya V Galcheva, Myriam Galfo, Manoli Garcia-de-la-Hera, Pablo Garcia, Sarah P Garnett, Magda Gasull, Andrea Gazzinelli, Ulrike Gehring, Eva Gerdts, Ebrahim Ghaderi, Seyyed-Hadi Ghamari, Ali Ghanbari, Erfan Ghasemi, Oana-Florentina Gheorghe-Fronea, Anup Ghimire, Alessandro Gialluisi, Simona Giampaoli, Francesco Gianfagna, Glen Gironella, Aleksander Giwercman, Konstantinos Gkiouras, Natalya Glushkova, Ramesh Godara, Justyna Godos, Marcel Goldberg, Georgina Gómez, Jesús Humberto Gómez Gómez, Luis F Gomez, Santiago F Gómez, Aleksandra Gomula, Bruna Gonçalves Cordeiro da Silva, Helen Gonçalves, Mauer Gonçalves, Ana D González-Alvarez, David A Gonzalez-Chica, Esther M González-Gil, Marcela Gonzalez-Gross, Juan P González-Rivas, Angel R Gonzalez, Frederic Gottrand, Dušan Grafnetter, Aneta Grajda, Maria G Grammatikopoulou, Tomasz Grodzicki, Else Karin Grøholt, Anders Grøntved, Viviana Guajardo, Pilar Guallar-Castillón, Maëlenn Guerchet, Ramiro Guerrero, Andre L Guimaraes, Unjali P Gujral, Martin C Gulliford, Marc J Gunter, Rajeev Gupta, Oye Gureje, Mirjana A Gurinović, Beata Gurzkowska, Laura Gutierrez, Xinyi Gwee, Rosa Haghshenas, Hamid Hakimi, Jytte Halkjær, Ian R Hambleton, Behrooz Hamzeh, Willem A Hanekom, Dominique Hange, Abu AM Hanif, Sari Hantunen, Jie Hao, Carla Menêses Hardman, Louise Hardy, Rachakulla Hari Kumar, Javad Harooni, Seyed Mohammad Hashemi-Shahri, Maria Hassapidou, Jun Hata, Teresa Haugsgjerd, Mirjam Heinen, Marleen Elisabeth Hendriks, Rafael dos Santos Henrique, Ana Henriques, Leticia Hernandez Cadena, Sauli Herrala, Marianella Herrera-Cuenca, Victor M Herrera, Isabelle Herter-Aeberli, Karl-Heinz Herzig, Ramin Heshmat, Allan G Hill, Sai Yin Ho, Michelle Holdsworth, Reza Homayounfar, Clara Homs, Emiel O Hoogendijk, Andrea RVR Horimoto, Claudia M Hormiga, Bernardo L Horta, Leila Houti, Christina Howitt, Thein Thein Htay, Aung Soe Htet, Maung Maung Than Htike, José María Huerta, Ilpo Tapani Huhtaniemi, Laetitia Huiart, Constanta Huidumac Petrescu, Martijn Huisman, Abdullatif Husseini, Inge Huybrechts, Nahla Hwalla, Licia Iacoviello, Ellina M Iakupova, Anna G Iannone, Jannicke Igland, Chinwuba Ijoma, Violeta Iotova, Vilma E Irazola, Takafumi Ishida, Godsent C Isiguzo, Muhammad Islam, Sheikh Mohammed Shariful Islam, Duygu Islek, Till Ittermann, Ivaila Y Ivanova-Pandourska, Masanori Iwasaki, Tuija Jääskeläinen, Rod T Jackson, Hashem Y Jaddou, Michel Jadoul, Tazeen Jafar, Nataša Jan, Edward Janus, Juel Jarani, Gerald Jarnig, Marjo-Riitta Jarvelin, Grazyna Jasienska, Ana Jelaković, Bojan Jelaković, Anjani Kumar Jha, Ramon O Jimenez, Karl-Heinz Jöckel, Michel Joffres, Jari J Jokelainen, Jost B Jonas, Pradeep Joshi, Rohina Joshi, Josipa Josipović, Farahnaz Joukar, Jacek J Jóźwiak, Anne Juolevi, Vesna Juresa, Vesna Jureša, Rudolf Kaaks, Felix O Kaducu, Agnes L Kadvan, Anthony Kafatos, Eero O Kajantie, Natia Kakutia, Daniela Kállayová, Zhanna Kalmatayeva, Ofra Kalter-Leibovici, Srinivasan Kannan, Efthymios Kapantais, Eva Karaglani, Argyro Karakosta, Khem B Karki, Adoubi Kassi Anicet, Marzieh Katibeh, Prasad Katulanda, Peter T Katzmarzyk, Jussi Kauhanen, Gyulli M Kazakbaeva, François F Kaze, Calvin Ke, Sirkka Keinänen-Kiukaanniemi, Roya Kelishadi, Cecily Kelleher, Han CG Kemper, Maryam Keramati, Mathilde Kersting, Yousef Saleh Khader, Arsalan Khaledifar, Davood Khalili, Bahareh Kheiri, Motahareh Kheradmand, Alireza Khosravi, Ursula Kiechl-Kohlendorfer, Sophia J Kiechl, Stefan Kiechl, Hyeon Chang Kim, Heidi Klakk, Suntara Klanarong, Jana Klanova, Magdalena Klimek, Michael Knoflach, Susanne Kobel, Bhawesh Koirala, Elin Kolle, Patrick Kolsteren, Jürgen König, Raija Korpelainen, Paul Korrovits, Magdalena Korzycka, Jelena Kos, Seppo Koskinen, Malik Koussoh Simone, Éva Kovács, Irina Kovalskys, Sudhir Kowlessur, Slawomir Koziel, Jana Kratenova, Wolfgang Kratzer, Susi Kriemler, Peter Lund Kristensen, Helena Krizan, Maria F Kroker-Lobos, Steinar Krokstad, Herculina S Kruger, Ruan Kruger, Łukasz Kryst, Ruzena Kubinova, Urho M Kujala, Enisa Kujundzic, Zbigniew Kulaga, Mukhtar Kulimbet, Meena Kumari, Marie Kunešová, Pawel Kurjata, Catherine Kyobutungi, Quang Ngoc La, Demetre Labadarios, Carl Lachat, Daphne Lai, Youcef Laid, Lachmie Lall, Maritza Landaeta Jimenez, Edwige Landais, Tiina Lankila, Vera Lanska, Georg Lappas, Bagher Larijani, Mina P Lateva, Tint Swe Latt, Martino Laurenzi, Maria Lazo-Porras, Gwenaëlle Le Coroller, Khanh Le Nguyen Bao, Terho Lehtimäki, Daniel Lemogoum, Elvynna Leong, Justyna Leszczak, Gabriel M Leung, Yanping Li, Merike Liivak, Charlie Lim, Wei-Yen Lim, M Fernanda Lima-Costa, Hsien-Ho Lin, Lars Lind, Mieczyslaw Litwin, Liping Liu, Xiaotian Liu, Guadalupe Longo Abril, Oscar Lopes, Esther Lopez-Garcia, José Francisco López-Gil, Tania Lopez, José Eugenio Lozano, Janice L Lukrafka, Dalia Luksiene, Annamari Lundqvist, Nuno Lunet, Charles Lunogelo, Michala Lustigová, Jean-René M'Buyamba-Kabangu, George LL Machado-Coelho, Aristides M Machado-Rodrigues, Enguerran Macia, Ahmed A Madar, Gladys E Maestre, Stefania Maggi, Dianna J Magliano, Sara Magnacca, Emmanuella Magriplis, Gowri Mahasampath, Bernard Maire, Marcia Makdisse, Mohammad-Reza Malekpour, Fatemeh Malekzadeh, Reza Malekzadeh, Kodavanti Mallikharjuna Rao, Sofia Malyutina, Lynell V Maniego, Yannis Manios, Jim I Mann, Fariborz Mansour-Ghanaei, Enzo Manzato, Mala Ali Mapatano, Rosu Maria-Magdalena, Joany Mariño, Anastasia Markaki, Larissa Pruner Marques, Jaume Marrugat, Reynaldo Martorell, Katharina Maruszczak, Giovanna Masala, Luis P Mascarenhas, Mannix Masimango Imani, Masoud Masinaei, Ellisiv B Mathiesen, Alicia Matijasevich, Piotr Matłosz, Tandi E Matsha, Victor Matsudo, Giletta Matteo, Pallab K Maulik, Christina Mavrogianni, Anselmo J Mc Donald Posso, Shelly R McFarlane, Rachael M McLean, Sounnia Mediene Benchekor, Kirsten Mehlig, Amir Houshang Mehrparvar, Jesus D Melgarejo, Fabián Méndez, Carlos O Mendivil, Carlos Mendoza Montano, Ana Maria B Menezes, Gert BM Mensink, Alibek Mereke, Indrapal I Meshram, Diane T Meto, Haakon E Meyer, Jie Mi, Karolina Miłkowska, Jody C Miller, Olga Milushkina, Cláudia S Minderico, GK Mini, Juan Francisco Miquel, J Jaime Miranda, Mohammad Reza Mirjalili, Marjeta Mišigoj-Duraković, Antonio Mistretta, Veronica Mocanu, Pietro A Modesti, Sahar Saeedi Moghaddam, Kazem Mohammad, Mohammad Reza Mohammadi, Zahra Mohammadi, Noushin Mohammadifard, Reza Mohammadpourhodki, Viswanathan Mohan, Muhammad Fadhli Mohd Yusoff, Iraj Mohebbi, Niels C Møller, Dénes Molnár, Amirabbas Momenan, Charles K Mondo, Michele M Monroy-Valle, Roger A Montenegro Mendoza, Eric Monterrubio-Flores, Kotsedi Daniel K Monyeki, Jin Soo Moon, Mahmood Moosazadeh, Farhad Moradpour, Leila B Moreira, Alain Morejon, Luis A Moreno, Karen Morgan, George Moschonis, Alireza Moslem, Mildrey Mosquera, Malgorzata Mossakowska, Aya Mostafa, Seyed-Ali Mostafavi, Mohammad Esmaeel Motlagh, Jorge Motta, Marcos André Moura-dos-Santos, Malay K Mridha, Kelias P Msyamboza, Thet Thet Mu, Florian Muca, Boban Mugoša, Patricia B Munroe, Jaakko Mursu, Kamarul Imran Musa, Sanja Musić Milanović, Vera Musil, Geofrey Musinguzi, Norlaila Mustafa, Muel Telo Marie-Claire Muyer, Iraj Nabipour, Balkish M Naidu, Farid Najafi, Hanna Nalecz, Jana Námešná, KM Venkat Narayan, Take Naseri, Michels Nathalie, Nareemarn Neelapaichit, Azim Nejatizadeh, Ilona Nenko, Flavio Nervi, Hannelore K Neuhauser, Tze Pin Ng, Chung T Nguyen, Quang V Nguyen, Quang Ngoc Nguyen, Michael Y Ni, Peng Nie, Ramfis E Nieto-Martínez, Teemu J Niiranen, Toshiharu Ninomiya, Nobuo Nishi, Sania Nishtar, Marianna Noale, Oscar A Noboa, Helena Nogueira, Kevin I Norton, Davide Noto, Natalia Nowak-Szczepanska, Mohannad Al Nsour, Irfan Nuhoğlu, Eha Nurk, Fred Nuwaha, Moffat Nyirenda, Terence W O'Neill, Caleb Ochimana, Angélica M Ochoa-Avilés, Eiji Oda, Augustine N Odili, Kyungwon Oh, Ryutaro Ohtsuka, Brian Oldenburg, Valérie Olié, Mohd Azahadi Omar, Saeed M Omar, Altan Onat, Sok King Ong, N Charlotte Onland-Moret, Lariane M Ono, Obinna Onodugo, Pedro Ordunez, Rui Ornelas, Ana P Ortiz, Pedro J Ortiz, Clive Osmond, Sergej M Ostojic, Afshin Ostovar, Johanna A Otero, Charlotte B Ottendahl, Akaninyene Otu, Kim Overvad, Ellis Owusu-Dabo, Cristina P Padez, Ioannis Pagkalos, Natalja Pajula, Alberto Palloni, Luigi Palmieri, Wen-Harn Pan, Francesco Panza, Mariela Paoli, Sousana K Papadopoulou, Rossina G Pareja, Soon-Woo Park, Suyeon Park, Winsome R Parnell, Mahboubeh Parsaeian, Ionela M Pascanu, Patrick Pasquet, Nikhil D Patel, Halyna Pavlyshyn, Raimund Pechlaner, Ivan Pećin, João M Pedro, Sergio Viana Peixoto, Markku Peltonen, Alexandre C Pereira, Karen GDA Peres, Marco A Peres, Agustín Perez-Londoño, Cynthia M Pérez, Valentina Peterkova, Olga Petrovna Kovtun, Niloofar Peykari, Son Thai Pham, Rafael N Pichardo, Preux Pierre-Marie, Hynek Pikhart, Aida Pilav, Pavel Piler, Aleksandra Piwonska, Andreia N Pizarro, Silvia Plata, Raluca M Pop, Barry M Popkin, Stevo R Popovic, Miquel Porta, Anil Poudyal, Farhad Pourfarzi, Akram Pourshams, Hossein Poustchi, Rajendra Pradeepa, Alison J Price, Antonio Prista, Rui Providencia, Jardena J Puder, Iveta Pudule, Soile Puhakka, Maria Puiu, Margus Punab, Mostafa Qorbani, Anna Quialheiro, Hedley K Quintana, Pedro J Quiroga-Padilla, Tran Quoc Bao, Stefan Rach, Salar Rahimikazerooni, Mahmudur Rahman, Olli Raitakari, Sherali Rakhmatulloev, Ivo Rakovac, Ambady Ramachandran, Otim PC Ramadan, Manuel Ramirez-Zea, Rafel Ramos, Lekhraj Rampal, Sanjay Rampal, Sheena E Ramsay, João FLB Rangel Junior, Daniel A Rangel Reina, Lalka S Rangelova, Vayia Rarra, Mohammad-Mahdi Rashidi, Cassiano Ricardo Rech, Josep Redon, Valéria Regecová, Jane DP Renner, Judit A Repasy, Cézane P Reuter, Luis Revilla, Andrew Reynolds, Negar Rezaei, Abbas Rezaianzadeh, Elio Riboli, Fernando Rigo, Attilio Rigotti, Leanne M Riley, Tobias F Rinke de Wit, Ulf Risérus, Raphael M Ritti-Dias, Reina G Roa, Romana Roccaldo, Fernando Rodríguez-Artalejo, María del Cristo Rodriguez-Perez, Laura A Rodríguez-Villamizar, Andrea Y Rodríguez, Ulla Roggenbuck, Peter Rohloff, Rosalba Rojas-Martinez, Elisabetta L Romeo, Rafaela V Rosario, Annika Rosengren, Ian Rouse, Adolfo Rubinstein, Blanca Sandra Ruiz-Betancourt, Maria Ruiz-Castell, Emma Ruiz Moreno, Iuliia A Rusakova, Wojciech Rusek, Petra Rust, Marcin Rutkowski, Marge Saamel, Hamideh Sabbaghi, Harshpal S Sachdev, Alireza Sadjadi, Ali Reza Safarpour, Sare Safi, Mohammad Hossien Saghi, Olfa Saidi, Calogero Saieva, Satoko Sakata, Nader Saki, Sanja Šalaj, Eduardo Salazar Martinez, Akkumis Salkhanova, Jukka T Salonen, Margarita Samoutian, Jose Sánchez-Abanto, Inés Sánchez Rodríguez, Diana A Santos, Ina S Santos, Maria Paula Santos, Tamara R Santos, Jouko L Saramies, Luis B Sardinha, Giselle Sarganas, Nizal Sarrafzadegan, Kai-Uwe Saum, Stefan Savin, Mariana Sbaraini, Marcia Scazufca, Beatriz D Schaan, Anja Schienkiewitz, Karin Schindler, Sabine Schipf, Amand Floriaan Schmidt, Börge Schmidt, Carsten O Schmidt, Ben Schöttker, Sara Schramm, Stine Schramm, Helmut Schröder, Constance Schultsz, Aletta E Schutte, Sylvain Sebert, Moslem Sedaghattalab, Aye Aye Sein, Abhijit Sen, Sadaf G Sepanlou, Guillermo Sequera, Ľudmila Ševčíková, Ronel Sewpaul, Teresa Shamah-Levy, Seyed Morteza Shamshirgaran, Maryam Sharafkhah, Sanjib K Sharma, Almaz Sharman, Amaneh Shayanrad, Ali Akbar Shayesteh, Lela Shengelia, Kenji Shibuya, Hana Shimizu-Furusawa, Rahman Shiri, Marat Shoranov, Namuna Shrestha, Khairil Si-Ramlee, Abla M Sibai, Labros S Sidossis, Antonio M Silva, Caroline Ramos de Moura Silva, Diego Augusto Santos Silva, Kelly Samara Silva, Xueling Sim, Mary Simon, Michael Sjöström, Natalia A Skoblina, Jolanta Slowikowska-Hilczer, Przemysław Slusarczyk, Liam Smeeth, Lee Smith, Fernanda Cunha Soares, Grzegorz Sobek, Eugène Sobngwi, Morten Sodemann, Agustinus Soemantri, Vincenzo Solfrizzi, Mohammad Hossein Somi, Elin P Sørgjerd, Maroje Sorić, Victoria E Soto-Rojas, Aïcha Soumaré, Alfonso Sousa-Poza, Igor Spiroski, Jan A Staessen, Andreas Stang, Jostein Steene-Johannessen, Peter Stehle, Aryeh D Stein, George S Stergiou, Jakub Stokwiszewski, Ekaterina Stoyanova, Gareth Stratton, Karien Stronks, Lela Sturua, Milton F Suarez-Ortegón, Phalakorn Suebsamran, Gerhard Sulo, Johan Sundström, Paibul Suriyawongpaisal, Boyd A Swinburn, René Charles Sylva, Lucjan Szponar, E Shyong Tai, Konstantinos D Tambalis, Abdonas Tamosiunas, Baimakhan Tanabayev, Maya Tanrygulyyeva, Mohammed Rasoul Tarawneh, Jakob Tarp, Carolina B Tarqui-Mamani, Radka Taxová Braunerová, Saskia Te Velde, William R Tebar, Grethe S Tell, Tania Tello, KR Thankappan, Xenophon Theodoridis, Sathish Thirunavukkarasu, Nihal Thomas, Amanda G Thrift, Ľubica Tichá, Erik J Timmermans, Dwi Hapsari Tjandrarini, Anne Tjonneland, Janne S Tolstrup, Murat Topbas, Laura Torres-Collado, Giota Touloumi, Pierre Traissac, Areti Triantafyllou, Atul Trivedi, Lechaba Tshepo, Panagiotis Tsintavis, John Tuitele, Azaliia M Tuliakova, Marshall K Tulloch-Reid, Fikru Tullu, Tomi-Pekka Tuomainen, Maria L Turley, Evangelia Tzala, Themistoklis Tzotzas, Christophe Tzourio, Peter Ueda, Eunice Ugel, Flora AM Ukoli, Zhamyila Usupova, Hannu MT Uusitalo, Nalan Uysal, Gonzalo Valdivia, Damaskini Valvi, Rob M van Dam, Bert-Jan van den Born, Johan Van der Heyden, Yvonne T van der Schouw, Wendy Van Lippevelde, Hoang Van Minh, Natasja M Van Schoor, Irene GM van Valkengoed, Dirk Vanderschueren, Diego Vanuzzo, Gregorio Varela-Moreiras, Luz Nayibe Vargas, Senthil K Vasan, Daniel G Vasques, Tomas Vega, Gustavo Velasquez-Melendez, Biruta Velika, Charlotte Verdot, Maïté Verloigne, Giovanni Veronesi, WM Monique Verschuren, Roosmarijn Verstraeten, Lucie Viet, Frøydis N Vik, Monica Vilar, Salvador Villalpando, Jesus Vioque, Jyrki K Virtanen, Marjolein Visser, Bharathi Viswanathan, Mihaela Vladulescu, Henry Völzke, Ari Voutilainen, Martine Vrijheid, Alisha N Wade, Wan Mohamad Wan Bebakar, Wan Nazaimoon Wan Mohamud, Rildo de Souza Wanderley Júnior, Chongjian Wang, Huijun Wang, Ningli Wang, Qian Wang, Xiangjun Wang, Ya Xing Wang, Ying-Wei Wang, S Goya Wannamethee, Nicholas Wareham, Olivia Wartha, Adelheid Weber, Karen Webster-Kerr, Niels Wedderkopp, Daniel Weghuber, Wenbin Wei, Leo Westbury, Peter H Whincup, Kremlin Wickramasinghe, Kurt Widhalm, Indah S Widyahening, Andrzej Więcek, Rainford J Wilks, Karin Willeit, Peter Willeit, Julianne Williams, Tom Wilsgaard, Bogdan Wojtyniak, Roy A Wong-McClure, Andrew Wong, Emily B Wong, Frederick C Wu, Justyna Wyszyńska, Haiquan Xu, Liang Xu, Nor Azwany Yaacob, Li Yan, Weili Yan, Yang Yang, Martha Yépez García, Moein Yoosefi, Akihiro Yoshihara, Novie O Younger-Coleman, Yu-Ling Yu, Yunjiang Yu, Ahmad Faudzi Yusoff, Vassilis Zafiropulos, Ahmad A Zainuddin, Farhad Zamani, Sabina Zambon, Antonis Zampelas, Maria Elisa Zapata, Ko Ko Zaw, Tomasz Zdrojewski, Magdalena Żegleń, Kristyna Zejglicova, Tajana Zeljkovic Vrkic, Bing Zhang, Zhen-Yu Zhang, Yanitsa V Zhecheva, Bekbolat Zholdin, Paul Zimmet, Marie Zins, Julio Zuñiga Cisneros, Monika Zuziak, Majid Ezzati

  The Lancet 404 (10455) 851 - 863 0140-6736 2024/08
• Association between oral frailty and nutritional status among hemodialysis patients aged ≥50 years.

  Masanori Iwasaki, Yuko Ohta, Natsuka Furusho, Satoko Kakuta, Kosuke Muraoka, Toshihiro Ansai, Shuji Awano, Masayo Fukuhara, Hidetoshi Nakamura

  Geriatrics & gerontology international 2024/08/01 

  AIM: Malnutrition is a prevalent health issue among hemodialysis patients. Oral frailty, a condition characterized by impairments in multiple oral health aspects and functions, has been associated with nutritional status in the general population. We aimed to determine whether oral frailty was associated with nutritional status in hemodialysis patients aged ≥50 years. Our secondary aim was to determine the prevalence of oral frailty in this population. METHODS: This cross-sectional study included hemodialysis patients who were admitted to a single medical center. According to the Oral Frailty 5-item Checklist, oral frailty is characterized by the presence of two or more of the following criteria: (i) fewer teeth, (ii) difficulty in chewing, (iii) difficulty in swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. Patients' nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI). Multivariable ordinal logistic regression analysis was performed to assess the association between oral frailty and nutritional status (classified into three categories according to the GNRI: >98, 92-98, and <92). RESULTS: In total, 152 hemodialysis patients (55 women and 97 men) with a mean age of 70.4 years were included. The prevalence of oral frailty was 61.2%. After adjusting for health characteristics and sociodemographic background, oral frailty was associated with poor nutritional status according to the GNRI (odds ratio = 2.04, 95% confidence interval = 1.02-4.09). CONCLUSIONS: In this study, approximately 60% of hemodialysis patients aged ≥50 years exhibited oral frailty, and hemodialysis patients with oral frailty had poor nutritional status according to the GNRI. Geriatr Gerontol Int 2024; ••: ••-••.
• Evaluation of a Novel Immunochromatographic Device for Detecting Porphyromonas gingivalis in Patients with Periodontal Disease.

  Rieko Yamanaka, Michihiko Usui, Kaoru Kobayashi, Satoru Onizuka, Shingo Kasai, Kotaro Sano, Shou Hironaka, Ryota Yamasaki, Shinji Yoshii, Tsuyoshi Sato, Wataru Fujii, Masanori Iwasaki, Wataru Ariyoshi, Keisuke Nakashima, Tatsuji Nishihara

  International journal of molecular sciences 25 (15) 2024/07/26 

  Porphyromonas gingivalis is the most pathogenic periodontal bacterium in the world. Recently, P. gingivalis has been considered responsible for dysbiosis during the development of periodontitis. This study aimed to evaluate a novel immunochromatographic device using monoclonal antibodies against P. gingivalis in subgingival plaques. A total of 72 patients with chronic periodontitis and 53 periodontally healthy volunteers underwent clinical and microbiological examinations. Subgingival plaque samples were analyzed for the presence of P. gingivalis and compared using real-time polymerase chain reaction (PCR). In the periodontitis group, a significant positive correlation was observed between the test device scores and the real-time PCR results. The specificity, positive predictive value, negative predictive value, and accuracy of the test device for P. gingivalis, as determined by real-time PCR, were 98%, 94%, 89%, and 90%, respectively. There were significant differences in bacterial counts by real-time PCR among the groups with different ranges of device scores. Additionally, there was a significant positive correlation between the device scores for P. gingivalis and periodontal parameters. These results suggest that this novel immunochromatographic device can be effectively used for rapid detection and semi-quantification of P. gingivalis in subgingival plaques.
• Serum albumin redox state as an indicator of dietary protein intake among community-dwelling older adults.

  Keiko Motokawa, Maki Shirobe, Masanori Iwasaki, Yasuaki Wada, Fuka Tabata, Kazuhiro Shigemoto, Yurie Mikami, Misato Hayakawa, Yosuke Osuka, Narumi Kojima, Hiroyuki Sasai, Hiroki Inagaki, Fumiko Miyamae, Tsuyoshi Okamura, Hirohiko Hirano, Shuichi Awata

  Clinical nutrition ESPEN 63 157 - 161 2024/06/22 

  BACKGROUND AND AIMS: Serum markers capable of detecting mild levels of undernutrition, such as insufficient dietary protein intake (IDPI), have not been established among community-dwelling older adults. Although the serum albumin redox state, expressed as the ratio of reduced albumin (Alb) to total Alb (the reduced albumin ratio), has the potential to overcome this challenge, empirical epidemiological data are lacking. This study aimed to investigate the association between a serum reduced Alb ratio and dietary protein intake among community-dwelling older adults. METHODS: This study analyzed cross-sectional data from 1,005 community dwelling population (572 males and 433 females) aged 70-84 years who participated in the Itabashi Longitudinal Study on Aging. Exclusion criteria included participants with incomplete data, individuals with a history of kidney disease and high C-reactive protein (CRP) levels. The dietary protein intake was estimated using validated food frequency questionnaires. The IDPI was defined as not meeting the level recommended by the Dietary Reference Intakes for Japanese (Men ≥60 g/day, Women ≥50 g/day). RESULTS: IDPI was observed in 14.1% of the study population. Logistic regression analyses adjusted for sex, age, body weight and malnutrition showed that a serum reduced Alb ratio was significantly associated with IDPI (odds ratio = 0.962, 95% confidence interval = 0.926-0.999), whereas serum albumin concentration was not (odds ratio = 0.549, 95% confidence interval = 0.285-1.061). CONCLUSIONS: A serum reduced Alb ratio would be a useful indicator of protein insufficiency among community-dwelling older adults.
• Association of oral frailty with medical expenditure in older Japanese adults: The study of late-stage older adults in Tottori (START Tottori).

  Eri Arai, Yutaka Watanabe, Sayuri Nakagawa, Yuki Ohara, Masanori Iwasaki, Hirohiko Hirano, Kazunori Ikebe, Takahiro Ono, Katsuya Iijima, Akira Adachi, Takao Watanabe, Yutaka Yamazaki

  Gerodontology 2024/06/17 

  OBJECTS: This study aimed to determine the association between annual medical expenses and oral frailty in later-stage older adults (aged ≥ 75 years). No studies have investigated the association between medical costs and oral frailty, which would elucidate the association between oral frailty and the deterioration of mental and overall physical function. MATERIALS AND METHODS: In this cross-sectional study, 2190 adults (860 men and 1330 women aged 75-94 years) covered by the Medical System for the Elderly and residing in Tottori Prefecture, Japan, between April 2016 and March 2019, were included. Participants were classified into three groups: healthy, pre-orally frail or orally frail, based on dental health screening findings. The medical and dental expenses over the years, number of days of consultations and comorbidities were obtained from the Japanese Health Insurance Claims Database. RESULTS: The number of days of medical and dental consultations and annual medical expenses for outpatient care differed among the three study groups. A significant association was observed between oral frailty and high annual expenses for outpatient medical and dental care. Oral frailty was associated with higher medical expenses in participants with poor masticatory function. Higher and lower dental expenses were associated with subjective poor masticatory function and subjective impairment of swallowing function respectively. CONCLUSION: Medical and dental expenses for orally frail older adults are high, indicating that oral frailty may be related to the occurrence and severity of diseases other than oral health issues. Future studies should examine the mechanism by which oral weakness affects physical and mental functions.
• オーラルフレイルの新たな概念と評価方法 国民に向けてのさらなる普及・啓発と多職種連携の推進

  上田 貴之, 飯島 勝矢, 池邉 一典, 岩崎 正則, 田中 友規, 平野 浩彦, 水口 俊介

  日本歯科評論 (株)ヒョーロン・パブリッシャーズ 84 (6) 77 - 82 0289-0909 2024/06
• Oral frailty, appetite and dietary variety in late-stage older adults: A cross-sectional study (the STudy of lAte-stage oldeR adulTs in Tottori; START Tottori).

  Sayuri Nakagawa, Kazuhito Miura, Eri Arai, Kenshu Taira, Yutaka Watanabe, Maki Shirobe, Keiko Motokawa, Yuki Ohara, Masanori Iwasaki, Hirohiko Hirano, Takahiro Ono, Akira Adachi, Takao Watanabe, Yutaka Yamazaki

  Geriatrics & gerontology international 2024/05/07 

  AIM: Efforts to combat frailty and preserve good health in older adults have highlighted oral frailty as an early indicator of overall frailty. Individuals showing oral frailty are at an elevated risk of insufficient nutritional intake compared with those without oral frailty; however, underlying mechanisms remain poorly explored. In this cross-sectional study, we aimed to examine the link between oral frailty and undernutrition, especially regarding poor appetite and low dietary diversity. METHODS: The analysis included 2727 late-stage older adults (mean age 79.9 ± 4.3 years) who underwent dental checkups in a prefecture in Japan from 2016 to 2020. The examination involved a questionnaire survey (covering basic information, frailty screening index, appetite index: Simplified Nutritional Appetite Questionnaire; and dietary variety: Dietary Variety Score) and a measurement survey (including intraoral confirmation, oral diadochokinesis and masticatory efficiency test). Individuals with three or more indications of poor oral function, identified through oral function assessment, were defined as showing oral frailty. Binomial logistic regression and path analyses examined associations among oral frailty, Simplified Nutritional Appetite Questionnaire and Dietary Variety Score. RESULTS: Among those analyzed, 1208 (44.3%) participants were categorized into the oral frailty group. Binomial logistic regression analysis showed that Simplified Nutritional Appetite Questionnaire (odds ratio for oral frailty per 1-point increase 0.88, 95% confidence interval 0.84-0.93) and Dietary Variety Score (odds ratio 0.95, 95% confidence interval 0.92-0.98) were significantly associated with oral frailty. The path analysis showed individual associations between each examined factor. CONCLUSIONS: Oral frailty was associated with decreased appetite and dietary variety in late-stage older adults. Geriatr Gerontol Int 2024; ••: ••-••.
• Higher-level competence: Results from the Integrated Longitudinal Studies on Aging in Japan (ILSA-J) on the shape of associations with impaired physical and cognitive functions.

  Takumi Abe, Yoshinori Fujiwara, Akihiko Kitamura, Yu Nofuji, Yukiko Nishita, Hyuma Makizako, Seungwon Jeong, Masanori Iwasaki, Minoru Yamada, Narumi Kojima, Katsuya Iijima, Shuichi Obuchi, Ken Shinmura, Rei Otsuka, Takao Suzuki

  Geriatrics & gerontology international 24 (4) 352 - 358 2024/04 

  AIM: This study aimed to examine the relationships between levels of competence and impaired physical and cognitive functions in older adults. METHODS: We used a data set of the Integrated Longitudinal Studies on Aging in Japan for 2017 including 5475 community-dwelling older adults. Levels of competence were assessed using the Japan Science and Technology Agency Index of Competence (JST-IC). Grip strength (low grip strength: <28 kg for men and <18 kg for women) and gait speed (slow gait speed: <1.0 m/s for both sexes) were evaluated as physical function measurements, and the Mini-Mental State Examination (cognitive decline: <24 on the Mini-Mental State Examination) was used to assess cognitive function. RESULTS: The JST-IC had areas under the curve estimated from receiver operating characteristic analysis ranging from 0.65 to 0.73 for detecting low function as assessed by these tests. Restricted cubic spline curves showed that the shape of the association between the JST-IC and impaired function depended on sex and the test used. The comparison between perfect and imperfect JST-IC scores showed significant differences in the prevalence of low grip strength in both sexes, slow gait speed in women, and cognitive decline in men. CONCLUSIONS: It may be insufficient to identify those with impaired physical or cognitive function using the JST-IC. The shape of the association with the JST-IC varies across their measurements. Our findings can help interpret JST-IC scores in the context of low physical and cognitive functions. Geriatr Gerontol Int 2024; 24: 352-358.
• Proposal and validation of an equation to identify sarcopenia using bioelectrical impedance analysis-derived parameters

  Takashi Shida, Sho Hatanaka, Takahisa Ohta, Yosuke Osuka, Narumi Kojima, Keiko Motokawa, Masanori Iwasaki, Fumiko Miyamae, Tsuyoshi Okamura, Hirohiko Hirano, Shuichi Awata, Hiroyuki Sasai

  Nutrition 112453 - 112453 0899-9007 2024/04
• Feasibility of Oral Function Evaluation According to Dementia Severity in Older Adults with Alzheimer's Disease.

  Maki Shirobe, Ayako Edahiro, Keiko Motokawa, Shiho Morishita, Yoshiko Motohashi, Chiaki Matsubara, Masanori Iwasaki, Yutaka Watanabe, Hirohiko Hirano

  Nutrients 16 (7) 2024/03/28 

  Oral function evaluation in older adults with dementia is important for determining appropriate and practical dietary support plans; however, it can be challenging due to their difficulties in comprehending instructions and cooperating during assessments. The feasibility of oral function evaluation has not been well studied. This cross-sectional study aimed to determine the feasibility of oral function evaluation in older adults with Alzheimer's disease (AD) according to Functional Assessment Staging of Alzheimer's Disease (FAST) stages. In total, 428 older adults with AD (45 men and 383 women; mean age: 87.2 ± 6.2 years) were included. Multilevel logistic regression models were used to examine the prevalence of participants who were unable to perform oral function evaluations, including oral diadochokinesis (ODK), repeated saliva swallow test (RSST), and modified water swallow test (MWST). In comparison to the reference category (combined FAST stage 1-3), FAST stage 7 was associated with the infeasibility of ODK (adjusted odds ratio, 95% confidence interval = 26.7, 4.2-168.6), RSST (5.9, 2.2-16.1), and MWST (8.7, 1.6-48.5, respectively). Oral function evaluation is difficult in older adults with severe AD. Simpler and more practical swallowing function assessments and indicators that can be routinely observed are required.
• オーラルフレイルに関する3学会合同ステートメント

  神崎 恒一, 水口 俊介, 荒井 秀典, 秋下 雅弘, 飯島 勝矢, 池邉 一典, 岩崎 正則, 上田 貴之, 田中 友規, 平野 浩彦, オーラルフレイルに関する3学会合同ワーキンググループ

  老年歯科医学 (一社)日本老年歯科医学会 38 (4) 106 - 116 0914-3866 2024/03
• Association of decreased frequency of conversation with depression, oral function and eating alone: A cross‐sectional study of older adults during the COVID‐19 pandemic

  Yasuko Ishimoto, Yumi Kimura, Taizo Wada, Kiichi Hirayama, Emiko Kato, Mai Tatsuno, Michiko Fujisawa, Yoriko Kasahara, Masahiro Nakatsuka, Mitsuhiro Nose, Masanori Iwasaki, Satoko Kakuta, Mayumi Hirosaki, Kiyohito Okumiya, Kozo Matsubayashi, Ryota Sakamoto

  Geriatrics and Gerontology International 1444-1586 2024/03 [Refereed]
   

  AimThis study examined the associations between geriatric factors and decreased opportunities for conversation among older adults amid a period of self‐restraint during the COVID‐19 pandemic.MethodsA cross‐sectional questionnaire‐based survey was carried out in October 2020. The participants were 204 residents aged ≥65 years staying at a private care home in Kyoto city, Japan. Logistic regression analysis was carried out with the reduction of conversation opportunities as the dependent variable, and geriatric factors as independent variables after adjusting for age and sex. We compared the decreased frequency of opportunities between residents in the assisted living wing and in the nursing care wing of the private care home.ResultsThe percentages of respondents who reported a decrease in the opportunities for conversation among themselves were 43.9% for residents in the assisted living wing and 19.7% for those in the nursing care wing. After adjusting for age and sex, the opportunities for conversation was significantly associated with the basic activities of daily living (OR 1.07, 95% CI 1.01–1.12), instrumental self‐maintenance (OR 1.25, 95% CI 1.08–1.46), intellectual activity (OR 1.35, 95% CI 1.09–1.66), depression (OR 1.13, 95% CI 1.04–1.23), depressive mood (OR 3.83, 95% CI 1.98–7.42), decreased motivation (OR 3.11, 95% CI 1.58–6.12), appetite loss (OR 4.32, 95% CI 1.54–12.07), swallowing function (OR 1.05, 95% CI 1.00–1.10), chewing difficulty (OR 2.50, 95% CI 1.31–4.75) and eating alone (OR 2.5, 95% CI 1.35–4.62).ConclusionDecreased opportunities for conversation was more perceived among older adults with higher daily functioning, suggesting that it is associated with depressed mood, oral function and solitary eating. Geriatr Gerontol Int 2024; 24: 385–391.
• Sex-specific factors associated with acceptance of smartwatches among urban older adults: the Itabashi longitudinal study on aging

  Naoki Deguchi, Yosuke Osuka, Narumi Kojima, Keiko Motokawa, Masanori Iwasaki, Hiroki Inagaki, Fumiko Miyamae, Tsuyoshi Okamura, Hirohiko Hirano, Shuichi Awata, Hiroyuki Sasai

  Frontiers in Public Health 12 2024/02/23 

  Smartwatches (SW) are wearable devices that support daily life and monitor an individual’s health and activity status. This information is utilized to promote behavior modification, which could help prevent chronic diseases and manage the health of older adults. Despite being interested in SWs, older adults tend to decrease their SW usage as they age. Therefore, understanding the acceptance of SWs among older individuals can facilitate individual health management through digital health technology. This study investigated the factors associated with the acceptance of SWs among older adults in Japan and the variations in the factors by sex. This study utilized data from the 2022 Itabashi Longitudinal Study on Aging, an ongoing cohort study conducted by the Tokyo Metropolitan Institute for Geriatrics and Gerontology. We included 899 eligible individuals aged ≥65 years. Participants were classified into three groups: possessing SW (possessor group), not possessing SW but interested in possession in the future (interest group), and not interested in possession in the future (non-interest group) using a self-administered questionnaire. The level of SW acceptance was operationally defined as follows: low (non-interest group), medium (interest group), and high (possessor group). Further, we evaluated the association of acceptance and purchase intentions of SWs with sociodemographic variables, technology literacy, and health variables. Among the participants, 4.2% possessed SWs, with no significant sex difference (men, 4.2%; women, 4.3%). Among men, age &lt; 75 years, obesity, diabetes, and dyslipidemia were significantly associated with SW acceptance level. Contrastingly, among women, age &lt; 75 years, living alone, higher household income, and a high score for new device use in the technology literacy category were significantly associated with SW acceptance level. Health-related factors were associated with SW acceptance in men, while technology literacy and sociodemographic factors were associated with SW acceptance in women. Our findings may inform the development of sex-specific interventions and policies for increasing SW utilization among older adults in Japan.
• Prevalence of oral frailty and its association with dietary variety, social engagement, and physical frailty: Results from the Oral Frailty 5-Item Checklist.

  Masanori Iwasaki, Maki Shirobe, Keiko Motokawa, Tomoki Tanaka, Kazunori Ikebe, Takayuki Ueda, Shunsuke Minakuchi, Masahiro Akishita, Hidenori Arai, Katsuya Iijima, Hiroyuki Sasai, Shuichi Obuchi, Hirohiko Hirano

  Geriatrics & gerontology international 2024/02/23 

  AIM: This cross-sectional study had two aims: to assess the prevalence of oral frailty (OF), according to the Oral Frailty 5-Item Checklist (OF-5), among community-dwelling older adults; and to examine the associations among oral frailty, dietary variety, social engagement, and physical frailty. METHODS: We pooled data from two population-based studies (the Otassha Study and the Itabashi Longitudinal Study on Aging). With the OF-5, OF is characterized by the presence of two or more of the following: (i) fewer teeth, (ii) difficulty in chewing, (iii) difficulty in swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. We calculated the OF prevalence for each sex. We assessed dietary variety, social engagement, and physical frailty. Generalized structural equation modeling was employed to investigate the associations among oral frailty, low dietary variety (dietary variety score ≤3), social isolation (Lubben Social Network Scale score <12), and physical frailty (Japanese version of the Cardiovascular Health Study score ≥3). RESULTS: A total of 1206 individuals (626 women and 580 men) with a mean age of 74.7 years were included. The prevalence of OF was 36.7%, and it increased with age; however, there was no significant sex difference. OF was significantly indirectly associated with physical frailty via low dietary variety (odds ratio, 1.43; 95% confidence interval, 1.04-1.97) and social isolation (odds ratio, 1.42; 95% confidence interval, 1.04-1.94). CONCLUSIONS: Two of five community-dwelling older adults exhibited OF. Low dietary variety and social isolation are potential underlying mechanisms through which OF is indirectly associated with physical frailty. Geriatr Gerontol Int 2024; ••: ••-••.
• Association between dry eye and periodontal disease in community-dwelling Japanese adults: data from the Uonoma cohort study

  Kaung Myat Thwin, Noboru Kaneko, Hikaru Okubo, Takayuki Yamaga, Kana Suwama, Akihiro Yoshihara, Masanori Iwasaki, Yumi Ito, Junta Tanaka, Ichiei Narita, Hiroshi Ogawa

  BMC Oral Health 24 (1) 2024/01/08 

  Abstract Background While research has explored the risk of periodontal disease in various eye conditions, the link between dry eye and periodontal disease remains underexplored, especially in Japanese adults. This study aims to investigate the association between dry eye and periodontal disease in community-dwelling Japanese adults. Methods This study is a subset of the Uonuma cohort study, which includes Japanese adults aged 40 years and older residing in the Uonuma area of Niigata Prefecture, Japan. Participants completed a self-administered, paper-based questionnaire. Statistical analyses, including the chi-square test, independent t test, ANOVA test, and logistic regressions, were employed to assess the association of periodontal disease with independent variables. Results Among 36,488 participants (average age 63.3 years, 47.4% men), 39.3% had a history of periodontal disease, and gender differences were statistically significant (p < 0.001). Significant associations were found between periodontal disease and dry eye diagnosis or symptoms. Univariable logistic regression revealed links between periodontal disease and age, gender, living status, alcohol consumption, remaining teeth, bite molar availability, and history of dry eye disease or symptoms. Multiple-adjusted regression found that doctor-diagnosed dry eye was associated with a higher likelihood of periodontal disease (odds ratio, 1.12; 95% confidence interval, 1.03–1.22). Participants who never experienced dryness or foreign body sensation had lower ORs of periodontal disease than those who always experienced such symptoms across all models. Conclusion A significant correlation was found between dry eye and periodontal disease in Japanese adults. Regular check-ups, early detection, and effective management of both conditions are strongly recommended.
• Effect of periodontal therapy on glycaemic control in type 2 diabetes

  Misuzu Sato, Sachiko Ono, Hayato Yamana, Akira Okada, Miho Ishimaru, Yosuke Ono, Masanori Iwasaki, Jun Aida, Hideo Yasunaga

  Journal of Clinical Periodontology 0303-6979 2024/01/03 

  Abstract Aim This study aimed to elucidate the impact of periodontal therapy on glycaemic control in individuals with type 2 diabetes and various baseline blood glucose levels using a large‐scale claims database from Japan. Materials and Methods Using the JMDC Claims Database, we identified individuals with type 2 diabetes who underwent health check‐ups in the fiscal years 2018 or 2019 and were followed up until the next year's health check‐up. We conducted a weighted cohort analysis using stabilized inverse probability weights for treatment and censoring to estimate the effect of periodontal therapy on changes in haemoglobin A1c levels within a year. Analysis was done for different baseline haemoglobin A1c categories: 6.5%–6.9%, 7.0%–7.9% and ≥8.0%. Results Of the 4279 insured persons included in the study, 957 received periodontal therapy. Overall, there was a tendency towards improved glycaemic control among those who received periodontal therapy. Participants with baseline haemoglobin A1c levels of 7.0%–7.9% who received periodontal therapy exhibited significantly better glycaemic control compared with those without dental visits (difference; −0.094 [95% confidence interval: −0.181 to −0.007]). Conclusions Periodontal therapy may improve glycaemic control in individuals with diabetes, especially in those with haemoglobin A1c levels ≥7.0%.
• Associations of polypharmacy with frailty severity and each frailty phenotype in community-dwelling older adults: Itabashi Longitudinal Study on Aging.

  Kaori Daimaru, Yosuke Osuka, Narumi Kojima, Katsuyoshi Mizukami, Keiko Motokawa, Masanori Iwasaki, Hiroki Inagaki, Fumiko Miyamae, Tsuyoshi Okamura, Hirohiko Hirano, Shuichi Awata, Hiroyuki Sasai

  Geriatrics & gerontology international 2024/01/02 

  AIM: Although polypharmacy and frailty are concerns in older adults, there is limited understanding of their association, particularly regarding frailty severity and its phenotypes within this population. This study aimed to examine the association between polypharmacy and frailty severity or frailty phenotypes in community-dwelling older Japanese adults. METHODS: This cross-sectional study included 1021 older adults from the Itabashi Longitudinal Study on Aging. Men accounted for 45.4%, and the mean age (standard deviation) was 77.9 (5.1) years. Participants were classified into frail (n = 67), pre-frail (n = 543), and robust (n = 411) groups using the revised Japanese Cardiovascular Health Study criteria. Polypharmacy was defined as using five or more self-reported prescription drugs. Ordinal and binomial logistic regression analyses examined the association between polypharmacy and frailty severity or frailty phenotypes (weight loss, weakness, exhaustion, slowness, and low activity). These models were adjusted for age, sex, body mass index, number of comorbidities, living status, employment status, years of education, as well as drinking and smoking habits. RESULTS: The prevalence of frailty in participants with and without polypharmacy was 10.1% and 5.0%, respectively. Participants with polypharmacy were more likely to have frailty (adjusted odds ratio [95% confidence interval], 1.89 [1.40-2.57]), weight loss (1.81 [1.00-3.27]), weakness (1.50 [1.08-2.09]), and slowness (2.25 [1.29-3.94]) compared with the no-polypharmacy group. CONCLUSIONS: Polypharmacy was associated with frailty severity and three frailty phenotypes. Longitudinal studies are required to investigate whether polypharmacy can predict the development and progression of frailty. Geriatr Gerontol Int 2024; ••: ••-••.
• Social Activity and Functional Decline among Community-Dwelling Older Adults in Thailand and Japan: A Comparative Cohort Study

  Kwanchit Sasiwongsaroj, Yumi Kimura, Yasuko Ishimoto, Masanori Iwasaki, Matana Kettratad-Pruksapong, Sutee Suksudaj, Yupin Songpaisan, Ryota Sakamoto, Taizo Wada, Michiko Fujisawa, Kiyohito Okumiya, Hideo Miyazaki, Kozo Matsubayashi

  International Journal of Gerontology 18 (1) 18 - 23 1873-9598 2024/01 

  Background: Social activity has long been recognized as an essential component of active aging. However, an overlooked dimension is cross-national comparison within Asia on social activity and its relationship to the functional decline. This study examined functional decline among older Thai and Japanese adults over a two-year period and compared associated social and other factors. Methods: We collected data from two waves of a longitudinal cohort survey administered in Nakhon Pathom, Thailand and the city of Tosa, Japan, covering community-dwelling adults aged 3 65. The data cover basic activities of daily living (ADL), sociodemographic traits, health status, depression, and social activities. A total of 338 Thai and 869 Japanese participants with no functional limitations participated at baseline, and 216 Thai and 480 Japanese participants completed the follow-up study after two years. Results: At follow-up, Thai participants reported a higher percentage of functional decline than Japanese participants (22.2% vs. 13.5%). Risk factors associated with functional decline in Thai participants were increased age, female gender, low economic satisfaction, and low social activity levels. Functional decline among Japanese participants was associated with increased age, low social activity levels, and arthropathy. Low social activity was a strong predictor of decline in ADL, and the association was significant even after adjusting for related factors in Thai and Japanese individuals. Conclusion: Although there were differences in the variables associated with ADL decline between Thai and Japanese participants, our results support the promotion of social activities for older adults to preserve a healthy functional status.
• Questionnaire for Medical Checkup of Old-Old is non-inferior to the Kihon Checklist in screening frailty among independent older adults aged 75 years and older: The Itabashi Longitudinal Study on Aging.

  Naoki Deguchi, Yosuke Osuka, Narumi Kojima, Keiko Motokawa, Masanori Iwasaki, Hiroki Inagaki, Fumiko Miyamae, Tsuyoshi Okamura, Hirohiko Hirano, Shuichi Awata, Hiroyuki Sasai

  Geriatrics & gerontology international 2023/12/12 

  AIM: The Questionnaire for Medical Checkup of Old-Old (QMCOO) is a 15-item dichotomous questionnaire developed for the early detection and intervention of frailty in a nationwide health checkup program targeting the old-old (i.e. aged ≥75 years). The Kihon Checklist (KCL) is a 25-item questionnaire widely used for screening and self-monitoring frailty status in administrative settings. With fewer items than the KCL, the QMCOO might expedite the frailty screening process. This study tested whether the QMCOO shows noninferiority in detecting frailty compared with the KCL. METHODS: Overall, 645 participants aged ≥75 years in the Itabashi Longitudinal Study on Aging were assessed for their frailty status according to the revised Japanese version of the Cardiovascular Health Study criteria. They also completed the QMCOO and the KCL simultaneously. We compared the discriminative performance of the two questionnaires using non-inferiority testing with an operationally defined non-inferiority margin of 10% of the area under the receiver operating characteristic curve computed from the KCL. RESULTS: The prevalence of frailty was 8.8%. The area under the receiver operating characteristic curve for the QMCOO in determining frailty was 0.76 (95% CI 0.70, 0.82), and the corresponding area under the receiver operating characteristic curve for the KCL was 0.77 (95% CI 0.69, 0.84). The QMCOO was not inferior to the KCL for frailty discrimination (P for non-inferiority = 0.006). CONCLUSIONS: The accuracy of the QMCOO for determining frailty was not inferior to that of the KCL. The QMCOO might be more acceptable and useful, as it can be applied in a shorter time with fewer questions than the KCL. Geriatr Gerontol Int 2023; ••: ••-••.
• A neighbour to consult with is important in dementia‐friendly communities: associated factors of self‐efficacy allowing older adults to continue living alone in community settings

  Chiaki Ura, Hiroki Inagaki, Mika Sugiyama, Fumiko Miyamae, Ayako Edahiro, Kae Ito, Masanori Iwasaki, Hiroyuki Sasai, Tsuyoshi Okamura, Hirohiko Hirano, Shuichi Awata

  Psychogeriatrics 1346-3500 2023/12/05
• The association between trypsin-like protease activity in the oral cavity and kidney function in Japanese workers.

  Masanori Iwasaki, Maki Inoue, Michihiko Usui, Wataru Ariyoshi, Keisuke Nakashima, Yoshie Nagai-Yoshioka, Tatsuji Nishihara

  Journal of clinical periodontology 2023/11/28 

  AIM: To evaluate the association between trypsin-like protease (TLP) activity in the oral cavity as an indicator of periodontal health status and kidney function in Japanese workers. MATERIALS AND METHODS: This cross-sectional study included 1117 Japanese workers (mean age = 43.8 years). Tongue-swab TLP activity was quantified as a* value (the redness intensity of the matrix disc of the TLP activity assessment kit; a larger value indicates more intense enzymatic activity in the samples and poorer periodontal health status). Kidney function was assessed using the estimated glomerular filtration rate (eGFR; a lower value indicates poorer kidney function). We performed ordinal logistic regression analyses to assess the association of the a* value with three eGFR categories: ≥90, 60-89 and <60 mL/min/1.73 m2 . RESULTS: The prevalence for each eGFR category was as follows: ≥90 (31.6%), 60-89 (63.8%) and <60 mL/min/1.73 m2 (4.6%). After adjusting for potential confounders, the a* value was found to be significantly associated with reduced kidney function. The multivariable-adjusted odds ratio (95% confidence interval) for reduced kidney function was 1.12 (1.02-1.22) per unit increase in the a* value. CONCLUSIONS: Higher TLP activity was associated with reduced kidney function in Japanese workers.
• Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

  Bin Zhou, Kate E. Sheffer, James E. Bennett, Edward W. Gregg, Goodarz Danaei, Rosie K. Singleton, Jonathan E. Shaw, Anu Mishra, Victor P. F. Lhoste, Rodrigo M. Carrillo-Larco, Andre P. Kengne, Nowell H. Phelps, Rachel A. Heap, Archie W. Rayner, Gretchen A. Stevens, Chris J. Paciorek, Leanne M. Riley, Melanie J. Cowan, Stefan Savin, Stephen Vander Hoorn, Yuan Lu, Meda E. Pavkov, Giuseppina Imperatore, Carlos A. Aguilar-Salinas, Noor Ani Ahmad, Ranjit Mohan Anjana, Kairat Davletov, Farshad Farzadfar, Clicerio González-Villalpando, Young-Ho Khang, Hyeon Chang Kim, Tiina Laatikainen, Avula Laxmaiah, Jean Claude N. Mbanya, K. M. Venkat Narayan, Ambady Ramachandran, Alisha N. Wade, Tomasz Zdrojewski, Mohsen Abbasi-Kangevari, Hanan F. Abdul Rahim, Niveen M. Abu-Rmeileh, Shalkar Adambekov, Robert J. Adams, Wichai Aekplakorn, Imelda A. Agdeppa, Javad Aghazadeh-Attari, Charles Agyemang, Ali Ahmadi, Naser Ahmadi, Nastaran Ahmadi, Soheir H. Ahmed, Kamel Ajlouni, Halima Al-Hinai, Badreya Al-Lahou, Jawad A. Al-Lawati, Deena Al Asfoor, Nawal M. Al Qaoud, Monira Alarouj, Fadia AlBuhairan, Shahla AlDhukair, Maryam A. Aldwairji, Mohamed M. Ali, Farbod Alinezhad, Abdullah Alkandari, Husam F. Alomirah, Eman Aly, Deepak N. Amarapurkar, Lars Bo Andersen, Sigmund A. Anderssen, Dolores S. Andrade, Alireza Ansari-Moghaddam, Hajer Aounallah-Skhiri, Tahir Aris, Nimmathota Arlappa, Krishna K. Aryal, Felix K. Assah, Batyrbek Assembekov, Juha Auvinen, Mária Avdičová, Kishwar Azad, Mohsen Azimi-Nezhad, Fereidoun Azizi, Flora Bacopoulou, Nagalla Balakrishna, Mohamed Bamoshmoosh, Maciej Banach, Piotr Bandosz, José R. Banegas, Carlo M. Barbagallo, Alberto Barceló, Maja Baretić, Lena Barrera, Abdul Basit, Anwar M. Batieha, Aline P. Batista, Louise A. Baur, Antonisamy Belavendra, Habiba Ben Romdhane, Mikhail Benet, Salim Berkinbayev, Antonio Bernabe-Ortiz, Ximena Berrios Carrasola, Heloísa Bettiol, Augustin F. Beybey, Santosh K. Bhargava, Elysée Claude Bika Lele, Mukharram M. Bikbov, Bihungum Bista, Peter Bjerregaard, Espen Bjertness, Marius B. Bjertness, Cecilia Björkelund, Katia V. Bloch, Anneke Blokstra, Simona Bo, Martin Bobak, Jose G. Boggia, Marialaura Bonaccio, Alice Bonilla-Vargas, Herman Borghs, Pascal Bovet, Imperia Brajkovich, Hermann Brenner, Lizzy M. Brewster, Garry R. Brian, Yajaira Briceño, Miguel Brito, Anna Bugge, Frank Buntinx, Antonio Cabrera de León, Roberta B. Caixeta, Günay Can, Ana Paula C. Cândido, Mario V. Capanzana, Naděžda Čapková, Eduardo Capuano, Rocco Capuano, Vincenzo Capuano, Viviane C. Cardoso, Axel C. Carlsson, Felipe F. Casanueva, Laura Censi, Marvin Cervantes‐Loaiza, Parinya Chamnan, Snehalatha Chamukuttan, Queenie Chan, Fadi J. Charchar, Nish Chaturvedi, Huashuai Chen, Bahman Cheraghian, María-Dolores Chirlaque, Jerzy Chudek, Renata Cifkova, Massimo Cirillo, Frank Claessens, Emmanuel Cohen, Hans Concin, Cyrus Cooper, Simona Costanzo, Chris Cowell, Ana B. Crujeiras, Juan J. Cruz, Felipe V. Cureau, Sarah Cuschieri, Graziella D’Arrigo, Eleonora d’Orsi, Jean Dallongeville, Albertino Damasceno, Saeed Dastgiri, Amalia De Curtis, Giovanni de Gaetano, Stefaan De Henauw, Mohan Deepa, Vincent DeGennaro, Stefaan Demarest, Elaine Dennison, Valérie Deschamps, Meghnath Dhimal, Zivka Dika, Shirin Djalalinia, Chiara Donfrancesco, Guanghui Dong, Maria Dorobantu, Marcus Dörr, Nico Dragano, Wojciech Drygas, Yong Du, Charmaine A. Duante, Priscilla Duboz, Anar Dushpanova, Elzbieta Dziankowska-Zaborszczyk, Narges Ebrahimi, Ricky Eddie, Ebrahim Eftekhar, Vasiliki Efthymiou, Eruke E. Egbagbe, Sareh Eghtesad, Mohammad El-Khateeb, Jalila El Ati, Denise Eldemire-Shearer, Roberto Elosua, Ofem Enang, Rajiv T. Erasmus, Raimund Erbel, Cihangir Erem, Gul Ergor, Louise Eriksen, Johan G. Eriksson, Ali Esmaeili, Roger G. Evans, Ildar Fakhradiyev, Caroline H. Fall, Elnaz Faramarzi, Mojtaba Farjam, Yosef Farzi, Mohammad Reza Fattahi, Asher Fawwad, Francisco J. Felix-Redondo, Trevor S. Ferguson, Daniel Fernández-Bergés, Marika Ferrari, Catterina Ferreccio, Haroldo S. Ferreira, Eldridge Ferrer, Edith J. M. Feskens, David Flood, Maria Forsner, Sandrine Fosse, Edward F. Fottrell, Heba M. Fouad, Damian K. Francis, Guillermo Frontera, Takuro Furusawa, Zbigniew Gaciong, Sarah P. Garnett, Magda Gasull, Andrea Gazzinelli, Ulrike Gehring, Ebrahim Ghaderi, Seyyed-Hadi Ghamari, Ali Ghanbari, Erfan Ghasemi, Oana-Florentina Gheorghe-Fronea, Anup Ghimire, Alessandro Gialluisi, Simona Giampaoli, Francesco Gianfagna, Tiffany K. Gill, Glen Gironella, Aleksander Giwercman, David Goltzman, Aleksandra Gomula, Helen Gonçalves, Mauer Gonçalves, David A. Gonzalez-Chica, Marcela Gonzalez-Gross, Juan P. González-Rivas, María-Elena González-Villalpando, Angel R. Gonzalez, Frederic Gottrand, Dušan Grafnetter, Tomasz Grodzicki, Anders Grøntved, Ramiro Guerrero, Unjali P. Gujral, Rajeev Gupta, Laura Gutierrez, Xinyi Gwee, Rosa Haghshenas, Hamid Hakimi, Ian R. Hambleton, Behrooz Hamzeh, Willem A. Hanekom, Dominique Hange, Sari Hantunen, Jie Hao, Rachakulla Hari Kumar, Javad Harooni, Seyed Mohammad Hashemi-Shahri, Jun Hata, Christin Heidemann, Rafael dos Santos Henrique, Sauli Herrala, Karl-Heinz Herzig, Ramin Heshmat, Sai Yin Ho, Michelle Holdsworth, Reza Homayounfar, Wilma M. Hopman, Andrea R. V. R. Horimoto, Claudia Hormiga, Bernardo L. Horta, Leila Houti, Christina Howitt, Thein Thein Htay, Aung Soe Htet, Maung Maung Than Htike, José María Huerta, Ilpo Tapani Huhtaniemi, Martijn Huisman, Abdullatif Husseini, Inge Huybrechts, Licia Iacoviello, Ellina M. Iakupova, Anna G. Iannone, Norazizah Ibrahim Wong, Chinwuba Ijoma, Vilma E. Irazola, Takafumi Ishida, Godsent C. Isiguzo, Sheikh Mohammed Shariful Islam, Duygu Islek, Till Ittermann, Masanori Iwasaki, Tuija Jääskeläinen, Jeremy M. Jacobs, Hashem Y. Jaddou, Michel Jadoul, Bakary Jallow, Kenneth James, Kazi M. Jamil, Edward Janus, Marjo-Riitta Jarvelin, Grazyna Jasienska, Ana Jelaković, Bojan Jelaković, Garry Jennings, Anjani Kumar Jha, Ramon O. Jimenez, Karl-Heinz Jöckel, Jari J. Jokelainen, Jost B. Jonas, Pradeep Joshi, Josipa Josipović, Farahnaz Joukar, Jacek Jóźwiak, Anthony Kafatos, Eero O. Kajantie, Zhanna Kalmatayeva, Khem B. Karki, Marzieh Katibeh, Jussi Kauhanen, Gyulli M. Kazakbaeva, François F. Kaze, Calvin Ke, Sirkka Keinänen-Kiukaanniemi, Roya Kelishadi, Maryam Keramati, Mathilde Kersting, Yousef Saleh Khader, Arsalan Khaledifar, Davood Khalili, Bahareh Kheiri, Motahareh Kheradmand, Alireza Khosravi, Ursula Kiechl-Kohlendorfer, Sophia J. Kiechl, Stefan Kiechl, Andrew Kingston, Heidi Klakk, Jana Klanova, Michael Knoflach, Patrick Kolsteren, Jürgen König, Raija Korpelainen, Paul Korrovits, Jelena Kos, Seppo Koskinen, Sudhir Kowlessur, Slawomir Koziel, Susi Kriemler, Peter Lund Kristensen, Daan Kromhout, Ruzena Kubinova, Urho M. Kujala, Mukhtar Kulimbet, Pawel Kurjata, Catherine Kyobutungi, Quang Ngoc La, Demetre Labadarios, Carl Lachat, Youcef Laid, Lachmie Lall, Tiina Lankila, Vera Lanska, Georg Lappas, Bagher Larijani, Tint Swe Latt, Martino Laurenzi, Nils Lehmann, Terho Lehtimäki, Daniel Lemogoum, Gabriel M. Leung, Yanping Li, M. Fernanda Lima-Costa, Hsien-Ho Lin, Lars Lind, Lauren Lissner, Xiaotian Liu, Esther Lopez-Garcia, Tania Lopez, José Eugenio Lozano, Dalia Luksiene, Annamari Lundqvist, Nuno Lunet, Michala Lustigová, George L. L. Machado-Coelho, Aristides M. Machado-Rodrigues, Enguerran Macia, Luisa M. Macieira, Ahmed A. Madar, Gladys E. Maestre, Stefania Maggi, Dianna J. Magliano, Emmanuella Magriplis, Gowri Mahasampath, Bernard Maire, Marcia Makdisse, Mohammad-Reza Malekpour, Fatemeh Malekzadeh, Reza Malekzadeh, Kodavanti Mallikharjuna Rao, Sofia Malyutina, Lynell V. Maniego, Yannis Manios, Masimango Imani Mannix, Fariborz Mansour-Ghanaei, Enzo Manzato, Paula Margozzini, Joany Mariño, Larissa Pruner Marques, Reynaldo Martorell, Luis P. Mascarenhas, Masoud Masinaei, Ellisiv B. Mathiesen, Tandi E. Matsha, Anselmo J. Mc Donald Posso, Shelly R. McFarlane, Stephen T. McGarvey, Sounnia Mediene Benchekor, Kirsten Mehlig, Amir Houshang Mehrparvar, Jesus D. Melgarejo, Fabián Méndez, Ana Maria B. Menezes, Alibek Mereke, Indrapal I. Meshram, Diane T. Meto, Cláudia S. Minderico, G. K. Mini, Juan Francisco Miquel, J. Jaime Miranda, Mohammad Reza Mirjalili, Pietro A. Modesti, Sahar Saeedi Moghaddam, Mostafa K. Mohamed, Kazem Mohammad, Mohammad Reza Mohammadi, Zahra Mohammadi, Noushin Mohammadifard, Reza Mohammadpourhodki, Viswanathan Mohan, Muhammad Fadhli Mohd Yusoff, Iraj Mohebbi, Niels C. Møller, Dénes Molnár, Amirabbas Momenan, Charles K. Mondo, Roger A. Montenegro Mendoza, Eric Monterrubio-Flores, Mahmood Moosazadeh, Farhad Moradpour, Alain Morejon, Luis A. Moreno, Karen Morgan, Suzanne N. Morin, Alireza Moslem, Mildrey Mosquera, Malgorzata Mossakowska, Aya Mostafa, Seyed-Ali Mostafavi, Mohammad Esmaeel Motlagh, Jorge Motta, Kelias P. Msyamboza, Thet Thet Mu, Maria L. Muiesan, Jaakko Mursu, Kamarul Imran Musa, Norlaila Mustafa, Muel Telo M. C. Muyer, Iraj Nabipour, Gabriele Nagel, Balkish M. Naidu, Farid Najafi, Jana Námešná, Vinay B. Nangia, Take Naseri, Nareemarn Neelapaichit, Azim Nejatizadeh, Ilona Nenko, Flavio Nervi, Tze Pin Ng, Chung T. Nguyen, Quang Ngoc Nguyen, Michael Y. Ni, Peng Nie, Ramfis E. Nieto-Martínez, Toshiharu Ninomiya, Marianna Noale, Oscar A. Noboa, Davide Noto, Mohannad Al Nsour, Irfan Nuhoğlu, Terence W. O’Neill, Augustine N. Odili, Kyungwon Oh, Ryutaro Ohtsuka, Mohd Azahadi Omar, Altan Onat, Sok King Ong, Obinna Onodugo, Pedro Ordunez, Rui Ornelas, Pedro J. Ortiz, Clive Osmond, Afshin Ostovar, Johanna A. Otero, Charlotte B. Ottendahl, Akaninyene Otu, Ellis Owusu-Dabo, Luigi Palmieri, Wen-Harn Pan, Songhomitra Panda-Jonas, Francesco Panza, Mariela Paoli, Suyeon Park, Mahboubeh Parsaeian, Nikhil D. Patel, Raimund Pechlaner, Ivan Pećin, João M. Pedro, Sergio Viana Peixoto, Markku Peltonen, Alexandre C. Pereira, Thaliane Mayara Pessôa dos Prazeres, Niloofar Peykari, Modou Cheyassin Phall, Son Thai Pham, Hiep Hoang Phan, Rafael N. Pichardo, Hynek Pikhart, Aida Pilav, Pavel Piler, Freda Pitakaka, Aleksandra Piwonska, Andreia N. Pizarro, Pedro Plans-Rubió, Silvia Plata, Miquel Porta, Anil Poudyal, Farhad Pourfarzi, Akram Pourshams, Hossein Poustchi, Rajendra Pradeepa, Rui Providencia, Jardena J. Puder, Solie Puhakka, Margus Punab, Mostafa Qorbani, Hedley K. Quintana, Tran Quoc Bao, Salar Rahimikazerooni, Olli Raitakari, Manuel Ramirez-Zea, Jacqueline Ramke, Rafel Ramos, Lekhraj Rampal, Sanjay Rampal, Daniel A. Rangel Reina, Mohammad-Mahdi Rashidi, Josep Redon, Jane D. P. Renner, Cézane P. Reuter, Luis Revilla, Negar Rezaei, Abbas Rezaianzadeh, Fernando Rigo, Reina G. Roa, Louise Robinson, Fernando Rodríguez-Artalejo, María del Cristo Rodriguez-Perez, Laura A. Rodríguez-Villamizar, Andrea Y. Rodríguez, Ulla Roggenbuck, Peter Rohloff, Elisabetta L. Romeo, Annika Rosengren, Adolfo Rubinstein, Petra Rust, Marcin Rutkowski, Hamideh Sabbaghi, Harshpal S. Sachdev, Alireza Sadjadi, Ali Reza Safarpour, Sare Safi, Saeid Safiri, Mohammad Hossien Saghi, Olfa Saidi, Nader Saki, Sanja Šalaj, Benoit Salanave, Jukka T. Salonen, Massimo Salvetti, Jose Sánchez-Abanto, Diana A. Santos, Lèlita C. Santos, Maria Paula Santos, Tamara R. Santos, Jouko L. Saramies, Luis B. Sardinha, Nizal Sarrafzadegan, Kai-Uwe Saum, Mariana Sbaraini, Marcia Scazufca, Beatriz D. Schaan, Christa Scheidt-Nave, Sabine Schipf, Carsten O. Schmidt, Ben Schöttker, Sara Schramm, Sylvain Sebert, Moslem Sedaghattalab, Aye Aye Sein, Sadaf G. Sepanlou, Ronel Sewpaul, Teresa Shamah-Levy, Seyed Morteza Shamshirgaran, Maryam Sharafkhah, Sanjib K. Sharma, Almaz Sharman, Amaneh Shayanrad, Ali Akbar Shayesteh, Hana Shimizu-Furusawa, Rahman Shiri, Namuna Shrestha, Khairil Si-Ramlee, Diego Augusto Santos Silva, Mary Simon, Judith Simons, Leon A. Simons, Michael Sjöström, Jolanta Slowikowska-Hilczer, Przemysław Slusarczyk, Liam Smeeth, Eugène Sobngwi, Stefan Söderberg, Agustinus Soemantri, Reecha Sofat, Vincenzo Solfrizzi, Mohammad Hossein Somi, Aïcha Soumaré, Alfonso Sousa-Poza, Karen Sparrenberger, Jan A. Staessen, Bill Stavreski, Jostein Steene-Johannessen, Peter Stehle, Aryeh D. Stein, Jochanan Stessman, Jakub Stokwiszewski, Karien Stronks, Milton F. Suarez-Ortegón, Phalakorn Suebsamran, Johan Sundström, Paibul Suriyawongpaisal, René Charles Sylva, Moyses Szklo, Abdonas Tamosiunas, Mohammed Rasoul Tarawneh, Carolina B. Tarqui-Mamani, Anne Taylor, Julie Taylor, Tania Tello, K. R. Thankappan, Holger Theobald, Xenophon Theodoridis, Nihal Thomas, Amanda G. Thrift, Erik J. Timmermans, Dwi Hapsari Tjandrarini, Hanna K. Tolonen, Janne S. Tolstrup, Maciej Tomaszewski, Murat Topbas, Laura Torres-Collado, Pierre Traissac, Areti Triantafyllou, John Tuitele, Azaliia M. Tuliakova, Marshall K. Tulloch-Reid, Tomi-Pekka Tuomainen, Evangelia Tzala, Christophe Tzourio, Peter Ueda, Eunice Ugel, Flora A. M. Ukoli, Hanno Ulmer, Hannu M. T. Uusitalo, Gonzalo Valdivia, Bert-Jan van den Born, Johan Van der Heyden, Hoang Van Minh, Lenie van Rossem, Natasja M. Van Schoor, Irene G. M. van Valkengoed, Elisabeth M. van Zutphen, Dirk Vanderschueren, Diego Vanuzzo, Senthil K. Vasan, Tomas Vega, Gustavo Velasquez-Melendez, Roosmarijn Verstraeten, Lucie Viet, Salvador Villalpando, Jesus Vioque, Jyrki K. Virtanen, Bharathi Viswanathan, Ari Voutilainen, Wan Mohamad Wan Bebakar, Wan Nazaimoon Wan Mohamud, Chongjian Wang, Ningli Wang, Qian Wang, Ya Xing Wang, Ying-Wei Wang, S. Goya Wannamethee, Karen Webster-Kerr, Niels Wedderkopp, Wenbin Wei, Leo D. Westbury, Peter H. Whincup, Kurt Widhalm, Indah S. Widyahening, Andrzej Więcek, Rainford J. Wilks, Johann Willeit, Peter Willeit, Tom Wilsgaard, Bogdan Wojtyniak, Andrew Wong, Emily B. Wong, Mark Woodward, Frederick C. Wu, Haiquan Xu, Liang Xu, Nor Azwany Yaacob, Li Yan, Weili Yan, Moein Yoosefi, Akihiro Yoshihara, Novie O. Younger-Coleman, Yu-Ling Yu, Yunjiang Yu, Ahmad Faudzi Yusoff, Ahmad A. Zainuddin, Farhad Zamani, Sabina Zambon, Antonis Zampelas, Ko Ko Zaw, Tajana Zeljkovic Vrkic, Yi Zeng, Zhen-Yu Zhang, Bekbolat Zholdin, Paul Zimmet, Emanuel Zitt, Nada Zoghlami, Julio Zuñiga Cisneros, Majid Ezzati

  Nature Medicine 1078-8956 2023/11/09 

  Abstract Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance.
• Social isolation and well‐being among families of middle‐aged and older hikikomori people

  Sachiko Yamazaki, Chiaki Ura, Hiroki Inagaki, Mika Sugiyama, Fumiko Miyamae, Ayako Edahiro, Kae Ito, Masanori Iwasaki, Hiroyuki Sasai, Tsuyoshi Okamura, Hirohiko Hirano, Shuichi Awata

  Psychogeriatrics 1346-3500 2023/11/06
• Development of a multiple masticatory function model based on the evaluation of sarcopenia: A cross-sectional survey of the Otassha study.

  Masaharu Murakami, Hirohiko Hirano, Masanori Iwasaki, Maki Shirobe, Ayako Edahiro, Shuichi Obuchi, Hisashi Kawai, Yoshinori Fujiwara, Kazushige Ihara, Keiko Motokawa

  Archives of oral biology 155 105803 - 105803 2023/11 

  OBJECTIVE: The masticatory function is intricately linked to several factors like natural teeth count, occlusion, masticatory muscles, and tongue coordination. This study's goal was to formulate a comprehensive masticatory function model, considering sarcopenia's conceptual structure, and subsequently validate its measurement efficacy. DESIGN: The study encompassed 753 participants (59.1 % women; mean age: 73.0 ± 5.1 years) from an urban community. The model amalgamated masseter muscle mass, occlusal force, and mixing ability. Based on the Asian Working Group for Sarcopenia 2019 classification, participants were categorized into a multiple masticatory dysfunction (MMD) or severe MMD (S-MMD) group. Logistic regression analysis gauged the model's validity, using serum albumin levels and self-reported chewing difficulties as dependent variables. RESULTS: Of the total, 61 (8.1 %) participants exhibited MMD, while 24 (3.2 %) had S-MMD. S-MMD was correlated with low serum albumin levels (odds ratio: 3.62; 95 % confidence interval: 1.07-12.29) and heightened self-reported chewing difficulties (odds ratio: 2.82; 95 % confidence interval: 1.09-7.28). CONCLUSIONS: Our multiple masticatory function model offers a straightforward approach for assessing MMD. Furthermore, the study establishes a link between S-MMD, nutritional vulnerability, and self-reported chewing challenges, thus affirming the model's credibility.
• Relationship between phase angle and lower-extremity function in older adults: Itabashi Longitudinal Study on Aging

  Sho Hatanaka, Yosuke Osuka, Narumi Kojima, Keiko Motokawa, Misato Hayakawa, Yurie Mikami, Masanori Iwasaki, Hiroki Inagaki, Fumiko Miyamae, Tsuyoshi Okamura, Hirohiko Hirano, Shuichi Awata, Hiroyuki Sasai

  Nutrition 112289 - 112289 0899-9007 2023/10
• Barrier to sharing a dementia diagnosis with neighbors in Tokyo.

  Tsuyoshi Okamura, Tsutomu Taga, Hiroki Inagaki, Fumiko Miyamae, Chiaki Ura, Mika Sugiyama, Ayako Edahiro, Maki Shirobe, Keiko Motokawa, Narumi Kojima, Yosuke Osuka, Masanori Iwasaki, Hiroyuki Sasai, Hirohiko Hirano, Shuichi Awata

  Geriatrics & gerontology international 23 (10) 761 - 763 2023/10
• Associations between Plasma Antibody Levels against Porphyromonas gingivalis and Atrial Fibrillation among Community-Dwelling Older Individuals in Japan: A Cross-Sectional Study.

  Takashi Hoshino, Noboru Kaneko, Akihiro Yoshihara, Masanori Iwasaki, Kana Suwama, Yumi Ito, Junta Tanaka, Ichiei Narita, Hiroshi Ogawa

  Oral health & preventive dentistry 21 (1) 339 - 346 2023/09/27 

  PURPOSE: To investigate the association between plasma antibody levels against Porphyromonas gingivalis (PG) and atrial fibrillation (AF) history in community-dwelling older individuals in Japan. MATERIALS AND METHODS: This study was a subset of the Uonuma cohort study, including 3091 participants aged 60-79 years. Data were collected, including AF history as a dependent variable, plasma immunoglobulin G antibody levels against PG as an independent variable, and previously reported AF risk factors and demographic information as covariates. RESULTS: The median age of the participants was 69 years. Of the 3091 participants, 1411 (45.6%) were men, and 56 (1.8%) had an AF history. AF prevalence was significantly higher in participants with higher antibody levels against PG than in those with lower antibody levels (3.0% vs 1.4%; p = 0.005). Multivariable logistic regression analysis showed that participants with higher antibody levels against PG had twofold higher odds of having AF (odds ratio = 2.13; 95% confidence interval = 1.23-3.69). Restricted cubic spline analysis indicated a nonlinear relationship between antibody levels against PG and AF history. CONCLUSION: Plasma antibody levels against PG were associated with AF history in community-dwelling older individuals in Japan.
• Validation of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate in community-dwelling older Japanese adults: The Otassha Study.

  Masanori Iwasaki, Maki Shirobe, Keiko Motokawa, Misato Hayakawa, Kazuhito Miura, Lena Kalantar, Ayako Edahiro, Hisashi Kawai, Yoshinori Fujiwara, Kazushige Ihara, Yutaka Watanabe, Shuichi Obuchi, Hirohiko Hirano

  Geriatrics & gerontology international 23 (10) 729 - 735 2023/09/06 

  AIM: To assess the validity of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate (oral diadochokinesis [oral-DDK]) as a gold standard index for articulatory oral motor skill in community-dwelling older Japanese adults. METHODS: This cross-sectional study included 607 Japanese adults (mean age = 73.9 years). A single-item self-report questionnaire for articulatory oral motor skill was developed. Study participants completed a 1-month-interval test-retest protocol to assess reliability of the questionnaire, and the protocol was tested by the kappa statistic. Oral-DDK with /ta/ (i.e., the number of repetitions of the monosyllable /ta/ per second) was measured during the on-site examination. Low oral-DDK performance was defined as <5.2 times/s in men and <5.4 times/s in women. Oral-DDK performance, oral functions other than articulatory oral motor skill, and physical frailty were compared in the groups with and without self-reported low articulatory oral motor skill as determined by the response to the questionnaire. RESULTS: Self-reported low articulatory oral motor skill was identified in 18.5% of the study population. The self-report questionnaire had good test-retest reliability, with a kappa statistic of 0.71. Self-reported low articulatory oral motor skill was significantly associated with a lower value of oral-DDK with /ta/ and a higher proportion of low oral-DDK performance, difficulties in chewing and swallowing, dry mouth, and physical frailty. Self-report had high specificity (83.1%) but low sensitivity (42.1%) for detecting low oral-DDK performance. CONCLUSIONS: A single-item self-report questionnaire for articulatory oral motor skill had acceptable test-retest reliability and was associated with objectively measured articulatory oral motor skill. Geriatr Gerontol Int 2023; ••: ••-••.
• Oral frailty five-item checklist to predict adverse health outcomes in community-dwelling older adults: A Kashiwa cohort study.

  Tomoki Tanaka, Hirohiko Hirano, Kazunori Ikebe, Takayuki Ueda, Masanori Iwasaki, Maki Shirobe, Shunsuke Minakuchi, Masahiro Akishita, Hidenori Arai, Katsuya Iijima

  Geriatrics & gerontology international 23 (9) 651 - 659 2023/09 

  AIM: To enable easy assessment of oral frailty; that is, an overlapping slight decline in multifaceted oral function, in any setting, we developed the oral frailty five-item checklist (OF-5), and examined its predictive validity for increased risks of physical frailty, physical disability and mortality among community-dwelling older adults. METHODS: This population-based cohort study randomly selected 2044 residents in Kashiwa, Japan, with no long-term care needs. Baseline data were collected in 2012, and follow-up data were collected in 2013, 2014, 2016, 2018 and 2021. The OF-5 includes five measures: fewer teeth, difficulty in chewing, difficulty in swallowing, dry mouth and low articulatory oral motor skills. Physical frailty was defined according to the Cardiovascular Health Study criteria. Physical disability and mortality determined from the long-term care insurance receipt database were followed for 9 years. RESULTS: Of 2031 eligible participants (mean age 73.1 ± 5.6 years; 51.1% women), 39.3% individuals with ≥2 OF-5 points had significantly increased prevalence and new-onset rate of physical frailty. After adjusting for potential confounders, oral frailty, defined as ≥2 OF-5 points, was associated with increased risks of physical disability (adjusted hazard ratio 1.40; 95% confidence interval 1.14-1.72) and mortality (adjusted hazard ratio 1.44; 95% confidence interval 1.11-1.87). The highest adjusted hazard ratios were observed in older adults with coexisting physical and oral frailty. CONCLUSIONS: The OF-5 showed strong predictive validity for physical frailty, physical disability and mortality in Japanese older adults. This assessment tool can be implemented in various settings and foster comprehensive prevention through interprofessional collaboration. Geriatr Gerontol Int 2023; 23: 651-659.
• アルコール摂取状況と歯の喪失との関連についての研究 魚沼コホート研究ベースライン調査

  諏訪間 加奈, 岩崎 正則, 伊藤 由美, 葭原 明弘

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 73 (3) 177 - 184 0023-2831 2023/07 

  本研究の目的はアルコール摂取状況と歯の喪失との関連を明らかにすることである.40歳以上の25,216名を分析対象とした.分析では,性別およびアルコール摂取状況[非飲酒者,過去飲酒者,現在飲酒者(週1～149g,週150～299g,週300～449g,週450g以上)]により対象者特性を比較した.その後,アルコール摂取状況と歯の喪失との関連について,ロジスティック回帰分析を行った.従属変数を歯の喪失程度(「現在歯数20本未満」および「無歯顎」)とし,独立変数をアルコール摂取状況とした.その結果,男性で,現在歯数20本未満と非飲酒者,過去飲酒者,週450g以上との間に有意な関連がみられた[週1～149gと比較したオッズ比(95%信頼区間)=1.49(1.29-1.72),1.25(1.05-1.49),1.22(1.07-1.39)].無歯顎は非飲酒者との間に有意な関連がみられた[1.70(1.33-2.18)].一方,女性で,現在歯数20本未満と非飲酒者,週150～299g,週450g以上との間に有意な関連がみられた[1.20(1.08-1.34),1.28(1.04-1.57),1.64(1.12-2.40)].無歯顎は週450g以上との間に有意な関連がみられた[3.18(1.31-7.76)].アルコール摂取状況は歯の喪失と関連し,現在飲酒者においてアルコール摂取量が多いほど関連が強く,その関連の程度には性差がみられた.(著者抄録)
• Association between Death or Hospitalization and Observable Variables of Eating and Swallowing Function among Elderly Residents in Long-Term Care Facilities: A Multicenter Prospective Cohort Study.

  Maaya Takeda, Yutaka Watanabe, Kenshu Taira, Kazuhito Miura, Yuki Ohara, Masanori Iwasaki, Kayoko Ito, Junko Nakajima, Yasuyuki Iwasa, Masataka Itoda, Yasuhiro Nishi, Yoshihiko Watanabe, Masako Kishima, Hirohiko Hirano, Maki Shirobe, Shunsuke Minakuchi, Mitsuyoshi Yoshida, Yutaka Yamazaki

  Healthcare (Basel, Switzerland) 11 (13) 2023/06/22 

  This 1-year multicenter prospective cohort study aimed to determine the association between observable eating and swallowing function factors and outcomes (death/hospitalization or survival) among elderly persons in long-term care insurance facilities in Japan. Baseline assessments of factors, such as language, drooling, halitosis, hypersalivation, tongue movement, perioral muscle function, coughing, respiration after swallowing, rinsing, and oral residue, among others, were conducted. A score of 0 was considered positive, and a score of 1 or 2 was considered negative. Patient age, sex, body mass index, Barthel index, and Clinical Dementia Rating were recorded. The death/hospitalization or survival rates over 1 year were recorded, and patients were allocated into groups depending on the respective outcome (death/hospitalization group or survival group) and baseline characteristics. A total of 986 residents from 32 facilities were included, with 216 in the death/hospitalization group and 770 in the survival group. Language, salivation, halitosis, perioral muscle, coughing, respiration after swallowing, rinsing, and oral residue were significantly associated with the outcomes (p < 0.05). Therefore, routine performance of these simple assessments by caregivers may allow early detection and treatment to prevent death, pneumonia, aspiration, and malnutrition in elderly persons.
• Serum levels of vitamin D and periodontal inflammation in community-dwelling older Japanese adults: The Otassha Study.

  Masanori Iwasaki, Keiko Motokawa, Maki Shirobe, Misato Hayakawa, Yuki Ohara, Yoshiko Motohashi, Ayako Edahiro, Hisashi Kawai, Yoshinori Fujiwara, Yasuyuki Sakata, Kazushige Ihara, Yutaka Watanabe, Shuichi Obuchi, Hirohiko Hirano

  Journal of clinical periodontology 50 (9) 1167 - 1175 2023/06/15 

  AIM: To evaluate the association between vitamin D status and periodontal inflammation as determined by the periodontal inflamed surface area (PISA) in community-dwelling older adults. MATERIALS AND METHODS: This cross-sectional study included 467 Japanese adults (mean age = 73.1 years) who underwent full-mouth periodontal examinations and measurements of serum levels of 25-hydroxyvitamin D (25(OH)D). We used linear regression and restricted cubic spline models to analyse the association between exposure (serum 25(OH)D) and outcome (PISA). RESULTS: The linear regression model showed that, after adjusting for potential confounders, participants in the lowest quartile of serum 25(OH)D had 41.0 mm2 more PISA (95% confidence interval [CI]: 4.6-77.5) than the reference group (the highest quartile of serum 25(OH)D). The spline model showed that the association between serum 25(OH)D and PISA was non-linear and restricted to the low 25(OH)D range. PISA initially sharply decreased as serum 25(OH)D increased, and then the decreasing trend slowed and plateaued. The inflection point with the minimum PISA value was a serum 25(OH)D level of 27.1 ng/mL, above which there was no decreasing trend in PISA with increasing serum 25(OH)D levels. CONCLUSIONS: Low vitamin D status had an L-shaped association with periodontal inflammation in this cohort of Japanese adults.
• 5- to 15-Year Survival of Immediately Loaded Implants in Fully Edentulous Maxillae: A Multilevel Analysis in a Retrospective Cohort Study

  Yusuke Kondo, Chihiro Masaki, Taro Mukaibo, Haruka Takesue Yano, Masanori Iwasaki, Ryuji Hosokawa

  Int J Oral Macillofac Implants 38 (3) 516 - 522 2023/06 [Refereed]
  
• Diminishing benefits of urban living for children and adolescents’ growth and development

  NCD Risk Factor Collaboration, NCD-RisC

  Nature 615 (7954) 874 - 883 0028-0836 2023/03/29 [Refereed]
   

  Abstract Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being^1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m^–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
• Association between Dementia Severity and Oral Hygiene Management Issues in Older Adults with Alzheimer's Disease: A Cross-Sectional Study.

  Maki Shirobe, Ayako Edahiro, Keiko Motokawa, Shiho Morishita, Yuki Ohara, Yoshiko Motohashi, Masanori Iwasaki, Yutaka Watanabe, Hirohiko Hirano

  International journal of environmental research and public health 20 (5) 2023/02/21 

  Oral hygiene management issues vary across types and clinical stages of dementia. We aimed to clarify the issues related to oral hygiene management in older adults with Alzheimer's disease (AD) according to stages defined by the Functional Assessment Staging of Alzheimer's Disease (FAST). In all, 397 records (45 men and 352 women; average age, 86.8 years; age range, 65-106) from older adults with AD were used for the cross-sectional study. We used data from a cohort of older adults (≥65 years old) who required long-term care and lived in the Omorimachi area of Yokote City, Akita Prefecture, Japan. Multilevel logistic regression analysis was conducted to examine the associations of the FAST stage, set as the exposure variable, with oral hygiene management parameters set as outcome variables. Compared to the reference category (combined FAST stage 1-3), FAST stages 6 and 7 had significantly higher odds ratios for refusal of oral health care, dependence in performing oral health care, and rinsing and gargling disability. FAST stages 4 and 7 were associated with dental plaque accumulation. Oral health care for older adults with AD should be planned appropriately according to dementia severity.
• A cross-sectional study of the association between periodontitis and physical activity in the Japanese population.

  Masanori Iwasaki, Akihiro Yoshihara, Kana Suwama, Takashi Zaitsu, Seitaro Suzuki, Hikaru Ihira, Norie Sawada, Jun Aida

  Journal of periodontal research 58 (2) 350 - 359 2023/01/15 

  OBJECTIVE: The aim of this study was to determine whether physical activity (PA) is associated with periodontitis in the Japanese population. BACKGROUND: The potential association between PA and periodontitis has not been thoroughly investigated in the Japanese population. METHODS: We used cross-sectional data from the Japan Public Health Center-based Prospective Study for the Next-Generation Oral Health Study. Periodontitis was determined by a full-mouth periodontal examination. PA was assessed using a validated questionnaire. We performed multivariable ordinal logistic regression analyses to assess the association of total PA (the first quintile was set as the reference category) with periodontitis (three categories: no/mild, moderate, and severe), stratified by sex. The associations of periodontitis with domain- and intensity-specific PA were also studied in separate logistic regression models. RESULTS: This study included 2160 Japanese adults [1414 women and 746 men; mean (standard deviation) age 58.1 (9.6) years]. After adjusting for potential confounders, total PA was inversely associated with the presence and severity of periodontitis in women. The multivariable-adjusted odds ratios (95% confidence intervals) for periodontitis in the second to fifth quintiles (compared with the first quintile) of total PA were 0.81 (0.59-1.12), 0.74 (0.53-1.02), 0.77 (0.55-1.06), and 0.64 (0.46-0.89), respectively (p for trend = .01). We did not find different results when we further investigated the associations of periodontitis with domain- and intensity-specific PA. By contrast, PA was not associated with periodontitis in men. CONCLUSION: Total PA had an inverse, linear association with the presence and severity of periodontitis in Japanese women but not in Japanese men. Further prospective studies are required to determine the association between PA and periodontitis.
• 日本人男性労働者における主食の重ね食べと歯周病の関連についての横断研究

  岩崎 正則, 福原 正代, 大田 祐子, 藤澤 律子, 角田 聡子, 片岡 正太, 茂山 博代, 正木 千尋, 安細 敏弘, 細川 隆司

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 73 (1) 42 - 50 0023-2831 2023/01 

  男性労働者における主食の重ね食べ(1回の食事で炭水化物の供給源となる主食を2種類以上同時に食べること)と歯周病の関連を明らかにすることを目的に横断研究を実施した.福岡県内の一企業で行われた定期健康診断にあわせて実施した歯科健診,食事調査,質問紙調査に参加した539名の男性従業員(平均年齢47.9歳)のデータを用いた.歯科健診では10歯の代表歯の歯周ポケット深さを計測した.食事調査では1日あたりの炭水化物摂取量を推定し,摂取量上位20%を多量摂取と定義した.そして4mm以上の歯周ポケットを有する歯数を目的変数とし,主食の重ね食べの頻度「1日1食以上」「1日1食未満」を説明変数とする負の二項回帰モデルを用いて両者の関連を解析した.さらに,主食の重ね食べの頻度が高い者には炭水化物を多量に摂取している者が多く,歯周病へ影響を与えているとの関連を仮定し,一般化構造方程式モデリング(GSEM)を用いて3者の関連を分析した.解析対象集団の14.8%が1日1食以上の主食の重ね食べをしていた.主食の重ね食べの頻度が1日1食未満の群と比較して,1日1食以上の群では4mm以上の歯周ポケットを有する歯数が有意に多かった(発生率比=1.47,95%信頼区間=1.10-1.96).GSEMを用いた分析の結果,主食の重ね食べの頻度が高いことは炭水化物の多量摂取と関連があり,主食の重ね食べが歯周病に与える影響の一部は炭水化物の多量摂取を介していることが示された.(著者抄録)
• Association between sarcopenia and oral functions in community-dwelling older adults: A cross-sectional study.

  Yoshihiro Kugimiya, Masanori Iwasaki, Yuki Ohara, Keiko Motokawa, Ayako Edahiro, Maki Shirobe, Yutaka Watanabe, Yu Taniguchi, Satoshi Seino, Takumi Abe, Shuichi Obuchi, Hisashi Kawai, Takeshi Kera, Yoshinori Fujiwara, Akihiko Kitamura, Kazushige Ihara, Hunkyung Kim, Shoji Shinkai, Hirohiko Hirano

  Journal of cachexia, sarcopenia and muscle 14 (1) 429 - 438 2190-5991 2022/12/05 [Refereed][Not invited]
   

  BACKGROUND: Few studies have examined the state of oral function in older adults with sarcopenia. We assessed the oral functions of community-dwelling older adults with sarcopenia from multiple perspectives to clarify their potentially low oral function. METHODS: A total of 1517 (86.2%; 990 women, 527 men; mean age 76.1 ± 7.6 years) participants were included in this study. Grip strength, gait speed and skeletal muscle mass index were assessed, and sarcopenia was evaluated according to the criteria of the Asian Working Group for Sarcopenia 2019. The degree of tongue coating, oral moisture, occlusal force, tongue-lip motor function, tongue pressure, masticatory function and swallowing function were assessed. The criteria for oral hypofunction (a disease that is a combination of multiple low oral functions) were used to assess oral function. Statistical analyses were performed using Kolmogorov-Smirnov test, unpaired t-test, Mann-Whitney U test, χ2 test, and univariate and multivariable logistic regression analyses, with each oral function as the dependent variable and sarcopenia as one of the independent variables. The significance level was set at P < 0.05. RESULTS: The prevalence rates of sarcopenia and severe sarcopenia were 14.2% and 3.8%, respectively. The prevalence of oral hypofunction was 39.9%. Compared with the robust group, the sarcopenia and severe sarcopenia groups tended to have a higher frequency of the following components (all P < 0.01): low occlusal force, low tongue-lip motor function, low tongue pressure, low masticatory function, low swallowing function and oral hypofunction. Univariate logistic regression analysis showed that sarcopenia was associated with low occlusal force, low tongue-lip motor function, low tongue pressure, low masticatory function, low swallowing function and oral hypofunction. The odds ratios and 95% confidence intervals of sarcopenia for each oral function were 2.62 [2.00, 3.43], 2.21 [1.69, 2.89], 3.66 [2.79, 4.81], 3.23 [2.46, 4.25], 1.66 [1.26, 2.20] and 3.59 [2.72, 4.72], respectively. Multivariable logistic regression analysis showed that sarcopenia was associated with low occlusal force (1.63 [1.10, 2.40]), low tongue pressure (2.28 [1.65, 3.15]), low masticatory function, (1.94 [1.27, 2.97]), low swallowing function (1.64 [1.17, 2.28]) and oral hypofunction (2.17 [1.52, 3.09]). CONCLUSIONS: This study demonstrated that multiple aspects of oral function were low among community-dwelling older adults with sarcopenia. The potential decline in oral functions in older adults with sarcopenia may have been overlooked until now. This study indicates the need for dental perspectives in intervening with older adults with sarcopenia and the need to encourage them to see dental professionals.
• Associations among internet addiction, lifestyle behaviors, and dental caries among high school students in Southwest Japan.

  Masanori Iwasaki, Satoko Kakuta, Toshihiro Ansai

  Scientific reports 12 (1) 17342 - 17342 2022/10/15 

  Internet addiction (IA) negatively affects adolescents' lifestyle behaviors. Inappropriate lifestyle behaviors could have negative effects on dental health. This cross-sectional study aimed to test whether IA was indirectly associated with dental caries through unhealthy lifestyle behaviors among high school students in southwest Japan. IA was characterized by a Young's Internet Addiction Test score of ≥ 50, unhealthy lifestyle behaviors by a cumulative count of 8 different lifestyle behaviors (termed the unhealthy lifestyle behavior index [ULBI]), and dental caries by the number of decayed, missing, and filled permanent teeth (DMFT). Poisson regression and linear regression models were fitted to the relationship, with IA as the exposure, the ULBI as the mediator, and the DMFT as the outcome. The natural indirect effect (NIE) and the proportion mediated by the ULBI were estimated by performing a mediation analysis. Overall, 1562 high school students were included. IA was observed in 406 participants and was associated with a larger DMFT. The ULBI significantly mediated the association between IA and the DMFT (NIE: incidence rate ratio = 1.05, 95% confidence interval = 1.03-1.07, proportion mediated = 64.3%). Dental caries was more common in our cohort of high school students with IA, which is partially explained by these students having unhealthy lifestyle behaviors.
• 口腔機能とサルコペニアの関係の検討 Otassya・Kusatsu Studyからの知見

  釘宮 嘉浩, 岩崎 正則, 本川 佳子, 枝広 あや子, 白部 麻樹, 渡邊 裕, 大渕 修一, 河合 恒, 江尻 愛美, 伊藤 久美子, 阿部 巧, 藤原 佳典, 北村 明彦, 新開 省二, 平野 浩彦

  日本サルコペニア・フレイル学会雑誌 (一社)日本サルコペニア・フレイル学会 6 (Suppl.) 211 - 211 2433-1805 2022/10
• The Ability of a Novel Trypsin-like Peptidase Activity Assay Kit to Detect Red-Complex Species

  Michihiko Usui, Masanori Iwasaki, Wataru Ariyoshi, Kaoru Kobayashi, Shingo Kasai, Rieko Yamanaka, Keisuke Nakashima, Tatsuji Nishihara

  Diagnostics 12 (9) 2172 - 2172 2022/09/08 

  The trypsin-like peptidase activity assay kit measures the trypsin-like protease produced by three red-complex species, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, causing periodontitis, and detects the presence of these bacteria in samples. The purpose of this study was to investigate the relationship between the detection of TLPs by a novel TLP-AA, ADCHECK and the detection of red-complex pathogens by real-time PCR using tongue swabs from patients with periodontitis. The detection limit of trypsin-like protease activity by ADCHECK was validated using the culture supernatants of two different Porphyromonas gingivalis bacterial strains. Real-time PCR was performed to determine the number of red-complex species in the tongue coatings of patients with periodontal disease. Trypsin-like protease activity in tongue-swab samples was scored using ADCHECK. ADCHECK successfully detected trypsin-like protease activity in 103 Porphyromonas gingivalis bacterial strains. The specificity, positive predictive value, negative predictive value, and accuracy of ADCHECK for the presence of red-complex pathogens determined by real-time PCR were 90%, 97%, 98%, and 92%, respectively. ADCHECK is an effective tool for the detection of red-complex pathogens.
• Periodontal status is associated with oral function in community‐dwelling older adults, independent of dentition status

  Yui Ueno, Masanori Iwasaki, Yumi Kimura, Satoko Kakuta, Chihiro Masaki, Taizo Wada, Ryota Sakamoto, Yasuko Ishimoto, Michiko Fujisawa, Kiyohito Okumiya, Toshihiro Ansai, Kozo Matsubayashi, Ryuji Hosokawa

  Journal of Periodontal Research 0022-3484 2022/09/04
• Association between denture use and food form in older adults requiring long-term care: A multicenter cross-sectional study.

  Kenshu Taira, Yutaka Watanabe, Kazutaka Okada, Miyako Kondo, Maaya Takeda, Kayoko Ito, Junko Nakajima, Masanori Iwasaki, Masataka Itoda, Ken Inohara, Rikimaru Sasaki, Yasuhiro Nishi, Junichi Furuya, Yoshihiko Watanabe, George Umemoto, Masako Kishima, Takashi Tohara, Yuji Sato, Mitsuyohi Yoshida, Yutaka Yamazaki

  Journal of prosthodontic research 67 (3) 366 - 375 2022/08/19 

  PURPOSE: This study aimed to determine whether denture use contributes to maintaining and improving food forms in long-term care facility (LTCFs) residents. METHODS: In 888 residents of 37 LTCFs in Japan, the following were investigated: nutritional intake status, food forms, age, sex, Barthel index (BI), clinical dementia rating (CDR), number of teeth present, number of occlusal supports, swallowing function, and use of dentures. Among all residents, those who were well-nourished and had ≤9 occlusal supports were analyzed. Based on standardized criteria, the food forms consumed by the subjects were divided into two groups: dysphagia and normal diet, which were further classified into four levels. Analysis was performed using a generalized estimation equation with the four levels of food forms as dependent variables and age, sex, BI, CDR, presence of dysphagia, number of teeth present, and use of dentures as independent variables. RESULTS: The final analysis included 622 (70.0%) residents. Of these, 380 (61.1%) used dentures. The analyses revealed that food form was significantly associated with age (adjusted odds ratio [OR], 0.98), BI (OR, 1.04), number of teeth present (OR, 1.03), presence of dysphagia (OR, 0.44), and use of dentures (OR, 2.82). CONCLUSION: Denture use was associated with food forms among Japanese LTCF residents. This indicates that the use of dentures is related to the maintenance of food forms, even in the elderly who participate in few activities of daily living, have reduced cognitive function, and require long-term care.
• 通所サービス利用者の歯科医療ニーズの実態および歯科衛生士によるアセスメントの有用性の検討

  小原 由紀, 白部 麻樹, 森下 志穂, 松原 ちあき, 濱 芳央子, 川島 貴重, 有松 ひとみ, 久保山 裕子, 岩崎 正則, 平野 浩彦

  日本歯科衛生学会雑誌 日本歯科衛生学会 17 (1) 95 - 95 1884-5193 2022/08
• 高齢者の口腔機能に影響を与える新規歯周組織評価指標の横断調査による検証

  上野 結衣, 岩崎 正則, 野代 知孝, 宗政 翔, 向坊 太郎, 近藤 祐介, 正木 千尋, 平野 浩彦, 細川 隆司

  日本補綴歯科学会誌 (公社)日本補綴歯科学会 14 (特別号) 151 - 151 1883-4426 2022/07
• 静電容量型感圧センサシートを用いた咬合力測定装置による咬合力の基準値の検討

  目黒 郁美, 五十嵐 憲太郎, 岩崎 正則, 釘宮 嘉浩, 伊藤 誠康, 河相 安彦, 渡邊 裕, 平野 浩彦

  日本補綴歯科学会誌 (公社)日本補綴歯科学会 14 (特別号) 303 - 303 1883-4426 2022/07
• 高齢者の口腔機能に影響を与える新規歯周組織評価指標の横断調査による検証

  上野 結衣, 岩崎 正則, 野代 知孝, 宗政 翔, 向坊 太郎, 近藤 祐介, 正木 千尋, 平野 浩彦, 細川 隆司

  日本補綴歯科学会誌 (公社)日本補綴歯科学会 14 (特別号) 151 - 151 1883-4426 2022/07
• Factors Predicting Tongue Pressure Decline among Community-Dwelling Older Adults: The Takashimadaira Study.

  Chika Takahashi, Masanori Iwasaki, Keiko Motokawa, Yutaka Watanabe, Misato Hayakawa, Yurie Mikami, Maki Shirobe, Hiroki Inagaki, Ayako Edahiro, Yuki Ohara, Hirohiko Hirano, Shoji Shinkai, Shuichi Awata

  International journal of environmental research and public health 19 (13) 2022/06/26 

  A limited number of longitudinal studies have explored factors contributing to decreases in tongue pressure (TP). This longitudinal study aimed to clarify the factors affecting TP decline among community-dwelling older adults. We followed the Takashimadaira Study participants with a baseline TP ≥ 30 kPa for 2 years. A TP of <30 kPa at follow-up was defined as TP decline. We used Poisson regression with robust standard errors to explore the factors related to TP decline. The studied baseline variables were dental status, sociodemographic characteristics, health behaviors, appetite, medical conditions, physical function, cognitive status, and anthropometric and body composition characteristics. Inverse probability weighting (IPW) was used to adjust for selection bias. Overall, 357 individuals (159 men and 198 women) with a mean (standard deviation) age of 75.9 (4.1) years were included in the analyses. Of these, 59 study participants (16.5%) exhibited TP decline. After adjusting for baseline TP and applying IPW, poor appetite (incident rate ratio [95% confidence interval] = 1.58 [1.01-2.48]), low skeletal muscle mass index (1.66 [1.02-2.70]), and cognitive impairment (1.93 [1.12-3.33]) were associated with TP decline. In conclusion, we demonstrated that baseline appetite, body composition, and cognitive status could predict future TP decline among community-dwelling older adults.
• Older adults' preferences for and actual situations of artificial hydration and nutrition in end-of-life care: An 11-year follow-up study in a care home.

  Taizo Wada, Yasuko Ishimoto, Kiichi Hirayama, Emiko Kato, Mai Tatsuno, Michiko Fujisawa, Yumi Kimura, Yoriko Kasahara, Eriko Fukutomi, Hissei Imai, Masahiro Nakatsuka, Mitsuhiro Nose, Masanori Iwasaki, Satoko Kakuta, Mayumi Hirosaki, Kiyohito Okumiya, Kozo Matsubayashi, Ryota Sakamoto

  Geriatrics & gerontology international 22 (8) 581 - 587 2022/06/18 

  AIM: To clarify older adults' preferences for and actual situations of artificial hydration and nutrition (AHN) in end-of-life care in a care home. METHODS: Participants were residents of a care home who had completed advance directives regarding preferred methods of AHN from 2009 to 2018. Advance directives alone were available from April 2009 to June 2016 (Wave 1), and advance care planning for AHN including advance directives was introduced in July 2016 (Wave 2). AHN preferences included (i) intensive methods (percutaneous endoscopic gastrostomy, nasogastric tube feeding and total parenteral nutrition), (ii) drip infusion, and (iii) oral intake only. Participants were followed until the end of 2020, and we checked whether decisions about AHN were based on older adults' preferences. RESULTS: In total, 272 participants had completed advance directives. Most participants preferred "oral intake only" (59.5%), followed by drip infusion (32.0%) and intensive methods (8.5%) in advance directives. Ninety of the 272 participants completed advance directives twice; 83.3% did not change their AHN preferences from Wave 1 to Wave 2. By the end of 2020, 93 of the 272 participants died in the care home. AHN was provided according to older adults' preferences in 48.9% (oral intake only), in 51.4% (drip infusion) and in 55.6% (intensive methods) of cases respectively. CONCLUSIONS: Most participants preferred oral intake only, and their preferences were reflected in decisions about actual situations of AHN in end-of-life care. To prepare for advanced dementia and senility, early advance care planning for AHN should be promoted. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
• 通所介護サービス利用者における低栄養リスクに関連する要因の検討

  小原 由紀, 岩崎 正則, 白部 麻樹, 岩佐 康行, 森下 志穂, 恒石 美登里, 小玉 剛, 平野 浩彦, 渡邊 裕, 吉田 光由, 水口 俊介

  日本老年歯科医学会総会・学術大会プログラム・抄録集 (一社)日本老年歯科医学会 33回 P2 - 08 2022/06
• Observational Variables for Considering a Switch from a Normal to a Dysphagia Diet among Older Adults Requiring Long-Term Care: A One-Year Multicenter Longitudinal Study.

  Maaya Takeda, Yutaka Watanabe, Takae Matsushita, Kenshu Taira, Kazuhito Miura, Yuki Ohara, Masanori Iwasaki, Kayoko Ito, Junko Nakajima, Yasuyuki Iwasa, Masataka Itoda, Yasuhiro Nishi, Junichi Furuya, Yoshihiko Watanabe, George Umemoto, Masako Kishima, Hirohiko Hirano, Yuji Sato, Mitsuyoshi Yoshida, Yutaka Yamazaki

  International journal of environmental research and public health 19 (11) 2022/05/28 

  This one-year multicenter longitudinal study aimed to assess whether older adult residents of long-term care facilities should switch from a normal to a dysphagia diet. Using the results of our previous cross-sectional study as baseline, older adults were subdivided into those who maintained a normal diet and those who switched to a dysphagia diet. The explanatory variables were age, sex, body mass index (BMI), Barthel Index, clinical dementia rating (CDR), and 13 simple and 5 objective oral assessments (remaining teeth, functional teeth, oral diadochokinesis, modified water swallowing test, and repetitive saliva swallowing test), which were used in binomial logistic regression analysis. Between-group comparison showed a significantly different BMI, Barthel Index, and CDR. Significant differences were also observed in simple assessments for language, drooling, tongue movement, perioral muscle function, and rinsing and in objective assessments. In multi-level analysis, switching from a normal to a dysphagia diet was significantly associated with simple assessments of tongue movement, perioral muscle function, and rinsing and with the objective assessment of the number of functional teeth. The results suggest that simple assessments can be performed regularly to screen for early signs of discrepancies between food form and eating/swallowing functions, which could lead to the provision of more appropriate food forms.
• Standard Values and Concurrent Validity of a Newly Developed Occlusal Force-Measuring Device among Community-Dwelling Older Adults: The Otassha Study.

  Masanori Iwasaki, Ichinosuke Maeda, Yota Kokubo, Yoshitomo Tanaka, Tetsuji Ueno, Yuki Ohara, Keiko Motokawa, Misato Hayakawa, Maki Shirobe, Ayako Edahiro, Hisashi Kawai, Yoshinori Fujiwara, Kazushige Ihara, Hunkyung Kim, Yutaka Watanabe, Shuichi Obuchi, Hirohiko Hirano

  International journal of environmental research and public health 19 (9) 2022/05/04 

  Recently, an occlusal force-measuring device with a capacitive-type pressure-mapping sensor (OFMD-CPS) was developed. We aimed to establish age- and sex-specific standard values for OFMD-CPS-measured occlusal force (OF) and to assess the concurrent validity of the OFMD against another OF measuring system with a pressure-sensitive sheet (Dental Prescale II). Using data from a population-based study, we calculated the OFMD-CPS-measured OF means and deciles in 5-year age groups for each sex. The OFMD-CPS-measured OF was validated against the Dental Prescale II-measured OF with Spearman correlation coefficients. Furthermore, we calculated the area under the receiver operating characteristic curve (AUC) against the preexisting Dental Prescale II-measured OF cutoff value of 350 N. In total, 596 individuals (236 men and 360 women) with a mean (standard deviation (SD)) age of 73.7 (6.7) years were included in the analyses. The mean (SD) OFMD-CPS-measured OFs were 581.6 (284.6) N in men and 446.9 (209.9) N in women. There was a strong positive correlation (Spearman's Rho = 0.73) between OFMD-CPS-measured and Dental Prescale II-measured OF. The diagnostic accuracy of the OFMD-CPS-measured OF for the Dental Prescale II-measured OF cutoff value was high (AUC = 0.88). In conclusion, we demonstrated standard values and concurrent validity of OFMD-CPS-measured OF in community-dwelling older adults.
• フレイルおよび認知症と口腔健康の関係に焦点化した人生100年時代を見据えた歯科治療指針作成に関する研究

  平野 浩彦, 佐藤 裕二, 飯島 勝矢, 小玉 剛, 古屋 純一, 上田 貴之, 恒石 美登里, 渡邊 裕, 岩崎 正則, 小原 由紀, 枝広 あや子

  日本歯科医学会誌 日本歯科医学会 41 27 - 31 0286-164X 2022/03 

  本研究は口腔健康を阻害する因子としてのフレイル・認知症の位置付けを明確にすることを目的に、地域在住高齢者(1,819人)を対象に検討した。本研究から得られた知見は、口腔機能評価項目の特性(加齢、現在歯数の影響など)、さらには現在歯数別の対象者の特性(身体機能、認知機能など)を視野に入れ、個々の状況に応じた口腔機能管理の必要性を示すものであった。つまり、高齢期口腔機能管理を実施する上で、現在歯数は可逆性が無く(一度失った自身の歯は回復できない)それに大きく影響される口腔機能の特性を再認識すること、さらに、健康寿命延伸施策で注目されている、フレイルと認知機能も包含した対応の必要性が示唆された。(著者抄録)
• Population-based reference values for tongue pressure in Japanese older adults: A pooled analysis of over 5,000 participants.

  Masanori Iwasaki, Yuki Ohara, Keiko Motokawa, Misato Hayakawa, Maki Shirobe, Ayako Edahiro, Yutaka Watanabe, Shuichi Awata, Tsuyoshi Okamura, Hiroki Inagaki, Naoko Sakuma, Shuichi Obuchi, Hisashi Kawai, Manami Ejiri, Kumiko Ito, Yoshinori Fujiwara, Akihiko Kitamura, Yu Nofuji, Takumi Abe, Katsuya Iijima, Tomoki Tanaka, Bo-Kyung Son, Shoji Shinkai, Hirohiko Hirano

  Journal of prosthodontic research 67 (1) 62 - 69 2022/01/27 

  PURPOSE: To establish age- and sex-specific population reference values for tongue pressure (TP) in community-dwelling Japanese older adults. METHODS: For this analysis, we pooled four population-based studies on community-dwelling adults aged ≥65 years that measured TP using a JMS tongue pressure measuring device. We calculated the means and deciles of TP per 5-year age group for each sex. We also estimated age trends in TP for men and women. RESULTS: In total, 5,083 individuals (2,150 men and 2,933 women, with a mean [standard deviation] age of 75.2 [6.5] years) were included in the present analysis. In male participants, the mean (standard deviation) TPs for ages 65-69, 70-74, 75-79, 80-84, and ≥85 years were 34.0 (8.4), 32.2 (8.1), 30.8 (8.3), 28.4 (8.9), and 24.4 (8.2) kPa, respectively. In female participants, the corresponding values were 31.5 (7.1), 30.5 (7.5), 29.6 (7.3), 28.4 (8.0), and 26.4 (7.6) kPa, respectively. For both sexes, there were significant declining trends in TP with advanced age. In addition, the interaction between age and sex had a significant effect on TP (regression coefficient [95% confidence interval] = -0.18 [-0.25 to -0.11] when age was modeled as a continuous variable and sex was modeled as a categorical variable [coded as 0=women, 1=men]). CONCLUSION: This study determined age- and sex-specific reference values for TP, presented as means and deciles, in community-dwelling Japanese older adults aged ≥65 years. This study also demonstrated sex differences in age-related declines in TP.
• Capacitive-Type Pressure-Mapping Sensor for Measuring Bite Force.

  Masanori Iwasaki, Ichinosuke Maeda, Yota Kokubo, Yoshitomo Tanaka, Tetsuji Ueno, Wataru Takahashi, Yutaka Watanabe, Hirohiko Hirano

  International journal of environmental research and public health 19 (3) 2022/01/24 

  Bite force is an important indicator of masticatory performance. However, existing methods for measuring bite force are either ineffective or expensive. Hence, we developed a novel capacitive-type pressure-mapping sensor that converts mechanical forces into changes in capacitance and calculates bite force. A portable device was fabricated based on this sensor sheet, and the accuracy of the bite-force measurements provided by the device was evaluated. The sensor has a thickness of 1.6 mm and has 63 measurement points. It was inserted into a dental model, where the output value was measured and compared with that of a universal testing machine (AG-IS 100 kN). A regression equation to estimate the bite force was obtained based on the relationship between the output of the capacitive-type pressure-mapping sensor and that of the load cell of the universal testing machine. The estimated bite force from the sensor and the quadratic regression equation closely resembled the known load applied by the compression tester (R2 = 0.992). We therefore conclude that the developed sensor can measure bite force accurately and effectively. A device with a built-in capacitive-type pressure-mapping sensor can potentially be a user-friendly tool for bite-force measurements in both clinical and epidemiological settings.
• Relationship between Eating Alone and Poor Appetite Using the Simplified Nutritional Appetite Questionnaire.

  Yurie Mikami, Keiko Motokawa, Maki Shirobe, Ayako Edahiro, Yuki Ohara, Masanori Iwasaki, Misato Hayakawa, Yutaka Watanabe, Hiroki Inagaki, Hunkyung Kim, Shoji Shinkai, Shuichi Awata, Hirohiko Hirano

  Nutrients 14 (2) 2022/01/14 

  One prominent factor associated with malnutrition is poor appetite. In Japan, the number of older adults living alone has increased annually. Those living alone tended to eat alone, which may lead to poor appetite. This study aimed to investigate the association between eating alone and poor appetite using an index called the Simplified Nutritional Appetite Questionnaire (SNAQ). We surveyed 818 people aged 70 and over in Takashimadaira, Itabashi-ku, Tokyo, Japan, in 2016. Comparisons were made between two groups, a poor appetite group (n = 295) and a good appetite group (n = 523), and results indicate that the poor appetite group had a higher rate of eating alone than the good appetite group (38.0% vs. 20. 1%: p < 0.001). Multivariable logistic regression (OR; 95%CI) was performed and poor appetite was significantly associated with the Geriatric Depression Scale (GDS) score (1.707; 1.200-2.427), the number of medications (1.061; 1.007-1.118), JST score (0.894; 0.841-0.950), the indication of "very healthy" on a self-rated health scale (0.343; 0.152-0.774), and reports of eating alone (1.751; 1.130-2.712). Our results suggest that eating alone is associated with a poor appetite.
• [Regular dental visits and changes in oral health among high school students during the coronavirus disease pandemic: A study using data from medical checkup at a school].

  Masanori Iwasaki, Satoko Kakuta, Toshihiro Ansai

  [Nihon koshu eisei zasshi] Japanese journal of public health 68 (12) 865 - 875 2021/12/24 

  Objective Continuous oral health care and regular dental visits are important for maintaining oral health. As a result of the high communicability of the coronavirus disease (COVID-19), individuals are reluctant to visit medical institutions. It is as yet unclear how the oral health of the population has been affected by the interruption of regular medical services during the COVID-19 pandemic. This study aimed to examine the association between the status of regular dental visits and changes in oral health among high school students during the pandemic using data from routine medical checkups conducted at a school, as well as data obtained from a questionnaire-based survey conducted simultaneously with medical checkups.Methods This study included 878 participants (comprising freshmen and sophomores) during the 2019 academic year from a high school in Fukuoka prefecture, Japan. Data on the frequency of dental checkups and anxiety related to dental visits during the pandemic was obtained through a questionnaire-based survey. Changes in dental health and gingival status between 2019 and 2020 were determined using data from routine medical checkups at the school. Poisson regression analysis with robust standard errors was used to evaluate the association between changes in dental health and gingival status and the status of regular dental visits.Results Of 878 participants, 417 (47.5%) did not have regular dental visits, 320 (36.4%) continued to have regular dental visits, and 141 (16.1%) had interrupted regular dental visits during the pandemic. In the interrupted regular dental visit group, 30.5% of participants were anxious about visiting a dental institution, which was a significantly higher proportion than other groups. Of the 521 participants who did not have gingival inflammation at the time of dental checkup in 2019, gingival inflammation at the time of dental checkup in 2020 was observed in 31.0% of participants having no regular dental visits, 20.2% participants having regular dental visits, and 38.2% participants having interrupted regular dental visits. The multivariable adjusted incidence rate ratios were 1.95 [95% confidence interval (CI), 1.34-2.84] in the interrupted regular dental visit group and 1.50 (95%CI,1.07-2.10) in the no regular dental visit group. There was no significant association between interruption of regular dental visits and changes in dental health status.Conclusion The study results showed that there was a significant association between interruptions in regular dental visits and anxiety related to dental visits during the COVID-19 pandemic, and that a higher proportion of participants who had interruptions in regular dental visits had gingival inflammation at the time of the medical checkup at the school.
• Association between dry mouth and physical frailty among community-dwelling older adults in Japan: The Otassha Study.

  Yuki Ohara, Hisashi Kawai, Maki Shirobe, Masanori Iwasaki, Keiko Motokawa, Ayako Edahiro, Hunkyung Kim, Yoshinori Fujiwara, Kazuhige Ihara, Yutaka Watanabe, Shuichi Obuchi, Hirohiko Hirano

  Gerodontology 39 (1) 41 - 48 2021/11/11 

  OBJECTIVE: To elucidate the relationship between physical frailty and dry mouth among community-dwelling older adults in Japan. BACKGROUND: Oral hypofunction is associated with physical frailty in older adults. Dry mouth, subjectively evaluated as xerostomia and objectively measured as hyposalivation, is highly prevalent in older adults. However, few reports have used both measures of dry mouth and investigated their association with physical frailty. MATERIALS AND METHODS: This cross-sectional study included 643 individuals (mean age, 73.9 years) from the Otassha Study in 2019. Xerostomia was assessed using the 5-item Summated Xerostomia Inventory (SXI). Hyposalivation was assessed by measuring the amount of resting saliva using the modified cotton roll method. Frailty phenotypes were defined by weakness, slowness, weight loss, low physical activity level and exhaustion components, and served as the outcome variable. Participants with three or more components were considered physically frail, and those with one or two components were considered pre-frail. Ordinal logistic regression analyses were performed to evaluate the associations between physical frailty and xerostomia and hyposalivation. RESULTS: Among the participants, 4.5% and 49.8% had physical frailty and pre-frailty, respectively. In ordinal logistic regression analysis adjusted for demographic and health characteristics, the SXI score was associated with physical frailty status (adjusted odds ratio for a one-point increase in SXI, 1.12; 95% confidence interval, 1.06-1.19). However, no difference was observed between the amount of resting saliva and severity of physical frailty. CONCLUSION: Xerostomia is associated with physical frailty among community-dwelling older adults in Japan. CLINICAL TRIAL REGISTRATION: Not applicable.
• Pneumonia incidence and oral health management by dental hygienists in long-term care facilities: A 1-year prospective multicentre cohort study.

  Kaoko Hama, Yasuyuki Iwasa, Yuki Ohara, Masanori Iwasaki, Kayoko Ito, Junko Nakajima, Takae Matsushita, Takashi Tohara, Mayumi Sakamoto, Masataka Itoda, Ken Inohara, Yoshie Ozaki, Rikimaru Sasaki, Yasuhiro Nishi, Midori Tsuneishi, Junichi Furuya, Yutaka Watanabe, Yoshihiko Watanabe, Yuji Sato, Mitsuyoshi Yoshida

  Gerodontology 2021/11/09 

  OBJECTIVE: To investigate the association between oral health management (OHM) by dental hygienists and the occurrence of pneumonia, and determine the effectiveness of OHM in pneumonia prevention. BACKGROUND: In long-term care facilities in Japan, the need for professional OHM is increasing with an increase in the number of severely debilitated residents. MATERIALS AND METHODS: A 1-year prospective multicentre cohort study was conducted using data from 504 residents (63 men; mean age: 87.4 ± 7.8 years) in Japanese long-term care facilities. Basic information, medical history, willingness to engage in oral hygiene behaviour, need for OHM and oral conditions were investigated at baseline. In addition, information on the occurrence of pneumonia was collected using a follow-up survey after one year. A Poisson regression analysis with robust standard errors was conducted, with pneumonia as the dependent variable, and factors associated with OHM and pneumonia occurrence as explanatory variables. RESULTS: Overall, 349 (69.2%) residents required OHM by dental hygienists during that year of follow-up. Of those, 238 (68.2%) were provided with OHM, and 18 (7.5%) developed pneumonia. Among the 111 patients (31.8%) who were not provided with OHM, 21 (18.9%) developed pneumonia. The OHM group had lower pneumonia rates than the non-OHM group (prevalence rate ratio: 0.374; 95% CI: 0.210-0.665). CONCLUSION: Oral health management by dental hygienists was associated with a lower incidence of pneumonia among residents of long-term care facilities, underlining the importance of professional OHM for such individuals. It is recommended that OHM be practised routinely in long-term care facilities.
• 認知症重症度に注目したアルツハイマー型認知症高齢者の口腔衛生管理課題に関する検討

  白部 麻樹, 枝広 あや子, 本川 佳子, 小原 由紀, 森下 志穂, 本橋 佳子, 岩崎 正則, 渡邊 裕, 平野 浩彦

  日本公衆衛生学会総会抄録集 日本公衆衛生学会 80回 439 - 439 1347-8060 2021/11
• The association of oral function with dietary intake and nutritional status among older adults: Latest evidence from epidemiological studies.

  Masanori Iwasaki, Hirohiko Hirano, Yuki Ohara, Keiko Motokawa

  The Japanese dental science review 57 128 - 137 2021/11 

  Inadequate and poor quality of diet and malnutrition are common and associated with adverse health outcomes, including morbidity and mortality, among older persons. This review aimed to establish the latest evidence from studies investigating the association between oral function and nutrition among older adults. An electronic search of MEDLINE using PubMed for literature published in English between March 2018 and March 2021 was conducted, and 27 papers were identified. The selected studies comprised 23 observational studies (17 cross-sectional and 6 longitudinal studies) and 4 interventional studies. Most of the observational studies demonstrated the following associations in older adults: older adults with poor oral function are likely to have poorer dietary intake and poorer nutritional status, and malnourished older adults are likely to have poorer oral function. The results of the intervention studies demonstrated that the combination of prosthodontic treatment and dietary counseling is more effective for improving dietary intake and nutritional status in older persons with tooth loss than the prosthodontic treatment alone. Our review confirmed that a relationship exists between oral function and nutrition and revealed the need for additional high-quality studies investigating comprehensive oral function, rather than a single aspect of oral function, with regard to nutritional status.
• Etiology of aggressive periodontitis in individuals of African descent.

  Akihiro Yoshida, Amal Bouziane, Samir Erraji, Leila Lakhdar, Meryem Rhissassi, Hideo Miyazaki, Toshihiro Ansai, Masanori Iwasaki, Oumkeltoum Ennibi

  The Japanese dental science review 57 20 - 26 2021/11 

  Aggressive periodontitis (AgP) is a form of periodontitis that affects adolescents and has a significantly higher prevalence in individuals of African descent. AgP typically shows familial aggregation, suggesting a genetic predisposition. Young age, good health status, rapid attachment loss, and familial aggregation are the primary features of this disease. AgP has been closely linked to specific bacterial strains of Aggregatibacter actinomycetemcomitans. A. actinomycetemcomitans strains isolated from patients with AgP produce leukotoxin (LtxA), which specifically affects polymorphonuclear leukocytes in primates, especially humans. High-throughput 16S rRNA gene sequencing and bioinformatics analyses revealed differences in the subgingival microbiota between patients with AgP and those with chronic periodontitis (ChP). The genera Atopobium and Prevotella show increased prevalences in AgP than in ChP. According to AgP susceptibility, several single nucleotide polymorphisms have been detected in different genes in individuals of African descent. Interleukin (IL)-1α and IL-1β genetic polymorphisms may be associated with the severity of both ChP and AgP. An elevated serum level of IL-17 produced by Th17 cells may be a characteristic of AgP. Analyses of the relationships among bacteria, host defenses, genetic predisposition, and numerous other factors are required to understand the progression of this disease.
• Relationship between weight loss and regular dental management of older adults residing in long-term care facilities: a 1-year multicenter longitudinal study.

  Yusuke Sunakawa, Hideki Tsugayasu, Yutaka Watanabe, Takae Matsushita, Yuki Ohara, Masanori Iwasaki, Maki Shirobe, Kayoko Ito, Junko Nakajima, Yasuyuki Iwasa, Masataka Itoda, Rikimaru Sasaki, Yasuhiro Nishi, Junichi Furuya, Yoshihiko Watanabe, Yukie Ishiguro, Hirohiko Hirano, Yuji Sato, Mitsuyoshi Yoshida, Yutaka Yamazaki

  European geriatric medicine 13 (1) 221 - 231 2021/10/28 

  PURPOSE: This study aimed to determine the association between home visits by a dentist and regular oral hygiene management by a dental hygienist (regular dental management: RDM) and weight loss among older adults in long-term care facilities. METHODS: A total of 468 older residents from 26 Japanese long-term care facilities participated in two surveys in 2018 and 2019. Participants were divided into two groups based on their diet during the baseline survey (regular diet, n = 256; dysphagia diet, n = 212). Participants with a regular diet were further divided into those who exhibited a weight loss ≥ 5% over 1 year (weight loss group: n = 77) and those with a weight loss < 5% (consistent weight group: n = 179). The explanatory variables were age, sex, baseline weight, Barthel index, and clinical dementia rating, as well as the patients' medical history of pneumonia, stroke, diabetes, and depression (which is reportedly associated with weight). Additionally, a Poisson regression with robust standard error, was carried out to analyze the explanatory variables, namely the prevalence of RDM noted during the study and functional teeth (which seemed to affect weight loss). RESULTS: A multivariate analysis revealed that older residents' lack of RDM, clinical dementia assessment, and their history of pneumonia (prevalence rate ratio: 0.35, 95% confidence interval 0.24-0.95) were all significantly associated with weight loss when on a regular diet. CONCLUSION: Thus, weight loss and RDM were related to each other. Weight loss may be suppressed by incorporating RDMs during the early nursing care for older residents on regular diets.
• Interrelationships among whole-body skeletal muscle mass, masseter muscle mass, oral function, and dentition status in older Japanese adults.

  Masanori Iwasaki, Hirohiko Hirano, Keiko Motokawa, Maki Shirobe, Ayako Edahiro, Yuki Ohara, Hisashi Kawai, Motonaga Kojima, Shuichi Obuchi, Hiroshi Murayama, Yoshinori Fujiwara, Kazushige Ihara, Shoji Shinkai, Akihiko Kitamura

  BMC geriatrics 21 (1) 582 - 582 2021/10/20 

  BACKGROUND: Generalized loss of skeletal muscle mass (SMM) may modulate or otherwise affect the loss of masseter muscle mass and be responsible for low masseter muscle performance and strength (i.e., low oral function). Moreover, dentition status can affect oral function independent of the muscle state. This cross-sectional study aimed to simultaneously investigate the relationships among whole-body SMM, masseter muscle mass, oral function (masseter muscle performance and strength), and dentition status in 1349 Japanese adults (mean age = 73.6 years). METHODS: We determined the estimated masseter muscle mass (e-MMM) based on morphological measurements of the masseter muscle. Masseter muscle performance was assessed via masticatory performance evaluation scores using gum, and strength was assessed as the maximal occlusal force. Dentition status was assessed as the number of functional teeth. SMM was measured by bioelectrical impedance analysis. Structural equation modeling stratified by sex was employed to investigate associations among SMM, e-MMM, gum score, occlusal force, and number of functional teeth. RESULTS: The direct path from SMM to e-MMM was statistically significant, as was the direct path from e-MMM to oral function (gum score and maximum occlusal force) for both sexes. We additionally confirmed that SMM indirectly affected gum score and maximum occlusal force via e-MMM (men; standardized coefficient [95% CI] = 3.64 [1.31 to 5.96] for maximum occlusal force and 0.01 [0.01 to 0.02] for gum score, women; 2.01 [0.38 to 3.81] for maximum occlusal force and 0.01 [0.002 to 0.01] for gum score). The number of functional teeth had direct effects on e-MMM, gum score, and maximum occlusal force. CONCLUSIONS: Low SMM was significantly indirectly associated with poor oral function through a low masseter muscle mass, and dentition status was independently associated with oral function.
• Association between Weight Loss and Food Form in Older Individuals Residing in Long-Term Care Facilities: 1-Year Multicenter Longitudinal Study.

  Akemi Endo, Yutaka Watanabe, Takae Matsushita, Kazutaka Okada, Yuki Ohara, Masanori Iwasaki, Kayoko Ito, Junko Nakajima, Yasuyuki Iwasa, Masataka Itoda, Rikimaru Sasaki, Yasuhiro Nishi, Junichi Furuya, Yoshihiko Watanabe, George Umemoto, Masako Kishima, Hirohiko Hirano, Yuji Sato, Mitsuyoshi Yoshida, Yutaka Yamazaki

  International journal of environmental research and public health 18 (20) 2021/10/14 

  Changing the food form for older adults requiring nursing care from a regular to dysphagia diet is thought to impact their nutritional status. We assessed the association between changes in food form and weight loss over 1 year in older adults. Older adults residing in long-term care facilities in Japan (n = 455) who participated in the baseline (2018) and follow-up (2019) surveys were divided into two groups (regular diet, n = 284; dysphagia diet, n = 171). The regular diet group was further divided into the weight loss (n = 80; weight loss ≥5% over 1 year) and weight maintenance (n = 204; weight loss <5%) groups. After 1 year, the Barthel Index significantly decreased, and the proportion of participants who switched from a regular diet to a dysphagia diet significantly increased in the weight loss group than in the weight maintenance group. Multivariate logistic regression analysis found that Barthel index variation (odds ratio (OR): 0.97, 95% confidence interval (CI): 0.94‒0.99), change from a regular diet to a dysphagia diet (OR: 4.41, 95% CI: 1.87‒10.41), and body weight at baseline (OR = 1.06, 95% CI: 1.01‒1.11) were significantly associated with weight loss. Our results suggest that maintaining the food form inhibits weight loss and improves health outcomes in older adults.
• Sleep duration and severe periodontitis in middle-aged Japanese workers.

  Masanori Iwasaki, Michihiko Usui, Wataru Ariyoshi, Keisuke Nakashima, Yoshie Nagai-Yoshioka, Maki Inoue, Kaoru Kobayashi, Tatsuji Nishihara

  Journal of clinical periodontology 2021/10/03 

  AIM: To evaluate the association between sleep duration and severe periodontitis in Japanese workers. MATERIALS AND METHODS: This cross-sectional study included 1130 workers (mean age 43.0 years) who underwent full-mouth periodontal examinations and health check-ups and completed a self-administered questionnaire that included questions on sleep duration. We used logistic regression and a restricted cubic spline model to analyze the data. RESULTS: Severe periodontitis was identified in 6.3% of the study population. The percentages of those with <5, 5-5.9, 6-6.9, 7-7.9, and ≥8 hours of sleep were 6.7%, 17.4%, 40.3%, 26.3%, and 8.9%, respectively. After adjusting for potential confounders, study participants who slept <5 hours were more likely to have severe periodontitis (adjusted odds ratio=2.64; 95% confidence interval=1.06-6.60) than those who slept 7-7.9 hours. The spline model, with a reference value of 399 minutes (the median sleep duration), showed a nonlinear association between sleep duration and severe periodontitis, where an increased prevalence of severe periodontitis was observed among only those with a shorter sleep duration. The prevalence of severe periodontitis was not increased with longer sleep duration. CONCLUSIONS: Short sleep duration was associated with severe periodontitis in this cohort of Japanese adults. This article is protected by copyright. All rights reserved.
• サルコペニアが舌口唇運動機能に与える影響の縦断的検討 お達者健診研究

  釘宮 嘉浩, 岩崎 正則, 小原 由紀, 本川 佳子, 枝広 あや子, 白部 麻樹, 渡邊 裕, 河合 恒, 大渕 修一, 藤原 佳典, 井原 一成, 上田 貴之, 平野 浩彦

  日本サルコペニア・フレイル学会雑誌 (一社)日本サルコペニア・フレイル学会 5 (Suppl.) 225 - 225 2433-1805 2021/10
• 口腔機能低下症とサルコペニアの関連の検討:お達者健診研究

  釘宮 嘉浩, 岩崎 正則, 小原 由紀, 本川 佳子, 枝広 あや子, 白部 麻樹, 渡邊 裕, 大渕 修一, 平野 浩彦, 上田 貴之

  老年歯科医学 (一社)日本老年歯科医学会 36 (2) 106 - 106 0914-3866 2021/09
• Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

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Al-Raddadi, Monira Alarouj, Fadia AlBuhairan, Shahla AlDhukair, Mohamed M Ali, Abdullah Alkandari, Ala'a Alkerwi, Kristine Allin, Eman Aly, Deepak N Amarapurkar, Norbert Amougou, Philippe Amouyel, Lars Bo Andersen, Sigmund A Anderssen, Ranjit Mohan Anjana, Alireza Ansari-Moghaddam, Daniel Ansong, Hajer Aounallah-Skhiri, Joana Araújo, Inger Ariansen, Tahir Aris, Raphael E Arku, Nimmathota Arlappa, Krishna K Aryal, Thor Aspelund, Felix K Assah, Maria Cecília F Assunção, Juha Auvinen, Mária Avdićová, Ana Azevedo, Mohsen Azimi-Nezhad, Fereidoun Azizi, Mehrdad Azmin, Bontha V Babu, Suhad Bahijri, Nagalla Balakrishna, Mohamed Bamoshmoosh, Maciej Banach, Maja Banadinović, Piotr Bandosz, José R Banegas, Joanna Baran, Carlo M Barbagallo, Alberto Barceló, Amina Barkat, Marta Barreto, Aluisio JD Barros, Mauro Virgílio Gomes Barros, Anna Bartosiewicz, Abdul Basit, Joao Luiz D Bastos, Iqbal Bata, Anwar M Batieha, Assembekov Batyrbek, Louise A Baur, Robert Beaglehole, Antonisamy Belavendra, Habiba 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Haghshenas, Hamid Hakimi, Jytte Halkjær, Ian R Hambleton, Behrooz Hamzeh, Dominique Hange, Abu AM Hanif, Sari Hantunen, Jie Hao, Carla Menêses Hardman, Rachakulla Hari Kumar, Seyed Mohammad Hashemi-Shahri, Jun Hata, Teresa Haugsgjerd, Alison J Hayes, Yuna He, Margit Heier, Marleen Elisabeth Hendriks, Rafael dos Santos Henrique, Ana Henriques, Leticia Hernandez Cadena, Herqutanto, Sauli Herrala, Ramin Heshmat, Allan G Hill, Sai Yin Ho, Suzanne C Ho, Michael Hobbs, Michelle Holdsworth, Reza Homayounfar, Gonul Horasan Dinc, Andrea RVR Horimoto, Claudia M Hormiga, Bernardo L Horta, Leila Houti, Christina Howitt, Thein Thein Htay, Aung Soe Htet, Maung Maung Than Htike, Yonghua Hu, José María Huerta, Ilpo Tapani Huhtaniemi, Laetitia Huiart, Martijn Huisman, Abdullatif S Husseini, Inge Huybrechts, Nahla Hwalla, Licia Iacoviello, Anna G Iannone, Mohsen M Ibrahim, Norazizah Ibrahim Wong, M Arfan Ikram, Violeta Iotova, Vilma E Irazola, Takafumi Ishida, Godsent C Isiguzo, Muhammad Islam, Sheikh Mohammed Shariful Islam, Masanori Iwasaki, Rod T Jackson, Jeremy M Jacobs, Hashem Y Jaddou, Tazeen Jafar, Kenneth James, Konrad Jamrozik, Imre Janszky, Edward Janus, Marjo-Riitta Jarvelin, Grazyna Jasienska, Ana Jelaković, Bojan Jelaković, Garry Jennings, Anjani Kumar Jha, Chao Qiang Jiang, Ramon O Jimenez, Karl-Heinz Jöckel, Michel Joffres, Mattias Johansson, Jari J Jokelainen, Jost B Jonas, Torben Jørgensen, Pradeep Joshi, Farahnaz Joukar, Jacek Jóżwiak, Anne Juolevi, Gregor Jurak, Vesna Jureša, Rudolf Kaaks, Anthony Kafatos, Eero O Kajantie, Zhanna Kalmatayeva, Natasa Kalpourtzi, Ofra Kalter-Leibovici, Freja B Kampmann, Srinivasan Kannan, Eva Karaglani, Line L Kårhus, Khem B Karki, Marzieh Katibeh, Joanne Katz, Jussi Kauhanen, Prabhdeep Kaur, Maryam Kavousi, Gyulli M Kazakbaeva, Ulrich Keil, Lital Keinan Boker, Sirkka Keinänen-Kiukaanniemi, Roya Kelishadi, Han CG Kemper, Maryam Keramati, Alina Kerimkulova, Mathilde Kersting, Timothy Key, Yousef Saleh Khader, Davood Khalili, Kay-Tee Khaw, Bahareh Kheiri, Motahareh Kheradmand, Alireza Khosravi, Ursula Kiechl-Kohlendorfer, Stefan Kiechl, Japhet Killewo, Dong Wook Kim, Jeongseon Kim, Heidi Klakk, Magdalena Klimek, Jurate Klumbiene, Michael Knoflach, Elin Kolle, Patrick Kolsteren, Jukka P Kontto, Raija Korpelainen, Paul Korrovits, Jelena Kos, Seppo Koskinen, Katsuyasu Kouda, Sudhir Kowlessur, Slawomir Koziel, Jana Kratenova, Vilma Kriaucioniene, Peter Lund Kristensen, Steiner Krokstad, Daan Kromhout, Herculina S Kruger, Ruzena Kubinova, Renata Kuciene, Urho M Kujala, Zbigniew Kulaga, R Krishna Kumar, Pawel Kurjata, Yadlapalli S Kusuma, Vladimir Kutsenko, Kari Kuulasmaa, Catherine Kyobutungi, Tiina Laatikainen, Carl Lachat, Youcef Laid, Tai Hing Lam, Orlando Landrove, Vera Lanska, Georg Lappas, Bagher Larijani, Tint Swe Latt, Gwenaëlle Le Coroller, Khanh Le Nguyen Bao, Tuyen D Le, Jeannette Lee, Jeonghee Lee, Nils Lehmann, Terho Lehtimäki, Daniel Lemogoum, Naomi S Levitt, Yanping Li, Christa L Lilly, Wei-Yen Lim, M Fernanda Lima-Costa, Xu Lin, Yi-Ting Lin, Lars Lind, Vijaya Lingam, Allan Linneberg, Lauren Lissner, Mieczyslaw Litwin, Wei-Cheng Lo, Helle-Mai Loit, Esther Lopez-Garcia, Tania Lopez, Paulo A Lotufo, José Eugenio Lozano, Iva Lukačević Lovrenčić, Janice L Lukrafka, Dalia Luksiene, Annamari Lundqvist, Robert Lundqvist, Nuno Lunet, Michala Lustigová, Edyta Luszczki, Guansheng Ma, Jun Ma, George LL Machado-Coelho, Aristides M Machado-Rodrigues, Enguerran Macia, Luisa M Macieira, Ahmed A Madar, Stefania Maggi, Dianna J Magliano, Emmanuella Magriplis, Gowri Mahasampath, Bernard Maire, Marjeta Majer, Marcia Makdisse, Fatemeh Malekzadeh, Reza Malekzadeh, Rahul Malhotra, Kodavanti Mallikharjuna Rao, Sofia K Malyutina, Lynell V Maniego, Yannis Manios, Jim I Mann, Fariborz Mansour-Ghanaei, Enzo Manzato, Anie Marcil, Staffan B Mårild, Mihalea Marinović Glavić, Pedro Marques-Vidal, Larissa Pruner Marques, Jaume Marrugat, Reynaldo Martorell, Luis P Mascarenhas, Marija Matasin, Ellisiv B Mathiesen, Prashant Mathur, Alicia Matijasevich, Piotr Matlosz, Tandi E Matsha, Christina Mavrogianni, Jean Claude N Mbanya, Anselmo J Mc Donald Posso, Shelly R McFarlane, Stephen T McGarvey, Stela McLachlan, Rachael M McLean, Scott B McLean, Breige A McNulty, Sounnia Mediene Benchekor, Jurate Medzioniene, Parinaz Mehdipour, Kirsten Mehlig, Amir Houshang Mehrparvar, Aline Meirhaeghe, Christa Meisinger, Carlos Mendoza Montano, Ana Maria B Menezes, Geetha R Menon, Alibek Mereke, Indrapal I Meshram, Andres Metspalu, Haakon E Meyer, Jie Mi, Nathalie Michels, Kairit Mikkel, Karolina Milkowska, Jody C Miller, Cláudia S Minderico, GK Mini, Mohammad Reza Mirjalili, Erkin Mirrakhimov, Marjeta Mišigoj-Duraković, Pietro A Modesti, Sahar Saeedi Moghaddam, Bahram Mohajer, Mostafa K Mohamed, Shukri F Mohamed, Kazem Mohammad, Mohammad Reza Mohammadi, Zahra Mohammadi, Noushin Mohammadifard, Reza Mohammadpourhodki, Viswanathan Mohan, Salim Mohanna, Muhammad Fadhli Mohd Yusoff, Iraj Mohebbi, Farnam Mohebi, Marie Moitry, Line T Møllehave, Dénes Molnár, Amirabbas Momenan, Charles K Mondo, Eric Monterrubio-Flores, Kotsedi Daniel K Monyeki, Jin Soo Moon, Mahmood Moosazadeh, Leila B Moreira, Alain Morejon, Luis A Moreno, Karen Morgan, George Moschonis, Malgorzata Mossakowska, Aya Mostafa, Seyed-Ali Mostafavi, Jorge Mota, Mohammad Esmaeel Motlagh, Jorge Motta, Marcos André Moura-dos-Santos, Malay K Mridha, Kelias P Msyamboza, Thet Thet Mu, Alfa J Muhihi, Maria L Muiesan, Martina Müller-Nurasyid, Neil Murphy, Jaakko Mursu, Kamarul Imran Musa, Sanja Musić Milanović, Vera Musil, Norlaila Mustafa, Iraj Nabipour, Shohreh Naderimagham, Gabriele Nagel, Balkish M Naidu, Farid Najafi, Harunobu Nakamura, Jana Námešná, Ei Ei K Nang, Vinay B Nangia, Sameer Narake, Ndeye Coumba Ndiaye, William A Neal, Azim Nejatizadeh, Ilona Nenko, Martin Neovius, Chung T Nguyen, Nguyen D Nguyen, Quang V Nguyen, Quang Ngoc Nguyen, Ramfis E Nieto-Martínez, Teemu J Niiranen, Yury P Nikitin, Toshiharu Ninomiya, Sania Nishtar, Marina A Njelekela, Marianna Noale, Oscar A Noboa, Ahmad Ali Noorbala, Teresa Norat, Maria Nordendahl, Børge G Nordestgaard, Davide Noto, Natalia Nowak-Szczepanska, Mohannad Al Nsour, Baltazar Nunes, Terence W O'Neill, Dermot O'Reilly, Caleb Ochimana, Eiji Oda, Augustine N Odili, Kyungwon Oh, Kumiko Ohara, Ryutaro Ohtsuka, Valérie Olié, Maria Teresa A Olinto, Isabel O Oliveira, Mohd Azahadi Omar, Altan Onat, Sok King Ong, Lariane M Ono, Pedro Ordunez, Rui Ornelas, Pedro J Ortiz, Clive Osmond, Sergej M Ostojic, Afshin Ostovar, Johanna A Otero, Kim Overvad, Ellis Owusu-Dabo, Fred Michel Paccaud, Cristina Padez, Elena Pahomova, Karina Mary de Paiva, Andrzej Pająk, Domenico Palli, Luigi Palmieri, Wen-Harn Pan, Songhomitra Panda-Jonas, Francesco Panza, Mariela Paoli, Dimitrios Papandreou, Soon-Woo Park, Suyeon Park, Winsome R Parnell, Mahboubeh Parsaeian, Patrick Pasquet, Nikhil D Patel, Halyna Pavlyshyn, Ivan Pećin, Mangesh S Pednekar, João M Pedro, Nasheeta Peer, Sergio Viana Peixoto, Markku Peltonen, Alexandre C Pereira, Karen GDA Peres, Marco A Peres, Annette Peters, Janina Petkeviciene, Niloofar Peykari, Son Thai Pham, Rafael N Pichardo, Iris Pigeot, Hynek Pikhart, Aida Pilav, Lorenza Pilotto, Freda Pitakaka, Aleksandra Piwonska, Andreia n Pizarro, Pedro Plans-Rubió, Ozren Polašek, Miquel Porta, Anil Poudyal, Farhad Pourfarzi, Akram Pourshams, Hossein Poustchi, Rajendra Pradeepa, Alison J Price, Jacqueline F Price, Rui Providencia, Soile E Puhakka, Maria Puiu, Margus Punab, Radwan F Qasrawi, Mostafa Qorbani, Daniel Queiroz, Tran Quoc Bao, Ivana Radić, Ricardas Radisauskas, Salar Rahimikazerooni, Mahfuzar Rahman, Olli Raitakari, Manu Raj, Ellina M Rakhimova, Sudha Ramachandra Rao, Ambady Ramachandran, Elisabete Ramos, Lekhraj Rampal, Sanjay Rampal, Daniel A Rangel Reina, Vayia Rarra, Cassiano Ricardo Rech, Josep Redon, Paul Ferdinand M Reganit, Valéria Regecová, Luis Revilla, Abbas Rezaianzadeh, Robespierre Ribeiro, Elio Riboli, Adrian Richter, Fernando Rigo, Tobias F Rinke de Wit, Raphael M Ritti-Dias, Cynthia Robitaille, Fernando Rodríguez-Artalejo, María del Cristo Rodriguez-Perez, Laura A Rodríguez-Villamizar, Ulla Roggenbuck, Rosalba Rojas-Martinez, Dora Romaguera, Elisabetta L Romeo, Annika Rosengren, Joel GR Roy, Adolfo Rubinstein, Jean-Bernard Ruidavets, Blanca Sandra Ruiz-Betancourt, Maria Ruiz-Castell, Iuliia A Rusakova, Paola Russo, Marcin Rutkowski, Charumathi Sabanayagam, Hamideh Sabbaghi, Harshpal S Sachdev, Alireza Sadjadi, Ali Reza Safarpour, Sare Safi, Saeid Safiri, Olfa Saidi, Sibel Sakarya, Nader Saki, Benoit Salanave, Eduardo Salazar Martinez, Diego Salmerón, Veikko Salomaa, Jukka T Salonen, Massimo Salvetti, Jose Sánchez-Abanto, Susana Sans, Diana A Santos, Ina S Santos, Lèlita C Santos, Maria Paula Santos, Rute Santos, Jouko L Saramies, Luis B Sardinha, Giselle Sarganas, Nizal Sarrafzadegan, Thirunavukkarasu Sathish, Kai-Uwe Saum, Savvas Savva, Norie Sawada, Mariana Sbaraini, Marcia Scazufca, Beatriz D Schaan, Herman Schargrodsky, Sabine Schipf, Carsten O Schmidt, Peter Schnohr, Ben Schöttker, Sara Schramm, Constance Schultsz, Aletta E Schutte, Sylvain Sebert, Aye Aye Sein, Abhijit Sen, Idowu O Senbanjo, Sadaf G Sepanlou, Jennifer Servais, Svetlana A Shalnova, Teresa Shamah-Levy, Morteza Shamshirgaran, Coimbatore Subramaniam Shanthirani, Maryam Sharafkhah, Sanjib K Sharma, Jonathan E Shaw, Amaneh Shayanrad, Ali Akbar Shayesteh, Zumin Shi, Kenji Shibuya, Hana Shimizu-Furusawa, Dong Wook Shin, Majid Shirani, Rahman Shiri, Namuna Shrestha, Khairil Si-Ramlee, Alfonso Siani, Rosalynn Siantar, Abla M Sibai, Caroline Ramos de Moura Silva, Diego Augusto Santos Silva, Mary Simon, Judith Simons, Leon A Simons, Michael Sjöström, Jolanta Slowikowska-Hilczer, Przemyslaw Slusarczyk, Liam Smeeth, Hung-Kwan So, Fernanda Cunha Soares, Eugène Sobngwi, Stefan Söderberg, Agustinus Soemantri, Reecha Sofat, Vincenzo Solfrizzi, Mohammad Hossein Somi, Emily Sonestedt, Yi Song, Thorkild IA Sørensen, Elin P Sørgjerd, Maroje Sorić, Charles Sossa Jérome, Aïcha Soumaré, Bente Sparboe-Nilsen, Karen Sparrenberger, Jan A Staessen, Gregor Starc, Bill Stavreski, Jostein Steene-Johannessen, Peter Stehle, Aryeh D Stein, George S Stergiou, Jochanan Stessman, Jutta Stieber, Doris Stöckl, Tanja Stocks, Jakub Stokwiszewski, Karien Stronks, Maria Wany Strufaldi, Machi Suka, Chien-An Sun, Yn-Tz Sung, Paibul Suriyawongpaisal, Rody G Sy, Holly E Syddall, René Charles Sylva, Moyses Szklo, E Shyong Tai, Mari-Liis Tammesoo, Abdonas Tamosiunas, Eng Joo Tan, Xun Tang, Frank Tanser, Yong Tao, Mohammed Rasoul Tarawneh, Carolina B Tarqui-Mamani, Anne Taylor, Julie Taylor, William R Tebar, Grethe S Tell, Tania Tello, Yih Chung Tham, KR Thankappan, Holger Theobald, Xenophon Theodoridis, Lutgarde Thijs, Mikael Thinggaard, Nihal Thomas, Barbara Thorand, Betina H Thuesen, Erik J Timmermans, Dwi H Tjandrarini, Anne Tjonneland, Ulla Toft, Hanna K Tolonen, Janne S Tolstrup, Murat Topbas, Roman Topór-Madry, María José Tormo, Michael J Tornaritis, Maties Torrent, Laura Torres-Collado, Giota Touloumi, Pierre Traissac, Areti Triantafyllou, Dimitrios Trichopoulos, Antonia Trichopoulou, Oanh TH Trinh, Atul Trivedi, Lechaba Tshepo, Shoichiro Tsugane, Azaliia M Tuliakova, Marshall K Tulloch-Reid, Fikru Tullu, Tomi-Pekka Tuomainen, Jaakko Tuomilehto, Maria L Turley, Gilad Twig, Per Tynelius, Christophe Tzourio, Peter Ueda, Eunice Ugel, Hanno Ulmer, Hannu MT Uusitalo, Gonzalo Valdivia, Damaskini Valvi, Rob M van Dam, Bert-Jan van den Born, Johan Van der Heyden, Yvonne T van der Schouw, Koen Van Herck, Hoang Van Minh, Natasja M Van Schoor, Irene GM van Valkengoed, Elisabeth M van Zutphen, Dirk Vanderschueren, Diego Vanuzzo, Anette Varbo, Senthil K Vasan, Tomas Vega, Toomas Veidebaum, Gustavo Velasquez-Melendez, Giovanni Veronesi, WM Monique Verschuren, Roosmarijn Verstraeten, Cesar G Victora, Lucie Viet, Salvador Villalpando, Paolo Vineis, Jesus Vioque, Jyrki K Virtanen, Sophie Visvikis-Siest, Bharathi Viswanathan, Tiina Vlasoff, Peter Vollenweider, Ari Voutilainen, Alisha N Wade, Janette Walton, Elvis OA Wambiya, Wan Mohamad Wan Bebakar, Wan Nazaimoon Wan Mohamud, Rildo de Souza Wanderley Júnior, Ming-Dong Wang, Ningli Wang, Qian Wang, Xiangjun Wang, Ya Xing Wang, Ying-Wei Wang, S Goya Wannamethee, Nicholas Wareham, Wenbin Wei, Aneta Weres, Bo Werner, Peter H Whincup, Kurt Widhalm, Andrzej Wiecek, Rainford J Wilks, Johann Willeit, Peter Willeit, Emmanuel A Williams, Tom Wilsgaard, Bogdan Wojtyniak, Roy A Wong-McClure, Andrew Wong, Tien Yin Wong, Jean Woo, Frederick C Wu, Shouling Wu, Justyna Wyszynska, Haiquan Xu, Liang Xu, Nor Azwany Yaacob, Weili Yan, Ling Yang, Xiaoguang Yang, Yang Yang, Tabara Yasuharu, Xingwang Ye, Panayiotis K Yiallouros, Moein Yoosefi, Akihiro Yoshihara, San-Lin You, Novie O Younger-Coleman, Ahmad Faudzi Yusoff, Ahmad A Zainuddin, Seyed Rasoul Zakavi, Farhad Zamani, Sabina Zambon, Antonis Zampelas, Maria Elisa Zapata, Ko Ko Zaw, Kristyna Zejglicova, Tajana Zeljkovic Vrkic, Yi Zeng, Luxia Zhang, Zhen-Yu Zhang, Dong Zhao, Ming-Hui Zhao, Shiqi Zhen, Yingfeng Zheng, Bekbolat Zholdin, Dan Zhu, Marie Zins, Emanuel Zitt, Yanina Zocalo, Nada Zoghlami, Julio Zuñiga Cisneros, Majid Ezzati

  The Lancet 398 (10304) 957 - 980 0140-6736 2021/09 [Refereed]
  
• Interruption of regular dental visits during the COVID‐19 pandemic due to concerns regarding dental visits was associated with periodontitis in Japanese office workers

  Masanori Iwasaki, Michihiko Usui, Wataru Ariyoshi, Keisuke Nakashima, Yoshie Nagai‐Yoshioka, Maki Inoue, Kaoru Kobayashi, Tatsuji Nishihara

  Journal of Periodontal Research 56 (6) 1091 - 1098 0022-3484 2021/08/25 

  OBJECTIVE: To investigate the interrelationships among concerns regarding dental visits, the status of regular dental visits, and periodontal health during the coronavirus disease 2019 (COVID-19) pandemic. BACKGROUND: Continuous oral health care and regular dental visits are important for maintaining periodontal health. Due to the possibility of contracting COVID-19, individuals have been reluctant to visit medical institutions. It is unclear how the periodontal health of the Japanese population has been affected by the interruption of regular dental visits during the COVID-19 pandemic and how concerns regarding dental visits have affected attendance at regular dental visits. METHODS: This study included 199 Japanese office workers in one municipal office at Fukuoka Prefecture, Japan (average age = 42.6 years; age range = 19-77 years; 123 men and 76 women). Periodontitis was defined based on a full-mouth periodontal examination. The status of regular dental visits during the COVID-19 pandemic and concerns regarding dental visits were obtained via questionnaire. We tested the hypothesis that concerns regarding dental visits would indirectly affect periodontal health through the interruption of regular dental visits during the COVID-19 pandemic. We used mediation analysis, in which concerns regarding dental visits (present or absent) were set as the exposure, periodontitis (present or absent) was set as the outcome, and the status of regular dental visits (continued during the COVID-19 pandemic or not) was set as the mediator. RESULTS: Of the 199 study participants, 108 had a habit of attending regular dental visits. Of these, 31 (28.7%) discontinued regular dental visits during the COVID-19 pandemic. Compared to the individuals who continued regular dental visits, those who discontinued regular dental visits had a higher prevalence of periodontitis (49.4% vs 77.4%, p < 0.05) and concerns regarding dental visits (22.1% vs 64.5%, p < 0.05). Discontinuing regular dental visits significantly mediated the association between concerns regarding dental visits and periodontitis (natural indirect effect: odds ratio = 1.68, 95% confidence interval = 1.02-2.79, proportion mediated = 64.3%). CONCLUSION: The study results showed that individuals who discontinued regular dental visits during the COVID-19 pandemic due to concerns regarding dental visits had relatively poor periodontal health.
• Denture wearing is associated with nutritional status among older adults requiring long-term care: A cross-sectional study

  Ayami Meguro, Yuki Ohara, Masanori Iwasaki, Ayako Edahiro, Maki Shirobe, Kentaro Igarashi, Keiko Motokawa, Masayasu Ito, Yutaka Watanabe, Yasuhiko Kawai, Hirohiko Hirano

  Journal of Dental Sciences 1991-7902 2021/08
• Validation of a self-report questionnaire for periodontitis in a Japanese population.

  Masanori Iwasaki, Michihiko Usui, Wataru Ariyoshi, Keisuke Nakashima, Yoshie Nagai-Yoshioka, Maki Inoue, Kaoru Kobayashi, Wenche S Borgnakke, George W Taylor, Tatsuji Nishihara

  Scientific reports 11 (1) 15078 - 15078 2021/07/23 [Refereed]
   

  We aimed to assess the validity of the self-report questionnaire for periodontitis in a Japanese population. A Japanese 9-item self-report questionnaire, developed by translating English-version questions that were used to detect periodontitis, was validated against full-mouth clinically-assessed periodontitis in 949 Japanese adults (average age = 43.2 years). Multivariable logistic regression modeling was used to calculate the area under the receiver operating characteristic curve (AUC), wherein the periodontitis case definition of the Centers for Disease Control and Prevention/American Academy of Periodontology was considered the gold standard. Severe, moderate, and mild periodontitis were identified in 6.2%, 30.0%, and 6.7% of the study population, respectively. Self-reported oral health questions combined with socio-demographic and health-related variables had an AUC > 0.70 (range, 0.71-0.87) for any periodontitis category. Four oral health questions ("have gum disease," "loose tooth," "lost bone," and "bleeding gums") were selected in the parsimonious model for severe periodontitis. The periodontitis screening score generated by the responses to these four questions had an AUC, sensitivity, and specificity of 0.82, 73.1%, and 74.3%, respectively, where the cut-off was set at 2 points. In conclusion, a locally adapted version of the self-report questionnaire had an acceptable diagnostic capacity for the detection of periodontitis in this study population.
• 地域在宅超高齢者の食事パターンと栄養素摂取量、栄養状態および嚥下状態との関連

  秋山 理加, 濱嵜 朋子, 岩崎 正則, 角田 聡子, 片岡 正太, 茂山 博代, 濃野 要, 葭原 明弘, 小川 祐司, 安細 敏弘, 宮崎 秀夫

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 71 (3) 136 - 146 0023-2831 2021/07 

  わが国では,年々超高齢者数が増加している.健康度の高い在宅超高齢者の食生活の実態を把握することは健康寿命延伸の有益な知見になると考えられる.そのため著者らは,在宅超高齢者を対象として,食事パターンを同定し,栄養素摂取量,栄養状態および嚥下状態との関連について明らかにすることを目的として本研究を行った.新潟市の91歳在宅高齢者86名を対象として,簡易型自記式食事歴法質問票(BDHQ),簡易栄養状態評価(MNA-SF),簡易嚥下状態評価票(EAT-10)による調査を行った.食品群別摂取量から主成分分析を行い,食事パターンを同定し,それらと栄養素摂取量の関連を検討した.さらに,各食事パターンと食に関連する因子,MNA-SFおよびEAT-10との関連を比較検討した.主成分分析の結果,4つの食事パターンが同定された.それぞれの主成分得点三分位によって栄養素摂取量を比較したところ,肉,魚,野菜類の摂取量が多く,ご飯,パンが少ない「副菜型」では,高得点群ほどたんぱく質やビタミンDなどの栄養素摂取量が多く,栄養状態も良好な者が多かった.また,MNA-SFで低栄養と判定された群では対照群と比べて嚥下機能低下のリスクのある者の割合が有意に高かった.さらに,「副菜型」の食事パターンでは居住形態や共に食事をする人の有無との関連も示唆された.(著者抄録)
• Factors Associated with Denture Non-use in Older Adults Requiring Long-Term Care

  Ayami Meguro, Yuki Ohara, Ayako Edahiro, Maki Shirobe, Masanori Iwasaki, Kentaro Igarashi, Keiko Motokawa, Masayasu Ito, Yutaka Watanabe, Yasuhiko Kawai, Hirohiko Hirano

  Archives of Gerontology and Geriatrics 95 104412 - 104412 0167-4943 2021/07
• Oral hypofunction and malnutrition among community-dwelling older adults: Evidence from the Otassha study.

  Masanori Iwasaki, Keiko Motokawa, Yutaka Watanabe, Maki Shirobe, Yuki Ohara, Ayako Edahiro, Hisashi Kawai, Yoshinori Fujiwara, Hunkyung Kim, Kazushige Ihara, Shuichi Obuchi, Hirohiko Hirano

  Gerodontology 2021/07/01 [Refereed]
   

  OBJECTIVE: This study investigated the association between oral hypofunction and malnutrition among community-dwelling older adults. BACKGROUND: Oral hypofunction, a 7-component phenotype of the clinical features of oral health, has been described in Japan. Data about its association with nutritional status are limited. MATERIALS AND METHODS: This cross-sectional study enrolled 715 adults (mean age, 73.5 years; range, 65-91 years) from the Otassha Study. Oral hypofunction was defined as the presence of ≥3 of the following 7 components: poor oral hygiene; oral dryness; low occlusal force; low articulatory oral motor skill; low tongue pressure; low masticatory performance; and compromised swallowing function. The Mini Nutritional Assessment® -Short Form (MNA® -SF) was used to assess the nutritional status. Malnutrition was defined as having an MNA® -SF score of seven or less. The association between oral hypofunction and nutritional status was evaluated using ordinal logistic regression analyses. RESULTS: The prevalence rates of oral hypofunction and malnutrition were 42.7% and 4.1%, respectively. Multivariable Poisson regression analyses revealed that oral hypofunction was associated with malnutrition. The adjusted relative risk of malnutrition in the study participants with oral hypofunction was 3.00 with a 95% confidence interval of 1.29-6.98. CONCLUSION: Community-dwelling older adults whose oral functions were compromised in multiple aspects had poor nutritional status.
• Relationship between Oral Hypofunction and Sarcopenia in Community-Dwelling Older Adults: The Otassha Study.

  Yoshihiro Kugimiya, Masanori Iwasaki, Yuki Ohara, Keiko Motokawa, Ayako Edahiro, Maki Shirobe, Yutaka Watanabe, Shuichi Obuchi, Hisashi Kawai, Yoshinori Fujiwara, Kazushige Ihara, Hunkyung Kim, Takayuki Ueda, Hirohiko Hirano

  International journal of environmental research and public health 18 (12) 2021/06/21 

  Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02-2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.
• 口腔機能低下症とサルコペニアの関連の検討 The Otassha Study

  釘宮 嘉浩, 岩崎 正則, 小原 由紀, 川本 佳子, 枝広 あや子, 白部 麻樹, 渡邊 裕, 大渕 修一, 平野 浩彦, 上田 貴之

  日本老年歯科医学会総会・学術大会プログラム・抄録集 (一社)日本老年歯科医学会 32回 合同3 - 3(歯) 2021/06
• The oral function of community-dwelling older adults complaining of an oral function deterioration: An examination using the oral function-related items of the Questionnaire for Latter-stage Elderly People

  Yoshihiro Kugimiya, Masanori Iwasaki, Yuki Ohara, Keiko Motokawa, Ayako Edahiro, Maki Shirobe, Yutaka Watanabe, Shuichi Obuchi, Hisashi Kawai, Takeshi Kera, Yoshinori Fujiwara, Kazushige Ihara, Hunkyung Kim, Kentaro Igarashi, Daichi Hoshino, Hirohiko Hirano

  Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 58 (2) 245 - 254 0300-9173 2021/04/25
• 地域在住高齢者における口腔機能低下有訴者の口腔機能 後期高齢者の質問票を構成する口腔機能関連項目を用いた検討

  釘宮 嘉浩, 岩崎 正則, 小原 由紀, 本川 佳子, 枝広 あや子, 白部 麻樹, 渡邊 裕, 大渕 修一, 河合 恒, 解良 武士, 藤原 佳典, 井原 一成, 金 憲経, 五十嵐 憲太郎, 星野 大地, 平野 浩彦

  日本老年医学会雑誌 (一社)日本老年医学会 58 (2) 245 - 254 0300-9173 2021/04 

  目的:本研究の目的は,後期高齢者の質問票の口腔機能類型質問に相当する基本チェックリストの咀嚼機能と嚥下機能を評価する質問項目から,後期高齢者の質問票の口腔機能類型質問の該当者率を推定することおよび,該当者の具体的な口腔機能を明らかにすることである.方法:本研究は,地域在住高齢者699名(男性274名,女性425名,平均年齢73.4±6.6歳)を対象とした.後期高齢者の質問票の口腔機能類型質問の基となった基本チェックリストの2つの質問項目を用いて,対象者の咀嚼機能と嚥下機能を評価した.質問に該当した者を,それぞれ咀嚼機能低下と嚥下機能低下とした.具体的な口腔機能として,現在歯数,機能歯数,口腔衛生状態,口腔粘膜湿潤度,咬合力,オーラルディアドコキネシス/pa/,/ta/,/ka/,舌圧,混合能力,咬断能力,EAT-10を評価した.EAT-10は3点以上を機能低下の基準値とした.結果:対象者のうち,咀嚼機能低下の該当者率は21.5%,嚥下機能低下の該当者率は26.6%だった.両方に該当した者の割合は7.4%だった.咀嚼機能低下の該当者は,非該当者に比べて現在歯数,咬合力,オーラルディアドコキネシス/pa/,混合能力,咬断能力が低値を示し,EAT-10の基準値の該当者率が高値を示した.嚥下機能低下の該当者では,EAT-10の基準値の該当者率のみが非該当者に比べ高値を示した.結論:咀嚼機能低下の該当者率は,前期高齢者で15.6%,後期高齢者で29.4%だった.嚥下機能低下の該当者率は,前期高齢者で27.8%,後期高齢者で25.0%だった.咀嚼機能低下と嚥下機能低下の両方に該当している者の割合は,前期高齢者で6.0%,後期高齢者で9.5%だった.また,本研究で用いた質問項目で咀嚼機能低下に該当した高齢者は,複数の口腔機能の低下が認められた.(著者抄録)
• A population-based cross-sectional study of the association between periodontitis and arterial stiffness among the older Japanese population.

  Masanori Iwasaki, Yumi Kimura, Takayuki Yamaga, Naomune Yamamoto, Motonao Ishikawa, Taizo Wada, Ryota Sakamoto, Yasuko Ishimoto, Michiko Fujisawa, Kiyohito Okumiya, Kuniaki Otsuka, Kozo Matsubayashi, Hiroshi Ogawa

  Journal of periodontal research 56 (2) 423 - 431 2021/04 [Refereed]
   

  OBJECTIVE: To investigate the potential association between periodontitis and arterial stiffness among the older Japanese population. BACKGROUND: The prevalence of periodontitis is increasing in Japanese older adults. Arterial stiffness increases the risks of cardiovascular events and death, morbidity, and dementia. METHODS: This secondary analysis of data from a cross-sectional study evaluated the periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue that was estimated by a full-mouth periodontal examination. Severe periodontitis was defined per the parameters provided by the Centers for Disease Control/American Academy of Periodontology. The Cardio-Ankle Vascular Index (CAVI) was used for measuring the overall stiffness of the artery, and higher CAVI indicated increased arterial stiffness. An ordinal logistic regression model was used to evaluate the association between periodontitis and arterial stiffness. RESULTS: The analysis included 185 Japanese adults [35% men; age, mean (standard deviation) 80.2 (4.4) years]. The average PISA and the prevalence of severe periodontitis were 64.4 mm2 and 27.6%, respectively; 54 (29.2%), 56 (30.3%), and 75 (40.5%) participants were stratified to the CAVI < 9, 9 ≤ CAVI <10, and CAVI ≥ 10 groups, respectively. After adjusting for potential confounders, the odds ratio of the prevalence and severity of arterial stiffness evaluated using CAVI was 1.06 [95% confidence interval (CI) 1.01 to 1.10] for PISA per 10 mm2 and 2.12 (95% CI 1.09 to 4.11) for severe periodontitis. CONCLUSION: Periodontitis was associated with arterial stiffness among Japanese older adults. Further studies are needed to investigate whether arterial stiffness is an intermediate factor in the pathway between periodontitis and systemic diseases, including cardiovascular disease and dementia.
• Association between periodontitis and the Mediterranean diet in young Moroccan individuals.

  Masanori Iwasaki, Oum Keltoum Ennibi, Amal Bouziane, Samir Erraji, Leila Lakhdar, Meryem Rhissassi, Toshihiro Ansai, Akihiro Yoshida, Hideo Miyazaki

  Journal of periodontal research 56 (2) 408 - 414 2021/04 [Refereed]
   

  BACKGROUND & OBJECTIVES: Adherence to the Mediterranean diet (MedDiet) has been reported to be associated with a lower risk of various chronic diseases. This cross-sectional study aimed to investigate the potential association between adherence to the MedDiet and periodontitis, which is highly prevalent in young Moroccan individuals. METHODS: We evaluated 1075 Moroccan individuals (72% women, mean [standard deviation] age = 20.2 [1.5] years). Adherence to the MedDiet was assessed using the MedDiet score (MDS) based on the frequency of intake of eight food groups (vegetables, legumes, fruits, cereals or potatoes, fish, red meat, dairy products, and olive oil). A value of 0 (unhealthy) or 1 (healthy) was assigned to each food group, and the MDS (range, 0-8 points) was generated by adding the individual scores, with a higher score indicating better adherence to the MedDiet. The logistic regression model was used to evaluate the MDS (high [5-8 points]/low [0-4 points]) and each component score (1/0) with the presence of periodontitis, which was determined through full-mouth periodontal examinations. Age, sex, and oral health behavior were considered as potential confounders. RESULTS: In total, 693 (64.5%) study participants showed high MDSs. Periodontitis was observed in 71 (6.6%) participants. No significant association between MDS and periodontitis was observed. Nonetheless, olive oil consumption, a component of the MDS, showed a significant inverse association with periodontitis (adjusted odds ratio = 0.55; 95% confidence interval, 0.32-0.96). CONCLUSIONS: The MedDiet was not significantly associated with periodontitis among young Moroccans. However, frequent consumption of olive oil may have a protective effect against periodontitis, although the temporal association needs to be clarified in further studies.
• Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

  Maria LC Iurilli, Bin Zhou, James E Bennett, Rodrigo M Carrillo-Larco, Marisa K Sophiea, Andrea Rodriguez-Martinez, Honor Bixby, Bethlehem D Solomon, Cristina Taddei, Goodarz Danaei, Mariachiara Di Cesare, Gretchen A Stevens, Leanne M Riley, Stefan Savin, Melanie J Cowan, Pascal Bovet, Albertino Damasceno, Adela Chirita-Emandi, Alison J Hayes, Nayu Ikeda, Rod T Jackson, Young-Ho Khang, Avula Laxmaiah, Jing Liu, J Jaime Miranda, Olfa Saidi, Sylvain Sebert, Maroje Sorić, Gregor Starc, Edward W Gregg, Leandra Abarca-Gómez, Ziad A Abdeen, Shynar Abdrakhmanova, Suhaila Abdul Ghaffar, Hanan F Abdul Rahim, Niveen M Abu-Rmeileh, Jamila Abubakar Garba, Benjamin Acosta-Cazares, Robert J Adams, Wichai Aekplakorn, Kaosar Afsana, Shoaib Afzal, Imelda A Agdeppa, Javad Aghazadeh-Attari, Carlos A Aguilar-Salinas, Charles Agyemang, Mohamad Hasnan Ahmad, Noor Ani Ahmad, Ali Ahmadi, Naser Ahmadi, Soheir H Ahmed, Wolfgang Ahrens, Gulmira Aitmurzaeva, Kamel Ajlouni, Hazzaa M Al-Hazzaa, Badreya Al-Lahou, Rajaa Al-Raddadi, Monira Alarouj, Fadia AlBuhairan, Shahla AlDhukair, Mohamed M Ali, Abdullah Alkandari, Ala'a Alkerwi, Kristine Allin, Mar Alvarez-Pedrerol, Eman Aly, Deepak N Amarapurkar, Parisa Amiri, Norbert Amougou, Philippe Amouyel, Lars Bo Andersen, Sigmund A Anderssen, Lars Ängquist, Ranjit Mohan Anjana, Alireza Ansari-Moghaddam, Hajer Aounallah-Skhiri, Joana Araújo, Inger Ariansen, Tahir Aris, Raphael E Arku, Nimmathota Arlappa, Krishna K Aryal, Thor Aspelund, Felix K Assah, Maria Cecília F Assunção, May Soe Aung, Juha Auvinen, Mária Avdicová, Shina Avi, Ana Azevedo, Mohsen Azimi-Nezhad, Fereidoun Azizi, Mehrdad Azmin, Bontha V Babu, Maja Bæksgaard Jørgensen, Azli Baharudin, Suhad Bahijri, Jennifer L Baker, Nagalla Balakrishna, Mohamed Bamoshmoosh, Maciej Banach, Piotr Bandosz, José R Banegas, Joanna Baran, Carlo M Barbagallo, Alberto Barceló, Amina Barkat, Aluisio JD Barros, Mauro Virgílio Gomes Barros, Abdul Basit, Joao Luiz D Bastos, Iqbal Bata, Anwar M Batieha, Rosangela L Batista, Zhamilya Battakova, Assembekov Batyrbek, Louise A Baur, Robert Beaglehole, Silvia Bel-Serrat, Antonisamy Belavendra, Habiba Ben Romdhane, Judith Benedics, Mikhail Benet, Ingunn Holden Bergh, Salim Berkinbayev, Antonio Bernabe-Ortiz, Gailute Bernotiene, Heloísa Bettiol, Jorge Bezerra, Aroor Bhagyalaxmi, Sumit Bharadwaj, Santosh K Bhargava, Zulfiqar A Bhutta, Hongsheng Bi, Yufang Bi, Daniel Bia, Elysée Claude Bika Lele, Mukharram M Bikbov, Bihungum Bista, Dusko J Bjelica, Peter Bjerregaard, Espen Bjertness, Marius B Bjertness, Cecilia Björkelund, Katia V Bloch, Anneke Blokstra, Simona Bo, Martin Bobak, Lynne M Boddy, Bernhard O Boehm, Heiner Boeing, Jose G Boggia, Elena Bogova, Carlos P Boissonnet, Stig E Bojesen, Marialaura Bonaccio, Vanina Bongard, Alice Bonilla-Vargas, Matthias Bopp, Herman Borghs, Lien Braeckevelt, Lutgart Braeckman, Marjolijn CE Bragt, Imperia Brajkovich, Francesco Branca, Juergen Breckenkamp, João Breda, Hermann Brenner, Lizzy M Brewster, Garry R Brian, Lacramioara Brinduse, Sinead Brophy, Graziella Bruno, H Bas Bueno-de-Mesquita, Anna Bugge, Marta Buoncristiano, Genc Burazeri, Con Burns, Antonio Cabrera de León, Joseph Cacciottolo, Hui Cai, Tilema Cama, Christine Cameron, José Camolas, Günay Can, Ana Paula C Cândido, Felicia Cañete, Mario V Capanzana, Nadežda Capková, Eduardo Capuano, Vincenzo Capuano, Marloes Cardol, Viviane C Cardoso, Axel C Carlsson, Esteban Carmuega, Joana Carvalho, José A Casajús, Felipe F Casanueva, Ertugrul Celikcan, Laura Censi, Marvin Cervantes-Loaiza, Juraci A Cesar, Snehalatha Chamukuttan, Angelique W Chan, Queenie Chan, Himanshu K Chaturvedi, Nish Chaturvedi, Norsyamlina Che Abdul Rahim, Miao Li Chee, Chien-Jen Chen, Fangfang Chen, Huashuai Chen, Shuohua Chen, Zhengming Chen, Ching-Yu Cheng, Bahman Cheraghian, Angela Chetrit, Ekaterina Chikova-Iscener, Arnaud Chiolero, Shu-Ti Chiou, María-Dolores Chirlaque, Belong Cho, Kaare Christensen, Diego G Christofaro, Jerzy Chudek, Renata Cifkova, Michelle Cilia, Eliza Cinteza, Frank Claessens, Janine Clarke, Els Clays, Emmanuel Cohen, Hans Concin, Susana C Confortin, Cyrus Cooper, Tara C Coppinger, Eva Corpeleijn, Simona Costanzo, Dominique Cottel, Chris Cowell, Cora L Craig, Amelia C Crampin, Ana B Crujeiras, Semánová Csilla, Alexandra M Cucu, Liufu Cui, Felipe V Cureau, Ewelina Czenczek-Lewandowska, Graziella D'Arrigo, Eleonora d'Orsi, Liliana Dacica, María Ángeles Dal Re Saavedra, Jean Dallongeville, Camilla T Damsgaard, Rachel Dankner, Thomas M Dantoft, Parasmani Dasgupta, Saeed Dastgiri, Luc Dauchet, Kairat Davletov, Guy De Backer, Dirk De Bacquer, Giovanni de Gaetano, Stefaan De Henauw, Paula Duarte de Oliveira, David De Ridder, Karin De Ridder, Susanne R de Rooij, Delphine De Smedt, Mohan Deepa, Alexander D Deev, Vincent Jr DeGennaro, Abbas Dehghan, Hélène Delisle, Francis Delpeuch, Stefaan Demarest, Elaine Dennison, Katarzyna Dereń, Valérie Deschamps, Meghnath Dhimal, Augusto F Di Castelnuovo, Juvenal Soares Dias-da-Costa, María Elena Díaz-Sánchez, Alejandro Diaz, Zivka Dika, Shirin Djalalinia, Visnja Djordjic, Ha TP Do, Annette J Dobson, Maria Benedetta Donati, Chiara Donfrancesco, Silvana P Donoso, Angela Döring, Maria Dorobantu, Ahmad Reza Dorosty, Kouamelan Doua, Nico Dragano, Wojciech Drygas, Jia Li Duan, Charmaine A Duante, Priscilla Duboz, Rosemary B Duda, Vesselka Duleva, Virginija Dulskiene, Samuel C Dumith, Anar Dushpanova, Vilnis Dzerve, Elzbieta Dziankowska-Zaborszczyk, Ricky Eddie, Ebrahim Eftekhar, Eruke E Egbagbe, Robert Eggertsen, Sareh Eghtesad, Gabriele Eiben, Ulf Ekelund, Mohammad El-Khateeb, Jalila El Ati, Denise Eldemire-Shearer, Marie Eliasen, Paul Elliott, Reina Engle-Stone, Macia Enguerran, Rajiv T Erasmus, Raimund Erbel, Cihangir Erem, Louise Eriksen, Johan G Eriksson, Jorge Escobedo-de la Peña, Saeid Eslami, Ali Esmaeili, Alun Evans, David Faeh, Albina A Fakhretdinova, Caroline H Fall, Elnaz Faramarzi, Mojtaba Farjam, Victoria Farrugia Sant'Angelo, Farshad Farzadfar, Mohammad Reza Fattahi, Asher Fawwad, Francisco J Felix-Redondo, Trevor S Ferguson, Romulo A Fernandes, Daniel Fernández-Bergés, Daniel Ferrante, Thomas Ferrao, Marika Ferrari, Marco M Ferrario, Catterina Ferreccio, Eldridge Ferrer, Jean Ferrieres, Thamara Hubler Figueiró, Anna Fijalkowska, Günther Fink, Krista Fischer, Leng Huat Foo, Maria Forsner, Heba M Fouad, Damian K Francis, Maria do Carmo Franco, Ruth Frikke-Schmidt, Guillermo Frontera, Flavio D Fuchs, Sandra C Fuchs, Isti I Fujiati, Yuki Fujita, Matsuda Fumihiko, Takuro Furusawa, Zbigniew Gaciong, Mihai Gafencu, Andrzej Galbarczyk, Henrike Galenkamp, Daniela Galeone, Myriam Galfo, Fabio Galvano, Jingli Gao, Manoli Garcia-de-la-Hera, Marta García-Solano, Dickman Gareta, Sarah P Garnett, Jean-Michel Gaspoz, Magda Gasull, Adroaldo Cesar Araujo Gaya, Anelise Reis Gaya, Andrea Gazzinelli, Ulrike Gehring, Harald Geiger, Johanna M Geleijnse, Ali Ghanbari, Erfan Ghasemi, Oana-Florentina Gheorghe-Fronea, Simona Giampaoli, Francesco Gianfagna, Tiffany K Gill, Jonathan Giovannelli, Glen Gironella, Aleksander Giwercman, Konstantinos Gkiouras, Justyna Godos, Sibel Gogen, Marcel Goldberg, Rebecca A Goldsmith, David Goltzman, Santiago F Gómez, Aleksandra Gomula, Bruna Goncalves Cordeiro da Silva, Helen Gonçalves, David A Gonzalez-Chica, Marcela Gonzalez-Gross, Margot González-Leon, Juan P González-Rivas, Clicerio González-Villalpando, María-Elena González-Villalpando, Angel R Gonzalez, Frederic Gottrand, Antonio Pedro Graça, Sidsel Graff-Iversen, Dušan Grafnetter, Aneta Grajda, Maria G Grammatikopoulou, Ronald D Gregor, Tomasz Grodzicki, Else Karin Grøholt, Anders Grøntved, Giuseppe Grosso, Gabriella Gruden, Dongfeng Gu, Emanuela Gualdi-Russo, Pilar Guallar-Castillón, Andrea Gualtieri, Elias F Gudmundsson, Vilmundur Gudnason, Ramiro Guerrero, Idris Guessous, Andre L Guimaraes, Martin C Gulliford, Johanna Gunnlaugsdottir, Marc J Gunter, Xiu-Hua Guo, Yin Guo, Prakash C Gupta, Rajeev Gupta, Oye Gureje, Beata Gurzkowska, Enrique Gutiérrez-González, Laura Gutierrez, Felix Gutzwiller, Seongjun Ha, Farzad Hadaegh, Charalambos A Hadjigeorgiou, Rosa Haghshenas, Hamid Hakimi, Jytte Halkjær, Ian R Hambleton, Behrooz Hamzeh, Dominique Hange, Abu AM Hanif, Sari Hantunen, Jie Hao, Rachakulla Hari Kumar, Seyed Mohammad Hashemi-Shahri, Maria Hassapidou, Jun Hata, Teresa Haugsgjerd, Jiang He, Yuan He, Yuna He, Regina Heidinger-Felso, Mirjam Heinen, Tatjana Hejgaard, Marleen Elisabeth Hendriks, Rafael dos Santos Henrique, Ana Henriques, Leticia Hernandez Cadena, Sauli Herrala, Victor M Herrera, Isabelle Herter-Aeberli, Ramin Heshmat, Allan G Hill, Sai Yin Ho, Suzanne C Ho, Michael Hobbs, Michelle Holdsworth, Reza Homayounfar, Clara Homs, Wilma M Hopman, Andrea RVR Horimoto, Claudia M Hormiga, Bernardo L Horta, Leila Houti, Christina Howitt, Thein Thein Htay, Aung Soe Htet, Maung Maung Than Htike, Yonghua Hu, José María Huerta, Ilpo Tapani Huhtaniemi, Laetitia Huiart, Constanta Huidumac Petrescu, Martijn Huisman, Abdullatif Husseini, Chinh Nguyen Huu, Inge Huybrechts, Nahla Hwalla, Jolanda Hyska, Licia Iacoviello, Jesús M Ibarluzea, Mohsen M Ibrahim, Norazizah Ibrahim Wong, M Arfan Ikram, Violeta Iotova, Vilma E Irazola, Takafumi Ishida, Muhammad Islam, Sheikh Mohammed Shariful Islam, Masanori Iwasaki, Jeremy M Jacobs, Hashem Y Jaddou, Tazeen Jafar, Kenneth James, Kazi M Jamil, Konrad Jamrozik, Imre Janszky, Edward Janus, Juel Jarani, Marjo-Riitta Jarvelin, Grazyna Jasienska, Ana Jelakovic, Bojan Jelakovic, Garry Jennings, Anjani Kumar Jha, Chao Qiang Jiang, Ramon O Jimenez, Karl-Heinz Jöckel, Michel Joffres, Mattias Johansson, Jari J Jokelainen, Jost B Jonas, Jitendra Jonnagaddala, Torben Jørgensen, Pradeep Joshi, Farahnaz Joukar, Dragana P Jovic, Jacek J Jóźwiak, Anne Juolevi, Gregor Jurak, Iulia Jurca Simina, Vesna Juresa, Rudolf Kaaks, Felix O Kaducu, Anthony Kafatos, Eero O Kajantie, Zhanna Kalmatayeva, Ofra Kalter-Leibovici, Yves Kameli, Freja B Kampmann, Kodanda R Kanala, Srinivasan Kannan, Efthymios Kapantais, Argyro Karakosta, Line L Kårhus, Khem B Karki, Marzieh Katibeh, Joanne Katz, Peter T Katzmarzyk, Jussi Kauhanen, Prabhdeep Kaur, Maryam Kavousi, Gyulli M Kazakbaeva, Ulrich Keil, Lital Keinan Boker, Sirkka Keinänen-Kiukaanniemi, Roya Kelishadi, Cecily Kelleher, Han CG Kemper, Andre P Kengne, Maryam Keramati, Alina Kerimkulova, Mathilde Kersting, Timothy Key, Yousef Saleh Khader, Davood Khalili, Kay-Tee Khaw, Bahareh Kheiri, Motahareh Kheradmand, Alireza Khosravi, Ilse MSL Khouw, Ursula Kiechl-Kohlendorfer, Stefan Kiechl, Japhet Killewo, Dong Wook Kim, Hyeon Chang Kim, Jeongseon Kim, Jenny M Kindblom, Heidi Klakk, Magdalena Klimek, Jeannette Klimont, Jurate Klumbiene, Michael Knoflach, Bhawesh Koirala, Elin Kolle, Patrick Kolsteren, Jürgen König, Raija Korpelainen, Paul Korrovits, Magdalena Korzycka, Jelena Kos, Seppo Koskinen, Katsuyasu Kouda, Viktoria A Kovacs, Sudhir Kowlessur, Slawomir Koziel, Jana Kratenova, Wolfgang Kratzer, Susi Kriemler, Peter Lund Kristensen, Steiner Krokstad, Daan Kromhout, Herculina S Kruger, Ruzena Kubinova, Renata Kuciene, Urho M Kujala, Enisa Kujundzic, Zbigniew Kulaga, R Krishna Kumar, Marie Kunešová, Pawel Kurjata, Yadlapalli S Kusuma, Kari Kuulasmaa, Catherine Kyobutungi, Quang Ngoc La, Fatima Zahra Laamiri, Tiina Laatikainen, Carl Lachat, Youcef Laid, Tai Hing Lam, Christina-Paulina Lambrinou, Edwige Landais, Vera Lanska, Georg Lappas, Bagher Larijani, Tint Swe Latt, Laura Lauria, Maria Lazo-Porras, Gwenaëlle Le Coroller, Khanh Le Nguyen Bao, Agnès Le Port, Tuyen D Le, Jeannette Lee, Jeonghee Lee, Paul H Lee, Nils Lehmann, Terho Lehtimäki, Daniel Lemogoum, Naomi S Levitt, Yanping Li, Merike Liivak, Christa L Lilly, Wei-Yen Lim, M Fernanda Lima-Costa, Hsien-Ho Lin, Xu Lin, Yi-Ting Lin, Lars Lind, Allan Linneberg, Lauren Lissner, Mieczyslaw Litwin, Lijuan Liu, Wei-Cheng Lo, Helle-Mai Loit, Khuong Quynh Long, Luis Lopes, Oscar Lopes, Esther Lopez-Garcia, Tania Lopez, Paulo A Lotufo, José Eugenio Lozano, Janice L Lukrafka, Dalia Luksiene, Annamari Lundqvist, Robert Lundqvist, Nuno Lunet, Charles Lunogelo, Michala Lustigová, Edyta Łuszczki, Guansheng Ma, Jun Ma, Xu Ma, George LL Machado-Coelho, Aristides M Machado-Rodrigues, Luisa M Macieira, Ahmed A Madar, Stefania Maggi, Dianna J Magliano, Sara Magnacca, Emmanuella Magriplis, Gowri Mahasampath, Bernard Maire, Marjeta Majer, Marcia Makdisse, Päivi Mäki, Fatemeh Malekzadeh, Reza Malekzadeh, Rahul Malhotra, Kodavanti Mallikharjuna Rao, Sofia K Malyutina, Lynell V Maniego, Yannis Manios, Jim I Mann, Fariborz Mansour-Ghanaei, Enzo Manzato, Paula Margozzini, Anastasia Markaki, Oonagh Markey, Eliza Markidou Ioannidou, Pedro Marques-Vidal, Larissa Pruner Marques, Jaume Marrugat, Yves Martin-Prevel, Rosemarie Martin, Reynaldo Martorell, Eva Martos, Katharina Maruszczak, Stefano Marventano, Luis P Mascarenhas, Shariq R Masoodi, Ellisiv B Mathiesen, Prashant Mathur, Alicia Matijasevich, Tandi E Matsha, Christina Mavrogianni, Artur Mazur, Jean Claude N Mbanya, Shelly R McFarlane, Stephen T McGarvey, Martin McKee, Stela McLachlan, Rachael M McLean, Scott B McLean, Breige A McNulty, Sounnia Mediene Benchekor, Jurate Medzioniene, Parinaz Mehdipour, Kirsten Mehlig, Amir Houshang Mehrparvar, Aline Meirhaeghe, Jørgen Meisfjord, Christa Meisinger, Ana Maria B Menezes, Geetha R Menon, Gert BM Mensink, Maria Teresa Menzano, Alibek Mereke, Indrapal I Meshram, Andres Metspalu, Haakon E Meyer, Jie Mi, Kim F Michaelsen, Nathalie Michels, Kairit Mikkel, Karolina Milkowska, Jody C Miller, Cláudia S Minderico, GK Mini, Juan Francisco Miquel, Mohammad Reza Mirjalili, Daphne Mirkopoulou, Erkin Mirrakhimov, Marjeta Mišigoj-Durakovic, Antonio Mistretta, Veronica Mocanu, Pietro A Modesti, Sahar Saeedi Moghaddam, Bahram Mohajer, Mostafa K Mohamed, Shukri F Mohamed, Kazem Mohammad, Zahra Mohammadi, Noushin Mohammadifard, Reza Mohammadpourhodki, Viswanathan Mohan, Salim Mohanna, Muhammad Fadhli Mohd Yusoff, Iraj Mohebbi, Farnam Mohebi, Marie Moitry, Drude Molbo, Line T Møllehave, Niels C Møller, Dénes Molnár, Amirabbas Momenan, Charles K Mondo, Michele Monroy-Valle, Eric Monterrubio-Flores, Kotsedi Daniel K Monyeki, Jin Soo Moon, Mahmood Moosazadeh, Leila B Moreira, Alain Morejon, Luis A Moreno, Karen Morgan, Suzanne N Morin, Erik Lykke Mortensen, George Moschonis, Malgorzata Mossakowska, Aya Mostafa, Anabela Mota-Pinto, Jorge Mota, Mohammad Esmaeel Motlagh, Jorge Motta, Marcos André Moura-dos-Santos, Malay K Mridha, Kelias P Msyamboza, Thet Thet Mu, Magdalena Muc, Boban Mugoša, Maria L Muiesan, Parvina Mukhtorova, Martina Müller-Nurasyid, Neil Murphy, Jaakko Mursu, Elaine M Murtagh, Kamarul Imran Musa, Sanja Music Milanovic, Vera Musil, Norlaila Mustafa, Iraj Nabipour, Shohreh Naderimagham, Gabriele Nagel, Balkish M Naidu, Farid Najafi, Harunobu Nakamura, Jana Námešná, Ei Ei K Nang, Vinay B Nangia, Martin Nankap, Sameer Narake, Paola Nardone, Matthias Nauck, William A Neal, Azim Nejatizadeh, Chandini Nekkantti, Keiu Nelis, Liis Nelis, Ilona Nenko, Martin Neovius, Flavio Nervi, Chung T Nguyen, Nguyen D Nguyen, Quang Ngoc Nguyen, Ramfis E Nieto-Martínez, Yury P Nikitin, Guang Ning, Toshiharu Ninomiya, Sania Nishtar, Marianna Noale, Oscar A Noboa, Helena Nogueira, Teresa Norat, Maria Nordendahl, Børge G Nordestgaard, Davide Noto, Natalia Nowak-Szczepanska, Mohannad Al Nsour, Irfan Nuhoglu, Eha Nurk, Terence W O'Neill, Dermot O'Reilly, Galina Obreja, Caleb Ochimana, Angélica M Ochoa-Avilés, Eiji Oda, Kyungwon Oh, Kumiko Ohara, Claes Ohlsson, Ryutaro Ohtsuka, Örn Olafsson, Maria Teresa A Olinto, Isabel O Oliveira, Mohd Azahadi Omar, Altan Onat, Sok King Ong, Lariane M Ono, Pedro Ordunez, Rui Ornelas, Ana P Ortiz, Pedro J Ortiz, Merete Osler, Clive Osmond, Sergej M Ostojic, Afshin Ostovar, Johanna A Otero, Kim Overvad, Ellis Owusu-Dabo, Fred Michel Paccaud, Cristina Padez, Ioannis Pagkalos, Elena Pahomova, Karina Mary de Paiva, Andrzej Pajak, Domenico Palli, Alberto Palloni, Luigi Palmieri, Wen-Harn Pan, Songhomitra Panda-Jonas, Arvind Pandey, Francesco Panza, Dimitrios Papandreou, Soon-Woo Park, Suyeon Park, Winsome R Parnell, Mahboubeh Parsaeian, Ionela M Pascanu, Patrick Pasquet, Nikhil D Patel, Ivan Pecin, Mangesh S Pednekar, Nasheeta Peer, Gao Pei, Sergio Viana Peixoto, Markku Peltonen, Alexandre C Pereira, Marco A Peres, Napoleón Pérez-Farinós, Cynthia M Pérez, Valentina Peterkova, Annette Peters, Astrid Petersmann, Janina Petkeviciene, Ausra Petrauskiene, Emanuela Pettenuzzo, Niloofar Peykari, Son Thai Pham, Rafael N Pichardo, Daniela Pierannunzio, Iris Pigeot, Hynek Pikhart, Aida Pilav, Lorenza Pilotto, Francesco Pistelli, Freda Pitakaka, Aleksandra Piwonska, Andreia N Pizarro, Pedro Plans-Rubió, Bee Koon Poh, Hermann Pohlabeln, Raluca M Pop, Stevo R Popovic, Miquel Porta, Georg Posch, Anil Poudyal, Dimitrios Poulimeneas, Hamed Pouraram, Farhad Pourfarzi, Akram Pourshams, Hossein Poustchi, Rajendra Pradeepa, Alison J Price, Jacqueline F Price, Rui Providencia, Jardena J Puder, Iveta Pudule, Soile E Puhakka, Maria Puiu, Margus Punab, Radwan F Qasrawi, Mostafa Qorbani, Tran Quoc Bao, Ivana Radic, Ricardas Radisauskas, Salar Rahimikazerooni, Mahfuzar Rahman, Mahmudur Rahman, Olli Raitakari, Manu Raj, Ellina Rakhimova, Sherali Rakhmatulloev, Ivo Rakovac, Sudha Ramachandra Rao, Ambady Ramachandran, Jacqueline Ramke, Elisabete Ramos, Rafel Ramos, Lekhraj Rampal, Sanjay Rampal, Vayia Rarra, Ramon A Rascon-Pacheco, Mette Rasmussen, Cassiano Ricardo Rech, Josep Redon, Paul Ferdinand M Reganit, Valéria Regecová, Luis Revilla, Abbas Rezaianzadeh, Lourdes Ribas-Barba, Robespierre Ribeiro, Elio Riboli, Adrian Richter, Fernando Rigo, Natascia Rinaldo, Tobias F Rinke de Wit, Ana Rito, Raphael M Ritti-Dias, Juan A Rivera, Cynthia Robitaille, Romana Roccaldo, Daniela Rodrigues, Fernando Rodríguez-Artalejo, María del Cristo Rodriguez-Perez, Laura A Rodríguez-Villamizar, Ulla Roggenbuck, Rosalba Rojas-Martinez, Nipa Rojroongwasinkul, Dora Romaguera, Elisabetta L Romeo, Rafaela V Rosario, Annika Rosengren, Ian Rouse, Joel GR Roy, Adolfo Rubinstein, Frank J Rühli, Jean-Bernard Ruidavets, Blanca Sandra Ruiz-Betancourt, Maria Ruiz-Castell, Emma Ruiz Moreno, Iuliia A Rusakova, Kenisha Russell Jonsson, Paola Russo, Petra Rust, Marcin Rutkowski, Charumathi Sabanayagam, Elena Sacchini, Harshpal S Sachdev, Alireza Sadjadi, Ali Reza Safarpour, Saeid Safiri, Nader Saki, Benoit Salanave, Eduardo Salazar Martinez, Diego Salmerón, Veikko Salomaa, Jukka T Salonen, Massimo Salvetti, Margarita Samoutian, Jose Sánchez-Abanto, Sandjaja, Susana Sans, Loreto Santa Marina, Diana A Santos, Ina S Santos, Lèlita C Santos, Maria Paula Santos, Osvaldo Santos, Rute Santos, Sara Santos Sanz, Jouko L Saramies, Luis B Sardinha, Nizal Sarrafzadegan, Thirunavukkarasu Sathish, Kai-Uwe Saum, Savvas Savva, Mathilde Savy, Norie Sawada, Mariana Sbaraini, Marcia Scazufca, Beatriz D Schaan, Angelika Schaffrath Rosario, Herman Schargrodsky, Anja Schienkiewitz, Sabine Schipf, Carsten O Schmidt, Ida Maria Schmidt, Peter Schnohr, Ben Schöttker, Sara Schramm, Stine Schramm, Helmut Schröder, Constance Schultsz, Aletta E Schutte, Aye Aye Sein, Rusidah Selamat, Vedrana Sember, Abhijit Sen, Idowu O Senbanjo, Sadaf G Sepanlou, Victor Sequera, Luis Serra-Majem, Jennifer Servais, Ludmila Ševcíková, Svetlana A Shalnova, Teresa Shamah-Levy, Morteza Shamshirgaran, Coimbatore Subramaniam Shanthirani, Maryam Sharafkhah, Sanjib K Sharma, Jonathan E Shaw, Amaneh Shayanrad, Ali Akbar Shayesteh, Lela Shengelia, Zumin Shi, Kenji Shibuya, Hana Shimizu-Furusawa, Dong Wook Shin, Majid Shirani, Rahman Shiri, Namuna Shrestha, Khairil Si-Ramlee, Alfonso Siani, Rosalynn Siantar, Abla M Sibai, Antonio M Silva, Diego Augusto Santos Silva, Mary Simon, Judith Simons, Leon A Simons, Agneta Sjöberg, Michael Sjöström, Gry Skodje, Jolanta Slowikowska-Hilczer, Przemyslaw Slusarczyk, Liam Smeeth, Hung-Kwan So, Fernanda Cunha Soares, Grzegorz Sobek, Eugène Sobngwi, Morten Sodemann, Stefan Söderberg, Moesijanti YE Soekatri, Agustinus Soemantri, Reecha Sofat, Vincenzo Solfrizzi, Mohammad Hossein Somi, Emily Sonestedt, Yi Song, Thorkild IA Sørensen, Elin P Sørgjerd, Charles Sossa Jérome, Victoria E Soto-Rojas, Aïcha Soumaré, Slavica Sovic, Bente Sparboe-Nilsen, Karen Sparrenberger, Angela Spinelli, Igor Spiroski, Jan A Staessen, Hanspeter Stamm, Maria G Stathopoulou, Kaspar Staub, Bill Stavreski, Jostein Steene-Johannessen, Peter Stehle, Aryeh D Stein, George S Stergiou, Jochanan Stessman, Ranko Stevanovic, Jutta Stieber, Doris Stöckl, Tanja Stocks, Jakub Stokwiszewski, Ekaterina Stoyanova, Gareth Stratton, Karien Stronks, Maria Wany Strufaldi, Lela Sturua, Ramón Suárez-Medina, Machi Suka, Chien-An Sun, Johan Sundström, Yn-Tz Sung, Jordi Sunyer, Paibul Suriyawongpaisal, Boyd A Swinburn, Rody G Sy, Holly E Syddall, René Charles Sylva, Moyses Szklo, Lucjan Szponar, E Shyong Tai, Mari-Liis Tammesoo, Abdonas Tamosiunas, Eng Joo Tan, Xun Tang, Maya Tanrygulyyeva, Frank Tanser, Yong Tao, Mohammed Rasoul Tarawneh, Jakob Tarp, Carolina B Tarqui-Mamani, Radka Taxová Braunerová, Anne Taylor, Julie Taylor, Félicité Tchibindat, William R Tebar, Grethe S Tell, Tania Tello, Yih Chung Tham, KR Thankappan, Holger Theobald, Xenophon Theodoridis, Lutgarde Thijs, Nihal Thomas, Betina H Thuesen, Lubica Tichá, Erik J Timmermans, Anne Tjonneland, Hanna K Tolonen, Janne S Tolstrup, Murat Topbas, Roman Topór-Madry, Liv Elin Torheim, María José Tormo, Michael J Tornaritis, Maties Torrent, Laura Torres-Collado, Stefania Toselli, Giota Touloumi, Pierre Traissac, Thi Tuyet-Hanh Tran, Dimitrios Trichopoulos, Antonia Trichopoulou, Oanh TH Trinh, Atul Trivedi, Lechaba Tshepo, Maria Tsigga, Shoichiro Tsugane, Azaliia M Tuliakova, Marshall K Tulloch-Reid, Fikru Tullu, Tomi-Pekka Tuomainen, Jaakko Tuomilehto, Maria L Turley, Gilad Twig, Per Tynelius, Themistoklis Tzotzas, Christophe Tzourio, Peter Ueda, Eunice Ugel, Flora AM Ukoli, Hanno Ulmer, Belgin Unal, Zhamyila Usupova, Hannu MT Uusitalo, Nalan Uysal, Justina Vaitkeviciute, Gonzalo Valdivia, Susana Vale, Damaskini Valvi, Rob M van Dam, Johan Van der Heyden, Yvonne T van der Schouw, Koen Van Herck, Hoang Van Minh, Natasja M Van Schoor, Irene GM van Valkengoed, Dirk Vanderschueren, Diego Vanuzzo, Anette Varbo, Gregorio Varela-Moreiras, Patricia Varona-Pérez, Senthil K Vasan, Tomas Vega, Toomas Veidebaum, Gustavo Velasquez-Melendez, Biruta Velika, Giovanni Veronesi, WM Monique Verschuren, Cesar G Victora, Giovanni Viegi, Lucie Viet, Salvador Villalpando, Paolo Vineis, Jesus Vioque, Jyrki K Virtanen, Marjolein Visser, Sophie Visvikis-Siest, Bharathi Viswanathan, Mihaela Vladulescu, Tiina Vlasoff, Dorja Vocanec, Peter Vollenweider, Henry Völzke, Ari Voutilainen, Sari Voutilainen, Martine Vrijheid, Tanja GM Vrijkotte, Alisha N Wade, Aline Wagner, Thomas Waldhör, Janette Walton, Elvis OA Wambiya, Wan Mohamad Wan Bebakar, Wan Nazaimoon Wan Mohamud, Rildo de Souza Wanderley Júnior, Ming-Dong Wang, Ningli Wang, Qian Wang, Xiangjun Wang, Ya Xing Wang, Ying-Wei Wang, S Goya Wannamethee, Nicholas Wareham, Adelheid Weber, Niels Wedderkopp, Deepa Weerasekera, Daniel Weghuber, Wenbin Wei, Aneta Weres, Bo Werner, Peter H Whincup, Kurt Widhalm, Indah S Widyahening, Andrzej Wiecek, Rainford J Wilks, Johann Willeit, Peter Willeit, Julianne Williams, Tom Wilsgaard, Bogdan Wojtyniak, Roy A Wong-McClure, Andrew Wong, Jyh Eiin Wong, Tien Yin Wong, Jean Woo, Mark Woodward, Frederick C Wu, Jianfeng Wu, Li Juan Wu, Shouling Wu, Haiquan Xu, Liang Xu, Nor Azwany Yaacob, Uruwan Yamborisut, Weili Yan, Ling Yang, Xiaoguang Yang, Yang Yang, Nazan Yardim, Mehdi Yaseri, Tabara Yasuharu, Xingwang Ye, Panayiotis K Yiallouros, Moein Yoosefi, Akihiro Yoshihara, Qi Sheng You, San-Lin You, Novie O Younger-Coleman, Safiah Md Yusof, Ahmad Faudzi Yusoff, Luciana Zaccagni, Vassilis Zafiropulos, Ahmad A Zainuddin, Seyed Rasoul Zakavi, Farhad Zamani, Sabina Zambon, Antonis Zampelas, Hana Zamrazilová, Maria Elisa Zapata, Abdul Hamid Zargar, Ko Ko Zaw, Tomasz Zdrojewski, Kristyna Zejglicova, Tajana Zeljkovic Vrkic, Yi Zeng, Luxia Zhang, Zhen-Yu Zhang, Dong Zhao, Ming-Hui Zhao, Wenhua Zhao, Shiqi Zhen, Wei Zheng, Yingfeng Zheng, Bekbolat Zholdin, Maigeng Zhou, Dan Zhu, Marie Zins, Emanuel Zitt, Yanina Zocalo, Julio Zuñiga Cisneros, Monika Zuziak, Majid Ezzati, Sarah Filippi

  eLife 10 2021/03/09 [Refereed]
   

  From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.
• Preliminary investigation of family caregiver burden and oral care provided to homebound older patients.

  Yuki Ohara, Masanori Iwasaki, Keiko Motokawa, Hirohiko Hirano

  Clinical and experimental dental research 7 (5) 840 - 844 2021/03/08 

  OBJECTIVES: Family caregivers play an important role in maintaining the oral health of homebound older adults. Thus, this preliminary study investigated family caregivers' burdens and the oral care they provide to homebound older patients. MATERIAL AND METHODS: A cross-sectional survey was conducted. A questionnaire was distributed to 230 family caregivers of homebound older patients. We used the Japanese version of the Zarit Burden Interview (J-ZBI) to measure caregiver burden. The cut-off score for the J-ZBI was 21 points. Caregivers with a care burden score below 21 points formed the mild group, while those scoring 21 points or more were included in the moderate/severe group. The differences between the groups were examined. The implementation status of oral care was assessed by the amount of time caregivers spent providing oral care and related concerns. The degree of independence for homebound older patients was measured using the Barthel Index. Multiple logistic regression analyses were conducted to determine the factors associated with the severity of caregiver burden. RESULTS: A total of 114 caregivers returned the questionnaires by mail (response rate: 49.6%). The moderate/severe care burden group represented 80.7% of the caregivers. A multiple logistic regression analysis revealed that the level of patient independence and time spent performing oral care were significantly associated with the severity of caregiver burden. CONCLUSIONS: The results show that family caregivers experiencing high caregiver burden spent less time providing oral care than caregivers who reported less caregiver burden. Thus, support for oral health management provided by oral health professionals is considered necessary for family with a high caregiver burden of homebound older patients.
• Oral frailty and gait performance in community-dwelling older adults: findings from the Takashimadaira study.

  Masanori Iwasaki, Yutaka Watanabe, Keiko Motokawa, Maki Shirobe, Hiroki Inagaki, Yoshiko Motohashi, Yurie Mikami, Yu Taniguchi, Yosuke Osuka, Satoshi Seino, Hunkyung Kim, Hisashi Kawai, Ryota Sakurai, Ayako Edahiro, Yuki Ohara, Hirohiko Hirano, Shoji Shinkai, Shuichi Awata

  Journal of prosthodontic research 65 (4) 467 - 473 2021/02/22 [Refereed]
   

  PURPOSE: This cross-sectional study compared gait performance between community-dwelling older adults with and without accumulated deficits in oral health, defined as oral frailty. METHODS: A total of 1,082 individuals (439 men and 643 women; mean age, 77.1 years) from the Takashimadaira study were included in the current analysis. Based on a multifaceted oral health assessment, oral frailty was defined as having three or more of the following six components: (i) fewer teeth, (ii) low masticatory performance, (iii) low articulatory oral motor skills, (iv) low tongue pressure, (v) difficulties in eating, and (vi) swallowing. Eight gait parameters were assessed using an electronic walkway. Gait characteristics comparison between groups with and without oral frailty was performed using multiple linear regression models. Models were adjusted for age, sex, educational status, income, smoking, drinking, physical activity level, height, body mass index, comorbidities, and the presence of chronic pain. RESULTS: Oral frailty was observed in 227 (21.0%) participants. After adjusting for potential confounders, the participants with oral frailty had slower gait speed, shorter stride and step length, wider step width, and longer double support duration as well as higher variability of stride length and step length. CONCLUSIONS: Oral frailty was associated with poor gait performance among community-dwelling older adults.
• Low Dietary Variety and Diabetes Mellitus Are Associated with Frailty among Community-Dwelling Older Japanese Adults: A Cross-Sectional Study.

  Misato Hayakawa, Keiko Motokawa, Yurie Mikami, Kaori Yamamoto, Maki Shirobe, Ayako Edahiro, Masanori Iwasaki, Yuki Ohara, Yutaka Watanabe, Hisashi Kawai, Motonaga Kojima, Shuichi Obuchi, Yoshinori Fujiwara, Hunkyung Kim, Kazushige Ihara, Hiroki Inagaki, Shoji Shinkai, Shuichi Awata, Atsushi Araki, Hirohiko Hirano

  Nutrients 13 (2) 2021/02/16 

  The association between dietary diversity and frailty remains unknown in older people. We evaluated whether a limited dietary variety is associated with frailty in older adults with diabetes mellitus (DM). This cross-sectional investigation included 1357 adults (median age: 77 years, women: 61.3%). DM was determined by self-reporting, the Dietary Variety Score (DVS) was used to evaluate dietary variety, and the revised Japanese version of the Cardiovascular Health Study criteria evaluated frailty. Participants were divided into 4 groups: no DM/high DVS (non-DMHV), no DM/low DVS (non-DMLV), DM/high DVS (DMHV), and DM/low DVS (DMLV). The prevalence of frailty in each group was 3.6%, 6.7%, 6.7%, and 12.2%. After adjusting for covariates, logistic regression analysis revealed the highest odds ratio (OR) of frailty in the DMLV (non-DMLV, OR = 2.18 (95% confidence interval (CI): 1.25-3.83); DMHV, OR = 1.87 (95% CI: 0.63-5.52); DML, OR = 5.03 (95% CI: 2.05-12.35)). Another logistic regression analysis revealed that a low DVS and DM were independently associated with frailty. Both a low dietary variety and DM were independently related to frailty in older people and the combination increased the prevalence of frailty. These findings suggest that high dietary variety could be important for the prevention of frailty in people with DM.
• Relationship between Mortality and Oral Function of Older People Requiring Long-Term Care in Rural Areas of Japan: A Four-Year Prospective Cohort Study.

  Shiho Morishita, Yuki Ohara, Masanori Iwasaki, Ayako Edahiro, Keiko Motokawa, Maki Shirobe, Junichi Furuya, Yutaka Watanabe, Takeo Suga, Yayoi Kanehisa, Akitugu Ohuchi, Hirohiko Hirano

  International journal of environmental research and public health 18 (4) 2021/02/10 

  Oral ingestion influences the life sustenance, quality of life, and dignity of older adults. Thus, it is an important issue in medical care and the welfare of older adults. The purpose of this four-year prospective cohort study was to investigate the relationship between mortality and oral function among older adults who required long-term care and were living in different settings in a rural area of Japan. This study included 289 participants aged 65 and older who required long-term care and lived in the former Omorimachi area in Yokote City, Akita Prefecture, located in northern Japan. Following the baseline survey, mortality data were collected over four years; 102 participants (35.3%) died during that time. A significant difference was noted in the overall survival rates between the groups with good and deterioration of oral function such as oral dryness, rinsing ability, swallowing function, and articulation, based on Log-rank test results. After adjusting for various potential confounders using Cox proportional-hazards regression, oral dryness (HR: 1.83, 95% confidence interval: 1.12-3.00) was significantly associated with mortality within four years. This study revealed that oral dryness influences the life prognosis of older adults who receive long-term care in different settings.
• Relationship between Chewing Ability and Nutritional Status in Japanese Older Adults: A Cross-Sectional Study.

  Keiko Motokawa, Yurie Mikami, Maki Shirobe, Ayako Edahiro, Yuki Ohara, Masanori Iwasaki, Yutaka Watanabe, Hisashi Kawai, Takeshi Kera, Shuichi Obuchi, Yoshinori Fujiwara, Kazushige Ihara, Hirohiko Hirano

  International journal of environmental research and public health 18 (3) 2021/01/29 

  OBJECTIVES: This study aimed to determine the relationship between objective chewing ability and the nutritional status of Japanese community-dwelling elders. DESIGN: A cross-sectional study. PARTICIPANTS: A total of 509 community-dwelling elders living in the Tokyo metropolitan area participated in a comprehensive survey conducted in October 2013. MEASUREMENTS: The basic characteristics were sex, age, and body mass index. Undernutrition was examined through serum albumin levels. Chewing ability was examined through color-changeable xylitol gum by evaluating the color changes in chewing gum. Nutritional intake was examined using the semi-quantitative food frequency questionnaire. RESULTS: In the poor chewing ability group, all nutrient intake levels were significantly low, except for carbohydrates, and intake levels for all food groups were significantly low, except for cereals, confectionery, sugars, seasonings, and spices. Additionally, after adjusting for covariates for sex, age, Tokyo Metropolitan Institute of Gerontology-Index of Competence (TMIG-IC) score, Mini-Mental State Examination (MMSE) score, body mass index (BMI), stroke, number of functional teeth, energy intake, and protein intake, chewing ability was found to be significantly associated with undernutrition. CONCLUSION: We concluded that chewing ability was closely associated with nutrient and different food groups' intake, as well as undernutrition, among Japanese community-dwelling elders. Thus, to ensure comprehensive nutritional management, nutritionists and dentists should collaborate when treating the same patients.
• Relationship between the rate of a decreased oral function and the nutrient intake in community-dwelling older persons: An examination using oral function-related items in a questionnaire for latter-stage elderly people

  Yoshihiro Kugimiya, Keiko Motokawa, Kaori Yamamoto, Misato Hayakawa, Yurie Mikami, Masanori Iwasaki, Yuki Ohara, Maki Shirobe, Ayako Edahiro, Yutaka Watanabe, Shuichi Obuchi, Hisashi Kawai, Takeshi Kera, Yoshinori Fujiwara, Kazushige Ihara, Hunkyung Kim, Hirohiko Hirano

  Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 58 (1) 91 - 100 0300-9173 2021/01/25
• A 5-year longitudinal association between dietary fermented soya bean (natto) intake and tooth loss through bone mineral density in postmenopausal women: The Yokogoshi cohort study.

  Masanori Iwasaki, Misuzu Sato, Akihiro Yoshihara, Toshiko Saito, Kaori Kitamura, Toshihiro Ansai, Kazutoshi Nakamura

  Gerodontology 38 (3) 267 - 275 2021/01/04 [Refereed]
   

  OBJECTIVE: In this 5-year cohort study, we aimed to determine whether the intake of natto, a fermented soya bean food product, has an indirect effect on tooth loss incidence through BMD changes among postmenopausal women. BACKGROUND: Evidence indicates (1) that natto has a beneficial effect on bone health and (2) that a decrease in bone mineral density (BMD) is associated with tooth loss. METHODS: The study recruited 435 postmenopausal women (average age = 64.2 years). Natto intake (exposure) was assessed at baseline using a food frequency questionnaire. Lumbar spine BMD and number of teeth were measured at baseline and 5-year follow-up. BMD change (mediator) and the number of teeth lost (outcome) over time were calculated. The mediation model consisted of these 3 variables. Mediation analysis was performed to test the indirect effect of the natto intake measured through BMD change on tooth loss. RESULTS: During the study, the mean number of teeth lost was 1.2 (standard deviation = 1.8), and the mean BMD decline was 2.5% (standard deviation = 7.1). After adjusting for potential confounders, increasing habitual natto intake was significantly indirectly associated with a lower incidence of tooth loss mediated by BMD change (incidence rate ratio of tooth loss among women with "≥1 pack/day" natto intake was 0.90 [95% confidence interval = 0.82-0.99] compared to those with natto consumption of "rarely"). CONCLUSIONS: Dietary natto intake is significantly indirectly associated with a lower incidence of tooth loss among postmenopausal women, and systemic bone density could be a mediator of this association.
• Nutritional status and body composition in cognitively impaired older persons living alone: The Takashimadaira study.

  Masanori Iwasaki, Keiko Motokawa, Yutaka Watanabe, Misato Hayakawa, Yurie Mikami, Maki Shirobe, Hiroki Inagaki, Ayako Edahiro, Yuki Ohara, Hirohiko Hirano, Shoji Shinkai, Shuichi Awata

  PloS one 16 (11) e0260412  2021 

  OBJECTIVES: To investigate nutritional status and body composition in cognitively impaired older persons living alone. METHODS: This cross-sectional study included 1051 older adults (633 women and 418 men, mean age: 77.1 years) from the Takashimadaira study. The study participants were categorized according to whether they lived alone, which was confirmed via questionnaire, and had cognitive impairment, which was defined as having a Mini Mental State Examination-Japanese score ≤23. Nutritional status was evaluated using the serum albumin level. The fat-free mass index (FFMI) was calculated based on anthropometric and body composition measurements. A logistic regression model with the outcome of a low serum albumin level (serum albumin <4 g/dL) and low FFMI (<16 kg/m2 in men and <14 kg/m2 in women) were used to analyze the data. RESULTS: The percentages of participants in the living alone (-)/cognitive impairment (-) group, the living alone (+)/cognitive impairment (-) group, the living alone (-)/cognitive impairment (+) group, and the living alone (+)/cognitive impairment (+) group were 54.8%, 37.3%, 5.6%, and 2.3%, respectively. Compared to the living alone (-)/cognitive impairment (-) group, the living alone (+)/cognitive impairment (+) group was more likely to have a low serum albumin level (adjusted odds ratio = 3.10, 95% confidence interval = 1.31 to 7.33) and low FFMI (adjusted odds ratio = 2.79, 95% confidence interval = 1.10 to 7.06) after adjusting for potential confounders. CONCLUSION: Cognitively impaired older adults living alone had poorer nutrition than cognitively normal and cohabitating persons in this study. Our results highlight the importance of paying extra attention to nutritional status for this group of community-dwelling older adults.
• Evaluation of the ability of the trypsin-like peptidase activity assay to detect severe periodontitis.

  Masanori Iwasaki, Michihiko Usui, Wataru Ariyoshi, Keisuke Nakashima, Yoshie Nagai-Yoshioka, Maki Inoue, Kaoru Kobayashi, Tatsuji Nishihara

  PloS one 16 (8) e0256538  2021 

  OBJECTIVES: N-benzoyl-DL-arginine peptidase (trypsin-like peptidase) is specifically produced by certain strains of periodontitis-associated bacteria. We aimed to examine the effectiveness of an objectively quantified trypsin-like peptidase activity assay (TLP-AA) for detecting severe periodontitis. METHODS: The study population included 347 adults (108 men and 239 women; average age, 43.3 years) who underwent a full-mouth periodontal examination. Specimens for the TLP-AA were obtained using tongue swabs. Using a color reader, the TLP-AA results were obtained as a* values, with higher positive a* values indicating an increased intense enzymatic activity. The predictive validity of the TLP-AA results for severe periodontitis was assessed using receiver operating characteristic curve analysis and the periodontitis case definition provided by the Centers for Disease Control and Prevention/American Academy of Periodontology as the gold standard. Furthermore, multivariable logistic regression analyses were performed to predict severe periodontitis using the TLP-AA results and health characteristics, as the exposure variables. RESULTS: Severe periodontitis was observed in 5.2% of the participants. TLP-AA had high diagnostic accuracy for severe periodontitis, with an area under the curve of 0.83 (95% confidence interval [CI]: 0.75-0.92). The cut-off score for the a* value that best differentiated individuals with severe periodontitis was 0.09, with a sensitivity of 83% and specificity of 77%. Multivariable logistic regression analyses revealed that the TLP-AA results were significantly associated with severe periodontitis after adjusting for health characteristics (adjusted odds ratios: 1.90 [95% CI: 1.37-2.62] for the a* value). CONCLUSIONS: Objectively quantified TLP-AA results are potentially useful for detecting severe periodontitis in epidemiological surveillance.
• 地域在住高齢者における口腔機能低下の有訴者率と栄養素等摂取量の関連 後期高齢者の質問票を構成する口腔機能関連項目を用いた検討

  釘宮 嘉浩, 本川 佳子, 山本 かおり, 早川 美知, 三上 友里江, 岩崎 正則, 小原 由紀, 白部 麻樹, 枝広 あや子, 渡邊 裕, 大渕 修一, 河合 恒, 解良 武士, 藤原 佳典, 井原 一成, 金 憲経, 平野 浩彦

  日本老年医学会雑誌 (一社)日本老年医学会 58 (1) 91 - 100 0300-9173 2021/01 

  目的:本研究の目的は,後期高齢者の質問票の口腔機能類型質問に採用された基本チェックリストの質問項目で地域在住高齢者の口腔機能を評価した場合の該当者率と,該当者の栄養素等摂取量を明らかとすることである.方法:本研究は,地域在住高齢者511名(男性217名,女性294名,平均年齢73.1±5.6歳)を対象とした.対象者の口腔機能は,後期高齢者の質問票の口腔機能類型質問であるNo.4とNo.5の基となった基本チェックリストのNo.13とNo.14を用いて評価した.No.4に採用されたNo.13は咀嚼機能を,No.5に採用されたNo.14は嚥下機能を評価する質問である.これらの質問項目のうち,どちらか一方でも該当した者を口腔機能が低下している群(該当群),該当しない群を非該当群と定義した.また,栄養素等摂取量の評価には,食物摂取頻度調査票を用いた聞き取り調査を行った.結果:該当群の該当者率は,全体で32.9%,前期高齢者で28.2%,後期高齢者で40.1%だった.該当群と非該当群の該当者率は,男女間で有意差を認めなかった.後期高齢者では,該当群の総エネルギー,たんぱく質エネルギー比,たんぱく質,パントテン酸,葉酸,ビタミンB6,ナイアシン,ビタミンK,銅,亜鉛,リン,マグネシウム,カリウム,食物繊維総量の摂取量が,非該当群と比較して有意に少なかった.結論:後期高齢者の質問票の口腔機能類型質問に採用された基本チェックリストの質問項目で高齢者の口腔機能を評価したところ,前期高齢者に比べ後期高齢者で口腔機能に不具合を訴える者の割合が高かった.また,口腔機能に不具合を訴える後期高齢者では,複数の栄養摂取量が少ない傾向が示された.口腔機能の低下を示した者に対しては,低下している口腔機能に限定した対応をするのではなく,食事摂取状態も合わせて評価し,適切な栄養指導を行うことが重要であると考えられた.(著者抄録)
• Dentition status and 10-year higher-level functional capacity trajectories in older adults.

  Masanori Iwasaki, Akihiro Yoshihara

  Geriatrics & gerontology international 21 (1) 48 - 53 2021/01 [Refereed]
   

  AIM: The effect of dentition status on higher-level functional capacity patterns over time remains unclear. We aimed to identify distinct higher-level functional capacity trajectories in individuals aged 70-80 years, and examine whether dentition status at 70 years predicted the trajectory. METHODS: The study included 551 community-dwelling adults aged 70 years at baseline. Higher-level functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) up to the age of 80 years. A higher TMIG-IC score indicated a higher level of competence. Group-based trajectory modeling was used to identify distinct TMIG-IC trajectories. The number of teeth, use of dentures, sex and education were added as baseline group membership predictors. Dental visits, health behaviors, body mass index and comorbidities during observation were added as time-varying covariates. RESULTS: Three TMIG-IC trajectories were identified: "high/stable" (65.3%), "middle/decline" (24.5%) and "low/decline" (10.2%). A lower number of teeth and non-denture use were associated with increased odds of a low/decline trajectory relative to a high/stable trajectory (odds ratio 1.09, 95% confidence interval 1.04-1.14 [per one decrease] and odds ratio 3.96, 95% confidence interval 1.54-10.16, respectively). CONCLUSIONS: Older adults with fewer teeth and those without dentures at the age of 70 years were more likely to follow a trajectory toward functional decline with low baseline TMIG-IC scores, which further declines by the age of 80 years. These findings suggest that preserving natural teeth later in life, as well as using dentures, could contribute toward maintaining a higher-level functional competence. Geriatr Gerontol Int 2021; 21: 48-53.
• A Two-Year Longitudinal Study of the Association between Oral Frailty and Deteriorating Nutritional Status among Community-Dwelling Older Adults.

  Masanori Iwasaki, Keiko Motokawa, Yutaka Watanabe, Maki Shirobe, Hiroki Inagaki, Ayako Edahiro, Yuki Ohara, Hirohiko Hirano, Shoji Shinkai, Shuichi Awata

  International journal of environmental research and public health 18 (1) 2020/12/30 [Refereed]
   

  BACKGROUND: Limited longitudinal studies exist to evaluate whether poor oral health and functions affect the incidence of deteriorating nutritional status. We investigated if there were longitudinal associations between oral frailty, defined as accumulated deficits in oral health, and deteriorating nutritional status among community-dwelling older adults. METHODS: The study population consisted of 191 men and 275 women (mean age, 76.4 years) from the Takashimadaira Study. Multifaced oral health assessment was performed at baseline, and oral frailty was defined as having ≥3 of the following six components: fewer teeth, low masticatory performance, low articulatory oral motor skill, low tongue pressure, and difficulties in chewing and swallowing. Nutritional status assessment was performed at baseline and two-year follow-up using the Mini Nutritional Assessment®-Short Form (MNA®-SF). Deteriorating nutritional status was defined as a decline in the nutritional status categories based on the MNA®-SF score during the study period. The association between oral frailty and deteriorating nutritional status was assessed using logistic regression analyses. RESULTS: Oral frailty was observed in 67 (14.4%) participants at baseline. During the study, 58 (12.4%) participants exhibited deteriorating nutritional status. After adjusting for potential confounders, oral frailty was significantly associated with deteriorating nutritional status (adjusted odds ratio, 2.24; 95% confidence interval, 1.08-4.63). CONCLUSION: Community-dwelling older adults with oral frailty had an increased risk of deteriorating nutritional status.
• [Assessment of participation and its associated lifestyle factors in the 2016 National Survey of Dental Diseases: an analysis through record linkage with National Health and Nutrition Survey].

  Yuichi Ando, Nayu Ikeda, Nobuo Nishi, Rumi Tano, Masanori Iwasaki, Hiroko Miura

  [Nihon koshu eisei zasshi] Japanese journal of public health 2020/12/19
• Association between anorexia and hyposalivation in community-dwelling older adults in Japan: a 6-year longitudinal study.

  Yuki Ohara, Hisashi Kawai, Maki Shirobe, Keiko Motokawa, Yoshinori Fujiwara, Hunkyung Kim, Kazushige Ihara, Shuichi Obuchi, Ayako Edahiro, Masanori Iwasaki, Yutaka Watanabe, Hirohiko Hirano

  BMC geriatrics 20 (1) 504 - 504 2020/11/25 

  BACKGROUND: Hyposalivation is associated with the nutritional status. Anorexia of ageing, defined as an age-related decrease in appetite and food intake, presents even in healthy adults and is considered an independent predictor of malnutrition, frailty, and mortality. However, the relationship between anorexia and hyposalivation of ageing is unclear. Thus, the present longitudinal study aimed to investigate the incidence of hyposalivation and its relationship with anorexia in community-dwelling older people in Japan. METHODS: The study population comprised 220 individuals (80 men and 140 women) aged 65-86 years at baseline. The participants underwent comprehensive health check-ups, including dental examinations and anthropometry, and face-to-face interviews in 2013 and 2019. Hyposalivation was determined on the basis of the unstimulated salivary flow rate measured using the modified cotton roll method. Anorexia was defined as a score of ≤29 in the Japanese version of the Council on Nutrition Appetite Questionnaire. Logistic regression analyses were used to test whether the presence of anorexia at baseline was an independent predictor of hyposalivation. RESULTS: Hyposalivation developed at a rate of 19.5% during the 6-year observation period. Anorexia was observed in 95 (43.2%) participants at baseline. After adjusting for potential confounding factors, anorexia (adjusted odds ratio [AOR], 2.65; 95% confidence interval [CI], 1.26-5.57) and polypharmacy (AOR, 3.29; CI, 1.06-10.19) were significant predictors of hyposalivation. CONCLUSION: Loss of appetite is independently correlated with and a risk factor for hyposalivation in older adults. Anorexia of ageing may have negative effects on the salivary flow rate in such settings. Salivation should be a standard feature in clinical assessments of the older adults.
• 地域在住高齢者における歯周疾患リスクとフレイルの関連 2年間の縦断研究

  松原 ちあき, 白部 麻樹, 岩崎 正則, 小原 由紀, 枝広 あや子, 本川 佳子, 稲垣 宏樹, 渡邊 裕, 平野 浩彦, 古屋 純一, 水口 俊介, 新開 省二, 粟田 主一

  日本サルコペニア・フレイル学会雑誌 (一社)日本サルコペニア・フレイル学会 4 (Suppl.) 177 - 177 2433-1805 2020/11
• A Preliminary Study on the Ability of the Trypsin-Like Peptidase Activity Assay Kit to Detect Periodontitis.

  Masanori Iwasaki, Michihiko Usui, Wataru Ariyoshi, Keisuke Nakashima, Yoshie Nagai-Yoshioka, Maki Inoue, Tatsuji Nishihara

  Dentistry journal 8 (3) 2020/09/01 

  This study aimed to explore whether the Trypsin-Like Peptidase Activity Assay Kit (TLP-AA-Kit), which measures the activity of N-benzoyl-dl-arginine peptidase (trypsin-like peptidase), can be used as a reliable tool for periodontitis detection in population-based surveillance. In total, 105 individuals underwent a full-mouth periodontal examination and provided tongue swabs as specimens for further analyses. The results of the TLP-AA-Kit were scored between 1 and 5; higher scores indicated higher trypsin concentrations. Receiver operating characteristic analyses were used to evaluate the predictive validity of the TLP-AA-Kit, where the periodontitis case definition provided by the Centers for Disease Control/American Academy of Periodontology served as the reference. Severe and moderate periodontitis were identified in 4.8% and 16.2% of the study population, respectively. The TLP-AA-Kit showed high diagnostic accuracy for severe periodontitis, with an area under the curve of 0.93 (95% confidence interval = 0.88-0.99). However, the diagnostic accuracy of the TLP-AA-Kit for moderate/severe periodontitis was not reliable. While further studies are necessary to validate our results, the results provided herein highlight the potential of the TLP-AA-Kit as a useful tool for the detection of periodontitis, particularly in severe cases, for population-based surveillance.
• 認知症重症度別の口腔衛生管理に関わる拒否等の症状の実態把握

  白部 麻樹, 枝広 あや子, 小原 由紀, 森下 志穂, 本川 佳子, 本橋 佳子, 五十嵐 憲太郎, 岩崎 正則, 渡邊 裕, 平野 浩彦

  日本歯科衛生学会雑誌 日本歯科衛生学会 15 (1) 96 - 96 1884-5193 2020/08
• 地域在住高齢者は人工的水分・栄養方法についてのアドバンス・ケア・プランニング(ACP)を望んでいるか?

  和田 泰三, 竜野 真維, 藤澤 道子, 木村 友美, 岩崎 正則, 石本 恭子, 加藤 恵美子, 平山 貴一, 松林 公蔵, 坂本 龍太

  日本老年医学会雑誌 (一社)日本老年医学会 57 (Suppl.) 72 - 72 0300-9173 2020/07
• 地域在住高齢者の高次ADL低下とフレイルとの関連

  木村 友美, 石本 恭子, 岩崎 正則, 坂本 龍太, 笠原 順子, 藤澤 道子, 加藤 恵美子, 竜野 真維, 和田 泰三, 松林 公蔵

  日本老年医学会雑誌 (一社)日本老年医学会 57 (Suppl.) 83 - 83 0300-9173 2020/07
• 地域在住後期高齢者における残存歯数と転倒の関連

  渡辺 真光, 濃野 要, 星野 剛志, 田村 浩平, 角田 聡子, 岩崎 正則, 石本 恭子, 木村 友美, 坂本 龍太, 小川 祐司

  日本老年医学会雑誌 (一社)日本老年医学会 57 (Suppl.) 134 - 134 0300-9173 2020/07
• The relationship between masticatory performance and intakes of foods and nutrients in Japanese male workers: A cross-sectional study.

  Fuyoko Kawashima Bori, Masayo Fukuhara, Chihiro Masaki, Yuko Ohta, Ikuo Nakamichi, Satoko Sakata, Kenichi Goto, Shota Kataoka, Satoko Kakuta, Masanori Iwasaki, Toshihiro Ansai, Ryuji Hosokawa

  Journal of oral rehabilitation 47 (9) 1142 - 1149 2020/06/29 [Refereed][Not invited]
   

  BACKGROUND: Although many studies have been conducted on the relationship between masticatory performance and nutrient ingestion in the elderly, few large-scale studies have been carried out using relatively young individuals. OBJECTIVES: The objective of this study was to clarify the association between the masticatory performance evaluated by the gummy-jelly test, not by visual examination, and nutrient ingestion state based on the brief self-administered diet history questionnaire (BDHQ). METHODS: This was a cross-sectional survey of 540 male workers. Somatometry, blood pressure measurement, blood test and medical interview were performed as a periodic health check-up. In the dental check-up, an oral examination, gummy-jelly test (glucosensor) and survey of ingested food and nutrients using BDHQ were performed. The participants were classified into two groups with low and normal values of masticatory performance. Participants with a score on the gummy-jelly test below 150 mg/dL or 150 mg/dL or higher were included in the low and normal groups, respectively. RESULTS: Two hundred and forty-eight participants (45.8%) had low masticatory performance, and 292 (53.2%) had normal masticatory performance. The intakes of some minerals and vitamins, such as calcium, vitamin D, vitamin B2 , small fish with bones and non-oily fish, were significantly lower in the low masticatory group than in the normal group. In contrast, the intake of sugar for coffee and tea and that of chicken were significantly higher in the low masticatory group than in the normal group. CONCLUSION: This study suggested that low masticatory performance can affect nutrient intake, which may cause non-communicable diseases.
• Repositioning of the global epicentre of non-optimal cholesterol.

  NCD Risk Factor Collaboration, NCD-RisC

  Nature 582 (7810) 73 - 77 2020/06 [Refereed][Not invited]
   

  High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular risk-changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.
• バス運転手を対象とした咀嚼機能と栄養摂取に関する横断研究

  川島 芙蓉子, 正木 千尋, 福原 正代, 角田 聡子, 片岡 正太, 岩崎 正則, 安細 敏弘, 細川 隆司

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 70 (2) 106 - 107 0023-2831 2020/04
• 高校生におけるインターネット依存度と永久歯う蝕との関連

  佐藤 美寿々, 皆川 久美子, 宮本 茜, 岩崎 正則

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 70 (増刊) 112 - 112 0023-2831 2020/03
• Combined effect of poor appetite and low masticatory function on sarcopenia in community-dwelling Japanese adults aged ≥ 75 years: A 3-year cohort study.

  Soichiro Senoo, Masanori Iwasaki, Yumi Kimura, Satoko Kakuta, Chihiro Masaki, Taizo Wada, Ryota Sakamoto, Yasuko Ishimoto, Michiko Fujisawa, Kiyohito Okumiya, Toshihiro Ansai, Kozo Matsubayashi, Ryuji Hosokawa

  Journal of oral rehabilitation 47 (5) 643 - 650 2020/02/19 [Refereed][Not invited]
   

  OBJECTIVE: This study aimed to investigate the longitudinal association of the combination of poor appetite (PA) and low masticatory function (LMF) with sarcopenia in community-dwelling older adults. METHODS: In total, 173 community-dwelling Japanese adults aged ≥ 75 years participated in the 3-year cohort study. Appetite assessment using the Simplified Nutritional Appetite Questionnaire (SNAQ) and masticatory function assessment using spectrophotometric measurement of differences in gum colour before and after masticating colour-changeable chewing gum (ΔE*ab) were performed at baseline. SNAQ score of ≤ 14 was defined as PA. The lowest tertile of ΔE*ab was defined as LMF. Follow-up examinations were administered annually over a 3-year period to determine sarcopenia incidence, which was defined by the criteria proposed by the Asian Working Group for Sarcopenia. Adjusted hazard ratios (HRs) of sarcopenia incidence according to the presence of PA and LMF were calculated using Cox proportional hazards regression models. RESULTS: At baseline, 81 participants (46.8%) had neither PA nor LMF, 34 (19.7%) had PA alone, 35 (20.2%) had LMF alone, and 23 (13.3%) had both PA and LMF. On follow-up, 31 participants (17.9%) developed sarcopenia. After adjusting for covariates, the adjusted HR for sarcopenia in participants with both PA and LMF was 4.4 (95% confidence interval = 1.6-12.2) compared with those without PA or LMF. PA or LMF alone was not significantly associated with sarcopenia development. CONCLUSIONS: Coexisting PA and LMF increase the risk of sarcopenia development among community-dwelling Japanese adults aged ≥ 75 years.
• National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: a pooled analysis of 458 population-based studies in Asian and Western countries

  NCD Risk Factor Collaboration, NCD-RisC

  International Journal of Epidemiology 49 (1) 173 - 192 0300-5771 2020/02/01 [Refereed][Not invited]
   

  Although high-density lipoprotein (HDL) and non-HDL cholesterol have opposite associations with coronary heart disease, multi-country reports of lipid trends only use total cholesterol (TC). Our aim was to compare trends in total, HDL and non-HDL cholesterol and the total-to-HDL cholesterol ratio in Asian and Western countries. We pooled 458 population-based studies with 82.1 million participants in 23 Asian and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol and mean total-to-HDL cholesterol ratio by country, sex and age group. Since ∼1980, mean TC increased in Asian countries. In Japan and South Korea, the TC rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western countries, except in Polish men. The decline was largest in Finland and Norway, at ∼0.4 mmol/L per decade. The decline in TC in most Western countries was the net effect of an increase in HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan, South Korea and most Western countries, by as much as ∼0.7 per decade in Swiss men (equivalent to ∼26% decline in coronary heart disease risk per decade). The ratio increased in China. HDL cholesterol has risen and the total-to-HDL cholesterol ratio has declined in many Western countries, Japan and South Korea, with only a weak correlation with changes in TC or non-HDL cholesterol.
• Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

  Andrea Rodriguez-Martinez, Bin Zhou, Marisa K Sophiea, James Bentham, Christopher J Paciorek, Maria LC Iurilli, Rodrigo M Carrillo-Larco, James E Bennett, Mariachiara Di Cesare, Cristina Taddei, Honor Bixby, Gretchen A Stevens, Leanne M Riley, Melanie J Cowan, Stefan Savin, Goodarz Danaei, Adela Chirita-Emandi, Andre P Kengne, Young-Ho Khang, Avula Laxmaiah, Reza Malekzadeh, J Jaime Miranda, Jin Soo Moon, Stevo R Popovic, Thorkild IA Sørensen, Maroje Soric, Gregor Starc, Ahmad A Zainuddin, Edward W Gregg, Zulfiqar A Bhutta, Robert Black, Leandra Abarca-Gómez, Ziad A Abdeen, Shynar Abdrakhmanova, Suhaila Abdul Ghaffar, Hanan F Abdul Rahim, Niveen M Abu-Rmeileh, Jamila Abubakar Garba, Benjamin Acosta-Cazares, Robert J Adams, Wichai Aekplakorn, Kaosar Afsana, Shoaib Afzal, Imelda A Agdeppa, Javad Aghazadeh-Attari, Carlos A Aguilar-Salinas, Charles Agyemang, Mohamad Hasnan Ahmad, Noor Ani Ahmad, Ali Ahmadi, Naser Ahmadi, Soheir H Ahmed, Wolfgang Ahrens, Gulmira Aitmurzaeva, Kamel Ajlouni, Hazzaa M Al-Hazzaa, Amani Rashed Al-Othman, Rajaa Al-Raddadi, Monira Alarouj, Fadia AlBuhairan, Shahla AlDhukair, Mohamed M Ali, Abdullah Alkandari, Ala'a Alkerwi, Kristine Allin, Mar Alvarez-Pedrerol, Eman Aly, Deepak N Amarapurkar, Parisa Amiri, Norbert Amougou, Philippe Amouyel, Lars Bo Andersen, Sigmund A Anderssen, Lars Ängquist, Ranjit Mohan Anjana, Alireza Ansari-Moghaddam, Hajer Aounallah-Skhiri, Joana Araújo, Inger Ariansen, Tahir Aris, Raphael E Arku, Nimmathota Arlappa, Krishna K Aryal, Thor Aspelund, Felix K Assah, Maria Cecília F Assunção, May Soe Aung, Juha Auvinen, Mária Avdicová, Ana Azevedo, Mohsen Azimi-Nezhad, Fereidoun Azizi, Mehrdad Azmin, Bontha V Babu, Maja Bæksgaard Jørgensen, Azli Baharudin, Suhad Bahijri, Jennifer L Baker, Nagalla Balakrishna, Mohamed Bamoshmoosh, Maciej Banach, Piotr Bandosz, José R Banegas, Joanna Baran, Carlo M Barbagallo, Alberto Barceló, Amina Barkat, Aluisio JD Barros, Mauro Virgílio Gomes Barros, Abdul Basit, Joao Luiz D Bastos, Iqbal Bata, Anwar M Batieha, Rosangela L Batista, Zhamilya Battakova, Assembekov Batyrbek, Louise A Baur, Robert Beaglehole, Silvia Bel-Serrat, Antonisamy Belavendra, Habiba Ben Romdhane, Judith Benedics, Mikhail Benet, James E Bennett, Salim Berkinbayev, Antonio Bernabe-Ortiz, Gailute Bernotiene, Heloísa Bettiol, Jorge Bezerra, Aroor Bhagyalaxmi, Sumit Bharadwaj, Santosh K Bhargava, Zulfiqar A Bhutta, Hongsheng Bi, Yufang Bi, Daniel Bia, Elysée Claude Bika Lele, Mukharram M Bikbov, Bihungum Bista, Dusko J Bjelica, Peter Bjerregaard, Espen Bjertness, Marius B Bjertness, Cecilia Björkelund, Katia V Bloch, Anneke Blokstra, Simona Bo, Martin Bobak, Lynne M Boddy, Bernhard O Boehm, Heiner Boeing, Jose G Boggia, Elena Bogova, Carlos P Boissonnet, Stig E Bojesen, Marialaura Bonaccio, Vanina Bongard, Alice Bonilla-Vargas, Matthias Bopp, Herman Borghs, Pascal Bovet, Lien Braeckevelt, Lutgart Braeckman, Marjolijn CE Bragt, Imperia Brajkovich, Francesco Branca, Juergen Breckenkamp, João Breda, Hermann Brenner, Lizzy M Brewster, Garry R Brian, Lacramioara Brinduse, Sinead Brophy, Graziella Bruno, H Bas Bueno-de-Mesquita, Anna Bugge, Marta Buoncristiano, Genc Burazeri, Con Burns, Antonio Cabrera de León, Joseph Cacciottolo, Hui Cai, Tilema Cama, Christine Cameron, José Camolas, Günay Can, Ana Paula C Cândido, Felicia Cañete, Mario V Capanzana, Nadežda Capková, Eduardo Capuano, Vincenzo Capuano, Marloes Cardol, Viviane C Cardoso, Axel C Carlsson, Esteban Carmuega, Joana Carvalho, José A Casajús, Felipe F Casanueva, Ertugrul Celikcan, Laura Censi, Marvin Cervantes-Loaiza, Juraci A Cesar, Snehalatha Chamukuttan, Angelique W Chan, Queenie Chan, Himanshu K Chaturvedi, Nish Chaturvedi, Norsyamlina Che Abdul Rahim, Chien-Jen Chen, Fangfang Chen, Huashuai Chen, Shuohua Chen, Zhengming Chen, Ching-Yu Cheng, Bahman Cheraghian, Angela Chetrit, Ekaterina Chikova-Iscener, Arnaud Chiolero, Shu-Ti Chiou, Adela Chirita-Emandi, María-Dolores Chirlaque, Belong Cho, Kaare Christensen, 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Frank Tanser, Yong Tao, Mohammed Rasoul Tarawneh, Jakob Tarp, Carolina B Tarqui-Mamani, Radka Taxová Braunerová, Anne Taylor, Julie Taylor, Félicité Tchibindat, William R Tebar, Grethe S Tell, Tania Tello, KR Thankappan, Holger Theobald, Xenophon Theodoridis, Lutgarde Thijs, Nihal Thomas, Betina H Thuesen, Lubica Tichá, Erik J Timmermans, Anne Tjonneland, Hanna K Tolonen, Janne S Tolstrup, Murat Topbas, Roman Topór-Madry, Liv Elin Torheim, María José Tormo, Michael J Tornaritis, Maties Torrent, Laura Torres-Collado, Stefania Toselli, Pierre Traissac, Thi Tuyet-Hanh Tran, Dimitrios Trichopoulos, Antonia Trichopoulou, Oanh TH Trinh, Atul Trivedi, Lechaba Tshepo, Maria Tsigga, Shoichiro Tsugane, Azaliia M Tuliakova, Marshall K Tulloch-Reid, Fikru Tullu, Tomi-Pekka Tuomainen, Jaakko Tuomilehto, Maria L Turley, Per Tynelius, Themistoklis Tzotzas, Christophe Tzourio, Peter Ueda, Eunice Ugel, Flora AM Ukoli, Hanno Ulmer, Belgin Unal, Zhamyila Usupova, Hannu MT Uusitalo, Nalan Uysal, Justina Vaitkeviciute, Gonzalo Valdivia, Susana Vale, Damaskini Valvi, Rob M van Dam, Johan Van der Heyden, Yvonne T van der Schouw, Koen Van Herck, Hoang Van Minh, Irene GM van Valkengoed, Dirk Vanderschueren, Diego Vanuzzo, Anette Varbo, Gregorio Varela-Moreiras, Patricia Varona-Pérez, Senthil K Vasan, Tomas Vega, Toomas Veidebaum, Gustavo Velasquez-Melendez, Biruta Velika, Giovanni Veronesi, WM Monique Verschuren, Cesar G Victora, Giovanni Viegi, Lucie Viet, Salvador Villalpando, Paolo Vineis, Jesus Vioque, Jyrki K Virtanen, Marjolein Visser, Sophie Visvikis-Siest, Bharathi Viswanathan, Mihaela Vladulescu, Tiina Vlasoff, Dorja Vocanec, Henry Völzke, Ari Voutilainen, Sari Voutilainen, Martine Vrijheid, Tanja GM Vrijkotte, Alisha N Wade, Aline Wagner, Thomas Waldhör, Janette Walton, Elvis OA Wambiya, Wan Mohamad Wan Bebakar, Wan Nazaimoon Wan Mohamud, Rildo de Souza Wanderley Júnior, Ming-Dong Wang, Ningli Wang, Qian Wang, Xiangjun Wang, Ya Xing Wang, Ying-Wei Wang, S Goya Wannamethee, Nicholas Wareham, Adelheid Weber, Niels Wedderkopp, Deepa Weerasekera, Daniel Weghuber, Wenbin Wei, Aneta Weres, Bo Werner, Peter H Whincup, Kurt Widhalm, Indah S Widyahening, Andrzej Wiecek, Rainford J Wilks, Johann Willeit, Peter Willeit, Julianne Williams, Tom Wilsgaard, Bogdan Wojtyniak, Roy A Wong-McClure, Andrew Wong, Jyh Eiin Wong, Tien Yin Wong, Jean Woo, Mark Woodward, Frederick C Wu, Jianfeng Wu, Li Juan Wu, Shouling Wu, Haiquan Xu, Liang Xu, Nor Azwany Yaacob, Uruwan Yamborisut, Weili Yan, Ling Yang, Xiaoguang Yang, Yang Yang, Nazan Yardim, Mehdi Yaseri, Tabara Yasuharu, Xingwang Ye, Panayiotis K Yiallouros, Moein Yoosefi, Akihiro Yoshihara, Qi Sheng You, San-Lin You, Novie O Younger-Coleman, Safiah Md Yusof, Ahmad Faudzi Yusoff, Luciana Zaccagni, Vassilis Zafiropulos, Ahmad A Zainuddin, Seyed Rasoul Zakavi, Farhad Zamani, Sabina Zambon, Antonis Zampelas, Hana Zamrazilová, Maria Elisa Zapata, Abdul Hamid Zargar, Ko Ko Zaw, Tomasz Zdrojewski, Tajana Zeljkovic Vrkic, Yi Zeng, Luxia Zhang, Zhen-Yu Zhang, Dong Zhao, Ming-Hui Zhao, Wenhua Zhao, Shiqi Zhen, Wei Zheng, Yingfeng Zheng, Bekbolat Zholdin, Maigeng Zhou, Dan Zhu, Yanina Zocalo, Julio Zuñiga Cisneros, Monika Zuziak, Majid Ezzati

  The Lancet 396 (10261) 1511 - 1524 0140-6736 2020 [Refereed][Not invited]
  
• 学童期における唾液中乳酸脱水素酵素とストレスの関連について

  田村 浩平, 葭原 明弘, 諏訪間 加奈, 角田 聡子, 岩崎 正則, 安細 敏弘, 小川 祐司

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 70 (1) 47 - 48 0023-2831 2020/01 [Refereed][Not invited]
  
• Associations between periodontal health/treatment and cognitive impairment: Latest evidence from epidemiological studies

  Misuzu Sato, Masanori Iwasaki, Kumiko Minagawa, Akane Miyamoto

  Current Oral Health Reports 2020 [Refereed][Invited]
  
• 日本とドイツにおける口腔健康とその費用効率性に関する比較(A Comparison of Oral Health in Japan and Germany and Its Cost Efficiency)

  Kocher Thomas, Iwasaki Masanori, Yoshihara Akihiro, Hoshino Takashi

  老年歯科医学 34 (3) 342 - 353 0914-3866 2019/12 

  日本とドイツには共に診療報酬制の法定健康保険制度があり、しかも口腔健康に関する代表的な調査研究が存在している。ドイツの代表的研究であるDeutsche Mundgesundheitsstudie(DMS III、DMS IV、DMS V研究)と日本の厚生労働省による歯科疾患実態調査のデータを利用し、両国の一般集団にみられる口腔健康と歯科健康保険制度のパフォーマンスを比較した。1997年におけるドイツ人の成人集団(35〜44歳)の平均歯数は25.3本、2014年では27.2本であった。日本の1999年の成人集団では27.2本、2016年では28.3本であった。高齢集団(65〜74歳)に関しては、上記と同じ2時点においてドイツ人の場合には平均歯数は10.1本と15.5本、日本人の場合には14.7本と22.7本であり、両国において歯数は増加していた。上記のように両国間の比較では成人集団、高齢集団のいずれの場合でも日本人の残存歯数の方が多かった。ドイツ人1人当たりの歯科診療医療費は上記と同じ2時点において216ユーロと302ユーロ、日本人では178ユーロと195ユーロであった。残存歯数の観点から総合的に判断するとドイツよりも日本の方が歯科医療費資源を効率的に利用していると考えられた。
• A Comparison of Oral Health in Japan and Germany and Its Cost Efficiency

  Kocher Thomas, Iwasaki Masanori, Yoshihara Akihiro, Hoshino Takashi

  老年歯科医学 34 (3) 342 - 353 0914-3866 2019/12 [Refereed][Not invited]
  
• Association between anorexia and poor chewing ability among community-dwelling older adults in Japan.

  Yumi Kimura, Masanori Iwasaki, Yasuko Ishimoto, Kwanchit Sasiwongsaroj, Ryota Sakamoto, Taizo Wada, Michiko Fujisawa, Kiyohito Okumiya, Hideo Miyazaki, Kozo Matsubayashi

  Geriatrics & gerontology international 19 (12) 1290 - 1292 2019/12 [Refereed][Not invited]
  
• Predicting gingivitis using visual gingival redness examination on 11 years old Japanese schoolchildren: A ROC analysis

  Lisdrianto Hanindriyo, Akihiro Yoshihara, Hiro-O Ito, Kana Suwama, Satoko Kakuta, Makoto Fukui, Masanori Iwasaki, Naofumi Tamaki, Toshihiro Ansai

  PEDIATRIC DENTAL JOURNAL 29 (2) 66 - 71 0917-2394 2019/08 [Refereed][Not invited]
   

  Aims: To identify more reliable and cost-effective methods to detect gingivitis, such as visual examinations, questionnaires, and salivary occult blood tests (SOBT).Methods: Sixty-five elementary school students in Yahiko Village, Niigata, Japan were recruited. Questionnaire was used to assess subjective gingival status. Hemoglobin (Hb) and lactate dehydrogenase (LDH) levels were measured by SOBT. Bleeding on marginal probing (BOMP) method at three labial sites per tooth for all anterior teeth was used to examine clinical gingiva condition. Occurrence of at least 1 site with BOMP positive was defined as gingivitis. Visual gingival redness examination was done at the same sites examined by probing.Results: Participants with gingivitis had higher numbers of sites with redness than those without [6 (0.25-12) vs 0 (0-2), p < 0.001]. Participants with more sites with redness had a 1.29-fold higher risk of suffering from gingivitis (p = 0.002). The overall model had a 77.3% probability of predicting a gingivitis event by the number of sites with gingival redness (p < 0.001). Highest Youden Index was 1.453, yielded from the cut-off value of 4-5 sites with gingival redness.Conclusion(s): This study found that a predictive model using visual gingival redness examination is a viable non-invasive screening test for gingivitis. (C) 2019 Japanese Society of Pediatric Dentistry. Published by Elsevier Ltd. All rights reserved.
• 加齢に伴う歯数の変化の軌跡と生命予後の関連 高齢期に28歯を維持することの意義

  岩崎 正則, 佐藤 美寿々, 皆川 久美子, 安細 敏弘, 小川 祐司, 葭原 明弘

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 69 (3) 131 - 138 0023-2831 2019/07 [Refereed][Not invited]
   

  本研究の目的は地域在住高齢者における歯数の加齢に伴う変化の軌跡(加齢変化パターン)を類型化し、生命予後との関連を明らかにすることである。70歳から80歳までの10年間に毎年実施した調査に参加した、ベースライン時点で20歯以上を有する299名(男性154名・女性145名)のデータを用いた。70歳から80歳までの歯数の変化に対して、異なる関数形の軌跡をもつグループに分割することを目的に集団軌跡モデルを適応した。その後、歯数の加齢変化パターンと生命予後の関連を評価することを目的にCox比例ハザードモデルによる生存解析を実施した。追跡期間(70歳から85歳)中の総死亡をアウトカムとし、加齢変化パターンごとのハザード比(HR)を算出した。歯数の加齢変化は3つ(28歯維持群、中間-減少群、少ない-減少群)に類型化された。生存解析の結果、少ない-減少群と比較して28歯維持群は総死亡リスクが有意に低いことがわかった(adjusted HR=0.50、95%信頼区間=0.28-0.89)。結論として70歳で20歯以上を有する地域在住高齢者において、その後10年間の歯数の加齢変化は一様でなく、生命予後の観点からはできる限り多くの歯を維持することが重要であり、28歯を維持できれば最も望ましいことが本研究から示唆された。(著者抄録)
• A polymorphism rs6815464 in the macrophage erythroblast attacher gene is associated with low bone mineral density in postmenopausal Japanese women.

  Yulan Che, Noriko Sugita, Akihiro Yoshihara, Masanori Iwasaki, Hideo Miyazaki, Kazutoshi Nakamura, Hiromasa Yoshie

  Gene 700 1 - 6 2019/06/05 [Refereed][Not invited]
   

  BACKGROUND AND PURPOSES: Osteoporosis and osteopenia are multifactorial diseases characterized by low bone mineral density (BMD) and are susceptible to genetic and environmental risk factors. The macrophage erythroblast attacher (MAEA) was discovered as a protein to mediate the attachment of erythroid cells to macrophages and is essential for bone marrow hematopoiesis. MAEA is expressed in a wide range of cells and tissues including osteoblasts and osteoclasts. Recent studies have shown that a single nucleotide polymorphism (SNP) rs6815464 (C/G) in the MAEA gene increases the susceptibility of type 2 diabetes mellitus. However, the contribution of MAEA to bone metabolism remains unknown. Therefore, we performed this study to evaluate the association between MAEA polymorphism and low BMD. METHODS: In a cross-sectional study with postmenopausal Japanese women living in the Yokogoshi area, Niigata City, we evaluated whether rs6815464 was associated with low BMD. Blood samples were collected from 353 subjects (age 63.8 ± 5.4 years). The MAEA genotype was determined by TaqMan assay. BMD was assessed by dual-energy X-ray absorptiometry at the lumbar spine (L2-L4), hip and femoral neck. Low BMD was defined as a T-score <-1. RESULTS: The percentage of subjects with low BMD in the lumbar spine, total hip and femoral neck were 71%, 75% and 84% respectively. After adjusting age, BMI, HbA1c, smoking and alcohol consumption, the G-allele carriage was found to be associated with low BMD of total hip (odds ratio = 2.11, 95% CI: 1.14-3.91, P = 0.018), but not of the lumbar spine or femoral neck. CONCLUSION: The MAEA gene polymorphism rs6815464 was associated with low hip BMD in postmenopausal Japanese women.
• Interaction between beta-3 adrenergic receptor genotype and environmental factors on periodontal progression.

  Akihiro Yoshihara, Noboru Kaneko, Kaname Nohno, Masanori Iwasaki

  Journal of clinical periodontology 46 (6) 623 - 630 2019/06 [Refereed][Not invited]
   

  OBJECTIVES: The purpose of this longitudinal study was to evaluate the relationship between beta-3 adrenergic receptor polymorphism and environmental factors such as smoking on periodontal disease by considering effect modification. MATERIALS AND METHODS: A total of 294 subjects who participated in all follow-up surveys over the 6-year study period were analysed. After dividing subjects into tertiles according to the number of years exposed to smoking, we conducted Poisson regression analysis to compare the incidence rate ratio (IRR) for periodontal disease events during the 6-year study period with beta-3 adrenergic receptor genotype (1: Arg allele carriers, 2: Arg allele non-carriers) for each tertile adjusted for other four variables. RESULTS: The number of years exposed to smoking (mean ± standard deviation) for the 1st, 2nd and 3rd tertiles was 0 ± 0, 20.1 ± 9.1 and 45.3 ± 7.7 years, respectively. The IRRs ± SE were 0.89 ± 0.08 (p = 0.218) for the 1st tertile, 1.93 ± 0.36 (p < 0.001) for the 2nd tertile and 2.56 ± 0.23 (p < 0.001) for the 3rd tertile. CONCLUSION: There was a clear dose-response relationship between beta-3 adrenergic receptor genotype and periodontal disease progression based on the number of years exposed to smoking.
• MAEA rs6815464 polymorphism and periodontitis in postmenopausal Japanese females: A cross-sectional study.

  Yulan Che, Noriko Sugita, Akihiro Yoshihara, Masanori Iwasaki, Hideo Miyazaki, Kazutoshi Nakamura, Hiromasa Yoshie

  Archives of oral biology 102 128 - 134 2019/06 [Refereed][Not invited]
   

  OBJECTIVES: Macrophage erythroblast attacher (MAEA) is a membrane protein that regulates the development of mature macrophages by mediating attachment with erythroblasts. A polymorphism rs6815464 (C/G) in MAEA gene was reported to be associated with type II diabetes. Along with diabetes, osteoporosis shows an increased prevalence in postmenopausal females, and both diseases have been reported to be associated with periodontitis. Therefore, we explored the relevance of the MAEA polymorphism to periodontitis, bone mineral density (BMD) and haemoglobin A1c (HbA1c). DESIGN: This was a cross-sectional study with the final sample comprised of 344 postmenopausal Japanese females. Probing pocket depth (PPD) and clinical attachment level (CAL) were measured. Genotype was determined by TaqMan assay. Blood biochemical parameters and BMD of the lumbar spine were evaluated. RESULTS: No differences were found in age, body mass index, HbA1c, BMD, number of teeth, bone metabolism parameters between the genotypes. Mean CAL and percentage of sites with PPD or CAL ≥ 5 mm were higher in the G-allele carriers than in the non-carriers. Multiple logistic regression analyses revealed that G-allele carriage was associated with severe periodontitis (odds ratio = 3.73, 95% CI = 1.36-10.19). CONCLUSION: Our results suggested that the MAEA gene polymorphism was independently associated with severe periodontitis.
• Periodontitis, periodontal inflammation, and mild cognitive impairment: A 5-year cohort study.

  Masanori Iwasaki, Yumi Kimura, Hiroshi Ogawa, Takayuki Yamaga, Toshihiro Ansai, Taizo Wada, Ryota Sakamoto, Yasuko Ishimoto, Michiko Fujisawa, Kiyohito Okumiya, Hideo Miyazaki, Kozo Matsubayashi

  Journal of periodontal research 54 (3) 233 - 240 0022-3484 2019/06 [Refereed][Not invited]
   

  BACKGROUND AND OBJECTIVES: Identification of modifiable factors for mild cognitive impairment (MCI) is important since individuals with MCI are at a high risk of dementia and disability. Previous studies have suggested a potential association between periodontitis and cognitive impairment, but the results remain inconclusive. We designed a 5-year longitudinal study to explore the association between MCI and periodontitis and periodontal inflammation in older adults. METHODS: This study included 179 community-dwelling dentate individuals (62 men and 117 women, average age: 80.1 years). A full-mouth periodontal examination at six sites per tooth was performed at baseline. Case definitions provided by the European Workshop in Periodontology Group C (EWP definition) and the Centers for Disease Control/American Academy of Periodontology (CDC/AAP definition) were used to define severe periodontitis. Additionally, the periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue, was calculated using clinical periodontal parameters. Follow-up cognitive examinations for MCI diagnosis were performed by neurologists 1, 2, 3, and 5 years after baseline. Odds ratios (ORs) for MCI according to the presence of periodontitis and periodontal inflammation at baseline were calculated using multilevel mixed-effects logistic regression. RESULTS: At baseline, 56.4% and 27.4% of the participants had severe periodontitis by the EWP and CDC/AAP definitions, respectively. After adjusting for follow-up period and other baseline health characteristics (age, sex, smoking status, educational level, physical activity level, obesity, depression, and diabetes), severe periodontitis by either definition was significantly associated with MCI (for the EWP definition: adjusted OR = 3.58, 95% confidence interval [CI] = 1.45-8.87; for the CDC/AAP definition: adjusted OR = 2.61, 95% CI = 1.08-6.28). Periodontal inflammation assessed by PISA was also significantly associated with a higher OR for MCI (adjusted OR = 1.05, 95% CI = 1.01-1.10, per 10-mm2 increase in PISA). CONCLUSION: Severe periodontitis and periodontal inflammation were associated with incident MCI among older community-dwelling men and women.
• 高齢者における咀嚼能力、食欲とサルコペニアとの関連 3年間の前向きコホート研究

  妹尾 宗一郎, 岩崎 正則, 正木 千尋, 近藤 祐介, 安細 敏弘, 細川 隆司

  日本補綴歯科学会誌 (公社)日本補綴歯科学会 11 (特別号) 314 - 314 1883-4426 2019/05
• Predicting gingivitis using visual gingival redness examination on 11 years old Japanese schoolchildren: A ROC analysis

  Lisdrianto Hanindriyo, Akihiro Yoshihara, Hiro-O. Ito, Kana Suwama, Satoko Kakuta, Makoto Fukui, Masanori Iwasaki, Naofumi Tamaki, Toshihiro Ansai

  Pediatric Dental Journal 29 (2) 66 - 71 2019/05 [Refereed][Not invited]
  
• Rising rural body-mass index is the main driver of the global obesity epidemic in adults.

  NCD Risk Factor Collaboration, NCD-RisC

  Nature 569 (7755) 260 - 264 2019/05 [Refereed][Not invited]
   

  Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3-6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
• バス運転手における糖尿病、不眠度、食習慣および歯周病の関連(第一報)

  芹田 千穂, 片岡 正太, 廣島屋 貴俊, 茂山 博代, 角田 聡子, 福原 正代, 正木 千尋, 岩崎 正則, 安細 敏弘, 細川 隆司

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 69 (増刊) 162 - 162 0023-2831 2019/04
• 動脈硬化と歯周病との関連 地域在住高齢者を対象とした横断研究

  佐藤 美寿々, 岩崎 正則, 皆川 久美子, 山賀 孝之, 小川 祐司

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 69 (増刊) 164 - 164 0023-2831 2019/04
• Effect of chronic kidney disease on progression of clinical attachment loss in older adults: A 4-year cohort study.

  Iwasaki M, Taylor GW, Sato M, Minagawa K, Ansai T, Yoshihara A

  Journal of periodontology 90 (8) 826 - 833 0022-3492 2019/02 [Refereed][Not invited]
   

  BACKGROUND: People with chronic kidney disease (CKD) may have an increased risk of periodontal disease, but longitudinal evidence is sparse. METHODS: This 4-year cohort study assessed the association between CKD and changes in periodontal health status, defined by attachment loss (AL) progression, among older adults. Participants were 388 community-dwelling Japanese adults who were 70 years old at baseline with 7053 teeth. Estimated glomerular filtration rate (eGFR) was calculated by using baseline serum creatinine concentration. AL at six sites for every tooth was recorded at baseline and follow-up examinations. Multilevel logistic regression models estimated the tooth-specific risk of AL progression (≥1 site exhibiting a ≥3 mm increase in AL) with baseline CKD (eGFR < 60 mL/min/1.73 m2 ) as the principal exposure. RESULTS: At baseline, 27.8% of the study population (108/388 participants) had CKD. After 4 years, 21.8% of the studied teeth (1537/7053 teeth) exhibited AL progression. After applying inverse probability weighting and adjusting for potential confounders, including sex, use of devices for interdental cleaning, smoking, diabetes, tooth location, abutment for a removable denture, and highest AL, CKD was associated with significantly higher odds of AL progression (adjusted odds ratio: 1.73; 95% confidence interval: 1.15-2.60). CONCLUSIONS: The results suggest that CKD increases the risk of periodontal disease progression in older community-dwelling Japanese adults. Additional studies with more complete information, as well as in other geographic areas and age groups, are necessary to further generalize the findings.
• The Association between Tongue Pressure and Nutrient Intake in Adults Receiving Home Care Services

  YAMADA Shima, IWASAKI Masanori, KAKUTA Satoko, KATAOKA Shota, SAKAI Rie, HAMASAKI Tomoko, OKADA Keiko, TSUTSUI Syuichi, ANSAI Toshihiro

  JOURNAL OF DENTAL HEALTH 一般社団法人 口腔衛生学会 69 (4) 189 - 197 0023-2831 2019 

   This cross-sectional study aimed to elucidate the relationship between tongue pressure and nutrient intake in adults receiving home care services.

   The study population consisted of 95 adults (mean age, 84.6 years) who received home care services covered by long-term care insurance. Tongue pressure was measured using a tongue pressure measurement device. A tongue pressure <20 kPa was defined as a low tongue pressure. Daily dietary intake of the following five nutrients was estimated using a brief-type self-administered diet history questionnaire: protein, vitamin D, vitamin E, vitamin C, and folate. According to the criteria proposed by a previous study or the Recommended Dietary Allowance (RDA) / the Adequate Intake (AI) proposed by the Dietary Reference Intakes for Japanese (2015), the above five nutrients were scored as low (1 point) or acceptable (0 point). The sum of the individual scores (0–5 points) gave the quantity of nutrients with levels below the proposed criteria. Using this score as an outcome, the association between tongue pressure and nutrient intake was estimated by Poisson regression analysis.

   A low tongue pressure was found to be significantly associated with nutrient levels below the proposed criteria (rate ratio = 1.8, 95% confidence interval = 1.2–2.7 for the criteria proposed by the previous study; rate ratio = 1.7, 95% confidence interval = 1.2–2.5 for the RDA or AI criteria).

   These findings suggest that low tongue pressure results in insufficient nutrient intake in adults receiving home care services.

• 小児の歯肉炎評価におけるGCFの応用に関する検討

  角田 聡子, 邵 仁浩, 葭原 明弘, 福井 誠, 岩崎 正則, 諏訪間 加奈, 鶴田 実穂, 平山 綾, 片岡 正太, 茂山 博代, 横田 誠, 牛島 直文, 玉木 直文, 伊藤 博夫, 安細 敏弘

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 69 (1) 19 - 26 0023-2831 2019/01 [Refereed][Not invited]
   

  歯肉炎の評価は視診もしくはプロービングによる方法が一般的であり、検診の場で使用可能な非侵襲的で簡便性、客観性、再現性を併せもつ検査方法はないのが現状である。本研究では、歯肉溝滲出液(GCF)中の成分が歯肉炎バイオマーカーとして有用であるかを検討した。対象は北九州市内某小学校5、6年生107名である。ブロッティングブラシ(以下、ブラシ)で採取したGCF中のα-1アンチトリプシン(A1AT)、ラクトフェリン(Lf)他4成分(AST、ALT、ALP、LDH)を定量し、PMA index(PMA)、プラーク付着状態(PlI)との比較を行った。PMA、PlIを低値群と高値群に2値化し、GCF成分との比較を行ったところ、PMAではすべての成分、PlIではLDH以外の成分で有意(p<0.05)に関連していた。さらに、ROC曲線から求めたPMA、PlIに対する各成分のカットオフ値はそれぞれ、A1ATが283.8、248.3、Lfが152.1、114.4、ASTが4.5、2.5、ALTはともに1.5、ALPは2.5、PMAでのLDHが26.0であった。陽性尤度比は1.5から3.0程度となった。以上の結果からGCF中A1AT、Lf、AST、ALTおよびALPは小児を対象とした歯肉炎スクリーニングのバイオマーカーとして有用であることが示唆された。(著者抄録)
• Ten-year survival of immediate-loading implants in fully edentulous mandibles in the Japanese population: a multilevel analysis.

  Kazuhiko Kaneda, Yusuke Kondo, Chihiro Masaki, Taro Mukaibo, Shintaro Tsuka, Akiko Tamura, Fumiko Aonuma, Kouhei Shinmyouzu, Masanori Iwasaki, Toshihiro Ansai, Ryuji Hosokawa

  Journal of prosthodontic research 63 (1) 35 - 39 2019/01 [Refereed][Not invited]
   

  PURPOSE: To evaluate the long-term clinical results of and risk factors for immediate-loading implant treatment of completely edentulous mandibles. METHODS: We retrospectively studied 220 implants in 52 patients who received immediate-loading implants in fully edentulous mandibles. Kaplan-Meier survival analyses, log-rank tests, and multilevel mixed-effects parametric survival analysis was used for statistical analyses. RESULTS: Thirteen of implants in seven patients failed, and the 10-year cumulative implant survival rate was 93.9 % and significantly (p=0.049) higher in women than in men. None of the predictor variables were significantly associated with implant survival, although sex tended to be associated with implant survival. CONCLUSIONS: Immediate-loading implant treatment for completely edentulous mandibles had acceptable clinical results in the long term. Although we could not identify significant risk factors, we established a multilevel mixed-effects parametric survival analysis with the immediate-loading implant survival data.
• Relationship between vitamin D receptor gene polymorphism and susceptibility to chronic kidney disease and periodontal disease in community-dwelling elderly.

  Akihiro Yoshihara, Noboru Kaneko, Masanori Iwasaki, Kaname Nohno, Hideo Miyazaki

  Journal of clinical periodontology 45 (6) 672 - 679 2018/06 [Refereed][Not invited]
   

  OBJECTIVES: The aim of this study was to investigate the possible correlation between vitamin D receptor (VDR) gene polymorphism and susceptibility to chronic kidney disease (CKD) and periodontal disease. MATERIAL AND METHODS: This study analysed 345 participants, who were all 79 years of age. Kidney function levels were determined based on the estimated glomerular filtration rate (eGFR; non-reduced function: ≥60 and reduced function: <60 ml min-1  1.73 m-2 ). VDR TaqI genotyping was also studied. We calculated the periodontal inflamed surface area (PISA). After classifying participants into quartile groups according to eGFR or PISA values, the subjects were then split into two groups (highest quartile versus the other three groups combined). Multiple logistic regression analysis was performed to evaluate the odds ratios between the eGFR and VDR TaqI genotype with the different PISA groups. The eGFR was set as the dependent variable while the VDR TaqI genotype, HbA1C, gender, smoking habits and body mass index were defined as independent variables. RESULTS: A significant association was observed between the VDR TaqI genotype and eGFR in the PISA high group (odds ratio = 3.97, p = .027). CONCLUSION: Study results suggest that VDR TaqI genotype might be associated with CKD during inflammatory conditions caused by periodontal disease.
• Hyposalivation and 10-year all-cause mortality in an elderly Japanese population

  Masanori Iwasaki, Wenche S. Borgnakke, Akihiro Yoshihara, Kayoko Ito, Hiroshi Ogawa, Kaname Nohno, Misuzu Sato, Kumiko Minagawa, Toshihiro Ansai, Hideo Miyazaki

  Gerodontology 35 (2) 87 - 94 1741-2358 2018/06/01 [Refereed][Not invited]
   

  Objective: To evaluate the association of salivary flow rate with all-cause mortality among older Japanese adults. We hypothesised that hyposalivation would be a marker for mortality. Background: Hyposalivation, which is an objectively measurable decrease in salivary flow, is highly prevalent among older adults. It is associated with malnutrition and poor general health. Methods: The study population comprised 600 community-dwelling Japanese adults (306 men and 294 women), who were 70 years old at baseline. They underwent stimulated salivary flow rate (SSFR) measurements and were followed up during a 10-year study period. After stratification by sex, the hazard ratios of all-cause mortality were estimated using Cox proportional hazards regression analysis comparing groups with and without hyposalivation (ie, SSFR <  0.7 mL/min). Results: The baseline prevalence of hyposalivation was 27.8% (85/306) among men and 47.3% (139/294) among women. During a mean (standard deviation) follow-up period of 104 (27) months, 80 deaths occurred: 60 (75.0%) deaths among men and 20 (25.0%) deaths among women. After adjusting for the number of remaining teeth, smoking status, exercise, hypoalbuminemia, diabetes and cardiovascular disease, hyposalivation at baseline was significantly associated with all-cause mortality among men (adjusted hazard ratio, 1.71 95% confidence interval, 1.01-2.89). In contrast, no association between SSFR and all-cause mortality existed among women. Conclusion: Hyposalivation could be a marker for all-cause mortality among older community-dwelling Japanese men. Future studies investigating the association between SSFR and cause-specific mortality are warranted.
• Association between objectively measured chewing ability and frailty: A cross-sectional study in central Thailand.

  Masanori Iwasaki, Yumi Kimura, Kwanchit Sasiwongsaroj, Matana Kettratad-Pruksapong, Sutee Suksudaj, Yasuko Ishimoto, Nai-Yuan Chang, Ryota Sakamoto, Kozo Matsubayashi, Yupin Songpaisan, Hideo Miyazaki

  Geriatrics & gerontology international 18 (6) 860 - 866 1444-1586 2018/06 [Refereed][Not invited]
   

  AIM: Limited data are available on the association between oral function and frailty, especially in developing countries. Additionally, the association between objectively assessed chewing function and frailty has not been well studied. The present cross-sectional study tested the hypothesis that objectively measured poor chewing ability is associated with frailty in community-dwelling older Thai adults. METHODS: The study population comprised 141 people in Nakhon Pathom, Thailand (median age 72 years). Demographic and clinical data were collected at a community center. Participants were asked to chew a gum designed for assessing chewing ability. The differences in gum color before and after chewing (ΔE*ab) were calculated and used as the exposure variable, where a lower ΔE*ab indicates lower chewing ability. Frailty phenotypes were defined by weakness, slowness, weight loss, low physical activity level and exhaustion components, and used as the outcome variable. Participants with three or more components were considered frail, and those with one or two components were considered pre-frail. Ordinal logistic regression analyses were carried out to assess the association of objective chewing ability with frailty. RESULTS: Of the 141 participants, 32 (22.7%) were categorized as frail and 78 (55.3%) as pre-frail. In the analysis adjusted for demographic and health characteristics, the adjusted odds ratio of the presence and severity of frailty was significantly higher in participants with lower ΔE*ab (adjusted odds ratio for one decrease in ΔE*ab 1.05, 95% confidence interval 1.01-1.10, P = 0.03). CONCLUSIONS: Objectively measured chewing ability was significantly associated with frailty in community-dwelling older Thai adults. Geriatr Gerontol Int 2018; 18: 860-866.
• Relationship between autoantibody associated with rheumatoid arthritis and tooth loss.

  Yuko Hayashi, George Taylor, Akihiro Yoshihara, Masanori Iwasaki, Stuart A Gansky, Hideo Miyazaki

  Gerodontology 2018/05/21 [Refereed][Not invited]
   

  INTRODUCTION: This study evaluated the relationship between serum Rheumatoid Factor (RF) levels and tooth loss in a community-dwelling elderly Japanese women. It was hypothesised that women with high baseline RF levels would experience greater tooth loss over 10 years than age-matched women with lower baseline serum RF levels. MATERIALS AND METHODS: The study population consisted of 197 women aged 70 years with ≥12 teeth at baseline. One hundred and twenty-four participants completed a 10-year follow-up and were divided into 2 groups according to their baseline serum RF levels as follows: RF negative (<15 U/mL; n = 114) and RF positive (>15 U/mL; n = 10). Negative binomial regression was used to investigate the relationship between baseline RFs and tooth lost over the 10-year period. RF and its interaction with the baseline number of teeth were independent variables, with 9 other adjustment covariates. RESULTS: Baseline RFs were significantly associated with tooth loss (P = .035). In addition, a statistical interaction between baseline RFs and baseline number of teeth was identified (P = .023), modifying the association between RFs and tooth loss. The adjusted incidence rate ratio (IRR) for RF-positive participants with 21 baseline teeth was 1.88 (95% confidence interval (95% CI): 0.76, 4.65). IRRs obtained for participants who had 25 baseline teeth (3.02; 95% CI: 1.03, 8.83) or 30 baseline teeth (5.47; 95% CI: 1.29, 23.13) suggested that RF-positive participants with a high number of baseline teeth would exhibit greater tooth loss than RF-negative participants. CONCLUSION: High serum RF levels were associated with a greater IRR for future tooth loss in elderly Japanese women.
• Effect of lifestyle on 6-year periodontitis incidence or progression and tooth loss in older adults.

  Iwasaki M, Borgnakke WS, Ogawa H, Yamaga T, Sato M, Minagawa K, Ansai T, Yoshihara A, Miyazaki H

  Journal of clinical periodontology 45 (8) 896 - 908 0303-6979 2018/05 [Refereed][Not invited]
   

  AIM: To evaluate the longitudinal association of combined healthy lifestyle factors with incidence or progression of periodontitis and tooth loss in older adults. MATERIALS AND METHODS: This 6-year study included 374 Japanese 70-year olds with 7,157 teeth, from a source eligible baseline population of 554 individuals. Four lifestyle factors-cigarette smoking, physical activity, relative weight, and dietary quality-were scored as healthy (1 point) or unhealthy (0 point). Adding the individual scores generated the "healthy lifestyle score" (0-4 points). Multilevel mixed-effects logistic regression models were applied to evaluate tooth-specific associations between the baseline healthy lifestyle score and the incidence or progression of periodontitis (increase in clinical attachment loss ≥3 mm) and tooth loss. RESULTS: After 6 years, 19.0% of the teeth exhibited periodontitis incidence or progression and 8.2% were lost. Compared with a healthy lifestyle score of 0-1 (least healthy), the highest score (4 points) was associated with a significantly lower tooth-specific risk of periodontitis (adjusted odds ratio = 0.32; 95% confidence interval: 0.16-0.62) and tooth loss (adjusted odds ratio = 0.42; 95% confidence interval: 0.23-0.77). CONCLUSIONS: Simultaneous adherence to multiple healthy lifestyle factors significantly lowers the risk of incidence or progression of periodontitis and tooth loss in older adults.
• Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1018 population-based measurement studies with 88.6 million participants

  NCD Risk Factor Collaboration, NCD-RisC

  International Journal of Epidemiology 47 (3) 872 - 883i 0300-5771 2018/05 [Refereed][Not invited]
  
• 納豆摂取と歯の喪失との関連 地域在住閉経後女性を対象とした縦断研究

  佐藤 美寿々, 岩崎 正則, 皆川 久美子, 葭原 明弘, 宮崎 秀夫

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 68 (増刊) 112 - 112 0023-2831 2018/04
• 高次生活機能の加齢に伴う変化の軌跡と歯の本数の関連についての縦断研究

  岩崎 正則, 佐藤 美寿々, 皆川 久美子, 安細 敏弘, 葭原 明弘, 小川 祐司, 宮崎 秀夫

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 68 (増刊) 112 - 112 0023-2831 2018/04
• Dentition status and frailty in community-dwelling older adults: A 5-year prospective cohort study

  Masanori Iwasaki, Akihiro Yoshihara, Misuzu Sato, Kumiko Minagawa, Mieko Shimada, Mamoru Nishimuta, Toshihiro Ansai, Yutaka Yoshitake, Hideo Miyazaki

  Geriatrics and Gerontology International 18 (2) 256 - 262 1447-0594 2018/02/01 [Refereed][Not invited]
   

  Aim: To examine the longitudinal association between dentition status and incidence of frailty in older adults. Methods: The present prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Dental examinations, biochemical blood examinations, physical performance and anthropometric measurements, and structured questionnaires were carried out at baseline. The presence of ≥20 teeth with nine or more occluding pairs of teeth was defined as functional dentition. Annual follow-up examinations, including physical performance, anthropometric measurements and structured questionnaires, were carried out over a 5-year period to determine the incidence of frailty, defined as three or more of the following five components derived from the Cardiovascular Health Study: weight loss, weakness, slowness, poor energy and low physical activity level. Adjusted hazard ratios of frailty incidence according to dentition status were calculated from Cox proportional hazards regression analyses. Results: At baseline, 118 participants (36.6%) were defined as having functional dentition. During the follow up, 48 participants (14.9%) developed frailty. The adjusted hazard ratio for frailty in participants with functional dentition was 0.50 (95% confidence interval 0.25–0.98) compared with participants without functional dentition, after adjusting for sex, income, education, smoking status, body mass index, serum biomarkers and comorbidities. Conclusions: Functional dentition was significantly associated with a lower risk of frailty defined by the Cardiovascular Health Study frailty index in older Japanese adults. These results suggest that maintaining healthy and functional dentition into later life is important for frailty prevention. Geriatr Gerontol Int 2018 18: 256–262.
• Association between Eating Assessment Tool-10 (EAT-10) and the Health, Dental, and Nutritional Status of Elderly Individuals Living at Home

  AKIYAMA Rika, HAMASAKI Tomoko, SAKAI Rie, IWASAKI Masanori, KAKUTA Satoko, SOH Inho, YOSHIHARA Akihiro, MIYAZAKI Hideo, ANSAI Toshihiro

  JOURNAL OF DENTAL HEALTH 一般社団法人 口腔衛生学会 68 (2) 76 - 84 0023-2831 2018 

   This study investigated the relationship between dysphagia and the nutritional status of elderly individuals living at home when screened with Eating Assessment Tool-10 (EAT-10). A total of 129 participants (62 males, 67 females, aged 85 years) were surveyed. Participants were sent a questionnaire by mail and asked to complete and return it to the authors. Assessments included in the questionnaire were EAT-10, the self-reported number of teeth, Short-form Mini Nutritional Assessment (MNA-SF), a subjective health evaluation, Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-Index of Competence), Oral Health Impact Profile-49 (OHIP), and number of foods that can be masticated. To evaluate variation in the study's variables, the analysis was based on established scores of EAT-10: those suspected of having dysphagia score above three; those with no suspicion of dysphagia score below two.

   When screened with EAT-10, 52.7% of the participants were classified as being suspected of having dysphagia. There were significant correlations between dysphagia and a low OHIP score (p<0.001), the number of foods that can be masticated (p<0.001), subjective health evaluation (p<0.001), and MNA-SF (p=0.007).

   Furthermore, logistic regression analysis revealed that the nutritional status was associated with dysphagia (p=0.043)．These findings suggest the association of dysphagia with malnutrition in elderly people living at home.

• Association of Eating Assessment Tool-10 Results with Oral Hygiene, Oral Function, and Nutritional Status of Elderly Individuals in Long-term Care Facility

  AKIYAMA Rika, ANSAI Toshihiro, HAMASAKI Tomoko, SAKAI Rie, KATAOKA Shota, KAKUTA Satoko, SOH Inho, TOMOE Miki, AWANO Shuji, IWASAKI Masanori

  JOURNAL OF DENTAL HEALTH 一般社団法人 口腔衛生学会 68 (3) 128 - 136 0023-2831 2018 

   In this study, we investigated the association of results obtained with Eating Assessment Tool-10 (EAT-10) and Repetitive Saliva Swallowing Test (RSST) with the oral hygiene, oral function, and nutritional status of elderly individuals. A total of 90 subjects (21 males, 69 females, average age: 86.0±7.2 years) were enrolled. We assessed the cleanliness of tooth surfaces as oral hygiene, mouth-opening capacity as the masticatory function, and Short-form Mini Nutritional Assessment (MNA-SF) findings as the nutritional status, as well as subjective symptoms related to swallowing. Associations between subjects with and without the risk of developing dysphagia were analyzed based on EAT-10 and RSST scores, while path analysis was also conducted. There were significant correlations of dysphagia assessed by EAT-10 with tooth surface cleanliness and the mouth-opening capacity, as well as the subjective symptoms of hard to swallow and choking. In addition, significant correlations of dysphagia assessed by RSST with the mouth-opening capacity, tongue movement, and number of chewable foods, as well as the subjective symptoms of hard to swallow and choking shown in MNA-SF findings were noted. Path analysis results indicated a weak association between EAT-10 and RSST, while there were significant paths from EAT-10 to tooth surface cleanliness and stains on the tongue, as well as the subjective symptoms of hard to swallow and choking, and significant paths or trends from RSST to tongue movement, number of chewable foods, and MNA-SF findings. The present results indicate that EAT-10 is influenced by factors related to oral hygiene and subjective symptoms, while factors influencing RSST are related to the masticatory function and nutritional status. It is suggested that findings obtained by screening with EAT-10 are correlated with those with RSST, although the specific characteristics are different.

• A Pilot Study of the Relationship between Whole-body Skeletal Muscle Mass and Tongue Pressure in ≥75-year-old Individuals Requiring Home-based Care Support

  HIROSHIMAYA Takatoshi, IWASAKI Masanori, SAKAI Rie, KAKUTA Satoko, HAMASAKI Tomoko, KATAOKA Shota, TSUTSUI Syuichi, ANSAI Toshihiro

  JOURNAL OF DENTAL HEALTH 一般社団法人 口腔衛生学会 68 (3) 145 - 152 0023-2831 2018 

   Tongue pressure is the force produced by contact between the anterior part of the hard palate and tongue, which is composed chiefly of muscle tissue. Tongue pressure is one of the objective indicators of oral function. Low whole-body skeletal muscle mass has been reported to be associated with functional impairment and physical disability. However, little is known about the relationship between whole-body skeletal muscle mass and oral function. This study aimed to elucidate the relationship between whole-body skeletal muscle mass and tongue pressure in individuals aged ≥75 years old requiring home-based support.

   This study included 64 individuals aged ≥75 years (average age = 86.4 years; 18 men and 46 women) who used home-based care support covered by long-term care insurance. Tongue pressure was measured using a tongue pressure measurement device. In addition, limb skeletal muscle mass was measured by a body composition analyzer. Subsequently, the skeletal muscle index (SMI) was calculated by dividing the absolute limb skeletal muscle mass by the height in meters squared. Then, the association between tongue pressure and SMI was estimated by robust regression analysis. Variables that showed a significant correlation with tongue pressure in univariate analysis were included as potential confounders in the multivariable model.

   Univariate analysis showed a significant positive correlation between SMI and tongue pressure. This remained significant after adjusting for potential confounders (regression coefficient=3.6; 95% confidence interval=1.6–5.5; p<0.01).

   In conclusion, this study demonstrated a significant positive correlation between whole-body skeletal muscle mass and tongue pressure in individuals aged ≥75 years old requiring home-based care support.

• Associations among Oral Function, Nutritional Status, and Nutrient Intake in Elderly Individuals Living at Home and Receiving Nursing Care

  SAKAI Rie, ANSAI Toshihiro, HAMASAKI Tomoko, KAKUTA Satoko, HIROSHIMAYA Takatoshi, SOH Inho, KATAOKA Shota, OKADA Keiko, TSUTSUI Syuichi, IWASAKI Masanori

  JOURNAL OF DENTAL HEALTH 一般社団法人 口腔衛生学会 68 (4) 207 - 218 0023-2831 2018 

   We investigated associations among the oral function, nutritional status, and nutrient intake in elderly individuals living at home and receiving nursing care. The subjects of this study were 63 individuals (25 males, 38 females) aged 65 years or older (average: 83.5±6.8 years). All subjects agreed to undergo a dental examination and answer survey questions regarding their diet. Using the Revised Oral Assessment Guide, we graded 8 intraoral items with a score of 1-3 points to determine the oral function. A total score of 8 points indicated a good function, 9-12 points indicated a mild decrease, and 13 or more indicated a severe decrease in function. The latter 2 groups were combined into a decreased group (oral function decrease of 9 or more points). Age, body mass index, skeletal muscle index, grip strength, and Mini Nutritional Assessment - Short Form results were not significantly different between the good and decreased groups. The good group showed significantly higher values of Alb (≥4.0 g/dL) and tongue pressure (≥35 kPa), and there were also significantly fewer individuals who required nursing care, based on recognition independence, as compared with the decreased group. Date on nutrient intake were extracted from answers to a brief-type self-administered diet history questionnaire, and they were also compared between the groups. The good group contained a significantly higher number of individuals who ate more than the recommended dietary allowance of protein for individuals aged 70 years or older, and had a lower intake of vitamin C. Regarding the nutrient food group intake, subjects in the good group consumed root crops, legumes, and fatty fish significantly more frequently, while those in the decreased group showed a significantly more frequent intake of potatoes, citrus fruits, and confectionery. Associations among a lower oral function, the nutrition status, and food group intake were noted in our results. Our study suggested that the appropriate management of oral care and nutrition can promote a better oral condition, which is important for effective care and living support for elderly individuals. In addition, collaboration between dental and diet professionals is considered helpful.

• 視診による歯肉炎評価の有用性

  渡辺 真光, 葭原 明弘, 諏訪間 加奈, 角田 聡子, 岩崎 正則, 安細 敏弘, 宮崎 秀夫

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 68 (1) 36 - 37 0023-2831 2018/01 [Not refereed][Not invited]
  
• 地域在住高齢者における現在歯数および義歯の使用状況・主観的評価とフレイルとの関連についての横断研究

  佐藤美寿々, 岩崎正則, 皆川久美子, 小川祐司, 山賀孝之, 葭原明弘, 宮崎秀夫

  口腔衛生会誌 (一社)日本口腔衛生学会 68 (2) 68 - 75 0023-2831 2018 [Refereed][Not invited]
   

  フレイルと歯・口腔の健康との関連は疫学的に十分に解明されていない。今回われわれは、地域在住高齢者における現在歯数および義歯の使用状況・主観的評価とフレイルとの関連を明らかにすることを目的とする横断研究を実施した。79歳高齢者344人を解析対象とした。フレイルは、Study of Osteoporotic Fracture Criteria for Frailtyを一部改変したものを用いて定義し、目的変数とした。説明変数には現在歯数および義歯の使用状況・主観的評価を用いた。そして両者の関連を性別、体格、および精神健康状態を共変量とするロジスティック回帰分析を用いて評価した。解析対象者におけるフレイルの頻度は8.4%であった。現在歯数(1本増加ごとの調整済オッズ比[OR]=0.94、95%信頼区間[CI]=0.90-0.99)、現在歯数20本以上有すること(20本未満と比較した調整済OR=0.39、95%CI=0.15-0.97)、義歯不使用(義歯使用者と比較した調整済OR=17.89、95%CI=5.00-64.32)、主観的に義歯不具合の訴えがあること(訴えなしと比較した調整済OR=3.38、95%CI=1.01-11.27)はフレイルと有意に関連していた。本研究結果から、地域在住高齢者において現在歯数および義歯の使用状況・主観的評価はフレイルと有意に関連していることが示された。(著者抄録)
• A 5-year longitudinal study of association of maximum bite force with development of frailty in community-dwelling older adults

  Iwasaki M, A. Yoshihara, N. Sato, M. Sato, K. Minagawa, M. Shimada, M. Nishimuta, T. Ansai, Y. Yoshitake, T. Ono, H. Miyazaki

  JOURNAL OF ORAL REHABILITATION 45 (1) 17 - 24 0305-182X 2018/01 [Refereed][Not invited]
   

  To determine whether maximum bite force (MBF), an objective measure of oral function, is associated with development of frailty in community-dwelling older adults. This prospective cohort study included community-dwelling Japanese adults aged 75years at baseline (n=322). Baseline MBF was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up examinations, including physical fitness and anthropometric evaluation and structured questionnaires, were administered annually over a 5-year period to determine the incidence of frailty, which was defined by the presence of 3 or more of the following 5 components derived from the Cardiovascular Health Study: low level of mobility, low physical activity level, weakness, shrinking and poor endurance and energy. Adjusted hazard ratios (HRs) of incidence of frailty according to sex-stratified tertiles of baseline MBF were calculated using Cox proportional hazards regression models. During the follow-up, 49 participants (15.2%) developed frailty. Participants in the lower tertile of MBF exhibited a significantly greater risk of frailty than those in the upper tertile. After adjustment for sex, depression, diabetes and Eichner index, the adjusted HRs for frailty in the upper through lower tertiles of MBF were 1.00 (reference), 1.27 (95% confidence interval [CI]: 0.50-3.20) and 2.78 (95% CI: 1.15-6.72), respectively (P for trend=.01). Poor oral function, as indicated by low MBF, increases the risk of development of frailty among elderly men and women.
• Periodontal disease and pneumonia mortality in haemodialysis patients: A 7-year cohort study

  Masanori Iwasaki, George W. Taylor, Shuji Awano, Akihiro Yoshida, Shota Kataoka, Toshihiro Ansai, Hidetoshi Nakamura

  Journal of Clinical Periodontology 45 (1) 38 - 45 1600-051X 2018/01/01 [Refereed][Not invited]
   

  Aim: To evaluate the association between periodontal disease and pneumonia mortality in haemodialysis patients. Materials and Methods: This prospective cohort study included 211 patients (mean age, 64.4 years) undergoing haemodialysis at a single medical centre. The patients underwent a baseline clinical dental examination in 2008 and were then followed up until July 2015. Periodontal disease was defined as the presence of clinical attachment loss of ≥4 mm in ≥30% of the probed sites. The primary endpoint, that is death from pneumonia, was determined by reviewing death certificates and was analysed using the competing-risks regression model. Results: At baseline, 92 patients (43.6%) had periodontal disease. The median follow-up period was 84 months (interquartile range, 36–86 months). Of the 68 deaths that occurred, 21 were from pneumonia. The multivariable competing-risks regression model showed that periodontal disease was significantly associated with death from pneumonia (adjusted subhazard ratio, 3.49 95% confidence interval, 1.14–10.64), after adjusting for other baseline health characteristics. Conclusions: The results of this study suggest that periodontal disease is independently associated with pneumonia mortality in haemodialysis patients. Future studies evaluating the potential effect of oral interventions for periodontal health improvement on pneumonia in haemodialysis patients would be of great interest.
• Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults

  NCD Risk Factor Collaboration, NCD-RisC

  LANCET 390 (10113) 2627 - 2642 0140-6736 2017/12 [Refereed][Not invited]
   

  Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods We pooled 2416 population-based studies with measurements of height and weight on 128.9 million participants aged 5 years and older, including 31.5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). Findings Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0.01 kg/m (2) per decade; 95% credible interval -0.42 to 0.39, posterior probability [PP] of the observed decrease being a true decrease= 0.5098) in eastern Europe to an increase of 1.00 kg/m(2) per decade (0.69-1.35, PP> 0.9999) in central Latin America and an increase of 0.95 kg/m (2) per decade (0.64-1.25, PP> 0.9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0.09 kg/m(2) per decade (-0.33 to 0.49, PP= 0.6926) in eastern Europe to an increase of 0.77 kg/m (2) per decade (0.50-1.06, PP> 0.9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0.7% (0.4-1.2) in 1975 to 5.6% (4.8-6.5) in 2016 in girls, and from 0.9% (0.5-1.3) in 1975 to 7.8% (6.7-9.1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9.2% (6.0-12.9) in 1975 to 8.4% (6.8-10.1) in 2016 in girls and from 14.8% (10.4-19.5) in 1975 to 12.4% (10.3-14.5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22.7% (16.7-29.6) among girls and 30.7% (23.5-38.0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese. Interpretation The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.
• Relationships among sense of coherence, oral health status, nutritional status and care need level of older adults according to path analysis.

  Nanae Dewake, Tomoko Hamasaki, Rie Sakai, Shima Yamada, Yuko Nima, Miki Tomoe, Satoko Kakuta, Masanori Iwasaki, Inho Soh, Yoshihiro Shimazaki, Toshihiro Ansai

  Geriatrics & gerontology international 17 (11) 2083 - 2088 2017/11 [Refereed][Not invited]
   

  AIM: Sense of coherence (SOC) is a measurement of ability of an individual to cope with psychological stress and remain in good health. The aim of the present study was to examine the relationships among SOC score, oral health status, nutritional status and care need level of older adults using path analysis. METHODS: We enrolled 53 older adults (17 men and 36 women) who were attending a day care service (mean age 80.4 ± 6.5 years). SOC was assessed using a 13-item, seven-scale instrument. Oral health status (number of present teeth, denture use) and nutritional status (assessed with Mini-Nutritional Assessment Short-Form) were also evaluated. Path analysis was used to examine the relationship of SOC with other related factors, including care need level. RESULTS: The mean SOC score was 57.0 ± 13.9. Mini-Nutritional Assessment Short-Form results showed that one participant (1.8%) was malnourished, 26 (49.1%) were at risk of malnutrition and 26 (49.1%) had normal nutritional status. Participants with high SOC scores showed a strong positive attitude, had a relatively large number of teeth, were in good nutritional condition and showed low care need levels. CONCLUSIONS: The present results showed that maintaining a high SOC level and good oral health help to reduce care need levels in older adults, and also prevent a worsening of their nutritional condition. Geriatr Gerontol Int 2017; 17: 2083-2088.
• 政策声明 認知症に対する口腔保健の予防的役割

  葭原 明弘, 安藤 雄一, 深井 穫博, 安細 敏弘, 伊藤 博夫, 佐々木 健, 山本 龍生, 皆川 久美子, 宮本 茜, 岩崎 正則, 竹内 研時, 日本口腔衛生学会, 日本口腔衛生学会疫学研究委員会および政策声明委員会

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 67 (4) 251 - 259 0023-2831 2017/10 [Not refereed][Not invited]
   

  認知症に影響する口腔関連の要因には、歯周組織の慢性炎症状態、口腔への刺激および咀嚼運動による脳への刺激、口腔機能の低下による低栄養、長期間にわたるバランスの良い食事スタイル、生活習慣病および社会交流が挙げられる。これらのエビデンスとして国内外での多くの縦断または介入研究において、認知機能の低下・認知症の発症と口腔健康状態との間で有意な関連が報告されている。したがって、口腔保健は認知症予防に寄与する蓋然性が高いと考えられ、口腔保健に従事する関係者は、このことを念頭に置いて一次〜三次予防(口腔疾患の予防、早期発見・早期治療による歯の喪失の予防、喪失部位に対する補綴治療)を系統的に今後進めていく必要がある。また、口腔保健からのアプローチは他職種との連携を通して行われる必要がある。加えて、政策面においては高齢者における介護予防プログラムへの歯科保健の導入を一層促進すべきであり、研究面においては認知機能の低下・認知症の発症に及ぼす口腔保健の効果についてエビデンスをさらに積み重ね、認知症予防に向けた認知症施策の推進と評価に資する根拠と実践を図ることが必要である(図)。(著者抄録)
• Relationship between renal function and periodontal disease in community-dwelling elderly women with different genotypes.

  Akihiro Yoshihara, Noriko Sugita, Masanori Iwasaki, Yanming Wang, Hideo Miyazaki, Hiromasa Yoshie, Kazutoshi Nakamura

  Journal of clinical periodontology 44 (5) 484 - 489 2017/05 [Refereed][Not invited]
   

  OBJECTIVES: The aim of this study was to examine the association between periodontal disease and renal function in elderly women with different genotypes. MATERIAL AND METHODS: A total of 332 postmenopausal never-smoking women were analysed. Poor renal function was defined as serum cystatin C > 0.91 mg/l. Periodontal disease markers such as periodontal inflamed surface area (PISA) were evaluated. Selected variables, including PISA quartile, body mass index (BMI), HbA1C and age in Arg allele carriers and non-carriers based on the beta-3 adrenergic receptor, or between Ala allele carriers and non-carriers based on peroxisome proliferator-activated receptor gamma, were analysed using multiple logistic regression analysis. RESULTS: The odds ratios of serum cystatin C level and PISA (fourth quartile) were significantly positive for both Arg (2.52; p = 0.035) and Ala allele non-carriers (2.36; p = 0.021). A significant association was also found between serum cystatin C level and BMI for both Arg (1.18; p = 0.001) and Ala allele non-carriers (1.12; p = 0.003). CONCLUSION: The results of this study suggest that periodontal inflammation might be associated with renal function. Furthermore, in both the Arg and Ala allele non-carriers, the associations between BMI and PISA for renal function became stronger.
• Malnutrition and Oral Disease in the Elderly––Is There Any Bidirectional Relationship?

  Masanori Iwasaki, Misuzu Sato, Akihiro Yoshihara, Hideo Miyazaki

  Current Oral Health Reports 4 (2) 70 - 78 2017/04/21
• 80歳地域住民における歯周病と糖尿病の生命予後への影響

  田上 綾香, 園木 一男, 秋房 住郎, 福原 正代, 粟野 秀慈, 角田 聡子, 邵 仁浩, 岩崎 正則, 安細 敏弘

  日本歯周病学会会誌 (NPO)日本歯周病学会 59 (1) 19 - 27 0385-0110 2017/04 

  80歳地域住民において糖尿病と歯周病が生命予後に影響するのか検討した。平成10年福岡県北九州市とその近郊に在住する80歳697名が歯科・内科検診を受診した。697名の12年後の生存調査から、全死亡および肺炎、循環器疾患、悪性腫瘍による死亡に分けて解析を行った。4mm以上の歯周ポケットのある歯数が0〜4本を軽症歯周病群(526名、無歯顎者を含む)、5本以上を重症歯周病群(169名)とした。糖尿病群は血糖値200mg/dl以上または糖尿病の既往歴や血糖降下剤を服用している77名とした。重症歯周病群は軽症歯周病群より肺炎死リスクが12年間で2.28倍有意に高かったが、全死亡、循環器死、悪性腫瘍死には影響しなかった。糖尿病群は12年間で非糖尿病群より全死亡、肺炎死のリスクが高かった。非糖尿病+軽症歯周病群、非糖尿病+重症歯周病群、糖尿病+軽症歯周病群、糖尿病+重症歯周病群の4群では、非糖尿病+軽症歯周病群に比べ肺炎死リスクが、非糖尿病+重症歯周病群で2.90倍、糖尿病+軽症歯周病群で5.93倍、糖尿病+重症歯周病群で6.20倍と上昇した。全死亡リスクは糖尿病+軽症歯周病群で2.24倍、糖尿病+重症歯周病群で2.21倍と有意に上昇した。80歳地域高齢者では重症歯周病があると肺炎死リスクが増大するが、糖尿病を合併するとさらに肺炎死リスクが上昇する可能性が示唆された。(著者抄録)
• 透析患者における唾液分泌量低下と健康関連Quality of Lifeの関連

  有永 靖, 岩崎 正則, 粟野 秀慈, 伊藤 加代子, 吉田 明弘, 角田 聡子, 邵 仁浩, 安細 敏弘

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 67 (2) 64 - 69 0023-2831 2017/04 [Refereed][Not invited]
   

  透析患者では唾液分泌量低下が高頻度で認められる。本横断研究では透析患者における唾液分泌量低下と健康関連quality of life(HRQOL)の関連を、包括的HRQOL尺度MOS Short-Form 36-Item Health Survey(SF-36)を用いて検討した。2008年5月から7月に透析専門病院にて血液透析治療を受けた患者347名中、本研究への同意が得られ、データの揃った212名を対象とした。安静時唾液分泌量が0.1ml/min以下かつ刺激時唾液分泌量が1.0ml/min以下の者を唾液分泌量低下と定義した。唾液分泌量低下がSF-36のサマリースコア、および下位尺度偏差得点に与える影響について一般線形モデルを用いて評価した。年齢、性別、透析原疾患、透析期間、現病歴、既往歴、body mass index、喫煙状況、飲酒状況を共変量として用いた。唾液分泌量低下と定義された者は103名、全体の48.6%であった。唾液分泌量低下とSF-36の下位尺度偏差得点である身体機能、身体的日常役割機能、全体的健康感、社会生活機能、および身体的側面のQOLサマリースコアとの間に負の関連を認めた(p<0.05)。透析患者において唾液量分泌低下はHRQOLと関連することが示された。(著者抄録)
• Relationships between pathologic subjective halitosis, olfactory reference syndrome, and social anxiety in young Japanese women.

  Miho Tsuruta, Toru Takahashi, Miki Tokunaga, Masanori Iwasaki, Shota Kataoka, Satoko Kakuta, Inho Soh, Shuji Awano, Hiromi Hirata, Masaharu Kagawa, Toshihiro Ansai

  BMC psychology 5 (1) 7 - 7 2017/03/14 [Refereed][Not invited]
   

  BACKGROUND: Pathologic subjective halitosis is known as a halitosis complaint without objective confirmation of halitosis by others or by halitometer measurements; it has been reported to be associated with social anxiety disorder. Olfactory reference syndrome is a preoccupation with the false belief that one emits a foul and offensive body odor. Generally, patients with olfactory reference syndrome are concerned with multiple body parts. However, the mouth is known to be the most common source of body odor for those with olfactory reference syndrome, which could imply that the two conditions share similar features. Therefore, we investigated potential causal relationships among pathologic subjective halitosis, olfactory reference syndrome, social anxiety, and preoccupations with body part odors. METHODS: A total of 1360 female students (mean age 19.6 ± 1.1 years) answered a self-administered questionnaire regarding pathologic subjective halitosis, olfactory reference syndrome, social anxiety, and preoccupation with odors of body parts such as mouth, body, armpits, and feet. The scale for pathologic subjective halitosis followed that developed by Tsunoda et al.; participants were divided into three groups based on their scores (i.e., levels of pathologic subjective halitosis). A Bayesian network was used to analyze causal relationships between pathologic subjective halitosis, olfactory reference syndrome, social anxiety, and preoccupations with body part odors. RESULTS: We found statistically significant differences in the results for olfactory reference syndrome and social anxiety among the various levels of pathologic subjective halitosis (P < 0.001). Residual analyses indicated that students with severe levels of pathologic subjective halitosis showed greater preoccupations with mouth and body odors (P < 0.05). Bayesian network analysis showed that social anxiety directly influenced pathologic subjective halitosis and olfactory reference syndrome. Preoccupations with mouth and body odors also influenced pathologic subjective halitosis. CONCLUSIONS: Social anxiety may be a causal factor of pathologic subjective halitosis and olfactory reference syndrome.
• Association between tooth loss and medical costs related to stroke in healthy older adults aged over 75 years in Japan

  Masanori Iwasaki, Misuzu Sato, Akihiro Yoshihara, Toshihiro Ansai, Hideo Miyazaki

  GERIATRICS & GERONTOLOGY INTERNATIONAL 17 (2) 202 - 210 1444-1586 2017/02 [Refereed][Not invited]
   

  AimGrowing evidence suggests that tooth loss is associated with increased risk of stroke. In the current study, we investigated cumulative medical costs related to stroke using data from the Advanced Elderly Medical Service System. We hypothesized that tooth loss was associated with an increase in medical costs related to stroke among older Japanese adults. MethodsA total of 273 Japanese adults aged 80 years were enrolled in the current study. Baseline medical and dental examinations were carried out in June 2008. Medical care use and costs were monitored by linkage with National Health Insurance claim files from baseline to the end of February 2011. Medical costs related to stroke per month were calculated and examined for any association with the baseline number of remaining teeth using a linear regression model with robust standard errors. ResultsA total of 19 individuals were admitted to hospital for stroke during the follow-up period. A significant negative association was found between the number of teeth and medical costs related to stroke per month. The regression coefficients of the number of teeth in relation to medical costs related to stroke was -248 (95% CI -438 to -58, P=0.011) in the crude model and -226 (95% CI -413 to -38, P=0.018) after adjusting for other confounders. ConclusionWithin the limitations of the present study, the reported findings suggest an independent relationship of tooth loss with increase in medical cost related to stroke among older Japanese adults. Further studies are necessary to substantiate these findings. Geriatr Gerontol Int 2017; 17: 202-210.
• Periodontitis and health-related quality of life in hemodialysis patients

  Masanori Iwasaki, Wenche S. Borgnakke, Shuji Awano, Akihiro Yoshida, Tomoko Hamasaki, Gou Teratani, Shota Kataoka, Satoko Kakuta, Inho Soh, Toshihiro Ansai, Hidetoshi Nakamura

  Clinical and Experimental Dental Research 3 (1) 13 - 18 2057-4347 2017/02/01 [Refereed][Not invited]
   

  Periodontitis is common among dialysis patients. The current cross-sectional study aimed to explore associations between periodontitis and health-related quality of life (HRQoL) among hemodialysis patients. Data from 188 dentate patients undergoing hemodialysis between May and July 2008 at a medical center in Kitakyushu city, Japan, were analyzed while applying modified Centers for Disease Control and Prevention/American Academy of Periodontology periodontitis case definitions to categorize the participants into the following three groups: severe, moderate, and no/mild periodontitis, respectively. HRQoL was assessed by the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) where a higher score indicates better health status. Associations between periodontitis groups and the eight health domains of SF-36 were evaluated using general linear models that were adjusted for age, sex, underlying cause of dialysis, duration of dialysis, comorbidities, serum biomarkers, body mass index, smoking status, and alcohol use. Among the 188 participants, 18 (9.6%) had severe periodontitis, 100 (53.2%) had moderate periodontitis, and the remaining 70 (37.2%) had no/mild periodontitis. Compared with the participants with no/mild periodontitis, those with severe periodontitis had worse scores in the following five of eight SF-36 health scales: physical functioning, role physical, vitality, social functioning, and mental health (P <  0.05). The findings suggest an independent relationship between severe periodontitis and decreased HRQoL among dialysis patients.
• Effects of periodontal disease and diabetes mellitus on the life prognosis in an 80-year-old community population

  Tagami Ayaka, Sonoki Kazuo, Akifusa Sumio, Fukuhara Masayo, Awano Shuji, Kakuta Satoko, Soh Inho, Iwasaki Masanori, Ansai Toshihiro

  Nihon Shishubyo Gakkai Kaishi (Journal of the Japanese Society of Periodontology) 特定非営利活動法人 日本歯周病学会 59 (1) 19 - 27 0385-0110 2017 [Not refereed]
   

  To determine whether presence of periodontal disease and diabetes mellitus influence the life prognosis in 80-year-old subjects, oral and medical examinations were conducted in 697 residents of Fukuoka Prefecture of Japan who were 80 years old in 1997, and the dates and causes of death among these residents were determined 5 years and 12 years later. We analyzed the all-cause death, pneumonia death, cardiovascular-disease death and cancer death rates between the subjects with mild periodontal disease (no. of teeth with a probing depth ≥4 mm = 0-4; n = 526) and those with severe periodontal disease (no. of teeth with a probing depth ≥4 mm ≥5; n = 169), and also between the 77 diabetic patients (history of diabetes mellitus and/or random blood sugar levels ≥200 mg/dl) and 620 non-diabetic subjects. The relative risk of pneumonia death in the severe periodontal disease group was 2.28 times higher at the 12-year follow-up as compared to that in the mild periodontal disease group. On the other hand, the relative risks of cardiovascular-disease death and cancer death were not affected by the severity of the periodontal disease. The relative risks of pneumonia death and all-cause death determined at the 12-year follow-up were higher in the diabetic patients than in the non-diabetic subjects. When we analyzed four other subject groups (mild periodontal disease+non-diabetic, mild periodontal disease+diabetic, severe periodontal disease+non-diabetic, and severe periodontal disease+diabetic), the relative risk of pneumonia death at the 12-year follow-up was 2.90 times higher in the severe periodontal disease+non-diabetic group, 5.93 times higher in the mild periodontal disease+diabetic group, and 6.20 times higher in the severe periodontal disease+diabetic group as compared to that in the mild periodontal disease+non-diabetic group. The relative risks of all-cause death in the mild periodontal disease+diabetic group and severe periodontal disease+diabetic group were 2.24 times higher and 2.21 times higher, respectively, as compared to the relative risk in the mild periodontal disease+non-diabetic group. In the 80-year-old study population, it appeared that severe periodontal disease and diabetes mellitus independently increased the risk of pneumonia death, but when diabetes mellitus was present concomitantly with severe periodontal disease, the risk of pneumonia death appeared to be further increased.
• Do Community-dwelling 75-year-old People with 20 or More Teeth Have a Healthy Dietary Pattern?

  KIMURA Hideki, WATANABE Tomoko, SUZUKI Ayuho, IWASAKI Masanori, YOSHIHARA Akihiro, OGAWA Hiroshi, MIYAZAKI Hideo

  JOURNAL OF DENTAL HEALTH 一般社団法人 口腔衛生学会 67 (3) 172 - 180 0023-2831 2017 

  The oral health of elderly people is not only important in the maintenance of solid nutrition and articulation but also for their quality of life (QOL). The presence of ≥20 teeth is one of the criteria in the maintenance of the oral function and general health. In 2015, the Ministry of Health, Labour and Welfare of Japan announced the guideline called "Healthy Diet", which supports the longevity of Japanese people. We examined the association between the presence of ≥20 teeth and healthy diet among 75-year-old people. This study included 338 people aged 75 years who participated in the Niigata Elderly Study (2003), in which oral examination, medical checkup, and a brief-type self-administered diet history questionnaire (BDHQ) survey had been carried out. A healthy dietary pattern was defined according to Japan's healthy diet guideline. The healthy diet assumes that one meal consists of three main dishes: grain dish, fish or meat dish, and vegetable dish. For each dish, there are lower and upper limits on the amount of food consumed per meal. For this reason, we set the per-day lower limit as equal to three times the lower limit for a meal. In this study, the sufficiency group satisfied all three dish divisions (i.e., those who achieved a healthy dietary pattern), and the insufficiency group did not meet at least one dish division. The association between the presence of ≥20 teeth and a healthy dietary pattern was evaluated using multivariable logistic regression. As a result, individuals with ≥20 teeth had significantly higher odds of having a healthy dietary pattern (adjusted odds ratio, 1.7; 95% confidence interval: 1.1–2.6). In conclusion, our results suggest that there is a relationship between the presence of ≥20 teeth and meal patterns in elderly people.

• Malnutrition and oral disease in the elderly – is there any bidirectional relationship?

  Masanori Iwasaki, Misuzu Sato, Akihiro Yoshihara, Hideo Miyazaki

  Current Oral Health Reports 4 (2) 70 - 78 2017 [Refereed][Invited]
  
• The association between dentition status and sarcopenia in Japanese adults aged 75years

  M. Iwasaki, Y. Kimura, H. Ogawa, T. Wada, R. Sakamoto, Y. Ishimoto, M. Fujisawa, K. Okumiya, T. Ansai, H. Miyazaki, K. Matsubayashi

  JOURNAL OF ORAL REHABILITATION 44 (1) 51 - 58 0305-182X 2017/01 [Refereed][Not invited]
   

  Sarcopenia is an age-related loss of muscle mass and muscle strength or physical performance. There are limited data on the association between oral health and sarcopenia. To test the hypothesis that impaired dentition status was associated with sarcopenia, we conducted a cross-sectional study. A total of 272 community-dwelling Japanese adults aged 75years for whom data were available from comprehensive health examinations conducted in 2015 were included in this study. During dental examination, the number of natural teeth and occluding pairs of natural teeth was counted. In denture wearers, the fit of the removable dentures was also evaluated. The criteria proposed by the Asian Working Group for Sarcopenia were used to define sarcopenia. A multivariable logistic regression model was used to evaluate the association between dentition status and the presence of sarcopenia. The prevalence of sarcopenia was 257% (70/272). Compared to individuals with 10 occluding pairs of natural teeth, those with no occluding pairs of natural teeth had significantly higher risk of having sarcopenia (adjusted odds ratio, 337; 95% confidence interval, 107-1061), after adjusting for possible confounders. In addition, compared to individuals with well-fitting dentures, those with ill-fitting dentures had significantly higher risk of having sarcopenia (adjusted odds ratio, 507; 95% confidence interval, 159-1619). Our findings suggest that impaired dentition status is significantly associated with sarcopenia among community-dwelling Japanese adults aged 75years. Future longitudinal studies with larger, more diverse populations are necessary to validate our findings.
• Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants

  NCD Risk Factor Collaboration, NCD-RisC

  LANCET 389 (10064) 37 - 55 0140-6736 2017/01 [Refereed][Not invited]
   

  Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. Methods For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. Findings We pooled 1479 studies that had measured the blood pressures of 19.1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127.0 mm Hg (95% credible interval 125.7-128.3) in men and 122.3 mm Hg (121.0-123.6) in women; age-standardised mean diastolic blood pressure was 78.7 mm Hg (77.9-79.5) for men and 76.7 mm Hg (75.9-77.6) for women. Global age-standardised prevalence of raised blood pressure was 24.1% (21.4-27.1) in men and 20.1% (17.8-22.5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1.13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence. Interpretation During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe. Funding Wellcome Trust. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license.
• Longitudinal association of dentition status with dietary intake in Japanese adults aged 75 to 80 years

  Iwasaki M, A. Yoshihara, H. Ogawa, M. Sato, K. Muramatsu, R. Watanabe, T. Ansai, H. Miyazaki

  JOURNAL OF ORAL REHABILITATION 43 (10) 737 - 744 0305-182X 2016/10 [Refereed][Not invited]
   

  Limited information is available on the temporal association between dentition status and dietary intake. The aim of this 5-year prospective cohort study was to investigate whether impaired dentition was associated with subsequent decline in dietary intake in older Japanese adults. Two hundred and eighty-six community-dwelling Japanese individuals, all aged 75 years at baseline, were included in the study. Functional tooth units (FTUs), defined as a pair of opposing natural or prosthetic teeth excluding third molars (range: 0-14), were counted on the basis of baseline dental examinations. Individuals with 5 FTUs were defined as having impaired dentition. Dietary intake was assessed at baseline and 5 years later, using a validated dietary questionnaire. Robust regression analyses were used to evaluate the differences in change in dietary intake between participants with and without impaired functional dentition, after adjustment for potential confounders. Sixty-one study participants (213 %) were defined as having impaired dentition. Overall, mean values for all estimated dietary variables (energy, nutrients and food groups) declined over time. Notably, individuals with impaired dentition demonstrated a significantly (P < 005) greater degree of decline in the intake of multiple nutrients (protein, sodium, potassium, calcium, vitamin A, vitamin E and dietary fibre) and food groups (vegetable and meat) than those without impaired dentition, after adjusting for potential confounders. The results of this study describe the temporal association of impaired dentition with the decline in selected nutrient and food group intake among older Japanese adults.
• Longitudinal relationship of severe periodontitis with cognitive decline in older Japanese

  Iwasaki M, A. Yoshihara, Y. Kimura, M. Sato, T. Wada, R. Sakamoto, Y. Ishimoto, E. Fukutomi, W. Chen, H. Imai, M. Fujisawa, K. Okumiya, G. W. Taylor, T. Ansai, H. Miyazaki, K. Matsubayashi

  JOURNAL OF PERIODONTAL RESEARCH 51 (5) 681 - 688 0022-3484 2016/10 [Refereed][Not invited]
   

  Background and Objective: Epidemiologic data examining the longitudinal relationship between periodontitis and cognitive status are very limited, especially in Asian populations. The present study examined the longitudinal relationship of periodontitis with cognitive decline in 85 Japanese community-dwelling individuals (average age: 79.3 years) for whom data were available from comprehensive health examinations conducted in 2010 and 2013. Material and Methods: Based on a baseline full-mouth periodontal examination, severe periodontitis was defined using a Centers for Disease Control and Prevention/American Academy of Periodontology definition. Cognitive decline during the 3-year study period was defined using the results of the Mini-Mental State Examination (MMSE). Information on age, gender, education, depression, body mass index, smoking status, alcohol use, exercise, hypertension, diabetes, history of cardiovascular disease and stroke, and baseline MMSE scores were obtained and tested as potential confounders in the statistical models. Results: Among 85 study participants, 21 (24.7%) were defined as having severe periodontitis. Multivariable Poisson regression analyses revealed that severe periodontitis was significantly associated with an increased risk of cognitive decline [adjusted relative risk = 2.2; 95% confidence interval (95% CI): 1.1-4.5]. Furthermore, multivariable linear regression analyses revealed that participants with severe periodontitis had a 1.8-point greater decrease (95% CI: -3.3 to -0.2) in MMSE score than those without severe periodontitis. Conclusion: Within the limitations related to its small sample size, the findings of the present study suggest that severe periodontitis is significantly associated with future decline in cognitive function among community-dwelling older Japanese subjects.
• Bidirectional relationship between renal function and periodontal disease in older Japanese women.

  Akihiro Yoshihara, Masanori Iwasaki, Hideo Miyazaki, Kazutoshi Nakamura

  Journal of clinical periodontology 43 (9) 720 - 6 2016/09 [Refereed][Not invited]
   

  OBJECTIVES: The purpose of this study was to evaluate the reciprocal effects of chronic kidney disease (CKD) and periodontal disease. MATERIAL AND METHODS: A total of 332 postmenopausal never smoking women were enrolled, and their serum high-sensitivity C-reactive protein, serum osteocalcin and serum cystatin C levels were measured. Poor renal function was defined as serum cystatin C > 0.91 mg/l. Periodontal disease markers, including clinical attachment level and the periodontal inflamed surface area (PISA), were also evaluated. Logistic regression analysis was conducted to evaluate the relationships between renal function and periodontal disease markers, serum osteocalcin level and hsCRP level. The prevalence-rate ratios (PRRs) on multiple Poisson regression analyses were determined to evaluate the relationships between periodontal disease markers and serum osteocalcin, serum cystatin C and serum hsCRP levels. RESULTS: On logistic regression analysis, PISA was significantly associated with serum cystatin C level. The odds ratio for serum cystatin C level was 2.44 (p = 0.011). The PRR between serum cystatin C level and periodontal disease markers such as number of sites with clinical attachment level ≥6 mm was significantly positive (3.12, p < 0.001). Similar tendencies were shown for serum osteocalcin level. CONCLUSION: This study suggests that CKD and periodontal disease can have reciprocal effects.
• Cystatin C-based estimated glomerular filtration rate and periodontitis

  Masanori Iwasaki, George W. Taylor, Misuzu Sato, Kazutoshi Nakamura, Akihiro Yoshihara, Hideo Miyazaki

  GERODONTOLOGY 33 (3) 328 - 334 0734-0664 2016/09 [Refereed][Not invited]
   

  Background and ObjectiveAccumulating evidence suggests that decreased kidney function characterised by low estimated glomerular filtration rate (eGFR) may be associated with periodontitis. Recent studies have suggested that the use of cystatin C strengthens the association between the eGFR and the risks of adverse outcomes in decreased kidney function. The aim of this cross-sectional study was to investigate the association of cystatin C-based eGFR (eGFRcys) and creatinine-based eGFR (eGFRcreat), the commonly used method to assess kidney function, with periodontitis in 502 Japanese women (average age, 68.6years). Materials and MethodsGFR was estimated from serum cystatin C and serum creatinine, respectively, using the Japanese equation for GFR. Participants were classified into five groups according to their eGFRcys and eGFRcreat values. Poisson regression models with robust error variance assessed the associations of eGFRcys and eGFRcreat with periodontitis. Tests for trends were performed by fitting the five-category eGFR variables in their continuous form to the regression models. ResultsParticipants with eGFRcys<50ml/min/1.73 m(2) were at significantly higher risk of periodontitis compared with the reference group (90ml/min/1.73m(2)) (adjusted relative risk = 2.12, 95% confidence interval = 1.12 to 4.02). Additionally, there was a trend towards a higher risk of periodontitis among participants with lower eGFRcys values (p for trend in the multivariable model = 0.008). In contrast, eGFRcreat did not show a significant association with periodontitis. ConclusionThe findings of this study of Japanese older women showed that eGFRcys had a stronger and more linear association with periodontitis than eGFRcreat.
• Maximum bite force at age 70 years predicts all-cause mortality during the following 13 years in Japanese men

  Iwasaki M, A. Yoshihara, N. Sato, M. Sato, G. W. Taylor, T. Ansai, T. Ono, H. Miyazaki

  JOURNAL OF ORAL REHABILITATION 43 (8) 565 - 574 0305-182X 2016/08 [Refereed][Not invited]
   

  There is limited information on the impact of oral function on mortality among older adults. The aim of this prospective cohort study was to examine whether an objective measure of oral function, maximum bite force (MBF), is associated with mortality in older adults during a 13-year follow-up period. Five hundred and fifty-nine community-dwelling Japanese (282 men and 277 women) aged 70 years at baseline were included in the study. Medical and dental examinations and a questionnaire survey were conducted at baseline. Maximum bite force was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up investigation to ascertain vital status was conducted 13 years after baseline examinations. Survival rates among MBF tertiles were compared using Cox proportional hazards regression models stratified by sex. There were a total of 111 deaths (82 events for men and 29 for women). Univariable analysis revealed that male participants in the lower MBF tertile had increased risk of all-cause mortality [hazard ratio (HR) = 1.94, 95% confidence interval (CI) = 1.13-3.34] compared with those in the upper MBF tertile. This association remained significant after adjustment for confounders (adjusted HR = 1.84, 95% CI = 1.07-3.19). Conversely, no association between MBF and all-cause mortality was observed in female participants. Maximum bite force was independently associated with all-cause mortality in older Japanese male adults. These data provide additional evidence for the association between oral function and geriatric health.
• Association between periodontitis and medical expenditure in older adults: A 33-month follow-up study.

  Misuzu Sato, Masanori Iwasaki, Akihiro Yoshihara, Hideo Miyazaki

  Geriatrics & gerontology international 16 (7) 856 - 64 2016/07 [Refereed][Not invited]
   

  AIM: Along with rapid aging, medical expenditure for older adults has been increasing in Japan. Research has shown that periodontitis is a useful predictor for excess medical expenditure; however, limited information is available on the elderly population after adequately considering confounding factors. The aim of the present study was to evaluate the association between periodontitis and long-term medical expenditure in elderly Japanese. METHODS: Baseline health and periodontal examinations were carried out in June 2008. Japanese adults (n = 245) aged 80 years were classified into quartiles based on periodontal inflamed surface area (PISA), which quantifies the degree of periodontal inflammation. Medical care use and costs were monitored by assessment of the National Health Insurance claim files from the baseline survey through the end of February 2011. Multivariable analysis of the differences in medical expenditure among PISA quartiles was carried out using linear regression with robust standard errors. RESULTS: The participants in the fourth (with the largest PISA) and third quartiles had significantly higher inpatient medical expenditure compared with those of the first quartile (P < 0.01 and = 0.04, respectively). Participants in the fourth quartile had significantly higher total medical expenditure (P < 0.01) compared with the first quartile. A trend was observed of higher inpatient and total medical expenditure with increasing PISA. CONCLUSIONS: A significant association was found between periodontitis and future increase in medical expenditure, suggesting that periodontitis might be a modifiable factor for the reduction of excess medical expenditure among elderly Japanese. Geriatr Gerontol Int 2016; 16: 856-864.
• Association between Dietary Intake and Bone Mineral Density in Japanese Postmenopausal Women: The Yokogoshi Cohort Study.

  Harumi Hirata, Kaori Kitamura, Toshiko Saito, Ryosaku Kobayashi, Masanori Iwasaki, Akihiro Yoshihara, Yumi Watanabe, Rieko Oshiki, Tomoko Nishiwaki, Kazutoshi Nakamura

  The Tohoku journal of experimental medicine 239 (2) 95 - 101 2016/06 [Refereed][Not invited]
   

  Diet and food intake play an important role in the development of osteoporosis. However, apart from calcium and vitamin D, how nutrients affect bone status is not fully understood. The purpose of this study was to determine cross-sectional and longitudinal associations between dietary intake and bone mineral density (BMD) in Japanese postmenopausal women. This 5-year cohort study included 600 community-dwelling women aged 55-74 years at baseline in 2005. Information on demographics, nutrition, and lifestyle was obtained through interviews, and nutritional and dietary intake was assessed using a validated food frequency questionnaire. BMD measurements were performed by dual energy X-ray absorptiometry. In 2010, 498 women underwent follow-up BMD examinations. Multiple linear regression analysis was performed to determine associations of predictor variables with BMD, adjusting for confounders. In cross-sectional analyses, coffee or black tea consumption was positively associated with lumbar spine (P = 0.004) and total hip (P = 0.003) BMD, and alcohol intake was positively associated with femoral neck (P = 0.005) and total hip (P = 0.001) BMD. In longitudinal analyses, vitamin K (P = 0.028) and natto (fermented soybeans) (P = 0.023) were positively associated with lumbar spine BMD, and meat or meat product consumption was inversely associated with total hip (P = 0.047) BMD. In conclusion, dietary factors other than calcium and vitamin D intake are predictors of bone mass and bone loss in Japanese postmenopausal women. In particular, natto intake is recommended for preventing postmenopausal bone loss on the basis of current evidence.
• Serum antibody to Porphyromonas gingivalis in metabolic syndrome among an older Japanese population

  Masanori Iwasaki, Kumiko Minagawa, Misuzu Sato, Noboru Kaneko, Susumu Imai, Akihiro Yoshihara, Hideo Miyazaki

  GERODONTOLOGY 33 (2) 193 - 200 0734-0664 2016/06 [Refereed][Not invited]
   

  Background and ObjectivePotentially significant associations between metabolic syndrome (MetS) and periodontal disease have been reported in recent studies; however, there is a dearth of literature regarding the relationship of MetS with serum antibody levels to periodontal pathogens. The aim of this cross-sectional study was to investigate the association between MetS and serum antibody to the periodontal pathogen Porphyromonas gingivalis (P.gingivalis) in 216 Japanese individuals aged 79years. Materials and MethodsSerum antibody levels to P.gingivalis were measured by enzyme-linked immunosorbent assay. An elevated serum antibody response was defined as the upper quartile and was considered as the outcome variable. A multivariable logistic regression model was used to evaluate the association of MetS defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria with an elevated antibody status. Adjustments for gender, income, education, smoking status, dental-care utilisation patterns and brushing frequency were considered. ResultsThe prevalence of MetS was 22.2% (n=48). Study participants with MetS were 2.9 times more likely to have an elevated serum antibody to P.gingivalis (adjusted odds ratio=2.91, 95% confidence interval=1.24-6.85) after simultaneous adjustment for other covariates. ConclusionOur findings suggest an independent relationship between MetS and serum antibody levels to P.gingivalis in the Japanese elderly. Additional longitudinal epidemiologic studies with larger, more diversified samples and more complete information are needed to substantiate our findings.
• A century of trends in adult human height

  NCD Risk Factor Collaboration, NCD-RisC

  eLIFE e13410 2016/05 [Refereed][Not invited]
  
• Hyposalivation and dietary nutrient intake among community-based older Japanese

  Masanori Iwasaki, Akihiro Yoshihara, Kayoko Ito, Misuzu Sato, Kumiko Minagawa, Kanako Muramatsu, Reiko Watanabe, Michael C. Manz, Toshihiro Ansai, Hideo Miyazaki

  GERIATRICS & GERONTOLOGY INTERNATIONAL 16 (4) 500 - 507 1444-1586 2016/04 [Refereed][Not invited]
   

  AimSaliva is important for maintaining oral function and regulating oral health. Reduced saliva flow rate, which is common among older adults, has been reported to be associated with perceived chewing and swallowing difficulties; however, its relationship to actual nutrient intake is unclear. The aim of the present cross-sectional study was to evaluate the relationship between hyposalivation and nutrient intake among older Japanese adults. MethodsThe participants were 352 community-based Japanese aged 80 years. A stimulated salivary flow rate <0.5mL/min was defined as hyposalivation. Multivariable analysis of differences in nutrient and food intake outcome variables, which were collected through a validated food frequency questionnaire, between groups with/without hyposalivation was carried out using general linear models. Models included adjustment for number of teeth, denture use, sex, income, education, body mass index, smoking status, alcohol use, diabetes, medication, activities of daily living, depression and total calorie intake. ResultsThe hyposalivation group had significantly lower intake of n-3 polyunsaturated fatty acid, potassium, vitamin D, vitamin E, vitamin B6 and folate than the group without hyposalivation (P<0.05) after adjusting for confounders. Vegetable, fish and shellfish consumption was significantly lower in the hyposalivation group (P<0.05). ConclusionsDietary intake was poorer in those with hyposalivation than among those without. A decrease in stimulated salivary flow rate could have negative effects on geriatric nutrition. Geriatr Gerontol Int 2016; 16: 500-507.
• Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants

  NCD Risk Factor Collaboration, NCD-RisC

  LANCET 387 (10026) 1377 - 1396 0140-6736 2016/04 [Refereed][Not invited]
   

  Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18.5 kg/m(2) [underweight], 18.5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to <30 kg/m(2), 30 kg/m(2) to <35 kg/m(2), 35 kg/m(2) to <40 kg/m(2), = 40 kg/m(2) [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19.2 million adult participants (9.9 million men and 9.3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21.7 kg/m(2) (95% credible interval 21.3-22.1) in 1975 to 24.2 kg/m(2) (24.0-24.4) in 2014 in men, and from 22.1 kg/m(2) (21.7-22.5) in 1975 to 24.4 kg/m(2) (24.2-24.6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21.4 kg/m(2) in central Africa and south Asia to 29.2 kg/m(2) (28.6-29.8) in Polynesia and Micronesia; for women the range was from 21.8 kg/m(2) (21.4-22.3) in south Asia to 32.2 kg/m(2) (31.5-32.8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13.8% (10.5-17.4) to 8.8% (7.4-10.3) in men and from 14.6% (11.6-17.9) to 9.7% (8.3-11.1) in women. South Asia had the highest prevalence of underweight in 2014, 23.4% (17.8-29.2) in men and 24.0% (18.9-29.3) in women. Age-standardised prevalence of obesity increased from 3.2% (2.4-4.1) in 1975 to 10.8% (9.7-12.0) in 2014 in men, and from 6.4% (5.1-7.8) to 14.9% (13.6-16.1) in women. 2.3% (2.0-2.7) of the world's men and 5.0% (4.4-5.6) of women were severely obese (ie, have BMI = 35 kg/m(2)). Globally, prevalence of morbid obesity was 0.64% (0.46-0.86) in men and 1.6% (1.3-1.9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia. Copyright (C) NCD Risk Factor Collaboration. Open Access article distributed under the terms of CC BY.
• Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants

  NCD Risk Factor Collaboration, NCD-RisC

  LANCET 387 (10027) 1513 - 1530 0140-6736 2016/04 [Refereed][Not invited]
   

  Background One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. Methods We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. Findings We used data from 751 studies including 4 372 000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-7.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Interpretation Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries. Funding Wellcome Trust. Copyright (C) NCD Risk Factor Collaboration. Open Access article distributed under the terms of CC BY.
• PPARγ gene polymorphism, C-reactive protein level, BMI and periodontitis in post-menopausal Japanese women.

  Yangming Wang, Noriko Sugita, Akihiro Yoshihara, Masanori Iwasaki, Hideo Miyazaki, Kazutoshi Nakamura, Hiromasa Yoshie

  Gerodontology 33 (1) 44 - 51 2016/03 [Refereed][Not invited]
   

  BACKGROUND: Several studies have reported inconsistent results regarding the association between the PPARγPro12Ala polymorphism and obesity. Obese individuals had higher C-reactive protein (CRP) levels compared with those of normal weight, and PPARγ activation could significantly reduce serum high-sensitive CRP level. We have previously suggested that the Pro12Ala polymorphism represents a susceptibility factor for periodontitis, which is a known risk factor for increased CRP level. OBJECTIVES: The aim was to investigate associations between PPARγ gene polymorphism, serum CRP level, BMI and/or periodontitis among post-menopausal Japanese women. MATERIALS AND METHODS: The final sample in this study comprised 359 post-menopausal Japanese women. Periodontal parameters, including PD, CAL and BOP, were measured per tooth. PPARγPro12Ala genotype was determined by PCR-RFLP. Hs-CRP value was measured by a latex nephelometry assay. RESULTS: No significant differences in age, BMI or periodontal parameters were found between the genotypes. The percentages of sites with PD ≥ 4 mm were significantly higher among the hsCRP ≥ 1 mg/l group than the hsCRP < 1 mg/l group (p = 0.003). Positive correlations were found between serum hsCRP levels and the percentages of sites with PD ≥ 4 mm (p = 0.043) in PPARγ Ala allele carriers, and BMI (p = 0.033) in non-carriers. After adjustment for model covariates, BMI was significantly associated with serum hsCRP level. CONCLUSION: The PPARγPro12Ala polymorphism was not independently associated with periodontitis, serum CRP level or BMI in post-menopausal Japanese women. However, serum hsCRP level correlated with periodontitis in Ala allele carriers, and with BMI in non-carriers.
• Effects of Periodontal Diseases on Diabetes-Related Medical Expenditure

  Masanori Iwasaki, Misuzu Sato, Akihiro Yoshihara, Hideo Miyazaki

  Current Oral Health Reports 3 (1) 7 - 13 2016 [Refereed][Invited]
  
• Oral health status in relation to cognitive function among older Japanese.

  Masanori Iwasaki, Yumi Kimura, Akihiro Yoshihara, Hiroshi Ogawa, Takayuki Yamaga, Misuzu Sato, Taizo Wada, Ryota Sakamoto, Yasuko Ishimoto, Eriko Fukutomi, Wenling Chen, Hissei Imai, Michiko Fujisawa, Kiyohito Okumiya, George W Taylor, Toshihiro Ansai, Hideo Miyazaki, Kozo Matsubayashi

  Clinical and experimental dental research 1 (1) 3 - 9 2015/10 [Refereed][Not invited]
   

  Epidemiologic data examining the relationship between oral health status and cognitive status are sparse, especially in Asian populations. This study aimed to assess whether periodontal disease and tooth loss were related to cognitive impairment among older Japanese. Study participants were 291 Japanese (101 men and 190 women, average age: 80.9 years), classified into three groups based on a clinical examination of oral health status: no periodontal disease, periodontal disease, and edentulous. Periodontal disease was defined using criteria recommended in the consensus report of the European Workshop in Periodontology with a modification. Cognitive impairment was defined using the results of the Mini-mental State Examination (MMSE) and Hasegawa Dementia Scale-Revised (HDS-R) scores. Multivariable logistic regression analyses assessed the relationship of the three-category oral health status variable (reference category = no periodontal disease) with low MMSE score (≤23) and low HDS-R score (≤20). Age, gender, years of education, body mass index, smoking status, drinking behavior, and history of cardiovascular disease were tested as potential confounders in the multivariable models. Periodontal disease and edentulous were significantly associated with greater odds of low cognitive performance after controlling for potential confounders. The multivariable adjusted odds ratios (ORs) (95% confidence intervals [CIs]) for low MMSE score associated with periodontal disease and edentulous were 2.21 (1.01-4.84) and 2.28 (1.06-4.90), respectively. The multivariable adjusted ORs (95% CIs) for low HDS-R score associated with periodontal disease and edentulous were 4.85 (1.29-18.15) and 3.86 (1.05-14.20), respectively. Poor oral health status was significantly associated with cognitive impairment among community-dwelling older Japanese. Additional well-controlled longitudinal studies are needed to elucidate whether there may be a possible cause-and-effect relationship between oral health status and cognitive function.
• The Interaction Between β-3 Adrenergic Receptor and Peroxisome Proliferator-Activated Receptor Gamma Gene Polymorphism to Periodontal Disease in Community-Dwelling Elderly Japanese.

  Akihiro Yoshihara, Noriko Sugita, Masanori Iwasaki, Yanming Wang, Hideo Miyazaki, Hiromasa Yoshie, Kazutoshi Nakamura

  Journal of periodontology 86 (8) 955 - 63 2015/08 [Refereed][Not invited]
   

  BACKGROUND: It has been hypothesized that β-3 adrenergic receptor and peroxisome proliferator-activated receptor gamma (PPARγ) might have gene-environmental and gene-gene interactions in periodontal disease. The purpose of this study is to elucidate the interaction between β-3 adrenergic receptor and PPARγ gene polymorphism with periodontal disease. METHODS: Three hundred thirty-two postmenopausal females were enrolled, and their serum high-sensitivity C-reactive protein (hsCRP) and hemoglobin A1c (HbA1c) were examined. β-3 adrenergic receptor and PPARγ genotypes were then determined. An oral examination was performed. The number of remaining teeth was counted, and the probing depth (PD) and clinical attachment level (CAL) were measured. Prevalence-rate ratios (PRRs) were calculated by multiple Poisson regression analyses to evaluate the relationship among periodontal disease markers, such as the number of sites with CAL 4 to 5 or ≥6 mm or PD 4 to 5 or ≥6 mm, and β-3 adrenergic receptor polymorphisms, PPARγ polymorphisms, and the interaction term adjusted by age, hsCRP, and HbA1c, after converting the number of remaining teeth (n) to an offset variable. RESULTS: In the participants with body mass index (BMI) ≥25, PRRs of β-3 adrenergic receptor genotype (Trp/Arg and Arg/Arg) for periodontal disease markers were 0.13 to 0.70 (P <0.0001 to 0.74), those of PPARγ genotype (Pro/Pro) were 0.66 to 3.14 (P = 0.01 to 0.68), and those of the interaction term for the two genotypes were 1.69 to 12.61 (P <0.0001 to 0.33). However, in the participants with BMI <25, a constant tendency was not observed. CONCLUSION: The results confirmed a positive relationship between the interaction term for β-3 adrenergic receptor genotype and PPARγ genotype and various periodontal markers in obese elderly females.
• Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331288 participants

  NCD Risk Factor Collaboration, NCD-RisC

  LANCET DIABETES & ENDOCRINOLOGY 3 (8) 624 - 637 2213-8587 2015/08 [Refereed][Not invited]
   

  Background Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA(1c). We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions. Methods We used data from 96 population-based health examination surveys that had measured at least two of the biomarkers used for defining diabetes. Diabetes was defined using HbA(1c) (HbA(1c) >= 6 . 5% or history of diabetes diagnosis or using insulin or oral hypoglycaemic drugs) compared with either FPG only or FPG-or-2hOGTT definitions (FPG >= 7 . 0 mmol/L or 2hOGTT >= 11 . 1 mmol/L or history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated diabetes prevalence, taking into account complex survey design and survey sample weights. We compared the prevalences of diabetes using different definitions graphically and by regression analyses. We calculated sensitivity and specificity of diabetes diagnosis based on HbA1c compared with diagnosis based on glucose among previously undiagnosed individuals (ie, excluding those with history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated sensitivity and specificity in each survey, and then pooled results using a random-effects model. We assessed the sources of heterogeneity of sensitivity by meta-regressions for study characteristics selected a priori. Findings Population prevalence of diabetes based on FPG- or-2hOGTT was correlated with prevalence based on FPG alone (r= 0 . 98), but was higher by 2-6 percentage points at different prevalence levels. Prevalence based on HbA(1c) was lower than prevalence based on FPG in 42 . 8% of age-sex-survey groups and higher in another 41 . 6%; in the other 15 . 6%, the two definitions provided similar prevalence estimates. The variation across studies in the relation between glucose-based and HbA(1c)-based prevalences was partly related to participants' age, followed by natural logarithm of per person gross domestic product, the year of survey, mean BMI, and whether the survey population was national, subnational, or from specific communities. Diabetes defined as HbA(1c) 6 . 5% or more had a pooled sensitivity of 52 . 8% (95% CI 51 . 3-54 . 3%) and a pooled specificity of 99 . 74% (99 . 71-99 . 78%) compared with FPG 7 . 0 mmol/L or more for diagnosing previously undiagnosed participants; sensitivity compared with diabetes defined based on FPG-or-2hOGTT was 30 . 5% (28 . 7-32 . 3%). None of the preselected study-level characteristics explained the heterogeneity in the sensitivity of HbA(1c) versus FPG. Interpretation Different biomarkers and definitions for diabetes can provide different estimates of population prevalence of diabetes, and differentially identify people without previous diagnosis as having diabetes. Using an HbA(1c)-based definition alone in health surveys will not identify a substantial proportion of previously undiagnosed people who would be considered as having diabetes using a glucose-based test.
• Association between dental status and food diversity among older Japanese

  Iwasaki M, Y. Kimura, A. Yoshihara, H. Ogawa, T. Yamaga, T. Takiguchi, T. Wada, R. Sakamoto, Y. Ishimoto, E. Fukutomi, W. Chen, H. Imai, M. Fujisawa, K. Okumiya, M. C. Manz, H. Miyazaki, K. Matsubayashi

  COMMUNITY DENTAL HEALTH 32 (2) 104 - 110 0265-539X 2015/06 [Refereed][Not invited]
   

  Objective: To investigate the relationship of dental status to food diversity among older Japanese. Design and Setting: A community-based cross-sectional study conducted in the town of Tosa, Kochi Prefecture, Japan. Methods: The study participants were 252 Japanese ( 84 men and 168 women, average age 81.2 years) and dentate participants were classified into three groups: 1-9 teeth, 10-19 teeth and 20 or more teeth. Food diversity was assessed as a validated measure of dietary quality using the 11-item Food Diversity Score Kyoto (FDSK-11), which evaluates frequency of consumption of 11 main food groups. Multivariable analysis of the differences in FDSK-11 score ranging from 0 to 11, with a higher score indicating greater food diversity, among the three dental status groups was conducted using general linear models. All the performed analyses were stratified by gender. Results: There was no association between dental status and food diversity score in models for men. In contrast, women with <= 9 teeth and with 10-19 teeth had significantly lower FDSK-11 scores than women with >= 20 teeth after adjusting for confounders (p<0.001 and p=0.009, respectively). Additionally, there was a trend toward lower scores for FDSK-11 with fewer teeth (p=0.001). Conclusion: A less varied diet, as indicated by low FDSK-11 score, was observed in female participants with fewer teeth. Tooth loss was associated with poor diet quality among older Japanese women.
• Relationships between IL-6 gene polymorphism, low BMD and periodontitis in postmenopausal women

  Y. Hanai, N. Sugita, Y. Wang, A. Yoshihara, Iwasaki M, H. Miyazaki, K. Nakamura, H. Yoshie

  ARCHIVES OF ORAL BIOLOGY 60 (4) 533 - 539 0003-9969 2015/04 [Refereed][Not invited]
   

  Objective: IL-6 plays critical roles in bone resorption and the pathogenesis of periodontitis in both inflammation and alveolar bone loss. A negative correlation was observed between periodontitis and truncal bone mineral density (BMD) in postmenopausal women. The C allele carriers of a genetic polymorphism IL-6-572G/C have higher levels of serum IL-6 compared to G allele carriers. We investigated the possible effect of IL-6-572G/C polymorphism on the relationship between low BMD and periodontitis in postmenopausal women. Subjects and methods: A total of 300 postmenopausal Japanese women who lived in Yokogoshi area of Niigata City, Japan, participated in this study. Genomic DNA was extracted from peripheral blood. The IL-6-572G/C genotypes were determined by the restriction fragment length polymorphism method. Bone mineral density (BMD) of right femoral neck and serum bone metabolism markers were measured. Low BMD was defined to have the BMD < 80% of the mean for young adults. Periodontal parameters at two sites per tooth were measured. Results: Serum osteocalcin levels were significantly lower in the IL-6-572G/G genotype (p = 0.025). In the -572G allele non-carriers, percentages of PPD >= 4 mm sites were significantly higher in low BMD group compared with the healthy control group (p = 0.021). Logistic regression analysis revealed low BMD to be associated with periodontitis (Odds ratio = 1.736, p = 0.027) after adjusted with IL-6-572G carriage, age, serum albumin level. Conclusions: IL-6-572G/C polymorphism was not an independent risk factor of low BMD or periodontitis, but may affect the relationship between the two diseases in postmenopausal Japanese women. (C) 2015 Published by Elsevier Ltd.
• 地域在住高齢者における歯・口腔の健康が認知機能検査スコアに与える影響

  岩崎 正則, 葭原 明弘, 小川 祐司, 山賀 孝之, 佐藤 美寿々, 安細 敏弘, 宮崎 秀夫

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 65 (2) 195 - 195 0023-2831 2015/04 [Refereed][Not invited]
  
• Relationship between metabolic syndrome and periodontitis in 80-year-old Japanese subjects.

  K Minagawa, Iwasaki M, H Ogawa, A Yoshihara, H Miyazaki

  Journal of periodontal research 50 (2) 173 - 9 2015/04 [Refereed][Not invited]
   

  BACKGROUND AND OBJECTIVE: Potentially significant associations between metabolic syndrome (MetS) and periodontitis have been reported in recent studies; however, there are limited data on their association in the very old. The aim of this cross-sectional study was to investigate the association between MetS and periodontitis among 80-year-old Japanese subjects. MATERIAL AND METHODS: The subjects were 234 Japanese aged 80 years old who participated in a health and periodontal examination in June 2008 in Niigata city, Japan, and were classified into three groups: (i) severe periodontitis: having six or more interproximal sites with clinical attachment level ≥ 6 mm and three or more interproximal sites with probing pocket depth (PPD) ≥ 5 mm (not on the same tooth) (n = 19); (ii) moderate periodontitis: having six or more interproximal sites with clinical attachment level ≥ 4 mm or six or more interproximal sites with PPD ≥ 5 mm (not on the same tooth) (n = 162); and (iii) no or mild periodontitis: neither "moderate" nor "severe" periodontitis (n = 53). MetS was defined using the modified criteria of the guidelines for the diagnosis of MetS in Japan. An ordinal logistic regression model was used to evaluate the association between MetS and periodontitis. Adjustments for gender, income, education, smoking status, dental visiting patterns, brushing frequency, exercise habits and dietary energy and food intake were considered. RESULTS: Overall, 57 individuals (24.4%) were diagnosed as having MetS. MetS was associated with the presence and severity of periodontitis (crude odds ratio = 2.24, 95% confidence interval = 1.14-4.41). This association remained statistically significant after multivariate adjustments (adjusted odds ratio = 2.10, 95% confidence interval = 1.03-4.28). CONCLUSION: Our findings provide evidence of an association between MetS and periodontitis in elderly Japanese.
• Longitudinal Relationship Between Metabolic Syndrome and Periodontal Disease Among Japanese Adults Aged >= 70 Years: The Niigata Study

  Masanori Iwasaki, Misuzu Sato, Kumiko Minagawa, Michael C. Manz, Akihiro Yoshihara, Hideo Miyazaki

  JOURNAL OF PERIODONTOLOGY 86 (4) 491 - 498 0022-3492 2015/04 [Refereed][Not invited]
   

  Background: There has been little evaluation in longitudinal epidemiologic studies of the effect of metabolic syndrome (MetS) on periodontal status. The specific aim of this longitudinal study is to investigate whether MetS in the Japanese population could be a risk factor for periodontal disease. Methods: A total of 125 older adults from Japan for whom data were available for the years 2003 to 2006 were selected for the current study. Full-mouth periodontal status, measured as clinical attachment level (CAL), was recorded at baseline and in follow-up examinations. Development of periodontal disease was considered to be >= 2 teeth demonstrating a longitudinal loss of proximal attachment of >= 3 mm at the follow-up dental examination. A multivariable Poisson regression model with robust error variance was used to evaluate the association of MetS defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria with development of periodontal disease. Adjustments for sex, income, education, smoking status, number of teeth at baseline, mean CAL at baseline, pattern of visits to a dentist, and brushing frequency were considered. Results: The prevalence of MetS was 21.6% (27/125). Study participants with MetS were approximately 2.6 times more likely to develop periodontal disease (adjusted relative risk 2.58, 95% confidence interval 1.17 to 5.67) after simultaneous adjustment for other covariates. Conclusions: These findings support the hypothesis that MetS may be a risk factor for periodontal disease in older Japanese individuals. Additional studies with larger, more diverse populations and more complete information are needed to substantiate the findings.
• Low dietary diversity among older Japanese adults with impaired dentition

  Iwasaki M, Kimura Y, Yoshihara A, Ogawa H, Yamaga T, Wada T, Sakamoto R, Ishimoto Y, Fukutomi E, Chen W, Imai H, Fujisawa M, Okumiya K, Manz MC, Ansai T, Miyazaki H, Matsubayashi K

  Journal of Dentistry and Oral Hygiene 7 (4) 71 - 77 2015 [Refereed][Not invited]
  
• Oral health status: relationship to nutrient and food intake among 80-year-old Japanese adults

  Masanori Iwasaki, George W. Taylor, Michael C. Manz, Akihiro Yoshihara, Misuzu Sato, Kanako Muramatsu, Reiko Watanabe, Hideo Miyazaki

  COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY 42 (5) 441 - 450 0301-5661 2014/10 [Refereed][Not invited]
   

  ObjectivesThe aim of this cross-sectional study was to investigate the relationship of oral health status defined on the basis of presence of posterior occluding pairs (POPs) and adequacy of removable denture fit as determined by self-report to nutrient and food intake among older Japanese. MethodsThe subjects were 353 Japanese aged 80years in 2008 and were classified into four groups according to the number of POPs, defined as pairs of occluding natural, restored, or fixed prosthetic postcanine teeth (range: 0-8) and removable denture status. The groups were: (i) good dentition (n=56; 8 POPs and no removable prosthesis), (ii) well-fitting dentures (n=158; <8 POPs with self-reported good-fitting dentures), (iii) ill-fitting dentures (n=70; <8 POPs with self-reported ill-fitting dentures), and (iv) compromised dentition (n=69; <8 POPs and no removable prosthesis). Multivariable analysis of the differences in nutrient and food intake outcome variables which were collected via validated food frequency questionnaire among the four oral health status groups was conducted using general linear models. ResultsIntake of multiple nutrients was significantly (P<0.05) lower in the group with ill-fitting dentures or compromised dentition than in the good dentition group. Vegetable, fish, and shellfish consumption was significantly lower in the ill-fitting dentures or compromised dentition groups. No significant differences were seen in dietary intake between the well-fitting dentures and good dentition groups. ConclusionsDietary intake was poorer in those with self-perceived ill-fitting dentures or fewer POPs than among those having all POPs. Regular dental care to maintain intact dentition, as well as dental treatment to replace missing teeth and ensure adequate denture fit and function, may be important to the diet intake and subsequent nutritional status of older Japanese.
• Association between low renal function and tooth loss over 5 years.

  Akihiro Yoshihara, Masanori Iwasaki, Hideo Miyazaki, Kazutoshi Nakamura

  Gerodontology 31 (2) 111 - 6 2014/06 [Refereed][Not invited]
   

  OBJECTIVES: This longitudinal study evaluated the relationship between low renal function and tooth loss in elderly subjects. MATERIAL AND METHODS: Subjects comprised 406 female subjects (55-74 years old) who agreed to participate in a baseline examination and a follow-up examination after 5 years. Serum cystatin C levels were used to assess renal function. Multiple logistic regression analysis was used to evaluate the relationship between tooth loss and change in serum cystatin C levels over 5 years. Tooth loss over 5 years (0: no, 1: yes) was used as the dependent variable. Seven variables were used as independent variables, including change in serum cystatin C levels over 5 years. RESULTS: Results of multiple logistic regression analysis showed that cystatin C change over 5 years, age, number of remaining teeth at baseline, number of sites with ≥4 mm clinical attachment level at baseline and serum 25-hydroxyvitamin D levels at baseline were significantly associated with tooth loss. The odds ratio for tooth loss with cystatin C change over 5 years was 7.70 (p=0.029). CONCLUSION: This study indicates a relationship between serum cystatin C levels and number of missing teeth, and thus suggests that low renal function is associated with tooth loss.
• The interaction between beta-3 adrenergic receptor polymorphism and obesity to periodontal disease in community-dwelling elderly Japanese.

  Akihiro Yoshihara, Noriko Sugita, Masanori Iwasaki, Hideo Miyazaki, Kazutoshi Nakamura

  Journal of clinical periodontology 41 (5) 460 - 6 2014/05 [Refereed][Not invited]
   

  OBJECTIVES: The purpose of this study was to elucidate whether the association between beta-3 adrenergic receptor polymorphism and periodontal disease is modified by body weight. MATERIAL AND METHODS: We enrolled 332 postmenopausal women and determined their HbA1C levels (%) and beta-3 adrenergic receptor (rs4994) genotypes. Periodontal parameters including clinical attachment level (CAL) were measured. After selecting subjects for each body mass index (BMI) level, the prevalence rate ratio (PRR) by multiple Poisson regression analysis was calculated to evaluate the relationship between periodontal disease and beta-3 adrenergic receptor polymorphism. The number of sites with CAL≥6 mm was used as a dependent variable, and beta-3 adrenergic receptor genotype [categorized as Arg non-carriers (reference) or Arg carriers], age (y) and HbA1C (%) were adopted as independent variables. We converted the number of probing sites (n) to an offset variable. RESULTS: The PRR of the beta-3 adrenergic receptor genotype for the number of sites of CAL≥6 mm showed a positive association in subjects with BMI≥25.0 and increased markedly with BMI. The PRR in subjects with BMI≥30 was 3.10 (p < 0.0001). CONCLUSION: This study indicates a positive association between periodontal disease and the beta-3 adrenergic receptor genotype in obese individuals.
• Association between low bone mineral density and clinical attachment loss in Japanese postmenopausal females

  Masanori Iwasaki, George W. Taylor, Kazutoshi Nakamura, Akihiro Yoshihara, Hideo Miyazaki

  Journal of Periodontology 84 (12) 1708 - 1716 0022-3492 2013/12 [Refereed][Not invited]
   

  Background: Previous studies have shown conflicting results as to whether low bone mineral density (BMD) is associated with severe clinical attachment loss (AL). The effect of dental restoration on AL was not considered in most studies. In addition, studies of this association in Japanese individuals are limited. The aim of this crosssectional study is to evaluate the possible association between BMD and AL with dental restoration information in Japanese community-dwelling postmenopausal females. Methods: The participants were 397 females (average age: 68.2 years). BMDs of the lumbar spine and right proximal femur were measured by the dual-energy x-ray absorptiometry method. Based on lower BMD/young adult mean (YAM) among the two sites measured, participants were classified into three groups: 1) normal: BMD = 80% YAM or higher (n = 161) 2) osteopenia: BMD = 70% to 80% YAM (n = 136) and 3) osteoporosis: BMD = < 70% YAM (n = 100). Multivariable analyses of the differences in AL values among three BMD groups was conducted using general linear models. Adjustments for the percentage of teeth restored and other covariates were considered. Results: Individuals with osteopenia had significantly higher average AL than individuals with normal BMD (P = 0.022). Additionally, the osteoporosis group displayed significantly higher average AL (P = 0.003) and higher percentages of sites with AL ≥4 mm (P = 0.007). Conclusion: The results of the present study indicate that low systemic BMD was associated with severe AL in Japanese community-dwelling postmenopausal females.
• Serum albumin levels and 10-year tooth loss in a 70-year-old population

  A. Yoshihara, Iwasaki M, H. Ogawa, H. Miyazaki

  JOURNAL OF ORAL REHABILITATION 40 (9) 678 - 685 0305-182X 2013/09 [Refereed][Not invited]
   

  Serum albumin levels are a practical marker of general health status in the elderly and have been used to determine the severity of underlying diseases and the risk for death. This longitudinal study evaluated the relationship between serum albumin concentrations and tooth loss over 10years in elderly subjects, after controlling for confounding factors. A sample of 554 dentate subjects among enrolled subjects (n=600) was involved in this planned longitudinal study with follow-up examinations after 5 and 10years. At the 5-year follow-up, 373 (673%), subjects were available for re-examination. In addition, 331 (597%) were available at the 10-year follow-up. Multiple Poisson regression analysis was conducted to evaluate the relationship between the number of missing teeth over 5 or 10years and serum albumin levels at baseline after adjusting for 10 variables: gender, serum markers levels at baseline, dental status, smoking habits and educational years and oral health behaviour. The number of missing teeth over 5 or 10years was significantly negatively associated with serum albumin levels at baseline [incidence rate ratios (IRR)=0373, P<00001 for 5years; IRR=0570, P<00001 for 10years]. We conclude that elderly subjects with hypoalbuminemia are at high risk for 5- and 10-year tooth loss.
• Dietary antioxidants and periodontal disease in community-based older Japanese: a 2-year follow-up study

  Masanori Iwasaki, Paula Moynihan, Michael C. Manz, George W. Taylor, Akihiro Yoshihara, Kanako Muramatsu, Reiko Watanabe, Hideo Miyazaki

  PUBLIC HEALTH NUTRITION 16 (2) 330 - 338 1368-9800 2013/02 [Refereed][Not invited]
   

  Objective: To investigate the longitudinal relationship between the intake of dietary antioxidants and periodontal disease in community-dwelling older Japanese. Design: A retrospective cohort study, with a follow-up of 2 years (2003-2005). Intakes of dietary antioxidants (vitamin C, vitamin E, alpha-carotene and beta-carotene) were assessed with a validated FFQ. Participants were classified by tertile of antioxidant intake. Full-mouth periodontal status, measured as the clinical attachment level, was recorded at baseline and follow-up examinations. Periodontal disease progression was considered as loss of attachment of 3mm or greater over the study period at the interproximal site for each tooth. Finally, the number of teeth with periodontal disease progression per person was calculated and was used as the outcome. Poisson regression analysis was conducted, with dietary antioxidants as the main exposure, to estimate their influence on the number of teeth with periodontal disease progression. Setting: Niigata City (Japan). Subjects: Dentate individuals aged 75 years in 2003, for whom data were available, were included in the analyses (n 264). Results: A higher intake of dietary antioxidants was inversely associated with the number of teeth with periodontal disease progression, controlling for other variables. The multivariate-adjusted incidence rate ratios in the first, second and third tertiles were 1.00, 0.76 (95% CI 0.60, 0.97) and 0.72 (95% CI 0.56, 0.93) for vitamin C; 1.00, 0.79 (95% CI 0.62, 0.99) and 0.55 (95% CI 0.42, 0.72), for vitamin E; and 1.00, 1.02 (95% CI 0.81, 1.29) and 0.73 (95% CI 0.56, 0.95) for beta-carotene. Conclusions: The study results suggest that higher intake of antioxidants may mitigate periodontal disease in community-dwelling older Japanese.
• Peroxisome proliferator-activated receptor (PPAR) γ polymorphism, vitamin d, bone mineral density and periodontitis in postmenopausal women

  Y. Wang, N. Sugita, A. Yoshihara, M. Iwasaki, H. Miyazaki, K. Nakamura, H. Yoshie

  Oral Diseases 19 (5) 501 - 506 1354-523X 2013 [Refereed][Not invited]
   

  OBJECTIVES: PPARg regulates bone metabolism and inflammation. Our previous study suggested PPARg Pro12Ala polymorphism to represent a susceptibility factor for periodontitis in pregnant Japanese women. Several recent papers have drawn attention to a possible link between low bone mineral density (BMD) and periodontitis in postmenopausal women. Since the pathogenesis for both involve bone remodeling, they might share common risk factors such as gene polymorphisms and vitamin D level. The present study investigated possible associations between the PPARgPro12Ala polymorphism, periodontitis, BMD and serum 25(OH)D in postmenopausal Japanese women. MATERIALS AND METHODS: PPARgPro12Ala genotypes of 359 women were determined by PCR-RFLP. BMD and periodontal parameters of each woman were measured. Serum 25(OH)D levels were determined by radioimmunoassay. RESULTS: PPARgPro12Ala polymorphism was not associated with periodontitis or BMD as an independent factor. Serum 25(OH)D was significantly higher in Ala allele carriers compared to non-carriers. Only in the Ala allele carriers, positive correlations were found between mean clinical attachment level and BMD, between BMD and 25(OH)D, and between percentage of sites with probing depth ≥4 mm and 25(OH)D. CONCLUSIONS: PPARgPro12Ala polymorphism was not independently associated with periodontitis or BMD. However, the polymorphism might be a modulator of the relationship between the two conditions in postmenopausal Japanese women.© 2012 John Wiley & Sons A/S.
• High serum 25-hydroxyvitamin D levels do not retard postmenopausal bone loss in Japanese women: the Yokogoshi study.

  Kaori Kitamura, Kazutoshi Nakamura, Toshiko Saito, Ryosaku Kobayashi, Rieko Oshiki, Tomoko Nishiwaki, Masanori Iwasaki, Akihiro Yoshihara

  Archives of osteoporosis 8 153 - 153 2013 [Refereed][Not invited]
   

  UNLABELLED: We conducted a cohort study exploring an association between serum 25-hydroxyvitamin D (serum 25(OH)D) and parathyroid hormone (PTH) levels and 5-year changes in bone mineral density (BMD) in 482 postmenopausal women. High serum 25(OH)D levels do not retard postmenopausal bone loss within the lumbar spine or femoral neck, and high PTH levels potentially increase hip bone loss. PURPOSE: The aim of this study was to explore an association between serum 25(OH)D levels and 5-year changes in BMD in postmenopausal women. METHODS: This 5-year cohort study included 482 women between 55 and 74 years of age who lived in a community in Japan. Medical examinations were conducted in 2005 and 2010. Data were obtained on baseline serum 25(OH)D and intact parathyroid hormone (iPTH) levels. Outcomes of this study were 5-year changes in BMDs of the lumbar spine and femoral neck. Covariates included years since menopause, body mass index (BMI), lifestyle factors, and weight change. Changes in BMDs among quartiles of serum 25(OH)D were compared with analysis of covariance. RESULTS: The mean age of subjects was 63.1 years, and mean serum 25(OH)D levels were 56.0 nmol/L. Age and decrease in weight were significantly associated with decreases in BMDs of both the lumbar spine (P for trend < 0.001 and =0.002, respectively) and femoral neck (P for trend = 0.026 and <0.001, respectively); low BMI was associated with a decrease in lumbar spine BMD (P for trend < 0.001). No significant associations were found between serum 25(OH)D levels and changes in BMDs. High serum iPTH levels were associated with a greater decrease in femoral neck BMD (P for trend = 0.026). CONCLUSIONS: High serum 25(OH)D levels do not retard postmenopausal bone loss within the lumbar spine or femoral neck, and high PTH levels potentially increase hip bone loss.
• Serum Antibody to Porphyromonas gingivalis in Chronic Kidney Disease

  Iwasaki M, G. W. Taylor, M. C. Manz, N. Kaneko, S. Imai, A. Yoshihara, H. Miyazaki

  JOURNAL OF DENTAL RESEARCH 91 (9) 828 - 833 0022-0345 2012/09 [Refereed][Not invited]
   

  Potentially significant associations between periodontal disease and chronic kidney disease (CKD) have been reported in recent studies. The aim of this cross-sectional study was to investigate the association between serum antibody to the periodontal pathogen Porphyromonas gingivalis (P. gingivalis) and CKD in 215 Japanese individuals, aged 79 yrs. Serum antibody levels to P. gingivalis were measured by enzyme-linked immunosorbent assay. An elevated serum antibody response was defined as the upper quartile and was compared with the bottom three quartiles. Participants were classified as having CKD when their glomerular filtration rate was between 15 and 59 mL/min/1.73 m(2). A multivariable logistic regression model was used to evaluate the association between elevated antibody status and the presence of CKD. Study participants with an elevated serum antibody to P. gingivalis were 2.6 times more likely to have CKD. The adjusted odds ratio of CKD for participants in the highest quartile of serum antibody to P. gingivalis was 2.59 (95% confidence interval, 1.05-6.34) when compared with others in lower quartiles after simultaneous adjustment for other covariates. In conclusion, the present study suggests that elevated serum antibody to P. gingivalis was significantly associated with decreased kidney function in a community-based cohort of elderly Japanese.
• Change in bone mineral density and tooth loss in Japanese community-dwelling postmenopausal women: a 5-year cohort study

  Masanori Iwasaki, Kazutoshi Nakamura, Akihiro Yoshihara, Hideo Miyazaki

  JOURNAL OF BONE AND MINERAL METABOLISM 30 (4) 447 - 453 0914-8779 2012/07 [Refereed][Not invited]
   

  The aim of this longitudinal study was to investigate the association between the change in bone mineral density (BMD) and tooth loss in Japanese community-dwelling postmenopausal women. The subjects were 404 women. At baseline (2005) and follow-up (2010), BMDs of the lumbar spine and right femoral neck were measured using dual-energy X-ray absorptiometry (QDR4500a) and participants were classified by tertiles of the annual percentage change in BMD. The number of teeth was counted at the baseline and follow-up to calculate the number of lost teeth over 5 years. Poisson regression analysis was conducted with tertiles of the changes in BMDs of the lumbar spine and femoral neck as the main exposures to estimate their influence on the number of lost teeth. Participants in the tertile with a greater decrease in BMD at each skeletal site (lumbar spine and femoral neck, respectively) had a larger number of lost teeth, controlling for possible confounders. The adjusted relative risks (95% confidence interval) for the mean number of lost teeth in the first, second, and third tertiles were 1.00, 1.15 (0.91-1.45), and 1.38 (1.11-1.72) for the lumbar spine and 1.00, 1.17 (0.93-1.47), and 1.27 (1.01-1.59) for the femoral neck, respectively. In conclusion, a significant relationship exists between a change in BMD and the number of lost teeth during 5-year study period in Japanese community-dwelling postmenopausal women.
• 地域在住高齢者におけるメタボリックシンドロームと歯周病の関連

  坂入 久美子, 岩崎 正則, 小川 祐司, 葭原 明弘, 宮崎 秀夫

  新潟歯学会雑誌 新潟歯学会 42 (1) 63 - 64 0385-0153 2012/06
• 地域在住高齢者におけるメタボリックシンドロームと歯周病の関連

  坂入 久美子, 岩崎 正則, 小川 祐司, 葭原 明弘, 宮崎 秀夫

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 62 (2) 217 - 217 0023-2831 2012/04
• Relations of Serum Ascorbic Acid and alpha-tocopherol to Periodontal Disease

  M. Iwasaki, M. C. Manz, G. W. Taylor, A. Yoshihara, H. Miyazaki

  JOURNAL OF DENTAL RESEARCH 91 (2) 167 - 172 0022-0345 2012/02 [Refereed][Not invited]
   

  Low concentrations of serum anti-oxidants, including ascorbic acid and alpha-tocopherol, are associated with higher risks of many inflammatory diseases that interrelate with oral health. The present study examined the longitudinal relationship of serum ascorbic acid and alpha-tocopherol to periodontal disease in 224 Japanese individuals, aged 71 yrs, for whom data were available for the years 1999-2007. Participants were classified by tertiles of serum ascorbic acid and of alpha-tocopherol. Full-mouth periodontal status, measured as clinical attachment level (CAL), was recorded at baseline and annual follow-up examinations. The number of teeth with a loss of CAL >= 3 mm at any site over the study period was calculated as 'periodontal disease events'. Poisson regression analysis was conducted to assess predictors of periodontal disease events, with serum ascorbic acid and alpha-tocopherol as the primary predictors of interest. The multivariate adjusted relative risks (95% confidence intervals) in the highest, middle, and lowest tertiles were 1.00 (reference), 1.12 (1.01-1.26), and 1.30 (1.16-1.47) for ascorbic acid and 1.00 (reference), 1.09 (0.98-1.21), and 1.15 (1.04-1.28) for alpha-tocopherol, respectively. Our findings support the hypothesis that low serum levels of ascorbic acid and alpha-tocopherol may be a risk factor for periodontal disease in Japanese elderly.
• Periodontal Disease and Decreased Kidney Function in Japanese Elderly

  Masanori Iwasaki, George W. Taylor, Willem Nesse, Arjan Vissink, Akihiro Yoshihara, Hideo Miyazaki

  AMERICAN JOURNAL OF KIDNEY DISEASES 59 (2) 202 - 209 0272-6386 2012/02 [Refereed][Not invited]
   

  Background: Early detection of decreased kidney function can help prevent the progression of kidney disease to kidney failure and cardiovascular events. Potentially significant associations between kidney function and periodontal disease have been reported in cross-sectional studies. However, no longitudinal study has been performed and no study has been performed in Japan. The aim of this longitudinal study was to investigate the effect of periodontal disease on kidney function in community-dwelling Japanese elderly. Study Design: Retrospective cohort. Setting & Participants: Members of this cohort were drawn from a longitudinal interdisciplinary study of aging. Included for this analysis were 317 participants (166 men, 151 women) aged 75 years in 2003. Predictor: The periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue, was calculated for each participant. Participants were classified in quartile groups according to PISA, then divided into 2 groups (highest quartile vs the other 3 groups combined). Outcomes: The primary outcome for the analysis was decreased kidney function, defined as a decrease in estimated glomerular filtration rate at follow-up. Measurements: Multivariable logistic regression analyses were performed to predict decreased kidney function on the basis of periodontal status, risk factors for kidney disease, and other potentially relevant covariates. Results: During the 2-year follow-up (2003-2005), 45 participants (14.2%) developed decreased kidney function. The highest PISA quartile was associated significantly with a greater cumulative incidence of decreased kidney function (OR, 2.24; 95% CI, 1.05-4.79) than the referent group (the other 3 quartiles) after adjusting for covariates. Limitations: Extension of interpreting the findings to other age groups is limited. Conclusion: These results suggest that periodontal disease may be a risk factor for decreased kidney function in Japanese elderly. Am J Kidney Dis. 59(2):202-209. (C) 2012 by the National Kidney Foundation, Inc.
• 地域在住女性高齢者における咀嚼能力判定試験と開眼片足立ち保持時間の関連

  岩崎正則, 葭原明弘, 宮崎秀夫

  日本口腔衛生学会雑誌 62 289 - 295 2012 [Refereed][Not invited]
  
• Mineral content of calcium and magnesium in the serum and longitudinal periodontal progression in Japanese elderly smokers.

  Akihiro Yoshihara, Masanori Iwasaki, Hideo Miyazaki

  Journal of clinical periodontology 38 (11) 992 - 7 2011/11 [Refereed][Not invited]
   

  OBJECTIVE: Evidence from physiological and clinical studies regarding the mechanism by which calcium and magnesium are associated with periodontal disease, adjusted for smoking habits, is lacking. This longitudinal study evaluated the association of serum calcium levels and the calcium/magnesium (Ca/Mg) ratio with periodontal disease progression among smokers and non-smokers. MATERIAL AND METHODS: A total of 309 subjects aged 73 years were included. Follow-up surveys were carried out every year for 6 years. After dividing subjects into smokers and non-smokers, multiple logistic regression analysis for men was performed to evaluate the relationship between the serum Ca/Mg ratio and periodontal disease progression. We used the 25th percentile of periodontal disease events for 6 years as the dependent variable and seven other variables, including quartiles for serum Ca/Mg ratios, as independent variables. RESULTS: There was a clear dose-response relationship of Ca/Mg ratio quartiles for periodontal disease events among smokers. Significant differences in odds ratios in the first and second quartiles were seen compared with the fourth quartile (reference): 6.28 (p=0.014) and 5.96 (p=0.022), respectively. However, there was no significant dose-response relationship among non-smokers. CONCLUSION: A low serum Ca/Mg ratio was significantly associated with periodontal disease progression in Japanese elderly smokers.
• 特定健診対象者における歯周疾患スクリーニングテストとメタボリックシンドロームとの関連性

  岩崎 正則, 葭原 明弘, 宮崎 秀夫

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 61 (5) 573 - 580 0023-2831 2011/10 [Not refereed][Not invited]
   

  本研究の目的は特定健診対象者における歯周疾患スクリーニングテストとメタボリックシンドロームの関連を検討することである。2009、2010年度に本調査に参加した40〜74歳、488名を本研究対象とした。唾液中の潜血反応を利用した歯周疾患スクリーニングテストを行い、対象者を陽性群、陰性群に分けた。また特定健診の結果からメタボリックシンドローム判定項目である肥満、高血圧、高血糖、および脂質異常を定義した。さらに肥満者でかつ判定項目3つ(高血圧、高血糖、脂質異常)のうち2つ以上を持つ者をメタボリックシンドロームと定義した。年齢、性別、および喫煙状況を共変量としたロジスティック回帰モデルを用い、歯周疾患スクリーニングテストとメタボリックシンドロームの関連を評価した。歯周疾患スクリーニングテスト陰性群を基準としたとき、陽性群の肥満、およびメタボリックシンドロームに対する調整オッズ比はそれぞれ1.64(95%信頼区間=1.03-2.61)および2.49(95%信頼区間=1.34-4.63)であり、統計学的に有意だった。歯周疾患スクリーニングテスト結果と高血圧、高血糖、および脂質異常の間には統計学的に有意な関連は認められなかった。本研究結果から、特定健診対象者において歯周疾患スクリーニングテストとメタボリックシンドロームの間には有意な関連があることが示された。(著者抄録)
• 成人期および高齢期における咀嚼回数と体格の関連

  岩崎 正則, 葭原 明弘, 宮崎 秀夫

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 61 (5) 563 - 572 0023-2831 2011/10 [Not refereed][Not invited]
   

  本研究の目的は咀嚼回数と体格の関連を成人期と高齢期に分けて比較検討し、年代による差異が存在するかどうかを明らかにすることである。2009、2010年に行われた調査に参加した614名を本研究対象とした。煎餅を用いた咀嚼回数の測定を行い、対象者を咀嚼回数24回以下、25〜30回、31回以上の3群に分けた。また身体計測結果から内臓脂肪蓄積、肥満、および痩せを定義した。そして年代(成人期:20〜64歳、高齢期:65〜89歳)、性別で層化し、ロジスティック回帰モデルを用い咀嚼回数と体格の関連を評価した。成人期では咀嚼回数が25〜30回の群を基準としたとき、24回以下の群および31回以上の群の男性は内臓脂肪蓄積オッズ比(95%信頼区間)がそれぞれ6.89(1.63-29.1)、および6.17(1.39-27.3)であり有意に高かった。さらに24回以下の群および31回以上の群の男性は肥満オッズ比も有意に高かった。(それぞれオッズ比[95%信頼区間]=7.33[1.42-37.8]、および8.09[1.50-43.7])。高齢期では咀嚼回数が30回以下の群を基準としたとき、31回以上の群の男性は痩せのオッズ比が有意に高かった(オッズ比[95%信頼区間]=5.76[1.17-28.4])。本研究結果から、男性において咀嚼回数と体格の関連は成人期と高齢期では異なることが示唆された。(著者抄録)
• Physical activity and 5-year changes in physical performance tests and bone mineral density in postmenopausal women: the Yokogoshi Study.

  Kaori Kitamura, Kazutoshi Nakamura, Ryosaku Kobayashi, Rieko Oshiki, Toshiko Saito, Mari Oyama, Shunsuke Takahashi, Tomoko Nishiwaki, Masanori Iwasaki, Akihiro Yoshihara

  Maturitas 70 (1) 80 - 4 2011/09 [Refereed][Not invited]
   

  OBJECTIVE: The effect of physical activity on musculoskeletal health in older adults is not completely understood. The aim of this study was to determine the relationship between physical activity and 5-year changes in physical performance tests and bone mineral density (BMD) in postmenopausal women. STUDY DESIGN: The design was a 5-year cohort study. MAIN OUTCOME MEASURES: Subjects were 507 women (55-74 years old) living in a rural community in Japan. Physical activity assessed included housework, farm work, and moderate leisure-time physical activity within the previous week. Measurements at baseline included handgrip strength, walking time (timed "Up & Go" test) and BMD of the femoral neck and vertebrae. Five-year changes in these measures (outcome variables) were compared among groups with different levels of physical activity by analysis of covariance. RESULTS: Women who did not do housework performed worse in changes in handgrip strength (difference=2.22 kg, P=0.0201) and worse in changes in the walking time (difference=0.54 s, P=0.0072) than those who did housework alone. Women who spent at least 9h per week (median=24) doing farm work performed better in changes in handgrip strength (difference=0.28 kg, P=0.0334), but worse in changes in the walking time (difference=0.66 s, P<0.0001) than those who did not do farm work. However, leisure-time activity was not associated with changes in any outcome variable, and none of the physical activities predicted BMD changes. CONCLUSIONS: Engaging in housework and farm work are determinants of physical function in postmenopausal women, which may help them maintain independence in daily living.
• Dietary ratio of n-6 to n-3 polyunsaturated fatty acids and periodontal disease in community-based older Japanese: A 3-year follow-up study

  Masanori Iwasaki, George W. Taylor, Paula Moynihan, Akihiro Yoshihara, Kanako Muramatsu, Reiko Watanabe, Hideo Miyazaki

  PROSTAGLANDINS LEUKOTRIENES AND ESSENTIAL FATTY ACIDS 85 (2) 107 - 112 0952-3278 2011/08 [Refereed][Not invited]
   

  The longitudinal relationship between dietary n-6 to n-3 PUFAs ratio and periodontal disease in 235 Japanese subjects for whom data were available for the years 2003-2006 was investigated. PUFAs intake was assessed at baseline with a brief-type self-administered diet history questionnaire. Full-mouth periodontal status, measured as the clinical attachment level (CAL), was recorded at baseline and once a year for 3 years. The number of teeth with a change in the loss of CAL >= 3 mm at any site over a year was calculated as 'periodontal disease events'. Poisson regression analysis was conducted, with dietary n-6 to n-3 PUFAs ratio as the main predictor, to estimate its influence on periodontal disease events. A high dietary n-6 to n-3 PUFAs ratio was significantly associated with greater number of periodontal disease events. The findings suggest the dietary n-6 to n-3 PUFAs ratio is associated with periodontal disease among older Japanese. (C) 2011 Elsevier Ltd. All rights reserved.
• Relationship between Saturated Fatty Acids and Periodontal Disease

  Iwasaki M, M. C. Manz, P. Moynihan, A. Yoshihara, K. Muramatsu, R. Watanabe, H. Miyazaki

  JOURNAL OF DENTAL RESEARCH 90 (7) 861 - 867 0022-0345 2011/07 [Refereed][Not invited]
   

  Saturated fatty acids (SFAs) produce an inflammatory response. Hyperinflammation is now recognized as one of the key underlying etiologic factors in periodontal disease. The longitudinal relationship between dietary SFAs and periodontal disease in 264 Japanese individuals, aged 75 years, for whom data were available for the years 2003-2004, was investigated. SFA intake was assessed with a brief self-administered diet history questionnaire. Participants were classified by quartiles of SFA intake. Full-mouth periodontal status, measured as the clinical attachment level (CAL), was recorded at baseline and follow-up examinations. The number of teeth with a loss of CAL >= 3 mm at any site over a year was calculated as 'periodontal disease events'. Poisson regression analysis was conducted, with dietary SFAs as the primary predictor of interest, to estimate their influence on periodontal disease events. High dietary SFA intake was significantly associated with a greater number of periodontal disease events among nonsmokers. The multivariate adjusted relative risk (95% confidence intervals) in the 1st, 2nd, 3rd, and 4th quartiles of dietary SFAs was 1.00, 1.19 (0.72-1.97), 1.55 (0.95-2.52), and 1.92 (1.19-3.11), respectively. These findings suggest an independent association of dietary SFA intake to the progression of periodontal disease in older Japanese non-smokers.
• Dietary omega-3 fatty acid may control periodontal disease Low dietary docosahexaenoic acid might be a significant risk factor of periodontal disease progression

  Masanori Iwasaki, Akihiro Yoshihara, Paula Moynihan, Reiko Watanabe, Hideo Miyazaki

  AGRO FOOD INDUSTRY HI-TECH 21 (6) 34 - 37 1722-6996 2010/11 [Refereed][Not invited]
   

  Objective: we investigated the longitudinal relation of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) to periodontal disease. Methods: dietary intake data were obtained by a 3-day weighed food intake. Dental examinations were carried out at baseline and once a year for 5 years in 36 participants. The number of teeth with periodontal progression per person was calculated as "periodontal disease events". Results: negative binomial regression analysis revealed that the mean number of periodontal disease events for participants who consumed the lowest tertile of DHA was approximately 1.5 times larger than the reference group (highest tertile), after simultaneously adjusting for possible confounders. Conclusion: within the limitations of the reported study, an inverse, independent relationship between dietary DHA intake and the progression of periodontal disease was found. Further studies are necessary to confirm these findings.
• Longitudinal relationship between dietary omega-3 fatty acids and periodontal disease

  Masanori Iwasaki, Akihiro Yoshihara, Paula Moynihan, Reiko Watanabe, George W. Taylor, Hideo Miyazaki

  NUTRITION 26 (11-12) 1105 - 1109 0899-9007 2010/11 [Refereed][Not invited]
   

  Objective: Fish oil has anti-inflammatory actions that may benefit periodontal health. We investigated the longitudinal relation between dietary omega-3 fatty acids (FAs), docosahexaenoic acid, (DHA), and eicosapentaenoic acid (EPA) to periodontal disease in community-dwelling elderly. Methods: Fifty-five participants aged 74 y were randomly selected from a longitudinal interdisciplinary study of aging. Dietary intake data were obtained by a 3-d weighed food intake. The dietary intakes of energy, DHA, and EPA were calculated based on the Standard Food Composition Tables in Japan. Dental examinations were carried out at baseline and once a year for 5 y. The number of teeth with periodontal progression over 5 y per person was calculated as "periodontal disease events." Negative binomial regression analysis was conducted, which included DHA, EPA, and other covariates as independent variables to estimate the influence on periodontal disease events. Longitudinal data were analyzed for participants for whom data were available for 5 y (n = 36). Results: Low DHA intake was significantly associated with more periodontal disease events. The mean number of periodontal disease events for participants who consumed the lowest tertile of DHA was approximately 1.5 times larger (lowest tertile, incidence rate ratio 1.49, 95% confidence interval 1.01-2.21) than the reference group (highest tertile of DHA consumption), after simultaneously adjusting for possible confounders. Conclusion: The findings suggest there may be an inverse, independent relation of dietary DHA intake to the progression of periodontal disease in older people. (C) 2010 Elsevier Inc. All rights reserved.
• 飽和脂肪酸が歯周病の発症・進行に与える影響

  岩崎 正則, 葭原 明弘, 村松 芳多子, 渡邊 令子, 宮崎 秀夫

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 60 (4) 388 - 388 0023-2831 2010/08 [Not refereed][Not invited]
  
• 高齢者における咀嚼回数と食品群別摂取量および栄養素等摂取量との関連

  岩崎 正則, 葭原 明弘, 村松 芳多子, 渡邊 令子, 宮崎 秀夫

  口腔衛生学会雑誌 (一社)日本口腔衛生学会 60 (2) 128 - 138 0023-2831 2010/04 [Not refereed][Not invited]
   

  本研究の目的は、高齢者における咀嚼回数と食品群および栄養素等の推定摂取量との関連を検討することである。2003年に行われた調査に協力の得られた75歳高齢者349名(男性182名、女性167名)を対象とした。咀嚼回数の測定には煎餅を用い、食品群および栄養素等の摂取量の推定には簡易自己式食事歴質問票を用いた。咀嚼回数と食品群および栄養素等の推定摂取量との関連について重回帰分析を用いて評価した。重回帰分析の結果から、咀嚼回数の多い者は食品群として、魚介類(p=0.041)、乳類(p=0.029)の摂取量が統計学的に有意に多く、菓子類(p=0.007)の摂取量が有意に少なかった。栄養素等摂取量では、総たんぱく質(p=0.001)、動物性たんぱく質(p=0.001)、カルシウム(p=0.008)、リン(p=0.001)、亜鉛(p=0.009)、ビタミンD(p=0.001)、ビタミンB2(p=0.010)、ビタミンB6(p=0.031)、ビタミンB12(p=0.004)、パントテン酸(p=0.001)、コレステロール(p=0.034)の摂取量が咀嚼回数の多い者で有意に多かった。本研究結果から、高齢者において咀嚼回数の多い者のほうが食品群として魚介類、乳類の摂取量が多く、菓子類の摂取量が少ないこと、また栄養素等として、たんぱく質、ミネラル、ビタミン類、コレステロールの摂取量が多いことが示唆された。(著者抄録)
• The Relationship between the Speed of Eating and Nutritional Intake of Japanese Aged 80 Years Old Based on Responses to a Brief-type Self-administered Diet History Questionnaire

  IWASAKI Masanori, YOSHIHARA Akihiro, MURAMATSU Kanako, WATANABE Reiko, MIYAZAKI Hideo

  Journal of dental health 有限責任中間法人日本口腔衛生学会 60 (1) 30 - 37 0023-2831 2010 [Refereed][Not invited]
   

  A brief-type self-administered diet history questionnaire (BDHQ) is a validated method of dietary assessment. This study investigated the relationship between the speed of eating, which is considered an eating behavior, and the estimated nutrient intake using the BDHQ in community-dwelling Japanese aged 80 years old. Three hundred and fifty-four participants (174 males and 180 females) aged 80 years old who participated in both dental examinations and BDHQ assessment conducted in 2008 were included in the analysis. The speed of eating was self-reported by giving a response chosen from five qualitative categories: 'very fast', 'relatively fast', 'medium', 'relatively slowly', and 'very slowly'. The five categories were classified into two categories for statistical analysis, that is, participants who answered 'very fast' and 'relatively fast' were defined as 'eating fast', while those who answered 'medium', 'relatively slowly', and 'very slowly' were defined as 'eating slowly'. The nutrient intake was calculated from the BDHQ using the ad-hoc program developed for nutrient calculation based on BDHQ responses. The estimated nutrient intake was compared between the two groups defined as eating 'fast' or 'slowly'. Furthermore, multivariable linear regression analysis was conducted using the speed of eating, gender, BMI, number of teeth, and masticatory function as independent variables to assess the influence on the estimated nutrient intake. The participants defined as eating 'fast' consumed significantly more zinc, copper, cryptoxanthin, and vitamin C than participants defined as eating 'slowly' (p=0.012, p=0.022, p=0.007, and p=0.049, respectively; Student's t-test). Moreover, the zinc, copper, cryptoxanthin, and vitamin C intakes of participants defined as eating 'fast' remained significantly higher than those of participants defined as eating 'slowly' after simultaneously adjusting for possible confounders (p=0.027, p=0.039, p=0.004, and p=0.043, respectively). The findings of this study suggest that Japanese people aged 80 years old who define themselves as eating fast consume higher levels of nutrients that are included in meat, fish, shellfish, vegetables, and fruits.
• Longitudinal study on the relationship between serum albumin and periodontal disease

  Masanori Iwasaki, Akihiro Yoshihara, Toshinobu Hirotomi, Hiroshi Ogawa, Nobuhiro Hanada, Hideo Miyazaki

  JOURNAL OF CLINICAL PERIODONTOLOGY 35 (4) 291 - 296 0303-6979 2008/04 [Refereed][Not invited]
   

  Aim: The purpose of this study was to evaluate the relationship between periodontal disease and the general health status in community-dwelling elderly using the serum albumin concentration as a criterion index of the severity of underlying disease and nutrition. Material and Methods: Six hundred subjects aged 70 years underwent a baseline examination. Dental examinations were carried out at baseline and once a year for 4 years. Periodontal conditions were estimated for subjects with at least one remaining tooth. Clinical attachment levels at six sites of all teeth present were measured. A change in loss of attachment of 3 mm or greater in 1 year at each site was defined as periodontal disease progression. Data were analysed in subjects for whom data were available for 4 years. Results: Serum albumin concentration at baseline ranged from 3.4 to 5.0 g/dl with a mean of 4.3 +/- 0.2. When the analysis was stratified by smoking status, we found that serum albumin concentration had a significant effect on periodontal disease progression among non-smokers (standardized regression coefficient=-0.16; p=0.017), using multiple regression analysis. Conclusions: The findings of the present study suggest that serum albumin concentration is a significant risk predictor of periodontal disease progression among elderly non-smokers.

MISC

• 腎機能と自己申告による現在歯数との関連(魚沼コホート調査ベースラインデータより)—Relationship between Renal Function and Self-reported Number of Current Teeth (From the Uonuma Cohort Study Baseline Data)

  皆川 久美子, 葭原 明弘, 宮本 茜, 諏訪間 加奈, 岩崎 正則, 竹原 祥子, 小川 祐司  口腔衛生学会雑誌 = Journal of dental health : official publication of Japanese Society for Oral Health / 日本口腔衛生学会 編  74-  (2)  125  -134  2024/04
• 日本人中年期男女における睡眠時間と歯周病の関連

  岩崎 正則, 臼井 通彦, 有吉 渉, 中島 啓介, 吉岡 香絵, 井上 真紀, 小林 薫, 西原 達次  Journal of Epidemiology  32-  (Suppl.1)  168  -168  2022/01
• Associations Between Periodontal Health/Treatment and Cognitive Impairment: Latest Evidence From Epidemiological Studies

  Misuzu Sato, Masanori Iwasaki, Kumiko Minagawa, Akane Miyamoto  Current Oral Health Reports  7-  (2)  119  -128  2020/06  

  Purpose of Review: With the aging of the worldwide population, the social impact of cognitive impairment is increasing. Periodontal disease may be a risk factor for cognitive impairment. This review aimed to establish the latest evidence for associations between cognitive impairment and periodontal health/treatment published in the past 5 years. Recent Findings: Electronic searches were conducted in PubMed for literature published in English between January 2015 and September 2019. The selected 15 studies included 3 cross-sectional, 9 longitudinal, and 3 case-control studies. Most studies demonstrated a significant association between periodontal health and cognitive impairment. On the other hand, evidence for the effect of periodontal treatment was scarce. Summary: The latest evidence suggests that prevention of periodontal disease may facilitate prevention of cognitive impairment; however, further interventional research should be conducted to obtain definite conclusions regarding the causal relationship between periodontal treatment and impaired cognition.
• 農村地域における高齢者の食行動と健康度との関連

  木村 友美, 坂本 龍太, 和田 泰三, 藤澤 道子, 奥宮 清人, 石本 恭子, 加藤 恵美子, 竜野 真維, 岩崎 正則, 松林 公蔵  日本老年医学会雑誌  56-  (Suppl.)  109  -109  2019/05  [Not refereed][Not invited]
  
• 75歳以上地域在住高齢者におけるフレイルとADL、転倒、うつ傾向、QOLとの関連

  笠原 順子, 木村 友美, 石本 恭子, 岩崎 正則, 坂本 龍太, 松林 公蔵  日本老年医学会雑誌  55-  (Suppl.)  151  -152  2018/05  [Not refereed][Not invited]
  
• アジア地域に暮らす高齢者のフレイル 日本とタイにおける混合研究法を用いた考察

  木村 友美, 石本 恭子, 岩崎 正則, 笠原 順子, 和田 泰三, 藤澤 道子, 坂本 龍太, 奥宮 清人, 松林 公蔵  日本老年医学会雑誌  55-  (Suppl.)  108  -108  2018/05  [Not refereed][Not invited]
  
• Effects of ritual tooth extraction on development of mandibular torus in Jomon people of Japan

  KATAOKA Shota, IWASAKI Masanori, TAKAHASHI Toru, TSURUTA Miho, KAKUTA Satoko, SOH Inho, ANSAI Toshihiro  Asian Journal of Paleopathology  2-  2018
• 高齢者における口腔と栄養

  岩崎 正則, 小川 祐司, 木村 友美, 葭原 明弘, 宮崎 秀夫  ヘルスサイエンス・ヘルスケア  17-  (2)  46  -52  2017/12  [Not refereed][Not invited]
  
• 地域在住高齢者のフレイルと食事摂取状況との関連

  木村友美, 石本恭子, 岩崎正則, 笠原順子, 坂本龍太, 和田泰三, 奥宮清人, 藤澤道子, 松林公蔵  日本老年医学会雑誌  54-  162  2017/05/25  [Not refereed][Not invited]
  
• 地域在住高齢者におけるフレイルスコアと転倒スコアの関連

  石本 恭子, 木村 友美, 岩崎 正則, 和田 泰三, 笠原 順子, 坂本 龍太, 藤澤 道子, 奥宮 清人, 松林 公蔵  日本老年医学会雑誌  54-  (Suppl.)  159  -160  2017/05  [Not refereed][Not invited]
  
• 地域在住高齢者の食欲不振と栄養・口腔状況およびQOLとの関連

  木村友美, 岩崎正則, 奥宮清人, 和田泰三, 藤澤道子, 坂本龍太, 石本恭子, 大塚邦明, 宮崎秀夫, 松林公蔵  日本老年医学会雑誌  53-  88  2016/05/18  [Not refereed][Not invited]
  
• Effects of Periodontal Diseases on Diabetes-Related Medical Expenditure

  Masanori Iwasaki, Misuzu Sato, Akihiro Yoshihara, Hideo Miyazaki  Current Oral Health Reports  3-  (1)  7  -13  2016/03  

  We conducted a review of English papers published between 2012 and April 2015 for associations between periodontal disease and diabetes-related medical expenditure. This resulted in only one paper being selected, which demonstrated that, to date, very little information exists on this topic. Although the evidence is limited, the current research findings support the hypothesis that periodontal disease is an important predictor for the growth of medical spending related to diabetes among the US population. Our ongoing project based on a Japanese elderly population also produced concordant results. It is necessary to conduct further research to accumulate more evidence and to be able to generalize these findings. Because periodontal disease is largely modifiable, controlled intervention studies are needed to elucidate whether health-care spending related to diabetes could be reduced thorough adequate preventive dental care, proper dental education, and oral health promotion.
• EBM : evidence-based medicine : Oral health and nutrition

  岩﨑 正則  8020 : はち・まる・にい・まる : 財団法人8020推進財団会誌  (15)  32  -35  2016/01  [Not refereed][Not invited]
  
• The relationship between oral health and medical expenditures among older adults

  岩﨑 正則, 葭原 明弘, 宮﨑 秀夫  8020 : はち・まる・にい・まる : 財団法人8020推進財団会誌  (14)  112  -114  2015/01  [Not refereed][Not invited]
  
• 高齢者における歯・口腔の健康と全身の健康の関連に関する医療費分析調査 (8020推進財団 指定研究事業報告)

  岩﨑 正則, 葭原 明弘, 宮﨑 秀夫  8020 : はち・まる・にい・まる : 財団法人8020推進財団会誌  (13)  111  -113  2014/01  [Not refereed][Not invited]
  
• O-10 地域在住女性高齢者における腎機能と歯周組織の炎症部位面積に関する横断調査(一般口演)

  岩崎 正則, 葭原 明弘, 宮崎 秀夫  口腔衛生学会雑誌  63-  (2)  148  -148  2013/04/30
• 高齢者における歯・口腔の健康と全身の健康の関連に関する医療費分析調査

  葭原 明弘, 岩崎 正則, 宮崎 秀夫  8020: はち・まる・にい・まる  (12)  102  -103  2013/01  [Not refereed][Not invited]
  
• 口腔の健康と全身の健康 : 新潟高齢者研究の結果から

  宮﨑 秀夫, 葭原 明弘, 岩崎 正則  日本歯科衛生学会雑誌  7-  (1)  24  -34  2012/08
• Longitudinal study on the relationship between serum albumin and periodontal disease

  Iwasaki Masanori  新潟歯学会雑誌  41-  (1)  39  -40  2011/06
• 血清アルブミンと歯周病の関係についての経年的評価

  岩崎 正則, 葭原 明弘, 廣冨 敏伸, 小川 祐司, 花田 信弘, 宮崎 秀夫  新潟歯学会雑誌  38-  (1)  46  -46  2008/06  [Not refereed][Not invited]
  

Books etc

• 新編衛生学・公衆衛生学

  安井利一, 尾﨑哲則, 埴岡隆, 森田学, 山下喜久, 岸光男, 嶋﨑義浩 (Contributor第2章 疫学)
  2021/02
• 臨床栄養 臨時増刊号 特集 管理栄養士・栄養士が知っておきたい口腔のミニマムエッセンス オーラルフレイルの視点から

  (Contributor歯・口腔の健康と栄養に関する最近の研究報告（文献レビュー）)
  2020/09
• <平成28年>歯科疾患実態調査報告

  岩﨑 正則 (Contributor永久歯う蝕の状況および保有（喪失）状況（5歳以上）・補綴の状況・歯肉の状況・歯ブラシの使用状況・顎関節の自覚症状（6歳以上）・歯や口の状態および清掃状況)
  2019/05
• 健康長寿のための口腔保健と栄養をむすぶエビデンスブック

  深井, 穫博 (Contributor栄養摂取と口腔保健の関係; 食事の多様性と口腔保健)
  医歯薬出版 2019 (ISBN: 9784263445624) viii, 163p
• 認知症の人への歯科治療ガイドライン

  日本老年歯科医学会, 日本医療研究開発機構研究費「認知症の容態に応じた歯科診療等の口腔管理及び栄養マネジメントによる経口摂取支援に関する研究」ガイドライン作成班 (Othersコンセンサスボードメンバー)
  医歯薬出版 2019 (ISBN: 9784263445563) xiii, 176p
• 文献ベースで歯科臨床の疑問に答えるチェアサイドQ&A 予防歯科編 PART1

  於保, 孝彦, 予防歯科臨床教育協議会 (Contributorデンタルフロス「フロスを使うと歯にすきまができるのではないか」と言われた。)
  クインテッセンス出版 2018/12 (ISBN: 9784781206585) 119p
• 臨床歯科栄養学 : 歯科に求められる栄養の基礎知識

  花田, 信弘, 萩原, 芳幸, 北川, 昇 (Contributor歯科疾患（う蝕, 歯周病, 咀嚼機能低下）と生活習慣病)
  口腔保健協会 2018/10 (ISBN: 9784896053494) vii, 137p
• Geriatric Medicine (老年医学) 56巻 8号

  岩﨑 正則 (Contributor口腔と全身の関係一疫学調査からみた口腔とフレイルの関連一)
  株式会社 ライフ・サイエンス 2018/08
• 食と医療 ２０１８ ＳＵＭＭＥＲ－ＦＡＬＬ Ｖｏｌ．６

  岩﨑 正則 (Contributor抗酸化ビタミンと歯周病)
  講談社 2018/06
• 口腔保健・予防歯科学

  安井, 利一, 宮崎, 秀夫, 鶴本, 明久, 川口, 陽子, 山下, 喜久, 廣瀬, 公治 (Contributor第4章 齲蝕)
  医歯薬出版 2017 (ISBN: 9784263458020) xiv, 303p
• 新臨床研修歯科医ハンドブック

  米田, 雅裕, 廣藤, 卓雄, 粟野, 秀慈, 松浦, 尚志, 馬場, 篤子, 西野, 宇信, 國領, 真也, 村岡, 宏祐 (Contributor20-2 う蝕の予防・管理)
  医歯薬出版 2016 (ISBN: 9784263457962) x, 390p
• Annual review 腎臓

  越川, 昭三, 長沢, 俊彦, 伊藤, 克己, 御手洗, 哲也, 富野, 康日己, 柏原, 直樹, 成田, 一衛 (Contributor歯周病と腎機能)
  中外医学社 冊

Presentations

• シンポジウム3「歯科口腔保健と骨の健康・身体機能」  [Invited]

  岩崎正則

  第43回日本骨形態計測学会  2023/06
• 合同シンポジウム15 高齢者の定義―その後の展開と展望「⼝の⽼化の経時的データ」  [Invited]

  第33回日本老年学会総会  2023/06
• シンポジウム2「歯周疾患検診等を含めた歯科健診の課題と今後」セルフレポートから得られる口腔情報と健診・疫学調査への活用  [Invited]

  岩崎正則

  日本口腔衛生学会第72回学術大会, 大阪府  2023/05
• 口の健康・機能と全身の健康 -栄養状態や運動機能を中心に-  [Invited]

  岩崎正則

  公益財団法人ロッテ財団 第4回噛むこと健康研究会  2022/10
• シンポジウム3「補綴治療は患者の何を改善できるか？：臨床アウトカムを多角的に評価する」健康な口腔から得られるもの -食・栄養を中心に-  [Invited]

  岩崎正則

  日本補綴歯科学会第131 回学術大会  2022/07
• オーラルフレイル予防  [Invited]

  岩崎正則

  特別区人事・厚生事務組合特別区職員研修所 専門研修「歯科保健」  2021/12
• シンポジウム8「口腔機能と血管病」  [Invited]

  岩崎正則

  第53回日本動脈硬化学会総会・学術集会  2021/10
• 特別シンポジウム「人生100年時代に向けての歯科的ロードマップ」口腔と長寿の文献レヴュー -健康長寿社会の実現を目指す戦略を支える 歯科的エビデンスの充実に向けて-  [Invited]

  岩崎正則

  第32回日本老年歯科医学会学術大会  2021/06
• Oral Hypofunction. Oral hypofunction and malnutrition -Findings from an epidemiological study of community-dwelling older adults-  [Invited]

  Masanori Iwasaki

  3rd International Gerodontology Symposium  2021/04
• 臨床研究 文献検索・文献の読み方・研究方法

  岩崎正則

  公益社団法人 日本歯科衛生士会 認定研修「医科歯科連携・口腔機能管理」  2019/09
• 口腔保健と栄養 -これまでのエビデンスと今後の展望-  [Invited]

  岩崎正則

  第28回日本健康教育学会学術大会  2019/06
• 高齢者の低栄養予防における歯科の役割 -地域に根ざした調査結果を中心に-  [Invited]

  岩崎正則

  島根県歯科医師会・島根県健康福祉部健康推進課 高齢者の低栄養予防対策研修会  2019/02
• 歯・口腔の健康と栄養  [Invited]

  岩崎正則

  長崎市歯科医師会・歯科健診協力歯科医部会・研修会  2017/09
• 慢性腎臓病と歯科疾患  [Invited]

  岩崎正則

  食と健康を学ぼう  2017/03
• 歯の健康 これだけは知っておきたい口の健康を守るコツ  [Invited]

  岩崎正則

  北九州市立年長者研修大学校周望学舎研修  2015/06
• Periodontal disease may affect kidney function in a community-based Japanese older population  [Not invited]

  Iwasaki M, Yoshihara A, Miyazaki H

  第59回日本口腔衛生学会・総会  2010/10
• 簡易自己式食事歴質問票BDHQによる高齢者の栄養摂取状況と食事摂取状況との関連  [Not invited]

  岩﨑正則, 葭原明弘, 宮﨑秀夫

  第20回日本口腔衛生学会甲信越北陸地方会総会  2009/07
• Longitudinal relationship between dietary docosahexaenoic acid and the dental condition  [Not invited]

  Iwasaki M, Yoshihara A, Moynihan P, Watanabe R, Miyazaki H

  87th General Session & Exhibition of the IADR  2009/04
• Longitudinal relationship between dietary docosahexaenoic acid and periodontal disease  [Not invited]

  Iwasaki M, Yoshihara A, Moynihan P, Watanabe R, Taylor GW, Miyazaki H

  University of Michigan School of Dentistry Research Day  2009/02
• フッ素洗口の有効性と安全性について  [Not invited]

  岩﨑正則

  フッ素洗口学習会  2008/09
• 血清アルブミンと歯周病の関係についての経年的評価  [Not invited]

  岩崎正則, 葭原明弘, 廣冨敏伸, 小川祐司, 花田信弘, 宮﨑秀夫

  第41回新潟歯学会総会  2008/04

Research Projects

• 血液透析患者の唾液分泌促進を目指した患者参加型口腔ケアプログラムの開発

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2024/04 -2028/03 

  Author : 古庄 夏香, 粟野 秀慈, 岩崎 正則, 前田 ひとみ
• 糖尿病性腎症の改善のための口腔健康プログラムの構築

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2024/04 -2027/03 

  Author : 村岡 宏祐, 粟野 秀慈, 園木 一男, 守下 昌輝, 角田 聡子, 安細 敏弘, 岩崎 正則, 大田 祐子, 福原 正代, 山口 紫乃, 中村 太志
• 口腔機能とサルコペニアを基軸としたベイジアンネットワーク解析による認知症予防戦略

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2024/04 -2027/03 

  Author : 細川 隆司, 近藤 祐介, 平野 浩彦, 笛木 賢治, 正木 千尋, 岩崎 正則
• Systematic Research on a New Elderly-Centered View of Care Prevention.

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2023/04 -2027/03 

  Author : 石本 恭子, 木村 友美, 依田 健志, 渡辺 長, 岩崎 正則
• 高齢者の口腔機能低下から摂食嚥下機能障害の包括的評価システム考案に関する調査研究

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2024/04 -2026/03 

  Author : 平野 浩彦, 山本 敏之, 福本 裕, 岩崎 正則, 有阪 直哉, 本川 佳子, 枝広 あや子
• Effect of intensified treatment with urate-lowering drugs on periodontal disease

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2023/04 -2026/03 

  Author : 大田 祐子, 福原 正代, 土橋 卓也, 岩崎 正則, 藤澤 律子, 井上 真紀
• 高齢者の口腔機能低下から摂食嚥下機能障害の包括的評価システム考案に関する調査研究

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2023/04 -2026/03 

  Author : 平野 浩彦, 山本 敏之, 福本 裕, 岩崎 正則, 有阪 直哉, 本川 佳子, 枝広 あや子
• 口腔機能と終末糖化産物に焦点を当てた時間生物学的アプローチによる認知症予防戦略

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2023/04 -2026/03 

  Author : 正木 千尋, 近藤 祐介, 平野 浩彦, 細川 隆司, 岩崎 正則
• Study on integrated implementation of public health service and care prevention for the elderly regarding oral frailty

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2024/04 -2025/03 

  Author : 渡邊 裕, 飯島 勝矢, 小原 由紀, 平野 浩彦, 池邉 一典, 岩崎 正則
• 多歯時代の歯周病：機械学習による将来予測とスクリーニングスコアの開発

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2022/04 -2025/03 

  Author : 岩崎 正則, 平野 浩彦, 福田 英輝

   

  多くの歯が残るようになった高齢者世代での歯周病有病率の上昇が顕著である。しかし高齢者歯周病対策への人的・物的資源の割当の指針となる有病率の将来推計は存在しない。また歯周病疫学研究の国際的ゴールドスタンダードは6点法プロービングであるものの、その実施困難さが高齢期歯周病疫学研究の進展を妨げている。 本研究では65歳以上高齢者約2,500人からなる国内最大規模の歯周病データベースを構築する。これを基盤として、機械学習を利用し、多くの特徴量を組み合わせた大規模・高次元データ解析を行うことで、高齢者歯周病対策の立案と高齢期歯周病疫学研究の進展・エビデンスの創出に資する知見を生み出すことを目指す。具体的な目的として以下の2つを設定した。 目的①65歳以上高齢者人口がピークとなる2040年までの高齢者歯周病有病率の将来推計 目的②申請者が開発した日本語版歯周健康状態評価質問紙をベースとした、プロービングによらない高齢期歯周病スクリーニングスコアの開発 研究初年度である2022年度には新たな研究対象集団の決定と、リクルートおよびデータ採得の準備を行った。あわせて、既存のデータを用いて日本語版歯周健康状態評価質問紙の高齢者における妥当性評価を行った。結果の一部を第65回秋季日本歯周病学会学術大会にて発表した（岩崎ほか, 2022, 地域在住高齢者におけるCDC・AAP歯周病質問票日本語版の妥当性の検討：お達者健診研究）。現在、論文化に向けて研究を進めている。
• A Study on Integrated Implementation of Health Service and Preventive Long-Term Care Service for the Elderly Regarding Oral Frailty

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2020/04 -2025/03 

  Author : 渡邊 裕, 飯島 勝矢, 小原 由紀, 平野 浩彦, 池邉 一典, 岩崎 正則

   

  ①オーラルフレイルの有病率と低栄養、要介護等の発生要因に関する調査 2021年度は2020年度に行われた口腔機能に関連する大規模長期コホート研究（板橋）、後期高齢者歯科健診（神奈川県、鳥取県）のデータを2018年、2019年のデータと統合した。2021年度は草津、高島平の調査と、介入研究（岩見沢）はCOVID-19のため実施できなかった。2018年から2020年までに実施された、板橋、草津、高島平、柏の統合データを用いて、地域在住の日本人高齢者5,083人の舌圧の年齢別および性別別の人口基準値を算出した。結果、男女ともに、高齢になるほど舌圧は有意に減少した。年齢と性別の相互作用は、舌圧に有意な影響を及ぼしていることが明らかになった。これについては論文化し公開した。オーラルフレイルと医療費との関連については、2190名の後期高齢者歯科検診のデータと国保データベースを統合し分析した。結果、オーラルフレイルは医科の年間外来医療費が高額であることと有意な関連を認めた。同様に歯科の年間外来医療費とオーラルフレイルにも有意な関連を認めた。オーラルフレイルの各検査項目と医療費との関連については，客観的咀嚼能力の低下と医科の年間外来医療費が高額であることと有意な関連を認めた。 ②地域包括ケアシステムにおける住民主体の通いの場と歯科診療所との共同によるオーラルフレイル予防のための地域介入研究、③オーラルフレイル改善プログラムの効果検証 令和２年度と同様に海老名市では歯科診療所において、岩見沢市では通いの場においてオーラルフレイル改善プログラムを実施する予定であったが、岩見沢市では通いの場がCOVID-19によって自粛となり、自宅でのセルフプログラムでの実施となった。海老名市では予定通りオーラルフレイル改善プログラムを実施し、効果について国保データベースと統合し分析している。
• ベイジアンネットワークによる口腔機能低下リスクの解明とフレイル予防戦略の構築

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2021/04 -2024/03 

  Author : 細川 隆司, 近藤 祐介, 木村 友美, 野代 知孝, 坂本 龍太, 宗政 翔, 向坊 太郎, 正木 千尋, 角田 聡子, 安細 敏弘, 岩崎 正則

   

  歯の支持に関連する指標として，歯根膜を介して歯槽骨と結合している歯根表面積の個人ごとの和(以下 RSA-PL)を算出し，RSA-PLがオーラルフレイルの評価における咀嚼能力・咬合力と関連するか検討した. 土佐町フィールド医学研究に参加した地域在住高齢者250名(平均年齢82.5歳，男性98名，女性152名)を本研究の対象とした.咀嚼能力評価には咀嚼チェックガムを用い測色計を用いてa*値を指標として評価した，咬合力は，デンタルプレスケールIIおよびバイトフォースアナライザを用いて計測した．また，全顎6点法でのPPD，CALを測定し，各歯の付着の喪失の総面積(以下ALSA)を算出した.先行研究で報告されている各歯の歯根表面積(RSA)からALSAを減ずることで，RSA-PLを算出した. a*値と咬合力のそれぞれを目的変数とし，RSA-PL を主要な説明変数とする単変量・多変量線形回帰分析を実施し，RSA-PLがa*値と咬合力に与える影響を評価した.また，平均PPD，平均CALがa*値と咬合力に与える影響を別途評価した. 解析の結果，研究対象集団におけるRSA-PLの平均値(標準偏差)は26.3(22.3)cm2であった.年齢，性別，定期歯科受診状況，喫煙状況，身体活動レベル，BMI，抑うつ，脳梗塞の既往，および糖尿病で調整した後も RSA-PLはa*値と咬合力とそれぞれ有意に関連していた(RSA-PL 1cm2増加毎のa*値に対する調整済回帰係数[95%信頼区間]= 0.16 [0.1 to 0.22];咬合力に対する調整済回帰係数[95%信頼区間]= 9.2 [5.3 to 13.1]).一方，平均PPD，平均CALはa*値と咬合力と関連していなかった. これらの結果から，RSA-PLはオーラルフレイルを評価する上で優れた指標であることが示唆された.
• Developing community-based programs for frailty in elderly people: an action research on primary care interventions in Thailand and Japan

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2019/04 -2024/03 

  Author : 木村 友美, 岩崎 正則, 石本 恭子, 渡辺 長, 河森 正人, 速水 洋子, 坂本 龍太

   

  本研究は、タイと日本において、文理融合の多分野の研究者らとともに、高齢期の「フレイル」の実態を社会的また文化的側面から明らかにし、地域の特性にそくした新たなフレイル指標を開発することを目的とする。 本研究は5年間の計画で、今年度はまず質的調査を中心として高齢期のフレイルの実態を探求した。日本とタイの両地域において、地域高齢者への質的インタビュー（グループインタビューおよび個別インタビュー）を行い、フレイルのとらえ方を問うと共に、その文化的・社会的背景（家族、親族関係、地域のつながり、社会的活動、信仰と仏教活動等）について調査した。日本では2019年8月に、高知県土佐町において総合機能健診を約300人対象に実施した。ここでは、多分野を専門とする研究分担者らとともに、運動機能、心身の健康度および認知機能、栄養状態、口腔機能（歯科）に関する検査・診査を実施し、既存のフレイル指標における評価だけでなく包括的な健康にかかわるデータを収集した。タイでは9月に、マヒドン大学の研究協力者らとの共同で、地域高齢者の総合機能健診の簡易版（運動機能、日常生活動作、うつ傾向、食事摂取の状況などの調査）を、約100人対象に実施し、フレイルの状況と健康関連因子のデータを収集した。また、タイでは、近年増加している「高齢者学校」における介護予防的な取り組みについても調査し、高齢者が「要介護」および「フレイル」の状況をどのようにとらえて予防的取り組みを行っているかをまとめた。健診で得た量的データを解析するとともに、質的インタビューともあわせてフレイルに関わる因子を分析しており、この作業は現在も進行中である。2020年2月にはふたたびタイを訪問し、現地研究協力者らとともに日常生活機能に関するデータのまとめおよび分析に関して議論し、結果をまとめて現在論文1本を投稿予定である。
• 高齢期における口腔機能低下と腸内細菌叢との関連性の探索に関する研究

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2021/04 -2024/03 

  Author : 小原 由紀, 平野 浩彦, 岩崎 正則

   

  本研究課題は、地域在住高齢者の栄養状態や全身状態といった要因を包括的に評価した上で、咀嚼や嚥下、舌口唇運動といった個々の口腔機能に着目し、腸内細菌叢との関連性を明らかにすること、口腔機能向上を目的とした教育的介入が腸内細菌叢に及ぼす効果を無作為比較化試験によって明らかにすることを目的としている。 初年度は、健康上問題のない30歳から59歳までの男女50名と地域在住高齢者50名を対象として、口腔機能および栄養状態と腸内細菌叢との関連を調査した。口腔機能および栄養状態等については、基本属性（年齢、性別、全身疾患、服薬状況、喫煙・飲酒習慣）、口腔評価（歯数、口腔乾燥度、咬合圧、口腔衛生状態、嚥下機能、舌圧、咀嚼機能評価、舌口唇運動巧緻性、う蝕・歯周疾患の状態）、口腔保健行動（歯科受診状況、口腔衛生習慣）、栄養に関する評価（身長、体重、四肢筋肉量、食品多様性スコア、食物摂取頻度調査FFQg、孤食/共食の状況）、運動機能（握力、歩行速度）に関するデータを収集した。一方、腸内細菌叢については、対象者に便検体の採取を依頼し、次世代シーケンサーを用いた16SrRNA解析により、腸内細菌叢の組成（バクテイロデーテス門、アクチノバクテリア門、ファーミキューテス門、プロテオバクテリア門に属する菌の構成比）、多様性指標（保有菌の種類、均等度、最優勢菌の占有率、バクテロイデーテス門の種類数）、短鎖脂肪酸指標、腸管免疫指標、口腔常在菌指標に関するデータを得た。以上の調査により。口腔機能と腸内細菌叢に関する指標に関する基礎的なデータを得た。
  
• Study on Oral and Swallowing Function in the Elderly and the Design of a Comprehensive Evaluation System

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2020/04 -2023/03 

  Author : Hirano Hirohiko

   

  The following two surveys were conducted to clarify the disease structure of oral hypofunction in old age and to construct basic data for its management. (1) Identification of the actual condition of oral and feeding/swallowing hypofunction: An integrated database of 2,503 elderly people (average age 77.0 years; 1,615 women) living in the community was created. (2) Identification of risks associated with oral and feeding and swallowing functional decline: A model of oral hypofunction was reconstructed in order of intensity of association with outcomes, and a four-item model of low tongue pressure, poor masticatory function, poor lingual-lip motor function, and poor bite strength was identified as a candidate model. In conclusion, the four-item model is comparable to the current seven-item assessment in terms of outcome discrimination, and will also enable the definition of the severity of oral hypofunction.
• 高齢血液透析患者の唾液分泌促進と口腔内衛生改善に向けた口腔ケアプログラムの開発

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2019/04 -2023/03 

  Author : 古庄 夏香, 前田 ひとみ, 岩崎 正則, 粟野 秀慈

   

  令和元年度の実態調査については、口腔乾燥の自覚の有群が、口腔乾燥の自覚無群に比べてQOLの低下が認められた。また、口腔乾燥有（刺激時唾液量の低下有）群が、口腔乾燥無（刺激時唾液量の低下無）群に比べて、GNRI、総蛋白、アルブミンの栄養をあらわすデータが低いことが分かった。今後は、さらに詳細な分析を継続し、透析患者の口腔内の実態を明らかにする。 実態調査に引き続き、令和2年度は歯科医師、歯科衛生士と協議し作成した口腔ケアプログラムを実施した。口腔ケアプログラムの作成は、歯科医師、歯科衛生士と協議し、唾液分泌を促進させる方法かつ、歯科領域の専門家でないと実施できない特別な器具や技術ではなく、看護師が実施できる内容のものとした。また、顎下腺、耳下腺といった唾液分泌部位をマッサージすることで唾液の分泌促した。口腔ケアプログラムは令和元年度末に方法を決定し手技の確認まで終わっていたが、新型コロナウイルス感染症の流行のため予定していた時期の介入が中止となった。 当初は、実態調査に引き続き介入を行う予定であったが、新型コロナウイルス感染症感染拡大のため介入時期が延期となった。R2年度に3カ月にわたる介入を実施した。令和3年度は3か月間の介入中に、27名の対象者から得られたデータ（栄養関連血液データ、安静時唾液量、刺激時唾液量、口腔内粘膜水分量、口腔内細菌数）を整理した。当初は29名の参加であったが、対象者の病態の変化により2名の介入ができなかった。 研究デザインがクロスオーバーであるため、今後は実態調査で得られたデータと、介入で得られたデータの比較を行い、口腔ケアプログラムの効果を評価する。また、今後は研究結果の分析から、プログラムの再検討を行っていく。
• Development of an oral health program for the prevention of diabetic nephropathy

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2019/04 -2023/03 

  Author : 村岡 宏祐, 角田 聡子, 守下 昌輝, 岩崎 正則, 園木 一男, 福原 正代, 安細 敏弘, 粟野 秀慈

   

  生活習慣病の一つで患者数が増加の一途を辿っており，患者数が多い疾患が糖尿病である。糖尿病の合併症の一つである糖尿病性腎症がある。血液透析導入の主要な原因疾患は糖尿病の一つである糖尿病性腎症である。糖尿病性腎症の重症化の予防は，患者の口腔内状態，全身状態の維持や医療費削減にも繋がり最も重要な課題となっている。 本研究の目的は，糖尿病患者ならびに糖尿病性腎症の患者の口腔健康状態の問題点を抽出し，問題点を図ることにより，最終的には糖尿病性腎症重症化予防プログラムの構築をすることである。 被験者は人工透析を行っている143名を解析した。口腔健康調査項目として，口腔状態，歯周ポケット，クリニカルアタッチメントレベル，歯肉からの出血などを測定した。全身健康調査として，血中ののADLH2遺伝子多型，IL-6遺伝子多型を測定した。ADLH2遺伝子多型，IL-6遺伝子多型の有無と口腔内，全状態を評価した。両パラメーターに有意に関与する因子はクレアチニンフォスフォキナーゼ（CPK）であった。本結果から歯周組織の程度によりCPKが影響し，このCPKが心機能に影響を及ぼすことを示唆した。 本解析により人工透析患者における口腔内状態と全身状態のサイクルについて考察することが可能になった。このことから，人工透析患者の重症化予防のプログラムの構築することが可能と考える。しかしながら解析中の被験者もいるため，今後詳細に解析，検討を行う予定である。
• 唾液バイオマーカーを用いた社会的フレイル評価法とコミュニティー支援システムの構築

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2019/04 -2023/03 

  Author : 角田 聡子, 安細 敏弘, 岩崎 正則, 邵 仁浩, 福原 正代, 濱嵜 朋子

   

  本研究の目的は大きく次の3つである。①社会的フレイルを唾液を用いて評価すること。②社会的フレイルと身体的フレイル(オーラルフレイル)の関連について調べること。③フレイル予測、予防・介入方法を立案することである。 フレイルの評価方法の標準化と社会的フレイルの客観的評価、さらにそれぞれのフレイルの 相互の影響を判断することでフレイルのリスク診断が可能になると考える。得られたデータを基に、調査期間中の体内組成の変化や口腔・栄養状態の変化、死亡や発症に伴う要介護認定の関連について解析することでフレイルリスク診断、予防プログラム を作成するのが大きな目的である。 本年度は研究全期間4年中3年目であり、本年度中に最終調査を行う予定であったが、Covid-19の影響により、大規模な集団調査を行うことは不可能であった。 そこで、これまでに収集したデータの解析を主に行い、国内学術学会および国際学術学会にて発表した。
• Association between periodontal disease and cardiovascular diseases in haemodialysis patients: A 10-year cohort study.

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2019/04 -2023/03 

  Author : 大田 祐子, 福原 正代, 岩崎 正則, 粟野 秀慈, 安細 敏弘, 邵 仁浩, 角田 聡子

   

  日本人の血液透析患者を対象とした心血管病データベースを再構築した疫学研究の成績を用いて、心血管病発症とそれによる死亡を標的として、歯周病重症度および歯周病原細菌感染度との関連を評価し、歯周病が心腎連関進展へ与える影響についての検討を行っている。 既往歴、家族歴、生活歴（飲酒・喫煙)、服薬状況（降圧薬、糖尿病治療薬など）、透析期間、透析基礎疾患の基本情報、身体計測（身長、体重、基準体重）、透析前後血圧、Kt/V（標準化透析量）、血液検査（血計、脂質、血糖など)の医科項目、残存歯数、歯冠・歯根の状態、咬合状態、歯周病罹患の有無、口臭、口腔粘膜、唾液検査（分泌量、pH）、縁下プラーク、 舌苔、唾液・プラーク・舌苔中の歯周病原性細菌の歯・口腔診査のデータベースの確認を行い、追跡調査として、本研究のエンドポイントである心血管病（心筋梗塞、狭心症、冠攣縮性狭心症、冠動脈バイパス術後、経皮的冠動脈形成術後、脳出 血、脳梗塞、くも膜下出血、心不全、心房細動、高血圧、その他の不整脈、大動脈瘤）発症と死亡のデータ収集中である（①近隣医療機関との緊密な連携のもと、心血管病発症や死亡の有無を定期的に調査する。②転院した者については、郵送・電話による アンケート調査を行い、心血管病発症や死亡の有無について調査する。上記①・②で心血管病が疑われた場合、および脂肪が確認された場合には、医療機関においてその診断に必要な臨床情報を系統的に収集し、心血管病の発症の有無を調査し、死亡の場合は死亡時の臨床情報と死亡 診断書により死因を確定する）。
• Development of a frailty assessment index that includes psycho-social factors.

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2019/04 -2023/03 

  Author : Ishimoto Yasuko

   

  We examined frailty-related factors in older residents of a private nursing home at one and two years. Depression scores were a frailty-related factor in both years. The results suggest that psychological factors were associated with frailty. The study also focused on one of the psychological factors, peace of mind behavior. A comparative study of older people living in a private nursing home in Japan and those community-dwelling in Thailand showed that living environment and lifestyle influenced peace of mind behavior. Furthermore, it was suggested that the continuance of peace of mind behavior may be related to the maintenance of basic activities of daily living. Attention to the psychological aspects of older people was necessary for the prevention of frailty.
• The significance of the repetition saliva swallow test for predicting pneumonia death

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2017/04 -2023/03 

  Author : Fukuhara Masayo

   

  In 1998，827 80-year-01d residents of Fukuoka Prefecture participated the dental and medical examination, which included the repetitive saliva swallowing test (RSST). The RSST is a safe and simple screening method for the swallowing function and evaluates how many times people can swallow in 30 seconds. Less than 3 cycles is considered as abnormal. We followed up 822, who completed the RSST, and investigated the association between dysphagia and mortality rate from pneumonia. For 12 years 504 died. Eighty-one died of pneumonia. Kaplan-Meier method showed the mortality rate from pneumonia was significantly higher in the subjects with dysphagia compared to the subjects without dysphagia (p<0.05)．In Cox proportional hazard model，dysphagia is a significant and independent risk factor for death of respiratory disease（hazard ratio 1.6）. The mortality rate from pneumonia was significantly higher in the subjects with dysphagia evaluated by RSST.
• 成人期における口腔の健康と全身の健康の関係性の解明のための研究

  厚生労働省：厚生労働科学研究費補助金 循環器疾患・糖尿病等生活習慣病対策総合 研究事業

  Date (from‐to) : 2021 -2022/03 

  Author : 小坂 健, 辻 一郎, 斎藤 武仁, 相田 潤, 岩崎 正則, 財津 崇, 大野 幸子
• Role of gene polymorphisms in the association between periodontal disease and cardiovascular disease mortality risk among hemodialysis patients:

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2018/04 -2022/03 

  Author : Iwasaki Masanori

   

  The aim of this study is to investigate the role of gene polymorphisms in the association between periodontal disease and cardiovascular disease mortality risk among hemodialysis patients. We could not complete the study due to the coronavirus disease 2019 (COVID-19) pandemic. However, with the use of existing data of epidemiological study, we have demonstrated the association of periodontal disease with kidney function, vascular endothelial function, cognitive function, and health behavior.
• Cohort study regarding association between oral and systemic health from chronobiology

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2018/04 -2021/03 

  Author : Ansai Toshihiro

   

  Many problems have been pointed out regarding the environment surrounding workers in Japan. Although clock-biology-related factors such as shift work and social jet lag are thought to negatively affect oral and systemic health and psychological status, the detailed mechanisms are not clear. We conducted oral health condition and questionnaire survey of 540 employees and bus drivers (average age 47.9 years) to evaluate their oral and general health status, as well as their dietary and nutritional intake. Those with low occlusal strength tended to be insomniacs, suggesting that the intake of vitamin D and vitamin B12 may influence the findings through a mediating effect. Also, the intake of calcium, vitamin D, vitamin B2, and small fish was lower in those with low chewing ability. The number of teeth with periodontal pockets of 4 mm or more was significantly higher in those who ate one or more staple stacked meals per day than in those who ate less than one stacked meal per day.
• Development and validation of a rehabilitation nutrition program for improvement of oral sarcopenia

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2016/04 -2020/03 

  Author : KAKUTA SATOKO

   

  It is not fully understood that the relation between decline of total body muscles, weakened muscles (sarcopenia) and oral function, nutrition, and also that how they can be prevented or improved. In this study, we investigated the relationship between sarcopenia , oral function and nutrition. This study shows that it is related to total body muscle mass and oral muscle strength (tongue pressure: power of the tongue) in the elderly. It was also shown that the functions of tongue and swallowing (power for swallowing)may affect decline nutrient status and nutrient intake.
• Frailty among the Elderly in Asia: A comprehensive study in Thailand and Japan

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2016/07 -2019/03 

  Author : Kimura Yumi

   

  The field survey had carried out in the community in Japan and Thailand and aim to reveal frailty with multiple aspects which include mental status such as depression and QOL, nutrition status, and social backgrounds, as well as physical functions. Frailty of the elderly in Nakhon Pathom in Thailand was associated with oral health status. However, the associations between frailty and other physical health status was not confirmed. The previous tool to screen “frailty” had introduced and studied in Western countries, and it is not confirmed if the tool is applicable to Asian communities or not. Through the quantitative interview to the elderly people, we found that the elderly in Thailand perceive “frailty” as a natural aging process. The keywords to express frailty for the elderly persons were connected with the words of “surroundings with people and society” and it’s not always stand for the physical strangeness or independence status.
• Epidemiological study regarding association between aggresive periodontitis and the Mediterranean diet in the Moroccan population

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2016/04 -2019/03 

  Author : Ansai Toshihiro

   

  Our aim was to investigate a prevalence of aggressive periodontitis (AgP) and the association between AgP and the Mediterranean diet in the Moroccan population. Olive oil consumption score (a component of MDS) was significantly and inversely associated with AgP (adjusted odds ratio = 0.55, 95% confidence interval = 0.32-0.96). The dietary pattern characterized by frequent consumption of olive oil may have a protective effect against AgP. Further longitudinal studies with data on serum fatty acid composition are required to substantiate our findings.
• Clinical research on malnutrition prevention effect and prognosis focusing on nutrition management in perioperative period of oral cancer

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2015/04 -2019/03 

  Author : SAKAI RIE, BEPPU Megumi

   

  We recognized the importance of maintaining nutritional status from the survey of inpatients with oral cancer at the Dental University Hospital in 2012-2013. The purpose of this research is to examine the effects and prognosis of malnutrition prevention by professional nutrition management that secures appropriate energy amount and nutrients before and after surgery by the dentist and the registered dietitian in cooperation in 2017-2018. As a result, although there are more severe patients in the 2nd term than in the 1st stage, the weight loss rate and the number of hospital days do not differ from those in the 1st stage, and the energy and nutrients that are lacking due to collaboration between the dentist It is surmised that the importance of nutritional management such as supplementation by using nutritional agents and instructing patients on the importance of food at admission and discharge was recognized.
• Analysis of pathologic subjective halitosis using psychological scales and development of clinical guideline for general practitioners

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2016/04 -2018/03 

  Author : Ansai Toshihiro

   

  Pathologic subjective halitosis is known as a halitosis complaint without objective confirmation of halitosis by others or by halitometer measurements; it has been reported to be associated with social anxiety disorder. However, causal relationship between pathological subjective halitosis and psychological variables remains unclear. Therefore, we investigated potential causal relationships among pathologic subjective halitosis, olfactory reference syndrome, social anxiety, and preoccupations with body part odors. A total of 1360 female students answered a self-administered questionnaire. Bayesian network analysis showed that social anxiety directly influenced pathologic subjective halitosis and olfactory reference syndrome. Preoccupations with mouth and body odors also influenced pathologic subjective halitosis. Social anxiety may be a causal factor of pathologic subjective halitosis and olfactory reference syndrome.
• Study of drug development targetting ADAMs in gingival epithelium for prevention of peridontal diseases

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2015/04 -2018/03 

  Author : Awano Shuji

   

  A disintegrin and metalloprotease 17 (ADAM17), one of proteases belonging ADAMs family, is a tumor necrosis factor (TNF)-converting enzyme that cleaves the prodomain of TNF-α, a proinflammatory cytokine that plays a central role in immune regulation and a variety of inflammatory responses in destructive periodontal disease. This study verified the possibility of ADAM17 in the gingival epithelium as a target for drug development to prevent periodontal diseases. Strong immunoreactivity for ADAM17 was observed in the epithelium of the inflamed gingival tissues and in in human oral keratinocytes (HOKs). Furthermore, treatment with either ADAM17 inhibitor or ADAM17 siRNA inhibited the generation of TNF-α induced by lipopolysaccharide (LPS) in HOKs. The present study demonstrates that ADAM17 is strongly expressed in the epithelium of gingival tissues and suggests that ADAM17 may be a key enzyme that regulates the generation of TNF-α in oral keratinocytes.
• Bacteriological and immunological analysis for the regulatory factors of aggressive periodontitis in Morocco

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2015/04 -2018/03 

  Author : YOSHIDA Akihiro

   

  Aggressive periodontitis (AgP) is particular form of periodontitis which affects adolescent. However, oral microbiota of AgP has not been studied. In this study, salivary microbiota of the AgP and healthy subjects in Moroccan peoples were analyzed. This study includes 130 (AgP and Healthy, 65 each) university students in Morocco. Multiplex 16S rRNA (V3-V4) sequencing of bacterial DNA was performed. The significantly higher levels of Fimicutes, Bacillales, Streptococcaceae, Staphyrococcaceae families were detected in saliva from AgP subjects (P < 0.05). On the contrary, Proteobacteria, Gammaproteobacteria, Lactobacillaceae families were dominant in saliva from non-AgP subjects (P < 0.05). In genera levels, Bacilli, Streptococcus, Staphyrococcus are dominant in patients with AgP, while Lactobacillus, Porphyromonas are dominant in non-AgP subjects (P < 0.05, respectively). HOMD NGS analysis of saliva revealed the characteristic bacterial families/genera in patients with AgP.
• Elucidation of social determinants of health associated with regional differences in caries prevalence among children : a multilevel analysis

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2014/04 -2018/03 

  Author : SOH INHO

   

  The purpose of this study was to identify regional differences in a prevalence of dental caries among children.The subjects were 3,243 children of one and a half or three years old, who participated in health checkups at Kitakyushu city. We examined a prevalence of dental caries among children of one and a half or three years old by administrative districts. Furthermore, we evaluated the relationship between a prevalence of caries at age of three and a lifestyle at the age of one and a half by administrative districts, employing logistic regression analysis. Then, we evaluated a prevalence of multiple dental caries among those who had one or more caries at the age of three as well.There were significant differences in a prevalence of multiple dental caries among those who had one or more caries at the age of three by administrative districts in Kitakyushu city. The odds ratio (95%CI) of multiple dental caries among children in C-district to A-district was 3.47 (1.47-8.23).
• Investigating the effect of serum antibodies to periodontal bacteria on cardiorenal association

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2014/04 -2017/03 

  Author : Iwasaki Masanori

   

  Recent epidemiological study confirmed cardiorenal association. Periodontal disease is thought to play important role in cardiovascular and renal function. However, its effect on cardiorenal association has not been fully studied yet. We investigated the effect of serum antibodies to periodontal bacteria on cardiorenal association. Based on the results of epidemiological survey of community-based population and hemodialysis patient group, we confirmed that periodontal disease was significantly associated with renal and cardiovascular status. Future studies evaluating the potential effect of oral interventions for periodontal health improvement on cardiorenal function in these study population would be of great interest.
• Molecular analyses of volatile organic metabolites identified from human odor and the association with cancer of head, neck and upper digestive organ

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2013/04 -2016/03 

  Author : Ansai Toshihiro, LEE SEUNGWOO, YOSHIDA AKIHIRO, TAKATA YUTAKA, IWASAKI MASANORI, SOH INHO, KAKUTA SATOKO, AWANO SHUJI, NAKAMICHI IKUO

   

  Disease diagnosis based on volatile organic compounds (VOCs) that are excreted from the human body is being realized in recent years. In this study, we report a novel method for analyzing VOCs present in healthy human saliva and urine via thin-film microextraction (TFME) coupled with gas chromatography-mass spectrometry (GC-MS). The VOC extraction was conducted with polydimethylsiloxane (PDMS) films hybridized with ZSM-5 that is one of aluminosilicate zeolites. The saliva and urine samples were collected from 8 healthy volunteers. Approximately 50 to 100 VOCs were obtained from the individual samples, among which 34 and 33 compounds were reproducible for the saliva and the urine samples, respectively. The current study based on TFME using PDMS/ZSM-5 hybrid films would provide a potential methodology for the sensitive analysis of VOCs or new biomarkers present at trace levels in biological samples.
• The association between serum antibody to the periodontal pathogen and chronic kidney disease

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2011 -2013 

  Author : IWASAKI Masanori

   

  Kidney disease is recognized as a global health problem; the estimated number of the people with chronic kidney disease (CKD) in Japan alone is 13.3 million, which represents 12.9% of the population. The aim of this study was to investigate the association between serum antibody to the periodontal pathogen and CKD in Japanese individuals. Data were available from 215 participants aged 79 yrs. We observed a significant association between elevated serum antibody titer to P. gingivalis and decreased kidney function, after controlling for other important health characteristics. The findings of the present study suggest that there is a significant association between elevated serum antibody titer to P. gingivalis and decreased kidney function in the community-based cohort of elderly Japanese. Future studies should evaluate the contribution of periodontal therapy in reducing the risk for the development or progression of CKD.