Coexistence of low body mass index and poor oral health negatively affects activities of daily living, swallowing, and cognition after stroke.

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY Geriatrics & Gerontology International Pub Date : 2024-08-27 DOI:10.1111/ggi.14971

Yoshihiro Yoshimura, Hidetaka Wakabayashi, Fumihiko Nagano, Ayaka Matsumoto, Sayuri Shimazu, Ai Shiraishi, Yoshifumi Kido, Takahiro Bise, Takenori Hamada, Kouki Yoneda

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Abstract

Aim: Low body mass index (BMI) and poor oral health are prevalent among older stroke patients and associated with adverse outcomes. However, their combined impact on functional recovery after stroke remains unclear. This study investigated the synergistic effects of low BMI and poor oral health on activities of daily living (ADL) independence, swallowing function, and cognitive status in post-stroke older patients.

Methods: A retrospective cohort study was conducted on 708 hospitalized post-stroke patients aged ≥70 years. Low BMI was defined as <20 kg/m², and poor oral health was assessed using the Revised Oral Assessment Guide (ROAG) with a score ≥13 indicating oral problems. The primary outcome was ADL independence (Functional Independence Measure-motor score >78) at discharge. Secondary outcomes included swallowing level (Food Intake Level Scale) and cognitive status (Functional Independence Measure-cognition score). Multiple regression analyses were performed to examine the associations of low BMI, poor oral health, and their combination with outcomes of interest.

Results: The coexistence of low BMI and poor oral health was independently associated with lower odds of achieving ADL independence (odds ratio 0.130, 95% confidence interval [CI] 0.023-0.718), worse swallowing level (B = -0.878, 95% CI -1.280 to -0.476), and poorer cognitive status (B = -1.872, 95% CI -2.960 to -0.784) at discharge, after adjusting for confounders. The combined impact was stronger than either condition alone.

Conclusions: The coexistence of low BMI and poor oral health exerts a synergistic negative impact on functional recovery in older stroke inpatients. Comprehensive interventions integrating nutritional support, oral management, and rehabilitation are crucial to optimizing outcomes in this vulnerable population. Geriatr Gerontol Int 2024; 00: 000-000. Geriatr Gerontol Int 2024; ••: ••-••.

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体重指数低和口腔健康状况差同时存在，会对中风后的日常生活活动、吞咽和认知能力产生负面影响。

目的：低体重指数（BMI）和口腔健康状况差在老年中风患者中很普遍，并且与不良预后有关。然而，它们对中风后功能恢复的综合影响仍不清楚。本研究调查了低体重指数和不良口腔健康状况对中风后老年患者日常生活活动（ADL）独立性、吞咽功能和认知状况的协同影响：对 708 名年龄≥70 岁的住院脑卒中后患者进行了回顾性队列研究。低体重指数（BMI）定义为 2，口腔健康状况不良采用修订口腔评估指南（ROAG）进行评估，得分≥13 分表示有口腔问题。主要结果是出院时 ADL 的独立性（功能独立性测量-运动得分大于 78 分）。次要结果包括吞咽水平（食物摄入水平量表）和认知状况（功能独立性测量-认知得分）。研究人员进行了多元回归分析，以检验低体重指数、口腔健康状况差及其组合与相关结果之间的关联：结果：在对混杂因素进行调整后，低体重指数和口腔健康状况差同时存在与出院时实现 ADL 独立的几率较低（几率比 0.130，95% 置信区间 [CI] 0.023-0.718）、吞咽水平较差（B = -0.878，95% CI -1.280 至 -0.476）和认知状况较差（B = -1.872，95% CI -2.960 至 -0.784）独立相关。综合影响强于单独影响：结论：低体重指数和不良口腔健康状况同时存在，对老年中风住院患者的功能恢复产生了协同的负面影响。整合营养支持、口腔管理和康复的综合干预措施对于优化这一弱势群体的治疗效果至关重要。Geriatr Gerontol Int 2024; 00: 000-000。Geriatr Gerontol Int 2024; --：-----.

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来源期刊

Geriatrics & Gerontology International 医学-老年医学

CiteScore

5.50

自引率

6.10%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Geriatrics & Gerontology International is the official Journal of the Japan Geriatrics Society, reflecting the growing importance of the subject area in developed economies and their particular significance to a country like Japan with a large aging population. Geriatrics & Gerontology International is now an international publication with contributions from around the world and published four times per year.