Geriatrics & Gerontology International最新文献

Aim: Recent studies have suggested that masticatory function may influence frailty progression. However, the relationship between posterior occlusal support and frailty remains underexplored. We aimed to evaluate the association between the loss of posterior occlusal support and frailty in a large cohort of Japanese adults.

Methods: This retrospective cohort study used data from the JMDC Claims Database. We included 386 270 individuals aged ≥ 40 years who underwent both specific health checkups and dental visits in 2016, with follow-up data available through 2020. We categorized posterior occlusal support using the Eichner classification (A, all support zones intact; B, partial support zones; C, no functional support zones). We assessed frailty annually using the claims-based frailty index (CFI) (a deficit accumulation-type frailty measure). We used generalized estimating equations to evaluate the association between occlusal support and frailty after adjusting for potential confounders.

Results: At baseline, the mean age was 49.6 (standard deviation, 7.2) years, and 47.4% of the participants were women. The prevalence of frailty was 4.9%, 9.5%, and 12.1% in the Eichner A, B, and C groups, respectively. Compared to Eichner A, the adjusted odds ratios (ORs) for frailty were 1.21 (95% confidence interval [CI], 1.13-1.30) for Eichner B and 1.39 (95% CI, 1.21-1.59) for Eichner C. This relationship was stronger among women than men.

Conclusions: Reduced posterior occlusal support is independently associated with an increased risk of frailty. These findings underscore the importance of oral health in preventing physical debilitation and suggest incorporating early dental interventions into health strategies for older populations.

This Letter questions whether JST-IC-based trajectories primarily reflect aging-related decline or enduring life-course capacities and contextual adaptation. We argue that trajectory patterns may represent mixed trait-change constructs shaped by cognitive reserve, digital literacy, and cohort-specific exposures, with important implications for interpretation and intervention.

We read with great interest the article by Nakai et al. [1], which elucidated the significance of visual correction of balance—quantified by the Romberg quotient—in care planning for fall prevention in dementia. As the authors highlighted, fall risk in dementia with Lewy bodies (DLB) is multifaceted. We would like to offer a complementary perspective from the standpoint of physical rehabilitation and sensory integration.

While the study effectively demonstrated that visual dysfunction correlates with postural instability, it raises a critical question regarding the mechanism of “sensory re-weighting.” In clinical practice, we often observe that patients with cognitive impairment struggle to switch between visual, vestibular, and somatosensory inputs [2]. A high Romberg quotient suggests a maladaptive reliance on visual input to compensate for deficits in other sensory systems. However, in DLB patients, visual processing itself is often fluctuating or impaired [3].

Therefore, simply identifying the reliance on vision is the first step. The logical next step for “care planning,” as proposed by the authors, should involve differentiating whether this visual dependence is a compensatory strategy that should be supported (e.g., by enhancing environmental lighting and visual cues) or a potential distractor that may precipitate falls when visual information is ambiguous.

We suggest that future research could benefit from combining the Romberg quotient with dynamic posturography or dual-task gait analysis. This would help determine if rehabilitation interventions should focus on “visual cueing training” or, conversely, “sensory re-weighting training” to reduce excessive visual dependence. The findings by Nakai et al. [1] provide an excellent foundation for tailoring such precision rehabilitation strategies.

The authors have nothing to report.

The authors have nothing to report.

The authors have nothing to report.

The authors declare no conflicts of interest.

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.