| Summary: | 碩士 === 高雄醫學大學 === 口腔衛生科學研究所碩士在職專班 === 99 === Background: The proportion of elderly aged between 45- 64 years old in Taiwan was 35.1% of the total population in 2008 and it will increase to 48.6% in 2056. The proportion of elderly aged over 64 in Taiwan was 10.4% of total population in 2008 and it will increase to 14.0% in 2017. That meets the definition of an aging society set by the United Nations. And it will increase to 37.5% in 2056. Chewing (mastication) and swallowing (deglutition) is the first step of consumption, and requires good oral function in order to acquire sufficient nutrition intake.
Purpose: The purpose of this study is to analyse the correlation between chewing and swallowing ability, nutrition and diet deviation of those aged over 45 years old and residents of long-term care institutions.
Materials and Methods: This study used cross-sectional study sampling, obtained from 21 out of 205 long-term care institutions in the Kaohsiung area. Through interviews held by the study investigators, residents over the age of 45 were enrolled in a questionnaire survey, oral examination, and water swallowing test. The total valid samples were 452 people. SPSS version 18.0 was used to perform the archive and statistical analysis.
Results: There were 60.4% of the residents of the long-term care institutions who have dysphagia in the Kaohsiung area. The social demographic factors of female, older, those who were disabled of movement for self-care of daily living, those who are unable to eat without assistance, those who can not live independently, physiology with CVA (cerebral vascular accident), those who have dementia, fewer teeth in the mouth, no corresponding teeth, no teeth or loose dentures, chew food such as porridge, cough after swallowing, choke and cough after drinking water, choke and cough after swallowing water ot nasal reflux, the rate of dysphagia is higher and had a statistically significant correlation. With chewing swallowing disorders, nutritional status display of the total MNA score＜17 points, screening score≦11 points, more than 3 kg of body weight loss, arm circumference＜21 cm, calf circumference＜31 cm, the biochemistry average rate of albumin and cholesterol in the blood tend to be lower. Those who experienced CVA or dementia and have dysphagia are 71.91% and 74.65%, respectively. After adjusting for gender and age factors, the correlation between dysphagia and nutrition showed: The odds ratio of dysphagia in those residents with MNA scores between 17-23.5 was 7.29 times of those with MNA scores＜17. The odds ratio of dysphagia in abnormal albumin value group is 3.04 times more than normal albumin value group. The odds ratio of dysphagia in abnormal cholesterol value group is 1.96 times more than normal group. There is a significant correlation in statistics.
Conclusions and Recommendations: The oral health condition, nutrition condition are highly related with dysphagia of the residents of long-term care institutions. Increasing the functional teeth number, traning and rehabilitation chewing and swallowing function, will reduce the incidence of dysphagia, enhance the nutrition status, and then, improve oral, general health and quality of life of residents in long-term care institutions.
Keywords: elderly, long-term care institutions, swallowing funtion, number of teeth, nutrition
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