要介護患者の「食べる力」!~12ヵ月の追跡調査で明らかになった経口摂取の可能性と歯科訪問診療の役割~

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2025-03-11 東京科学大学

要介護患者の「食べる力」!~12ヵ月の追跡調査で明らかになった経口摂取の可能性と歯科訪問診療の役割~
図1.経口摂取状況の変化。

東京科学大学の研究チームは、要介護の嚥下障害患者を対象に12ヵ月間の追跡調査を行い、経口摂取の状況が変化することを確認しました。経口摂取の状況には、年齢や誤嚥性肺炎の既往歴、居住環境などが影響し、初診時と6ヵ月後では関連因子が異なっていました。また、日本独自の歯科訪問診療による摂食嚥下リハビリテーションが、要介護患者の経口摂取機能の維持・改善に寄与する可能性が示されました。今後、地域での適切なリハビリ提供体制の整備が求められます。本研究成果は「The Journal of Prosthetic Dentistry」に掲載されました。

<関連情報>

訪問歯科診療を通じた地域居住の介護依存症患者における嚥下障害の進行と関連因子 12ヵ月間のレトロスペクティブ・コホート研究 Dysphagia progression and related factors in community-dwelling care-dependent patients through home-visit dental care: A 12-month retrospective cohort study

Kohei Yamaguchi, DDS, PhD∙ Sayaka Komori, DDS∙ Ryosuke Yanagida, DDS, PhD∙ … ∙ Kanako Yoshimi, DDS, PhD∙ Kazuharu Nakagawa, DDS, PhD∙ Haruka Tohara, DDS, PhD
The Journal of Prosthetic Dentistry  Published:March 8, 2025
DOI:https://doi.org/10.1016/j.prosdent.2025.02.006

Abstract

Statement of problem
Reports on the progress and characteristics of patients with dysphagia who require professional care at home or in a nursing home are sparse.

Purpose
The purpose of this 12-month retrospective cohort study was to investigate the characteristics of care-dependent patients with dysphagia in the community and the factors related to oral intake scale outcomes over 12 months of dysphagia rehabilitation through home-visit dental care.

Material and methods
A total of 323 participants receiving care at home or in a nursing facility who underwent dysphagia rehabilitation through home-visit dental care were enrolled. The outcome was the Functional Oral Intake Scale (FOIS) score at baseline and after 6 and 12 months of rehabilitation. Multivariable linear regression analysis was used to explore the factors associated with FOIS scores before and after dysphagia rehabilitation (α=.05).

Results
Approximately 90% of the participants had maintained or improved FOIS scores after 12 months. A difference in associated factors was observed between FOIS scores at baseline and after rehabilitation. Aspiration pneumonia history (B=-1.040, P<.001) and residential environment (B=-0.489, P=.035) were significantly linked to baseline FOIS scores but were not significant predictors of FOIS scores after 6 months (P>.05).

Conclusions
The findings demonstrate that FOIS scores improved in the community with 12-month dysphagia rehabilitation, although the rehabilitation was affected by the overall condition. This underscores the importance of accessible and tailored community-based services for those dependent on care services.

医療・健康
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