長期介護施設入居者の口腔機能低下に対する口腔衛生と口腔運動の効果

Effects of oral hygiene and oral exercise on oral hypofunction in residents of long-term care facilities.

抄録

嚥下機能障害（嚥下障害）は、栄養不良や虚弱の増加の一因となるため、長期介護施設に入所する高齢者の間で重大な関心事となっている。口腔機能の低下を特徴とする口腔機能低下は、口腔機能障害の前兆として認識されている。本研究では、口腔機能低下の有病率を調査し、口腔機能改善における口腔保健教育と口腔体操の有効性を評価した。台湾の7つの長期介護施設から合計295名の参加者を本研究のために募集し、包括的な評価を行った。主な評価項目は、口腔衛生、嚥下機能、栄養状態、虚弱であった。介入には口腔衛生教育と舌唇運動が含まれ、6ヵ月間にわたって実施された。嚥下機能、口腔の健康状態、舌圧、舌唇運動機能、栄養状態、握力、頬の膨らみなどのアウトカムを3つの時点で測定した。参加者の口腔機能低下の有病率は58.3％であった。介入により、口腔機能低下者の6ヵ月後の嚥下機能、3ヵ月後の口腔衛生と舌唇運動機能に有意な改善がみられた。さらに、口腔機能低下群では、6ヵ月後に栄養状態と頬の膨らみ機能が顕著に改善した。口腔衛生教育と口腔体操は、口腔機能低下を有する高齢者の嚥下機能、口腔衛生、舌唇運動機能を効果的に向上させ、それによって栄養状態を改善することが実証された。長期介護環境における口腔機能の改善には、早期発見と介入が極めて重要である。

Swallowing dysfunction, or dysphagia, is a critical concern among older residents in long-term care facilities because it contributes to malnutrition and increased frailty. Oral hypofunction, characterized by a decline in oral function, is recognized as a precursor to oral dysfunction. This study investigated the prevalence of oral hypofunction and assessed the effectiveness of oral health education and oral exercises in improving oral function. A total of 295 participants from seven long-term care facilities in Taiwan were recruited for this study, and they underwent comprehensive assessments. The key domains assessed were oral health, swallowing function, nutritional status, and frailty. The interventions included oral hygiene education and tongue-lip exercises, which were administered over a 6-month period. Outcomes such as swallowing function, oral health, tongue pressure, tongue-lip motor function, nutritional status, grip strength, and cheek bulging were measured at three time points. The prevalence of oral hypofunction in the participants was 58.3%. The intervention led to significant improvements in swallowing function 6 months later and in oral hygiene and tongue-lip motor function 3 months later in the participants with oral hypofunction. Additionally, in the oral hypofunction group, nutritional status and cheek bulging function were notably improved after 6 months. Oral hygiene education and oral exercises were demonstrated to effectively enhance swallowing function, oral hygiene, and tongue-lip motor function in older residents with oral hypofunction, thereby improving their nutritional status. Early identification and intervention are crucial for improving oral function in long-term care settings.