Evaluation of chewing ability and its relationship with activities of daily living, depression, cognitive status and food intake in the community-dwelling elderly

Aim: The aim of this study was to assess chewing ability using color-changeable chewing gum and to show the association between chewing ability and geriatric functions, as well as dietary status in the community-dwelling elderly. Methods: The study population consisted of 269 community-dwelling elderly aged >= 75 living in Tosa, Japan. Assessment of chewing ability was carried out by a dentist using color-changeable chewing gum. Activities of daily living (ADL), depression and subjective quality of life (QOL) were assessed by questionnaire. Cognitive status was assessed by; Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale-Revised (HDS-R) and Frontal Assessment Battery (FAB) during the check-up. Food diversity was assessed using the 11-item Food Diversity Score Kyoto (FDSK-11). Results: Number of teeth was significantly related to chewing ability (P < 0.001). The participants with low chewing ability had significantly lower ADL scores in the items of self-maintenance (P = 0.029) and intellectual activity (P = 0.021). There was a significant association between low chewing ability and depression (P < 0.001). Lower cognitive functions were significantly related to low chewing ability; MMSE (P = 0.022), HDSR (P = 0.017) and FAB (P = 0.002). The participants with low chewing ability had lower food variety (P < 0.001), and less frequent intake of beans, vegetables, seaweed and nuts, than the participants with high chewing ability. Conclusion: Low chewing ability evaluated by color-changeable gum was associated with lower ADL, lower cognitive functioning, depression and food insufficiency in the community-dwelling elderly. More attention should be paid to assessing chewing ability of elderly persons in community settings. Geriatr Gerontol Int 2013; 13: 718-725.