比較活動假牙與固定假牙對台灣老人營養狀況的影響

A comparison of the impact of removable vs. fixed denture on the nutritional status of elderly Taiwanese

趙心儀(hsin yi chao)

指導教授 ： 蔡仲弘

亞洲大學/健康學院/長期照護研究所在職專班/碩士(2009年)

摘要

目的：牙齒健康會直接影響個人的攝食能力及營養狀況，尤其是老人族群。本研究旨在探討台灣老人的假牙裝配率，其對營養狀況的影響，以及個案選擇配活動式假牙及影響營養狀況的的關聯因子。
方法：本研究以國民健康局 (1999) 執行的「台灣中老年身心社會生活狀況長期追蹤調查」 65歲以上的個案為研究對象，並以短式簡易營養評估 (
Short-form Mini Nutritional Assessment, MNA-SF) 進行營養不良風險評估。以邏輯迴歸分析配活動式假牙及影響營養狀況的的關聯因子。
結果：本研究有效個案數為2770人，平均74.4±5.9歲。配裝假牙個案2073人 (74.8%)，包含配裝活動式1239人 (59.8%)，其中具營養不良風險者316人 (25.5%)；固定式假牙831人 (40.2%)，具營養不良風險者176人 (21.1%) 。配裝活動式假牙個案有較高的營養不良風險、攝食能力差、自覺營養較差、蔬菜攝取率較低的特性。邏輯迴歸分析顯示性別、年齡、居住地區、自覺健康狀況、攝食能力、食量變化、自覺營養不良可做為高營養不良風險的預測因子；性別、年齡、種族、居住地區、居住地規模、嚼檳榔、BMI 特性，可做為老人裝配活動式假牙的預測因子。
結論：本研究發現大多老人(75%)配裝假牙。其中60%配裝活動式假牙40%固定式假牙。配裝活動式者具備較高(25.5 vs. 21%)的營養不良風險。配裝活動式者攝食能力較差，此趨勢不因性別有所差異，但隨年齡增高而顯著增加。因此，建議老年人應注重牙齒的保健或者是配裝適當的假牙，以確保良好的營養狀況。

關鍵字

營養狀況 ； 假牙 ； 短式簡易營養評估 ； 營養不良風險

並列摘要

Background: Good dental status is essential for maintaining good eating ability and good nutritional status, especially in the elderly. Dental status often deteriorates as people age and wearing denture is a good alternative. Many elderly choose fixed denture while others choose removable denture.
Objective: The study was aimed to compare the impact of the two types of denture, fixed vs. removable, on eating ability, food choice and nutritional status in elderly Taiwanese.
Method: This study analyzed 1999 data of the "Survey of Health and Living Status of the Elderly in Taiwan, SHLSET", a survey study conducted by the Bureau of Health Promotion of Taiwan. Subjects who were 65 y or older in 1999 and wore either fixed or removable dentures were included in the study. The nutritional risk status of each subject was screened with a modified version of the short form MNA (Mini Nutritional Assessment) that adopted population-specific anthropometric cut-points. Regression analysis was employed to determine the factors that impact nutritional status and denture selection.
Results: Of the 4440 subjects, 2770 were 65 y or older. Among them 1239 (59.8%) elderly wore removable dentures and 831 elderly wore fixed dentures. A greater proportion (25.5%) of the removable denture-wearers was at risk of malnutrition compared to those who wore fixed denture (21.1%). Removable denture-wearers had greater risk of malnutrition, poorer eating ability, poorer self-view nutritional status, and ate less vegetables, based on Chi-square tests. However, regression analysis showed that gender, age, residential areas, eating ability, food intake, self-view nutritional and health statuses, but not the type of denture were associated with one's nutritional status. Regression analysis also showed that age, gender, residential location, betel-nut chewing and BMI were significant predictors for choosing the removable denture.
Conclusion: Elderly who wear removable denture appear to have reduced eating ability and increased risk of malnutrition. However, after controlling for the confounding factors, the type of denture worn by the elderly is not significantly associated with the risk of malnutrition. These results suggest that other factors associated with aging can interact with denture types and impact the nutritional risk status.

並列關鍵字

Denture ； Removable denture ； Nutritional risk ； Nutritional assessment ； Elderly

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