Predictive Factors Associated with Future Decline in Swallowing Function among Japanese Older People Aged ≥ 75 Years

Predictive factors associated with a decline in swallowing function after 2 years were examined in 3409 Japanese older people aged ≥ 75 years who had undergone a dental checkup in Gifu Prefecture, Japan. Participants with normal swallowing function in a baseline survey in April 2018 were followed for 2 years. Swallowing function was assessed using a repetitive saliva swallowing test. In our study, 429 participants (13%) who were swallowing less than three times in 30 s based on a repetitive saliva swallowing test after 2 years were diagnosed as those with decline in swallowing function. Multivariate logistic regression analyses showed the decline in swallowing function after 2 years was associated with the male gender (odds ratio [ORs]: 0.772; 95% confidence interval [CIs]: 0.615-0.969), age ≥ 81 years (presence; ORs: 1.523; 95% CIs: 1.224-1.895), support/care-need certification (presence; ORs: 1.815; 95% CIs: 1.361-2.394), periodontal pocket depth (PPD) ≥ 4 mm (presence; ORs: 1.469; 95% CIs: 1.163-1.856), difficulty in biting hard food (yes; ORs: 1.439; 95% CIs: 1.145-1.808), choking on tea and water (yes; ORs: 2.543; 95% CIs: 2.025-3.193), and dry mouth (yes; ORs: 1.316; 95% CIs: 1.052-1.646) at baseline. Therefore, the dental checkup items associated with a decline in swallowing function after 2 years were a PPD ≥ 4 mm, difficulty in biting hard food, choking on tea and water, and dry mouth. PPD status and confirming to the self-administered questionnaire about biting, choking, and dry mouth may be useful in predicting future decline in swallowing function.