2022 Fiscal Year Final Research Report

The significance of the repetition saliva swallow test for predicting pneumonia death

Research Project

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Project/Area Number	17K12017
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Social dentistry
Research Institution	Kyushu Dental College
Principal Investigator	Fukuhara Masayo 九州歯科大学, 歯学部, 教授 (90360057)
Co-Investigator(Kenkyū-buntansha)	安細敏弘九州歯科大学, 歯学部, 教授 (80244789) 岩崎正則九州歯科大学, 歯学部, 准教授 (80584614) 中道郁夫九州歯科大学, 歯学部, 准教授 (60419570) 藤澤律子九州歯科大学, 歯学部, 助教 (50419587) 井手均九州歯科大学, 歯学部, 特別研修員 (10795537) 園木一男九州歯科大学, 歯学部, 教授 (50316155) 粟野秀慈九州歯科大学, 歯学部, 教授 (20301442) 秋房住郎九州歯科大学, 歯学部, 教授 (40295861) 邵仁浩九州歯科大学, 歯学部, 教授 (10285463)
Project Period (FY)	2017-04-01 – 2023-03-31
Keywords	高齢者 / コホート研究 / 嚥下障害 / 反復唾液嚥下テスト / 肺炎 / 呼吸器感染症 / 死亡
Outline of Final Research Achievements	In 1998，827 80-year-01d residents of Fukuoka Prefecture participated the dental and 　medical examination, which included the repetitive saliva swallowing test (RSST). The RSST is a safe and simple screening method for the swallowing function and evaluates how many times people can swallow in 30 seconds. Less than 3 cycles is considered as abnormal. We followed up 822, who completed the RSST, and investigated the association between dysphagia and mortality rate from pneumonia. For 12 years 504 died. Eighty-one died of pneumonia. Kaplan-Meier method showed the mortality rate from pneumonia was significantly higher in the subjects with dysphagia compared to the subjects without dysphagia (p<0.05)．In Cox proportional hazard model，dysphagia is a significant and independent risk factor for death of respiratory disease（hazard ratio 1.6）. The mortality rate from pneumonia was significantly higher in the subjects with dysphagia evaluated by RSST.
Free Research Field	疫学
Academic Significance and Societal Importance of the Research Achievements	嚥下機能検査としては、様々あるが、侵襲的なものが多い。非侵襲的な嚥下機能スクリーニング検査として、反復唾液嚥下テスト（RSST）がある（Kubota T et al, General Rehabilitaiton, 1982）。反復唾液嚥下テストが、肺炎の発症あるいは死亡を予測するかの検討が行われているが、多くは脳卒中患者や施設入所者での検討である。本研究は、福岡県8020追跡コホートを用いて、反復唾液嚥下テストで評価した嚥下障害と死亡との関連を検討し、肺炎の死亡の予測因子としての反復唾液嚥下テストの意義を示した。