Elderly patients with lower-jaw mobility require careful food texture modification: A cohort study.

Background: Few studies have investigated the relationship between lower-jaw mobility and oral ingestible food texture choices in elderly patients. This study aimed to evaluate whether lower-jaw mobility affects levels of food texture modification.

Methods: This prospective cohort study targeted inpatients aged ≥65 years with pneumonia or urinary tract infection from August 2014 through July 2015. We defined "lower-jaw mobility" as movement of the lower jaw (more than about 1 cm) when gently supported from both sides of the mandibular angle with index fingers. The primary outcome was food texture at discharge, which was evaluated using "Japanese Dysphagia Diet 2013": non per os, codes 0-4 (in the order of increasing swallowing difficulty), and normal meal.

Results: We evaluated 38 patients in the mobility group (mean age: 86.5 years) and 251 patients in the nonmobility group (mean age: 83.2 years). Percentages of patients capable of ingesting each food texture were as follows (mobility vs nonmobility): normal meal, 5.3% vs 50.1%; code 4, 39.5% vs 31.9%; code 3, 5.3% vs 8.8%; code 2, 10.5% vs 4.4%; code 1, 2.6% vs 0.8%; code 0, 0.0% vs 0.4%; and non per os, 36.8% vs 2.8%. Food texture codes were lower in the mobility group ( < 0.001). These relationships remained significant even after adjusting for potential confounding factors in multivariate analysis ( < 0.001).

Conclusion: Elderly patients with lower-jaw mobility were restricted to texture-modified foods. Lower-jaw mobility can be assessed easily even by nonmedical personnel, and regular assessment could help identify elderly patients requiring dietary adjustment.