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Oral Frailty and Nutrition Research


Theme Leader :
Hirohiko Hirano, D.D.S., Ph.D.
Researcher :
Keiko Motokawa, R.D.N., Ph.D.
Adjunct Researcher :
Yutaka Watanabe, D.D.S., PhD., Takao Suzuki, M.D., Ph.D., Ikuo Nasu, D.D.S., PhD., Masanori Iwasaki, D.D.S., PhD., Yoshiko Motohashi, D.D.S., PhD., Junko Nakajima, D.D.S., PhD., Masaharu Murakami, D.D.S., PhD., Daisuke Takagi, D.D.S., PhD., Sanae Hironaka, D.D.S., Shiho Morishita, R.D.H., Yurie Mikami, R.D.N., Misato Hayakawa, R.D.N., Kaori Yamamoto, R.D.N., Chika Takahashi, R.D.H


Oral Frailty, Healthy life expectancy, Dementia, Home care, End-of-life care, Appetite, Behavioral and Psychological Symptoms of Dementia for eating, Malnutrition, Dietary variety, Dysphagia diet, Oral function, Oral related health literacy, Community care, Day care

Major Research Titles

  1. 1.Research on improvement of oral function and nutrition in the elderly
  2. 2.Research on oral and nutritional support for elderly people with dementia
  3. 3.Research on oral cavity and nutrition policies


1. Research on improvement of oral function and nutrition in the elderly
This study examines the establishment of a method to evaluate oral function and nutrition, the development and verification of oral frailty prevention programs, and regulated diets that consider food type and swallowing function.
We are developing and verifying an index to evaluate oral function and nutrition in healthy elderly individuals, frail elderly individuals, and elderly individuals who need long-term care, and are aiming for widespread use in the community and in nursing practice. With regard to Oral Frailty and related prevention program, we are conducting a large-scale research project jointly with a number of research institutes. Our aim is to achieve widespread understanding of Oral Frailty and implementation of the prevention program not only in Japan but also in other Asian countries. Our research on regulated diets that consider food type and swallowing function extracts issues identified in a large-scale fact-finding survey and conducts multi-faceted analysis on methods to address these issues in the community with the aim of promoting their implementation.

Figure 1

2. Research on oral and nutritional support for elderly people with dementia
This study aims to clarify various problems related to oral intake of people suffering from dementia, neuromuscular symptoms, and drug side effects, and to through multi-occupation collaboration obtain collective intelligence related to evaluation and response measures. With the goal of addressing the issues that have been identified, we are creating guidelines on dental treatment and other oral care for elderly people with dementia, while using data collected at nursing-care insurance facilities, group homes, etc. to conduct analysis on the diagnosis, stage, and clinical condition of dementia patients, as well as information on medication, symptoms of oral intake difficulties, countermeasures, etc. We aim to establish a support method for oral intake, including evaluation and response measures, through multi-occupation collaboration that includes families and carers, so that ultimately, elderly dementia patients can continue to live in the area they are familiar with.

Figure 2

3. Research on oral cavity and nutrition policies
We will assess the effects of policies related to oral and nutrition medical and nursing care fees, extract new issues and other oral and nutrition-related institutional problems, and establish a basis for revising medical and nursing care fees. In addition, with the aim of further promoting an integrated community care system, we are conducting research projects to assess oral intake condition and nutritional status, promote continued home care, and increase the availability of nursing care, targeting healthy elderly individuals through to those requiring long-term care. In particular, we aim to contribute to the development of human resources and regional services, clarify the role of nursing care facilities, promote an integrated community care system, and maintain medical and long-term care insurance services to provide the oral and nutritional care necessary to enable elderly patients to continue to live as they wish.

Figure 3


  1. 1. Watanabe Y, Arai H, Hirano H, Morishita S, Ohara Y, Edahiro A, Murakami M, Shimada H, Kikutani T, Suzuki T. Oral function as an indexing parameter for mild cognitive impairment in elderly people. Geriatr Gerontol Int. 2018 Jan 30. doi:10.1111/ggi.13259.
  2. 2. Kera T, Kawai H, Hirano H, Kojima M, Watanabe Y, Fujiwara Y, Ihara K, Obuchi S. Comparison of body composition and physical and cognitive function between older Japanese adults with no diabetes, prediabetes and diabetes: A cross-sectional study in community-dwelling Japanese older people. Geriatr Gerontol Int. 2018 Mar 26. doi: 10.1111/ggi.13301.
  3. 3. Minakuchi S, Tsuga K, Ikebe K, Ueda T, Tamura T, Nagao K, Furuya J, Matsuo K, Yamamoto K, Kanazawa M, Watanabe Y, Hirano H, Kikutani T , Sakurai S. Oral Hypofunction in the Older Population Position Paper of the Japanese Society of Gerodontology in 2016. Gerodontology. 2018 in press
  4. 4. Horibe Y, Watanabe Y, Hirano H, Edahiro A, Ishizaki K, Ueda T, Sakurai K. Relationship between Masticatory Function and Frailty in Community-Dwelling Japanese Elderly. Aging Clin Exp Res. 2017 Dec 28. doi:10.1007/s40520-017-0888-3.
  5. 5. Tanaka T, Takahashi K, Hirano H, Kikutani T, Watanabe Y, Ohara Y, Furuya H, Tsuji T, Akishita M, Iijima K. Oral Frailty as a Risk Factor for Physical Frailty and Mortality in Community-Dwelling Elderly. J Gerontol A Biol Sci Med Sci. 2017 Nov 17. doi: 10.1093/gerona/glx225.
  6. 6. Motokawa K, Watanabe Y, Edahiro A, Shirobe M, Murakami M, Kera T, Kawai H, Obuchi S, Fujiwara Y, Ihara K, Hirano H, Frailty severity and dietary variety in Japanese older persons: A cross-sectional study. Journal of Nutritional Health and Aging, 2018;22(3):451-456.
  7. 7. Takagi D, Watanabe Y, Edahiro A, Ohara Y, Murakami M, Murakami K, Hironaka S. Taniguchi Y, Kitamura A, Shinkai S, Hirano H. Factors Affecting Masticatory Function of Community-Dwelling Older People: Investigation of the Differences in the Relevant Factors for Subjective and Objective Assessment. Gerodontology. 2017 Sep;34(3):357-364.
  8. 8. Umeki K, Watanabe Y, Hirano H. Relationship between Masseter Muscle Thickness and Skeletal Muscle Mass in Elderly Persons Requiring Nursing Care in North East Japan. Int J Oral-Med Sci 15(3)(4):152-159, 2017
  9. 9. Tokudome Y, Okumura K, Kumagai Y, Hirano H, Kim H, Morishita S, Watanabe Y. Development of the Japanese version of the Council on Nutrition Appetite Questionnaire and its simplified versions, and evaluation of their reliability, validity, and reproducibility. J Epidemiol. 2017 Feb 2. pii: S0917-5040(17)30001-1.
  10. 10. Watanabe Y, Hirano H, Arai H, Morishita S, Ohara Y, Edahiro A, Murakami M, Shimada H, Kikutani T, Suzuki T. Relationship Between Frailty and Oral Function in Community-Dwelling Elderly Adults. J Am Geriatr Soc. 2017 Jan;65(1):66-76.
  11. 11. Ohara Y, Yoshida N, Kawai H, Obuchi S, Yoshida H, Mataki S, Hirano H, Watanabe Y. Development of an oral health-related self-efficacy scale for use with older adults. Geriatr Gerontol Int . 2017 Oct;17(10):1406-1411.
  12. 12. Takagi D, Hirano H, Watanabe Y, Edahiro A, Ohara Y, Yoshida H, Kim H, Murakami K, Hironaka S. Relationship between Skeletal Muscle Mass and Swallowing Function in Patients with Alzheimer's Disease. Geriatr Gerontol Int. 2017 Mar;17(3):402-409.
  13. 13. Kim H, Hirano H, Edahiro A, Ohara Y, Watanabe Y, Kojima N, Kim M, Hosoi E, Yoshida Y, Yoshida H, Shinkai S. Sarcopenia: Prevalence and associated factors based on different suggested definitions in community-dwelling older adults. Geriatr Gerontol Int. 2016 Mar;16 Suppl 1:110-22.
  14. 14. Morishita S, Watanabe Y, Ohara Y, Edahiro A, Sato E, Suga T, Hirano H. Factors associated with the need of older adults for oral hygiene management by dental professionals. Geriatr Gerontol Int. 2016 Aug;16(8):956-62.
  15. 15. Sakai K, Hirano H, Watanabe Y, Tohara H, Sato E, Sato K, Katakura A. An examination of factors related to aspiration and silent aspiration in older adults requiring long-term care in rural Japan. J Oral Rehabil. Feb;43(2):103-10 2016.
  16. 16. Ohno T, Morita T, Tamura F, Hirano H, Watanabe Y, Kikutani T. The need and availability of dental services for terminally ill cancer patients: a nationwide survey in Japan. Support Care Cancer. 24(1):19-22 2016.
  17. 17. Murakami K, Hirano H, Watanabe Y, Edahiro A, Ohara Y, Yoshida H, Kim H, Takagi D, Hironaka S. Relationship between swallowing function and the skeletal muscle mass of elderly persons requiring long-term care. Geriatr Gerontol Int. 15(10):1185-92 2015.
  18. 18. Ohara Y, Hirano H, Watanabe Y, Obuchi S, Yoshida H, Fujiwara Y, Ihara K, Kawai H, Mataki S. Factors associated with self-rated oral health among community-dwelling older Japanese: A cross-sectional study. Geriatr Gerontol Int. 15(6):755-61 2015.
  19. 19. Murakami M, Hirano H, Watanabe Y, Sakai K, Kim H, Katakura A. Relationship between chewing ability and sarcopenia in Japanese community-dwelling older adults. Geriatr Gerontol Int. 15(8):1007-12 2015.