ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00358.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Mineralized tissues undergo continuous remodeling through an appropriate balance in activity of osteoblasts, which regulate bone formation, and osteoclasts, which regulate bone resorption. Identification of the factors which control the osteogenic process has not yet been accomplished. Such identification is vital however, if we are to understand any aberrations in remodeling, that may occur with disease and/or aging. It is known that aging is accompanied by a decrease in absolute bone volume, which may be attributed to alterations in bone specific factors that regulate osteoblast and osteoclast function. In order to better understand age associated bone changes, the author and colleagues have compared extracts of human fetal bone with adult bone using a chemotactic assay, SDS‐polyacrylamide gel electrophoresis and molecular sieve chromatography. The results show that the extract of adult bone, when compared with fetal bone, had a relative increase in organic components of lower molecular weight. Second, that chemoattractant activity was present in the extract of fetal bone, but not of adult bone. These differences may in part be related to the clinical condition of increased fracture rate and decreased fracture healing and bone remodeling in older individuals when compared with younger population

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00359.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Osteoporosis is a common, morbid, and expensive disease of the elderly skeleton, particularly in the postmenopausal female, resulting in fractures of the spine, hip, and wrist. Dental osteopenia (inadequate bone mass, particularly of the mandible) is also a condition of significant morbidity for the elderly, associated with loss of teeth and poorly fitting dentures. Questions of immediate concern regarding these disorders are: (1) Are techniques available for quantitating mandibular bone mass? (2) Is dental osteopenia a localized manifestation of a generalized skeletal osteoporosis, with similar etiologies and risk factors, or is it an entirely separate disease process, due primarily to periodontal disease with its associated causal factors? (3) Are therapeutic measures noted to be of benefit in osteoporosis also of benefit in dental osteopenia? Recent studies from our laboratories address these questions and indicate efficiency of the mandibular microdensitometry technique for measuring mandibular bone mass. Also, these studies suggest that dental osteopenia is part of a generalized skeletal osteoporosis of the elderly female, and that therapy for osteoporosis would possibly be of value in the treatment of dental osteopenia.

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00360.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

In view of the need for a multidisciplinary approach to study the effect of aging on the oral cavity, “The Veterans Administration Longitudinal and Cross‐Sectional Study of Oral Health in Healthy Veterans” or the Dental Longitudinal Study (DLS) was initiated in 1968, as an associated research program of the larger “VA Normative Aging Study.”. The current report presents a review of the literature of masticatory performance and relevant experimental data from the DLS on dentition and age‐related changes in performance levels. These data sets demonstrate that in volunteers with natural dentition, there was a slight, but significant, decrease in masticatory performance while dentitions with prostheses showed little change. It appears that when appreciable declines in masticatory function occur, significant alterations also occur in certain perceptual and sensory measures associated with food hedonics and consumption behavior. Generally, these perceptual changes reflect an alteration in taste and texture preferences; phenomena which persist even after appropriate restorative therapy with either removable partial or complete dentures. Information collected in some of our studies suggests that dentate‐impaired persons, with and without a dental prosthesis, may self‐impose certain dietary restrictions which, in time, can compromise their nutritional status and ultimately place them at health risk. These longitudinal results are attempting to provide a comprehensive description of oral phenomena and represent a unique study of the ora

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00361.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Normal speech and swallow depend on the integrity of the oral motor system and the underlying processes of respiration, phonation, sensation, resonance and articulation. A variety of age‐related changes occur in the oral peripheral mechanism, some of which affect speech and swallow. Nonpathologic changes in the thoracic and laryngeal structures that serve to reduce the vital capacity of the lungs and produce perturbations in the acoustic signal alter the quality of the aging voice. As one ages, the oral mucosa reportedly thins, salivary flow may be decreased, and the sensory and motor integrity of the tongue musculature is altered. The effect of such changes on speech articulation and voice production in the elderly is discussed. Although not dependent on one another, speech and swallowing use many of the same oral structures and underlying physiologic mechanisms. The anatomic and physiologic changes in the aging pharvngeal area and oral tract that can affect swallowing are reviewd and studies of these changes are discussed. Viewing the oral area and vocal tract has required invasive, cumbersome or dangerous radiographic procedures, thereby limiting the quantity of research in this field. Recent work on the use of real‐time ultrasound imaging to view the oral soft tissues and dynamic lingual gesturesin vivoduring speech and swallow are reviewed and ongoing studies of speech and swallowing performance in normal aging persons using this technique are presen

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00362.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Investigations of temporomandibular joint (TMJ) disorders have included assessment of the prevalence of signs such as joint clicking, limitation of jaw opening, and deviation of the mandible on function, and symptoms such as pain on function in patient and non‐patient populations. The former (signs) might be viewed as the prevalence of TMJ “disease”, and the latter (symptom presentation) might be viewed as TMJ “illness behavior.” The majority of the reports profiling TMJ patients suggest that most are females (80%) in the 20–40 year age group. Reports of the relationship of TMJ signs and symptoms to age have provided inconsistent findings, i.e. signs and symptoms have been found to increase with age, to decrease with age, or to be unrelated to age. Many of the inconsistencies reflect differences in the populations studied and lack of standardized criteria for diagnosing mandibular function/dysfunction. This study assessed the prevalence of the signs and symptoms of TMJ disorders in community‐dwelling, non‐health care seeking participants in the Baltimore Longitudinal Study of Aging, the intramural longitudinal aging study of the National Institute on Aging. The only age difference noted was in limitation of jaw opening among the

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00363.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Taste and smell have a primary role in food ingestion. Therefore, to understand why eating habits alter in elderly people, age‐related differences in the chemical senses should be investigated. In early anatomical studies, substantial decreases in numbers of taste buds in old human and mouse circumvallate papillae were observed. However, recent investigations in humans, monkeys, and rats indicate that there is not a significant loss of taste buds in old age. Neurophysiological recordings from the chorda tympani nerve, innervating taste buds in fungiform papillae, demonstrate significant but small differences in response magnitudes for some chemicals in old rats. Greater age‐related differences have been observed in the olfactory sense. Numbers of receptor neurons in the rat olfactory epithelium initially increase in adults and then decline in old animals; this decline is reflected in subsequent changes in the olfactory bulb. However, numbers of synapses in the bulb per receptor neuron are increased in the oldest rats, suggesting some compensatory mechanism. Differences in degree of aging effects in taste and smell might relate to the nature of receptors: a modified epithelial cell in taste versus a neuron in smell. However, in both sensory systems, large numbers of receptors remain even in old age. Since taste bud cells and olfactory receptors turn over and are replaced throughout life, the peripheral taste and smell systems might be relatively resistant to aging effe

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00364.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The taste and smell experience of other human beings cannot be known directly. Thus our understanding of age‐related changes in the perception of taste and smell is derived inferentially. Inferences based on verbal reports and on the performance of tasks involving taste and smell stimuli suggest that some older individuals are impaired. The perceptual disadvantage of older adults appears to be more marked or more easily measured for complex than for simple stimuli. Some difference between older and younger adults may not be primarily sensory; others may arise from differences only incidentally associated with aging. The study of taste and smell perception in aging continues to challenge the psychophysical investigator to define the nature and extent of age‐related change and to demonstrate its underlying mechani

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00365.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

This paper is a preliminary report of a dental pilot study which was recently conducted with 104 elderly subjects, 77 of whom also participated in a nutrition status survey. The study was comprehensive, including measurements of oral health status, and medical data concerning nutrition status. Also included were questionnaires concerning diet and nutritional habits, and attitudes towards dental care. A literature review is also presented. Statistical analysis reveals correlations between certain food types, (liquid/solid fermentable, slowly dissolving fermentable), and root and coronal decay. The correlation with coronal decay is greater. Some of the data are still undergoing analysis. When all the data are analyzed and available, additional reports will be forthcoming and will describe any other correlations that are found between nutritional and oral health status. Certain new periodontal indices will also be described. The relationships between the oral health status and the nutritional needs of the elderly have not been adequately studied. It is expected that with a broader data base, these relationships will be better understood.

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00366.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Dental care of elderly persons is similar to that of younger persons but is modified by a variety of age‐related and age‐associated changes, as well as diseases and drugs. Clinical decision‐making for the dental care of elderly persons is therefore more complex. The dental disease patterns in the elderly population seem to be changing and they seem to be expressed differently, which will require actual diagnosis and more complicated treatment planning. This paper evaluates the principles of problem solving and decision making in general, and applies them to dental diagnosis and treatment planning. A model of the different types of decision making in dentistry is presented, and its component parts discussed, with emphasis on the care of the elderly patient. The conclusions of this paper are that dental care for the elderly patient is becoming extremely complex, especially as more elderly patients will be dentate and more will be demanding care. Research is needed in the area of how dentists make decisions, and in methods of teaching decision‐making skills. Longitudinal studies are required to evaluate the outcomes of tr

ISSN:0734-0664    

DOI:10.1111/j.1741-2358.1984.tb00367.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY