A quantitative assessment of the eating capability in the elderly individuals

Ageing process implies physiologically weakened muscles, loss of natural teeth and movement coordination, causing difficulties in the eating process. A term "eating capability" has been proposed to measure objectively how capable an elderly individual is in overall food management. Our objectives were to establish feasible methodologies of eating capability assessment, examine correlations between hand and oro-facial muscle strengths and grade elderly subjects into groups based on their eating capabilities. This study was performed with 203 elderly subjects living in the UK (n=103, 7 community centres, 2 sheltered accommodation) and Spain (n=100, 3 nursing homes, 1 community centre). Hand gripping force, finger gripping force, biting force, lip sealing pressure, tongue pressing pressure and touching sensitivity were measured for elderly subjects. Measured parameters were normalised and scored between 1 and 5, with 1 being the weakest. Subjects were then grouped into 4 groups based on their eating capability scores, being participants of cluster 1 the weakest group and 4 the strongest. Perception of oral processing difficulty was assessed by showing food images. Hand gripping force showed a strong linear correlation with tongue pressure (UK: 0.35; Spain: 0.326) and biting force (UK: 0.351; Spain: 0.427). Biting force was strongly dependent on the denture status. Elderly of the first three groups perceived food products with more hardness and/or fibrous structure as difficult to process orally. The objective measurements of various physiological factors enabled quantitative characterisation of the eating capabilities of elderly people. The observed relationship between hand and oro-facial muscle strengths provides possibility of using non-invasive hand gripping force measurement for eating capability assessment.