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Updated: Jan 17, 2026
Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Aspiration Pneumonia Incidence and Recurrence in Elderly Stroke Patients: Oral Hygiene and Functional Status
Atsushi Hombo1, Koroku Kato2, Mai Jokaji-Ishimiya2
1Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan; Department of Oral and Maxillofacial Surgery, Noto General Hospital, Ishikawa, Japan.
Introduction And Aims:
We investigated the impacts of oral hygiene and oral function on the incidence and recurrence of aspiration pneumonia (AP) in elderly stroke patients.
Patients And Methods:
Among the 991elderly patients who underwent eating- and swallowing-function evaluations at the Department of Oral and Maxillofacial Surgery of Noto General Hospital over the years 2013-2017, we retrospectively analyzed the cases of the 559 patients with stroke. We divided them into an aspiration pneumonia (AP) group and a non-pneumonia (NP) group to analyze the relationship between oral hygiene or oral function factors and AP incidence. We further divided the AP patients into those who experienced recurrent pneumonia (rAP group) and those who did not (nrAP group) to examine the association between oral hygiene or oral function factors and AP recurrence.
Results:
A univariate analysis comparing the AP and NP groups revealed significant differences in 3 oral hygiene factors: membranous substances, xerostomia, and food residue (P < .001, respectively). Regarding oral function factors, only occlusion showed a significant intergroup difference (P < .001). A multivariate logistic regression analysis identified age (P = .017), tongue fur (P = .001), membranous substances (P = .005), xerostomia (P = .045), food residue (P < .001), and occlusion (P < .001) as factors influencing the incidence of AP. The univariate analysis comparing the rAP and nrAP groups showed a significant intergroup difference in food residue (P = .006) as an oral hygiene factor and significant differences in food bolus formation grade (FBFG) (P = .001) and Food Intake LEVEL Scale (FILS) (P < .001) as oral function factors. The multivariate logistic regression analysis identified FILS (P = .01) as a factor linked to AP recurrence.
Conclusion:
Oral hygiene conditions were significantly associated with AP incidence in elderly stroke patients, suggesting that structured oral care may help reduce AP risk. Given the association between oral function and AP recurrence, the importance of functional oral care through rehabilitation was highlighted.
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