Rieko Moritoyo

Visual cues strongly influence consumer evaluations of food, but sauce presentation may also affect how diners interact with a dish during consumption. In a naturalistic restaurant field study, 57 participants completed a counterbalanced within-participant comparison of minimal and drizzle sauce presentations, with evaluations collected before and after tasting. An integrated 2 (presentation) × 2 (phase) × 2 (presentation order) repeated-measures analysis showed that, before tasting, minimal presentation was rated as healthier than drizzle presentation after adjustment for order (adjusted mean difference = 0.60, 95% CI [0.19, 1.00], p = 0.005; Holm- and FDR-adjusted p = 0.032). After tasting, minimal presentation received higher unadjusted ratings of intention to eat more and overall liking, but neither difference survived multiplicity correction. No presentation × phase interaction was significant. Because sauce placement also changed diners’ opportunity to regulate sauce use, post-consumption findings are interpreted as effects of presentation-and-consumption format rather than visual presentation alone. Thus, the clearest finding concerns pre-consumption healthiness inference, whereas the post-consumption results are smaller and exploratory.

Background/Objective: In the context of global aging, maintaining daily habits such as adequate nutrition and regular exercise are essential to achieve healthy aging. Therefore, the preservation of swallowing and physical functions is fundamental. Jaw-opening force, an important swallowing function, is linked to physical function. Daily health behaviors are shaped by decision-making biases, which influence decision-making. Individuals with high procrastination tendencies may be less likely to engage in health-promoting behaviors, potentially leading to functional decline. While such tendencies are associated with general health behaviors, little is known about their associations with swallowing and physical functions among older adults. The objective of this study was to examine the associations between decision-making biases and swallowing and physical functions in community-dwelling older adults. Methods: A questionnaire survey was conducted to collect basic information and assess decision-making biases. The jaw-opening force (swallowing function) and grip strength (physical function) were measured. Associations of decision-making biases with jaw-opening force and grip strength were examined using multivariable linear regression analysis. We further conducted sex-stratified sensitivity analyses. Results: This cross-sectional study targeted 107 community-dwelling older adults. There was a significant negative association between procrastination tendency and jaw-opening force (B = −0.715, p = 0.005), and grip strength (B = −1.552, p = 0.003), indicating that individuals with a propensity for procrastination had lower jaw-opening force and grip strength. Conclusions: Procrastination tendency may be used as an indicator to detect swallowing and physical functions. Moreover, incorporating this modifiable factor to promote behavior change may prevent functional decline. The study results highlight the significance of considering individuals’ decision-making biases—particularly procrastination tendency—in clinical settings.

This study investigated telemedicine as an alternative to home-visit medical care (HMC) when HMC for patients with dysphagia was suspended. This retrospective study assessed whether telemedicine reduced adverse events compared to suspending care during the initial 3 months of the coronavirus pandemic. Seventy-six HMC patients were enrolled. Those who received telemedicine formed the telemedicine group (TG), and those who declined comprised the suspended group (SG). Baseline data and adverse events, including whole-body and dysphagia-related adverse events, were analyzed using the Mann–Whitney U-test, Fisher’s exact test, and binomial logistic regression. Of the 76 patients, 20 were in TG and 56 in SG. Telemedicine consultations’ frequency was 1–3. Significant baseline differences occurred in the Charlson Comorbidity Index (CCI) and caregiver type. In the TG and SG, 0% and 12.5% of patients experienced whole-body adverse events and 10.0% and 33.9% had dysphagia-related adverse events, respectively. Dysphagia-related adverse events were significantly lower in TG (p = 0.046). Telemedicine was significantly associated with fewer dysphagia-related adverse events after adjusting for age, CCI, and Dysphagia Severity Scale (p = 0.040). Telemedicine effectively supplemented in-person dysphagia rehabilitation, enabling continued monitoring and reducing complications, although patient self-selection and caregiver support may have influenced outcomes.

In clinical practice, we encounter cases wherein older adults lacking occlusal support consume foods requiring mastication and adequate swallowing function. This study investigated the relationship between jaw-closing force (JCF) and dietary form in older adults without occlusal support requiring nursing care. This prospective cross-sectional study included 123 older adults requiring nursing care who lost their molar occlusal support and consumed food orally without dentures. JCF was defined as the force required for crushing food with the edentulous ridges or with the tooth and edentulous ridge while closing the mouth. Participants were classified into four groups based on the International Dysphagia Diet Standardization Initiative framework for recommended dietary forms. Basic information was collected, and tongue pressure and JCF were measured. Differences in JCF were analyzed using one-way analysis of variance, while factors related to dietary form were evaluated using ordinal logistic regression analysis. Significant differences in JCF were observed among the four groups. Factors such as the Barthel Index, tongue pressure, and JCF were dietary form-related. Our findings suggest that older adults requiring nursing care tend to have higher JCF when consuming meals requiring mastication. Therefore, JCF could serve as an index for determining appropriate dietary forms in this population.

We prototyped a new device with a soft and flexible pressure sensor to measure the force to close the mandible with or without occlusal support (jaw-closing force, JCF). This study aimed to clarify the practicality of this instrument. Healthy young and older adults with occlusal support were recruited. Intra- and inter-rater reliability of the JCF meter was examined using data from younger participants. Data regarding age, sex, body mass index, remaining teeth, and dentures of the older adults were obtained. Furthermore, the right and left JCFs were measured using a JCF meter; occlusal force was measured using an existing occlusal force-measuring device. Intra- and inter-rater correlation coefficients were significantly reproducible (0.691–0.811, p < 0.05). JCF was correlated with occlusal force (p < 0.05). Multiple regression analysis revealed that factors significantly associated with JCF included denture status (p < 0.001), age (p = 0.038), and occlusal force (p = 0.043). The prototyped JCF meter can measure JCF with high reproducibility, reliability, and validity. Further, association with occlusal force, which is an existing index, was observed. This device could be used to measure the JCF with or without occlusal support as a new method of evaluating oral function in older adults.

Gerstmann-Sträussler-Scheinker disease (GSS) is a genetic prion disease. Swallowing function evaluation in patients with GSS remains unclear. Here, we describe a case of videofluoroscopic examination of swallowing (VF) to facilitate continued oral ingestion in a patient with P105L GSS. A 67-year-old woman developed gait disturbance and Parkinsonism symptoms at the age of 54 years. Since her family wanted her to continue oral ingestion, we performed VF, which revealed impairment and preservation of the oral and pharyngeal phases, respectively. Moreover, the impairment of the oral phase was improved by adjusting the patient’s posture and food consistency. A swallowing function evaluation based on the condition of a patient with GSS may facilitate continued oral ingestion.