Poor oral function was defined as presenting two or more positive response to three questions on oral function in the Kihon Checklist [13, 14] (Ministry of Health, Labor and Welfare, Japan): (1) “Do you have any difficulties eating tough foods compared to 6 months ago?” (2) “Have you choked on your tea or soup recently?” (3) “Do you often experience having a dry mouth?”

Participants with poor oral function were further classified as to whether they had quality of life (QOL) impairment due to dysphagia using the following question: “Are you disturbed with your work or other activities due to difficulty in swallowing?” The question was answered by five-point scale: (1) no problem at all, (2) somewhat problematic, (3) problematic, (4) quite problematic, (5) serious problematic. Participants with a rating of ≥2 were classified as having QOL impairment due to dysphagia.

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