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Abe A, Nakayama A, Otsuka Y, Shibata K, Matsui Y, Ito Y, Hayashi H, Momokita M, Taniguchi S. Relationship of preoperative oral hypofunction with prognostic nutritional index in gastric cancer: A case-control retrospective study. PLoS One 2023; 18:e0283911. [PMID: 37262024 DOI: 10.1371/journal.pone.0283911] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/17/2023] [Indexed: 06/03/2023] Open
Abstract
Preoperative nutritional status is an important prognostic factor in gastric cancer patients. This study will evaluate whether preoperative oral dysfunction is associated with prognostic nutrition index (PNI). This case-control study analyzed 95 patients who underwent oral function management. We assessed the following parameters: body mass index, stage of gastric cancer, C-reactive protein, total lymphocyte count, albumin, and prognostic nutritional index. The patients were divided into groups with prognostic nutritional indexes <45 and >45. Logistic regression analysis was used to assess the association between the measurements of oral function and the prognostic nutritional index. Univariate analysis of factors associated with decreased oral function and prognostic nutritional index showed significant differences between the two groups in C-reactive protein, neutrophils, and tongue pressure (p<0.01). However, oral hygiene, oral dryness, occlusal force, tongue-lip motor function, masticatory function, and swallowing function were not significantly different. Multivariate analysis showed that C-reactive protein (odds ratio: 0.12, 95% confidence interval: 0.30-0.45, p<0.01) and tongue pressure (odds ratio: 3.62, 95% confidence interval: 1.04-12.60, p<0.05) were independent risk factors for oral hypofunction. Oral function decreased in perioperative patients with gastric cancer, and decreased tongue pressure is associated with a decreased prognostic nutritional index.
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Affiliation(s)
- Atsushi Abe
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Aichi Prefecture, Japan
| | - Atsushi Nakayama
- The First Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Aichi Prefecture, Japan
| | - Yuya Otsuka
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Aichi Prefecture, Japan
| | - Kanae Shibata
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Aichi Prefecture, Japan
| | - Yoshihito Matsui
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Aichi Prefecture, Japan
| | - Yu Ito
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Aichi Prefecture, Japan
| | - Hiroki Hayashi
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Aichi Prefecture, Japan
| | - Moeko Momokita
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Aichi Prefecture, Japan
| | - Shinichi Taniguchi
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Aichi Prefecture, Japan
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Akema S, Mameno T, Nakagawa T, Inagaki H, Fukutake M, Hatta K, Murotani Y, Tsujioka Y, Hagino H, Higashi K, Takahashi T, Wada M, Maeda Y, Gondo Y, Kamide K, Kabayama M, Ishizaki T, Masui Y, Ogata S, Ikebe K. Relationship between occlusal force and psychological frailty in Japanese community-dwelling older adults: The Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study. J Am Geriatr Soc 2023; 71:1819-1828. [PMID: 36691687 DOI: 10.1111/jgs.18239] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/05/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND Frailty increases the risk of negative health-related events, such as falls, disability, hospitalizations, and death. Although the association between oral health and physical frailty is well established, the relationship between oral health and psychological frailty has not yet been investigated. Therefore, we conducted a cross-sectional study to examine the association between maximal occlusal force and psychological frailty in Japanese community-dwelling older adults. METHODS Psychological frailty was defined as a World Health Organization-5 scale (WHO-5) score of <13, cognitive and functional status was defined as a Japanese version of the Montreal Cognitive Assessment (MoCA-J) score of <23, and psychological robustness was defined as a WHO-5 score of ≥13 and a MoCA-J score of ≥23. We used a cross-sectional study design to measure maximal occlusal force in 1810 participants, and examined the following factors relevant to psychological frailty: educational level, financial status, living situation, history of chronic diseases, handgrip strength, and instrumental activities of daily living. We used propensity score matching to match the psychological frailty and psychological robustness groups according to demographic and confounding factors. This process, resulted in 344 participants, of whom 172 were in the psychological frailty group and 172 were in the psychological robustness group. In the matched cohort, differences between groups with and without psychological frailty were compared using generalized estimating equations for maximal occlusal force after adjusting for the number of teeth. RESULTS After controlling for potential confounding factors of frailty, the psychological frailty group showed lower maximal occlusal force compared with the psychological robustness group (unstandardized regression coefficients = -72.7, 95% confidence interval: -126.3 to -19.1). CONCLUSIONS Maximal occlusal force was associated with a reduced prevalence of psychological frailty among Japanese community-dwelling older adults participating in our study.
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Affiliation(s)
- Suzuna Akema
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Tomoaki Mameno
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takeshi Nakagawa
- National Center for Geriatrics and Gerontology, Research Institute, Aichi, Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Motoyoshi Fukutake
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kodai Hatta
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuki Murotani
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshitaka Tsujioka
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiromasa Hagino
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kotaro Higashi
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Toshihito Takahashi
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Masahiro Wada
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Osaka University Graduate School of Human Sciences, Osaka, Japan
| | - Kei Kamide
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Division of Health Sciences, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Mai Kabayama
- Division of Health Sciences, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Tatsuro Ishizaki
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yukie Masui
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
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Abbas H, Aida J, Kiuchi S, Kondo K, Osaka K. Oral status and homebound status: A 6-year bidirectional exploratory prospective cohort study. Oral Dis 2023; 29:1291-1298. [PMID: 34601759 DOI: 10.1111/odi.14039] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 09/09/2021] [Accepted: 09/28/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Little is known about the association between oral status and homebound status, and there is a possibility of a bidirectional relationship between them. In this exploratory prospective cohort study, we examined the association between four oral status measurements and being homebound bidirectionally. METHODS We used 2010-2016 panel data gathered from the Japan Gerontological Evaluation Study. All functionally independent participants aged 65 years or older (n = 26,579) were included in this study. Multiple imputation and Poisson regression were used for analyses. We adjusted for age, sex, education, comorbidity, and depressive symptoms. RESULTS In the fully adjusted model, the prevalence ratio (PR) of being homebound at follow-up was 1.42 for having <20 remaining teeth, 1.28 for having chewing difficulty, 0.99 for having choking experience, and 0.94 for having dry mouth at baseline. Reversely, being homebound at baseline predicted having chewing difficulty at follow-up (PR = 1.17), while no significant association was demonstrated with having <20 teeth (PR = 1.00), choking experience (PR = 1.06), and dry mouth (PR = 1.02). CONCLUSION Chewing difficulty and having <20 remaining teeth predicted homebound status after 6 years. Reversely, homebound status at baseline only predicted having chewing difficulty at follow-up. These findings may help to determine the oral frailty assessment measures for older people.
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Affiliation(s)
- Hazem Abbas
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Japan
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Schuller AA, Hoeksema AR. Determinants and barriers for visiting a dental clinic among (frail) older individuals. Acta Odontol Scand 2023; 81:227-234. [PMID: 36112367 DOI: 10.1080/00016357.2022.2118166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
AIMS With increasing age, the proportion of older individuals visiting a dental clinic decreases. The aim was to gain insight into a) whether frailty or dental status were associated with visiting a dental clinic and b) their perceived barriers to accessing oral health care. METHODS Individuals eligible for the yearly influenza vaccination in Winschoten, The Netherlands, were invited to participate in a questionnaire survey about dental visits and perceived barriers to such visits. RESULTS A total of 1027 individuals aged 60+ completed the questionnaire - 80% of the non-frail, 71% of the mildly frail and 60% of the moderately to severe frail individuals visited a dental clinic in the previous year. Dental status was the crucial determinant for not visiting a dental clinic. Edentate individuals were more likely to drop out of the dental care system than dentate individuals or individuals with partial prostheses. A higher proportion of moderately and severe frail people were edentate than non-frail or mildly frail people. Barriers to visiting a dentist were making an appointment, costs, and services available. Conclusions: Dental clinicians should pay attention to the barriers that they can influence. The influenza vaccination seems to be an interesting momentum for identifying people who have dropped out of the oral healthcare system.
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Affiliation(s)
- Annemarie A Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center, Groningen, The Netherlands
- TNO Child Health, Leiden, The Netherlands
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Slack-Smith L, Arena G, See L. Rapid Oral Health Deterioration in Older People-A Narrative Review from a Socio-Economic Perspective. J Clin Med 2023; 12:jcm12062396. [PMID: 36983395 PMCID: PMC10055339 DOI: 10.3390/jcm12062396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Poor oral health is a common morbidity in old age with older adults less likely to attend dental care and more likely to have dental disease; this situation is exacerbated by older adults retaining more teeth often with complex restorations. Evidence suggests that some older adults experience rapid oral health deterioration (ROHD). While more clinical and population level evidence is needed, current evidence suggests upstream changes addressing disadvantage through the social determinants of health (SDH) may impact broader disorders such as ROHD, often occurring as older adults become dependent. The aim of this paper is to conduct a narrative review to explore the social determinants of ROHD in older adults. The social determinants of health are important in understanding oral health including ROHD. This includes the important influence of the economic determinants. We explored the SDH as relevant to oral health and ROHD including using a framework based on that of the Fisher-Owens conceptual model (for children) but adapted for older adults. Better understanding of these relationships is likely to assist in future prevention and care.
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Affiliation(s)
- Linda Slack-Smith
- School of Population and Global Health M431, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Gina Arena
- School of Population and Global Health M431, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Lydia See
- School of Dentistry, The University of Queensland, 288 Herston Road, Herston, QLD 4006, Australia
- School of Dentistry, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
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Machado LF, Watanabe PCA, Rodrigues GA, Junior LOM. Deep learning for automatic mandible segmentation on dental panoramic x-ray images. Biomed Phys Eng Express 2023; 9. [PMID: 36724498 DOI: 10.1088/2057-1976/acb7f6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/01/2023] [Indexed: 02/03/2023]
Abstract
Many studies in the last decades have correlated mandible bone structure with systemic diseases like osteoporosis. Mandible segmentation, as well as segmentation of other oral structures, is an essential step in studies that correlate oral structures' conditions with systemic diseases in general. However, manual mandible segmentation is a time-consuming and training-required task that suffers from inter and intra-user variability. Further, the dental panoramic x-ray image (PAN), the most used image in oral studies, contains overlapping of many structures and lacks contrast on structures' interface. Those facts make both manual and automatic mandible segmentation a challenge. In the present study, we propose a precise and robust set of deep learning-based algorithms for automatic mandible segmentation (AMS) on PAN images. Two datasets were considered. An in-house image dataset with 393 image/segmentation pairs was prepared using image data of 321 image patient data and the corresponding manual segmentation performed by an experienced specialist. Additionally, a publicly available third-party image dataset (TPD) composed of 116 image/segmentation pairs was used to train the models. Four deep learning models were trained using U-Net and HRNet architectures with and without data augmentation. An additional morphological refinement routine was proposed to enhance the models' prediction. An ensemble model was proposed combining the four best-trained segmentation models. The ensemble model with morphological refinement achieved the highest scores on the test set (98.27%, 97.60%, 97.18%, ACC, DICE, and IoU respectively), with the other models scoring above 95% in all performance metrics on the test set. The present study achieved the highest ranked performance considering all the previously published results on AMS for PAN images. Additionally, those are the most robust results achieved since it was performed over an image set with considerable gender representativeness, a wide age range, a large variety of oral conditions, and images from different imaging scans.
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Affiliation(s)
- Leonardo Ferreira Machado
- Department of Physics. Faculty of Philosophy Sciences and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Plauto Christopher Aranha Watanabe
- Department of Stomatology, Public Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Luiz Otavio Murta Junior
- Department of Physics. Faculty of Philosophy Sciences and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.,Department of Computing and Mathematics, Faculty of Philosophy Sciences and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Nishio K, Arai Y, Abe Y, Takayama M, Fukasawa M, Oikawa D, Ito T, Takatsu M, Iinuma T. Relation between number of teeth, malnutrition, and 3-year mortality in elderly individuals ≥85 years. Oral Dis 2023; 29:827-835. [PMID: 34523194 PMCID: PMC10078753 DOI: 10.1111/odi.14023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/21/2021] [Accepted: 09/01/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The number of teeth has been shown to affect mortality. However, it is unclear why the number of teeth is associated with mortality. We focused on the number of teeth and malnutrition and examined whether these differences affect 3-year all-cause mortality among very elderly individuals. METHODS This analysis was conducted using data from the Tokyo Oldest Old Survey on Total Health study. Altogether 513 participants ≥85 years were categorized based on remaining teeth (0, 1-7, 8-18, ≥19). All-cause mortality was determined by calculating the cumulative 3-year survival rate according to the remaining number of teeth and the presence/absence of malnutrition. Further, hazard ratios (HRs) were analyzed using Cox regression analyses. RESULTS No difference was observed according to the number of teeth (p = 0.638), but the presence/absence of malnutrition was significantly associated with mortality (p < 0.001). Malnutrition was independently associated with higher HRs, even after adjusting for confounding factors associated with mortality. (HR: 2.315, 95% CI: 1.431-3.746). Additionally, adjusting for the number of teeth, HR remained significant (HR: 2.365, 95% CI: 1.449-3.853). CONCLUSION In the very elderly, malnutrition-but not the number of teeth-was independently associated with 3-year all-cause mortality after adjusting for various health issues.
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Affiliation(s)
- Kensuke Nishio
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Yukiko Abe
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Michiyo Takayama
- Center for Preventive Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Mai Fukasawa
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Daichi Oikawa
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Tomoka Ito
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Masaki Takatsu
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Toshimitsu Iinuma
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
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Abe A, Ito Y, Hayashi H, Ishihama T, Momokita M, Taniguchi S. Correlation between geriatric nutritional risk index and oral condition in gastric cancer patients. Oral Dis 2023; 29:836-842. [PMID: 34585816 DOI: 10.1111/odi.14035] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/24/2021] [Accepted: 09/20/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Nutritional status is a useful prognostic factor in gastric cancer patients. Since oral hypofunction may cause undernutrition, we cross-sectionally investigated whether the Geriatric Nutritional Risk Index (GNRI) is affected by the number of remaining teeth, occlusal support status and denture use. MATERIALS AND METHODS The participants were 114 patients diagnosed with gastric cancer between April 2017 and March 2020. The stage of gastric cancer, body mass index, albumin level, total lymphocyte count, C-reactive protein level and GNRI were evaluated. The number of remaining teeth was also evaluated, and the occlusion state was determined based on the Eichner classification. The patients were divided into three main groups representing different occlusal states based on the Eichner index and were also categorised based on denture use. RESULTS The mean age ± standard deviation of the patients was 75.2 ± 5.5 years. The Eichner classification had a significant positive correlation with GNRI. Low GNRI was associated with a poor occlusal state in group C, while a higher GNRI was associated with a stable occlusal state in group A. However, the denture-related groups showed no significant differences in GNRI. CONCLUSION The GNRI was associated with the occlusal support level but not with denture use.
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Affiliation(s)
- Atsushi Abe
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Yu Ito
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Hiroki Hayashi
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Takanori Ishihama
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Moeko Momokita
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Shinichi Taniguchi
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
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Neelamana SK, Janakiram C, Vijayakumar P, Varma B, Gopakumar D. Profile of 10,935 elderly patients attending the geriatrics department of a medical college: A retrospective study from South India. J Family Med Prim Care 2023; 12:531-535. [PMID: 37122649 PMCID: PMC10131949 DOI: 10.4103/jfmpc.jfmpc_1891_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 05/02/2023] Open
Abstract
Introduction Globally, the elderly population is growing at a rate of 2.6% per year. Understanding the health profile and healthcare needs of the elderly is important. The elderly is the most vulnerable and high-risk groups in terms of health status. Their healthcare-seeking behaviour is crucial in any society. There is a need to generate awareness among the public, politicians, and policymakers regarding multiple issues related to the ageing population in the country. Objective To know the health profile and health-related problems of geriatric patients visiting the department of geriatrics at a medical college. Methodology A five-year retrospective analysis of medical records of patients visiting the department of geriatrics from 4 September 2016 to 4 September 2021 was done using Microsoft Excel software and IBM SPSS Statistics. All records in that duration were reviewed and included. Results Descriptive statistics of medical and dental problems of geriatric patients were recorded. The association of medical and dental problems with gender was assessed. Conclusion A majority of geriatricians are unaware of oral health problems. Medical-dental collaboration is inadequate and should be improved in geriatrics.
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Affiliation(s)
- Sandhya K. Neelamana
- Amrita School of Dentistry, Amrita Viswavidyapeetham, Edapilly, Kochi, Kerala, India
- Address for correspondence: Dr. Sandhya K. Neelamana, Amrita School of Dentistry, Amrita Viswavidyapeetham, Edapilly, Kochi, Kerala, India. E-mail:
| | - Chandrasekhar Janakiram
- Deparment of Public Health Dentistry, Amrita School of Dentistry, Amrita Viswavidyapeetham, Edapally, Kochi, Kerala, India
| | - Priya Vijayakumar
- Department of Geriatrics, Amrita Institute of Medical Sciences, Edapilly, Kochi, Kerala, India
| | - Beena Varma
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Viswavidyapeetham, Edapally, Kochi, Kerala, India
| | - Divya Gopakumar
- Amrita School of Dentistry, Amrita Viswavidyapeetham, Edapilly, Kochi Kerala, India
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Viebranz S, Dederichs M, Kwetkat A, Schüler IM. Effectiveness of Individual Oral Health Care Training in Hospitalized Inpatients in Geriatric Wards. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4275. [PMID: 36901286 PMCID: PMC10001549 DOI: 10.3390/ijerph20054275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/20/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To investigate the effectiveness of individual oral health care training (IndOHCT) on dental plaque removal and denture cleaning in hospitalized geriatric inpatients. BACKGROUND The literature reveals neglect of hygiene and oral care in people aged over 65 years, especially in persons in need of care. Hospitalized geriatric inpatients have poorer dental health than those non-hospitalized. Furthermore, the existing literature reporting on oral healthcare training interventions for hospitalized geriatric inpatients is scarce. MATERIALS AND METHODS This pre-post-controlled intervention study dichotomized 90 hospitalized geriatric inpatients into an intervention group (IG) and a control group (CG). Inpatients in the IG received IndOHCT. Oral hygiene was assessed using the Turesky modified Quigley-Hein index (TmQHI) and the denture hygiene index (DHI), at baseline (T0), at a second examination (T1a), and after supervised autonomous tooth brushing and denture cleaning (T1b). The influence of the Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Barthel Index (BI) scores on oral hygiene was examined. RESULTS There was no significant plaque reduction on teeth or dentures between T0 and T1a in either group. Between T1a and T1b, plaque reduction on the teeth was more effective in the IG than in the CG (p < 0.001). Inpatients with 1-9 remaining teeth removed significantly more dental plaque than inpatients with 10 or more remaining teeth. Inpatients with lower MMSE scores (p = 0.021) and higher age (p = 0.044) reached higher plaque reduction on dentures. CONCLUSIONS IndOHCT improved oral and denture hygiene in geriatric inpatients by enabling them to clean their teeth and dentures more effectively.
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Affiliation(s)
- Stephanie Viebranz
- Department of Prosthetic Dentistry and Material Science, Centre for Dental Medicine, Jena University Hospital, 07743 Jena, Germany
| | - Marco Dederichs
- Department of Prosthetic Dentistry and Material Science, Centre for Dental Medicine, Jena University Hospital, 07743 Jena, Germany
| | - Anja Kwetkat
- Department of Geriatrics and Palliative Care, Klinikum Osnabrück GmbH, 49076 Osnabrück, Germany
| | - Ina Manuela Schüler
- Section of Preventive and Pediatric Dentistry, Department of Orthodontics, Centre for Dental Medicine, Jena University Hospital, 07743 Jena, Germany
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Pérez-Nicolás C, Pecci-Lloret MP, Guerrero-Gironés J. Use and efficacy of mouthwashes in elderly patients: A systematic review of randomized clinical trials. Ann Anat 2023; 246:152026. [PMID: 36402239 DOI: 10.1016/j.aanat.2022.152026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/18/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION A higher prevalence of oral problems has been observed in the elderly population. One of the treatment options for some of these pathologies is the administration of mouthwashes combined with mechanical removal techniques. Besides, each type of oral rinse treats certain oral diseases, and it should be selected for each specific situation. OBJECTIVE To determine the use and efficacy of mouthwashes in the elderly as a treatment for various pathologies, to indicate the most common kinds of mouth-rinses used, the diseases treated with them, their efficacy in each treatment, and their effectiveness when they are combined with other treatments. MATERIAL AND METHODS The review has been carried out following the PRISMA 2020 Statement. Individualized bibliographic searches were performed in five databases. Randomized clinical trials are included in patients over 60 years old where mouthwashes were administered to treat or prevent specific diseases. The PICO question aimed to assess what type of mouthwashes elderly patients use, what they use them for, and their efficacy. Study selection, data extraction, and quality analysis were achieved using the RoB-2 guide. RESULTS Thirteen articles were chosen to perform the qualitative analysis. The bibliometric analysis was carried out. We have eleven randomized controlled clinical trials and two uncontrolled. The mouthwash more used was chlorhexidine, followed by essential oils and fluorides. The most studied pathologies were a periodontal disease, caries, candidiasis, denture stomatitis, and xerostomia. Chlorhexidine used weekly is effective as antiplaque and antigingivitis. Fluorides effectively prevent and reverse caries; nystatin and essential oils to treat candidiasis; and pilocarpine rinse to manage xerostomia. CONCLUSIONS The included studies show that mouthwashes are widely extended in the elderly population, and each sort is specifically designed for treating a particular condition.
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Affiliation(s)
- Claudia Pérez-Nicolás
- Gerodontology and Special Care Dentistry Unit, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
| | - María Pilar Pecci-Lloret
- Gerodontology and Special Care Dentistry Unit, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain.
| | - Julia Guerrero-Gironés
- Gerodontology and Special Care Dentistry Unit, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
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62
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Neelamana SK, Varma B, Janakiram C, Vijayakumar P, Karuveettil V. Cross-cultural Adaptation of Oral and Maxillofacial Frailty Assessment Tools for Geriatric Population of Kerala. J Contemp Dent Pract 2023; 24:80-88. [PMID: 37272138 DOI: 10.5005/jp-journals-10024-3482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM The aim of this study is to translate the oral and maxillofacial frailty index (OMFI) into Malayalam, culturally adapt it, and test its reliability and validity in the Kerala geriatric population. MATERIALS AND METHODS OMFI was translated, culturally adapted, and validated in Malayalam using a methodological and cross-sectional study design. The Malayalam version of OMFI underwent full linguistic validation and was tested on 200 patients at Amritakripa Hospital in Kalpetta. Principal component analysis with varimax rotation was used for exploratory factor analysis, and Cronbach's alpha was used to assess reliability. RESULTS Two-hundred patients were recruited in this study. Participants ranged in age from 60 to 83 years; mean age was 68 years (SD: 15.21). In total 55.5% were male participants, and 30.5% were belonging to upper middle class as per the Kuppuswami scale. Only 12% of the participants were living alone. Kaiser-Meyer-Olkin was found to be 0.583, and Bartlett's test of sphericity was significant with a Chi-square test value of 1003.469. A principal axis factor analysis conducted on 20 items with orthogonal rotation (varimax). OMFI Malayalam version (5 items) had a good internal consistency (Cronbach's alpha = 0.751). Item-total correlations were reviewed for the items of OMFI. CONCLUSION The OMFI Malayalam version demonstrated acceptable validity and reliability and can be used to screen the oral frailty of the geriatric population in Kerala. CLINICAL SIGNIFICANCE As Kerala is having highest geriatric population in India, we need to assess the oral frailty burden of Kerala. This study provided the first measure to assess the oral frailty in elderly in Kerala.
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Affiliation(s)
| | - Beena Varma
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Edappally, Kochi, Kerala, India
| | - Chandrashekar Janakiram
- Department of Community Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Edappally, Kochi, Kerala, India
| | - Priya Vijayakumar
- Department of Geriatrics, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Vineetha Karuveettil
- Department of Community Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Edappally, Kochi, Kerala, India
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63
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Gancz AS, Weyrich LS. Studying ancient human oral microbiomes could yield insights into the evolutionary history of noncommunicable diseases. F1000Res 2023; 12:109. [PMID: 37065506 PMCID: PMC10090864 DOI: 10.12688/f1000research.129036.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 01/31/2023] Open
Abstract
Noncommunicable diseases (NCDs) have played a critical role in shaping human evolution and societies. Despite the exceptional impact of NCDs economically and socially, little is known about the prevalence or impact of these diseases in the past as most do not leave distinguishing features on the human skeleton and are not directly associated with unique pathogens. The inability to identify NCDs in antiquity precludes researchers from investigating how changes in diet, lifestyle, and environments modulate NCD risks in specific populations and from linking evolutionary processes to modern health patterns and disparities. In this review, we highlight how recent advances in ancient DNA (aDNA) sequencing and analytical methodologies may now make it possible to reconstruct NCD-related oral microbiome traits in past populations, thereby providing the first proxies for ancient NCD risk. First, we review the direct and indirect associations between modern oral microbiomes and NCDs, specifically cardiovascular disease, diabetes mellitus, rheumatoid arthritis, and Alzheimer's disease. We then discuss how oral microbiome features associated with NCDs in modern populations may be used to identify previously unstudied sources of morbidity and mortality differences in ancient groups. Finally, we conclude with an outline of the challenges and limitations of employing this approach, as well as how they might be circumvented. While significant experimental work is needed to verify that ancient oral microbiome markers are indeed associated with quantifiable health and survivorship outcomes, this new approach is a promising path forward for evolutionary health research.
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Affiliation(s)
- Abigail S Gancz
- Department of Anthropology, Pennsylvania State University, State College, PA, 16802, USA
| | - Laura S Weyrich
- Department of Anthropology, Pennsylvania State University, State College, PA, 16802, USA
- School of Biological Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- Huck Institutes of the Life Sciences, Pennsylvania State University, State College, PA, 16802, USA
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64
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Nakazawa N, Kusama T, Cooray U, Yamamoto T, Kiuchi S, Abbas H, Yamamoto T, Kondo K, Osaka K, Aida J. Large Contribution of Oral Status for Death Among Modifiable Risk Factors in Older Adults: The Japan Gerontological Evaluation Study (JAGES) Prospective Cohort Study. J Gerontol A Biol Sci Med Sci 2023; 78:167-173. [PMID: 35231123 DOI: 10.1093/gerona/glac052] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Oral diseases are preventable and modifiable, but highly prevalent, and cause worse oral status. Particularly, tooth loss has increased in aging societies. However, studies on population-attributable risks of modifiable risk factors for mortality have neglected oral status. This study aimed to investigate the impact of modifiable risk factors on mortality, including oral status. METHODS This cohort study used the Japan Gerontological Evaluation Study data, including participants aged ≥65 years. The outcome was death between August 2010 and March 2017. We calculated the hazard ratios (HRs) and population attributable fraction (PAF) of modifiable risk factors (oral status, hypertension, depression, heart disease, diabetes, physical activity, smoking status, and alcohol drinking history) for mortality. RESULTS Analyses included 24 175 men and 27 888 women (mean age: 73.8 [6.0] and 74.2 [6.1], respectively). In men, after adjusting for covariates, having no teeth showed the highest hazard ratio (HR = 1.67, 95% confidence interval [CI] = 1.51-1.86) among the modifiable risk factors, and the PAF for the number of teeth (18.2%) was the second largest following age. In women, having no teeth had the third largest HR (HR = 1.37, 95% CI = 1.19-1.56) following current and former smoking. The PAF for the number of teeth (8.5%) was the sixth largest, which was larger than that of smoking status (4.8%). CONCLUSIONS In the older population, the HR and PAF of the number of teeth on mortality were sufficiently large compared with other modifiable risk factors, especially in men. Therefore, maintaining good oral status should be included more in global health policies.
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Affiliation(s)
- Noriko Nakazawa
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan.,Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi, Japan
| | - Upul Cooray
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Takafumi Yamamoto
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan.,Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Hazem Abbas
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Tatsuo Yamamoto
- Department of Dental Sociology, Kanagawa Dental University, Kanagawa, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Jun Aida
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi, Japan.,Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Weening-Verbree LF, Schuller AA, Zuidema SU, Hobbelen JSM. A Qualitative Evaluation of the Implementation of an Oral Care Program in Home Care Nursing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2124. [PMID: 36767491 PMCID: PMC9915185 DOI: 10.3390/ijerph20032124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
An Oral Care Program (OCP) was implemented in home care nursing teams in a northern province of the Netherlands to improve the oral health and hygiene of older people who make use of formal home care in 2018-2019. The aim of the current study was to evaluate the experiences of the stakeholders involved (older people, home-care nurses and dental hygienists) and to report the experienced impact of OCP, with a qualitative approach. Three dental hygienists, nine home care nurses, and eight older people were interviewed with semi-structured interviews, which were audio recorded, transcribed and analyzed using thematic analysis. The codes derived were grouped into nine main themes. OCP was experienced as mostly positive by all stakeholders involved. The educational part lead to more awareness towards oral care, but should be repeated regularly. Personalized oral care plans for older people were experienced positively, however, obtaining oral care behavior changes appeared to be difficult. Collaboration between dental hygienists and home care nurses lead to a positive experience from both sides The method and intensity of collaboration varied between the teams. To provide better access to oral health care for older people in the community, a long term collaboration between home care nursing teams and dental care professionals in their working area should be established.
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Affiliation(s)
- Lina F. Weening-Verbree
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- FAITH Research, Groningen/Friesland, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, 9713 AV Groningen, The Netherlands
| | - Annemarie A. Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, 9713 AV Groningen, The Netherlands
- TNO the Netherlands Organization for Applied Scientific Research, 2333 BE Leiden, The Netherlands
| | - Sytse U. Zuidema
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
| | - Johannes S. M. Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- FAITH Research, Groningen/Friesland, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
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Self-reported hearing and vision impairment and incident frailty in Japanese older people: A 3-year longitudinal analysis of the Japan Gerontological Evaluation Study. Arch Gerontol Geriatr 2023; 104:104834. [PMID: 36257161 DOI: 10.1016/j.archger.2022.104834] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/01/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND We examined the associations and interactions of hearing impairment (HI) and vision impairment (VI) with frailty. METHODS We performed a 3-year longitudinal analysis of the Japan Gerontological Evaluation Study (JAGES), a nationwide prospective cohort study of functionally independent Japanese older people (age ≥ 65 years). Frailty status at baseline and follow-up was defined according to the Kihon Checklist. HI and VI at baseline were self-reported. Logistic regression models were used to examine the main and interaction effects of HI and VI on incident frailty during a 3-year follow-up period. RESULTS Of the 7,852 participants (mean age 73.2 years, standard deviation 5.6; 50.7% women), 9.7%, 5.3%, and 1.9% reported HI, VI, and concurrent HI and VI, respectively. After adjusting for possible confounders and the other sensory impairment, VI (odds ratio [OR] 2.50, 95% confidence interval [CI] 1.62-3.85, p < 0.001), but not HI (OR 1.29, 95% CI 0.97-1.72, p = 0.081), was significantly associated with incident combined pre-frailty and frailty from a robust baseline. No interaction was observed between HI and VI (OR 0.83, 95% CI 0.38-1.81, p = 0.636). We observed no significant associations between sensory impairments and incident frailty from a pre-frail baseline (HI: OR 1.26, 95% CI 0.88-1.80, p = 0.205; VI: OR 1.44, 95% CI 0.90-2.31, p = 0.127; interaction between HI and VI: OR 1.16, 95% CI 0.53-2.53, p = 0.718). CONCLUSIONS VI, rather than HI, may be an independent risk factor for frailty, without any interaction between the two.
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Hidaka R, Masuda Y, Ogawa K, Tanaka T, Kanazawa M, Suzuki K, Stading M, Iijima K, Matsuo K. Impact of the Comprehensive Awareness Modification of Mouth, Chewing and Meal (CAMCAM) Program on the Attitude and Behavior Towards Oral Health and Eating Habits as Well as the Condition of Oral Frailty: A Pilot Study. J Nutr Health Aging 2023; 27:340-347. [PMID: 37248757 DOI: 10.1007/s12603-023-1913-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 03/29/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Preserving sufficient oral function and maintaining aadequate nutrition are essential for preventing physical frailty and the following long-term care. We recently developed the 6-month Comprehensive Awareness Modification of Mouth, Chewing And Meal (CAMCAM) program, in which participants gather monthly to learn about oral health and nutrition while eating a textured lunch together. This study examined whether the CAMCAM program could improve attitude and behavior towards oral health, mastication, and diet as well as ameliorate oral frailty in community-dwelling older adults. DESIGN Single-arm pre-post comparison study. SETTING AND PARTICIPANTS A total of 271 community-dwelling adults (72.3 ± 5.7 years of age; 159 women [58.7%]) in 4 Japanese municipalities were recruited, of which 249 participants (92%) were assessed at the final evaluation. INTERVENTION Participants gathered once a month at community centers to learn about oral health and nutrition while eating a "munchy" textured lunch containing proper nutrition. MEASUREMENTS Oral frailty, frailty, and eating behavior were evaluated with the Oral Frailty Index-8 (OFI-8), Kihon checklist (KCL), and CAMCAM checklist, respectively. Participants were divided into Oral frailty (OF) and Robust groups according to OFI-8 scores. The differences in KCL and CAMCAM checklist results between the OF and Robust groups were statistically tested along with changes in scores after the program. RESULTS KCL and CAMCAM checklist scores were significantly lower in the OF group at the initial assessment. OFI-8 and KCL findings were significantly improved in the OF group after completing the program (all P <0.05). Regarding the CAMCAM checklist, awareness of chewing improved significantly in the Robust group (P=0.009), with a similar tendency in the OF group (P=0.080). CONCLUSION The findings of this pilot study suggest that the CAMCAM program may improve both oral and systemic frailty in addition to attitudes towards chewing, oral health, and meals, especially in individuals with oral frailty. The CAMCAM program merits expansion as a community-based frailty prevention program.
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Affiliation(s)
- R Hidaka
- Koichiro Matsuo, Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan, Phone: +81-3-5803-4545, E-mail:
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68
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Zhang J, Xu G, Xu L. Number of Teeth and Denture Use Are Associated with Frailty among Chinese Older Adults: A Cohort Study Based on the CLHLS from 2008 to 2018. J Nutr Health Aging 2023; 27:972-979. [PMID: 37997718 DOI: 10.1007/s12603-023-2014-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/01/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES The aim of this study was to determine the association between oral health and the development of frailty over a 10-year period in older Chinese adults. DESIGN This was a cohort study. SETTING AND PARTICIPANTS The data in this study were derived from the 2008, 2011, 2014 and 2018 waves of the Chinese Longitudinal Health Longevity Survey (CLHLS). The final analysis included 1155 older adults who had complete data for the Frailty Index (FI) and the other factors(oral health, sociodemographics, etc) that were analyzed in the study. MEASUREMENTS Frailty was assessed by the FI, which consists of 40 deficits(self-health assessments, diseases, physical functions,etc). Multivariable logistic regression was carried out to calculate the odds ratios (ORs) of the independent variables,which were obtained from investigator surveys and self-reports, in association with the development of frailty. RESULTS The prevalence of frailty at baseline was 22.94%, and the 10-year incidence of frailty was 24.16% (215/890). Age, number of natural teeth, use of dentures, toothache and sex were independent risk factors for frailty at baseline. After full adjustment, multivariate logistic regression analysis indicated that compared with having ≥21 teeth, edentulism (ORs 3.575; 95% CI 2.095,6.101) and partial tooth loss (ORs 2.448; 95% CI 1.592,3.766) were associated with progression to frailty. Compared with those with ≥21 teeth, those with <21 teeth and without dentures (ORs 2.617; 95% CI 1.713,3.999) were more likely to progress to frailty. CONCLUSION The loss of natural teeth is associated with the progression of frailty in older Chinese adults and denture using can help lower the odds of being frailty. Further research on maintain natural teeth and the appropriate use of dentures may help to establish effective frailty prevention strategies for the older adults.
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Affiliation(s)
- J Zhang
- Liyu Xu, Department of Geriatrics, Zhejiang Hospital, Hangzhou 310013, People's Republic of China, ; Tel. :+86 13486183817
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Gancz AS, Weyrich LS. Studying ancient human oral microbiomes could yield insights into the evolutionary history of noncommunicable diseases. F1000Res 2023; 12:109. [PMID: 37065506 PMCID: PMC10090864 DOI: 10.12688/f1000research.129036.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 04/19/2023] Open
Abstract
Noncommunicable diseases (NCDs) have played a critical role in shaping human evolution and societies. Despite the exceptional impact of NCDs economically and socially, little is known about the prevalence or impact of these diseases in the past as most do not leave distinguishing features on the human skeleton and are not directly associated with unique pathogens. The inability to identify NCDs in antiquity precludes researchers from investigating how changes in diet, lifestyle, and environments modulate NCD risks in specific populations and from linking evolutionary processes to modern health patterns and disparities. In this review, we highlight how recent advances in ancient DNA (aDNA) sequencing and analytical methodologies may now make it possible to reconstruct NCD-related oral microbiome traits in past populations, thereby providing the first proxies for ancient NCD risk. First, we review the direct and indirect associations between modern oral microbiomes and NCDs, specifically cardiovascular disease, diabetes mellitus, rheumatoid arthritis, and Alzheimer's disease. We then discuss how oral microbiome features associated with NCDs in modern populations may be used to identify previously unstudied sources of morbidity and mortality differences in ancient groups. Finally, we conclude with an outline of the challenges and limitations of employing this approach, as well as how they might be circumvented. While significant experimental work is needed to verify that ancient oral microbiome markers are indeed associated with quantifiable health and survivorship outcomes, this new approach is a promising path forward for evolutionary health research.
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Affiliation(s)
- Abigail S Gancz
- Department of Anthropology, Pennsylvania State University, State College, PA, 16802, USA
| | - Laura S Weyrich
- Department of Anthropology, Pennsylvania State University, State College, PA, 16802, USA
- School of Biological Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
- Huck Institutes of the Life Sciences, Pennsylvania State University, State College, PA, 16802, USA
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Zhang XM, Jiao J, Cao J, Wu X. The association between the number of teeth and frailty among older nursing home residents: a cross-sectional study of the CLHLS survey. BMC Geriatr 2022; 22:1007. [PMID: 36585614 PMCID: PMC9805096 DOI: 10.1186/s12877-022-03688-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 12/08/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Given that few studies have explored the association between oral health and frailty among older nursing home residents, the purpose of this study was to assess the association between oral health (i.e., the number of teeth and oral behaviors) and frailty in this population using the Chinese Longitudinal Healthy Longevity Survey (CLHLS). METHODS This was a national cross-sectional study derived from the seventh wave of CLHLS in 2018, consisting of 365 older nursing home residents aged 65 years or older. The frailty index was constructed based on 32 variables consisting of self-rated health status, anxiety, depression, ADL and IADL. Oral health was measured through the number of natural teeth and tooth brushing behavior. Multiple logistic regression was used to identify this association between the number of teeth, oral health behaviors, and frailty. RESULTS The mean age of this sample was 87.6 (SD = 9.5), with 154 (42.2%) males. The prevalence of frailty and edentulism was 71.2% and 33.4%, respectively. Multiple logistic regression analysis found that the likelihood of frailty decreased with an increased number of teeth, with an OR of 0.94 (95% CI: 0.91-0.98). Compared with participants with edentulism, older adults with 1 to 20 teeth had a lower likelihood of frailty (OR = 0.39, 95% CI: 0.17-0.88); these results were also found in older adults with more than 20 teeth (OR = 0.20, 0.07-0.57). Additionally, older adults who brush their teeth regularly have a lower likelihood of frailty than those who never brush their teeth (OR = 0.37, 95% CI: 0.13-0.99). CONCLUSION Older nursing home residents who maintain their natural teeth can help lower the risk of frailty, and regular toothbrushing also contributes to decreasing the risk of frailty. Our study emphasizes the importance of oral health, and cohort studies with large-scale samples to address this important issue are warranted in the future.
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Affiliation(s)
- Xiao-Ming Zhang
- grid.413106.10000 0000 9889 6335Department of Nursing, Chinese Academy of Medical Sciences Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Jing Jiao
- grid.413106.10000 0000 9889 6335Department of Nursing, Chinese Academy of Medical Sciences Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Jing Cao
- grid.413106.10000 0000 9889 6335Department of Nursing, Chinese Academy of Medical Sciences Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Xinjuan Wu
- grid.413106.10000 0000 9889 6335Department of Nursing, Chinese Academy of Medical Sciences Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
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Kang MG, Jung HW. Association Between Oral Health and Frailty in Older Korean Population: A Cross-Sectional Study. Clin Interv Aging 2022; 17:1863-1872. [PMID: 36575660 PMCID: PMC9790170 DOI: 10.2147/cia.s384417] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose Frailty is closely associated with biological age, concurrent medical conditions, morbidity, and decreased survival. Poor oral health is common in older individuals and is associated with frailty. Considering its potential importance, a study on the association between oral health and frailty is meaningful. Therefore, we aimed to analyze the association between major oral health factors and frailty using nationally representative samples of older adults. Patients and Methods This cross-sectional study included 3018 older adults (age ≥ 65 years) from the seventh Korea National Health and Nutrition Examination Survey. Oral examination results, laboratory data, handgrip strength, life style factors derived from questionnaires, and food intake survey results were analyzed. This study used the deficit accumulation model among the main operational definitions of frailty. We constructed a frailty index based on 36 items and classified participants as non-frail, pre-frail, or frail. Oral health factors included chewing difficulty, number of teeth, periodontal disease, and number of carious teeth. Logistic regression analysis was performed to determine significant factors. Results A total of 1222 (40.5%), 1014 (33.6%), and 782 (25.9%) individuals were classified as non-frail, pre-frail, and frail, respectively. Chewing difficulty was associated with increased risk of frailty after adjusting for age, sex, socioeconomic factors, and comorbidities (odds ratio 2.68, 95% confidence interval 2.08-3.44). Periodontal disease was positively associated with chewing difficulty (odds ratio 1.29, 95% confidence interval 1.07-1.56), and chewing difficulty decreased as the number of teeth increased (odds ratio 0.97, 95% confidence interval 0.96-0.99). Conclusion Chewing difficulty was significantly associated with frailty in the older population. Considering the negative effect of chewing difficulty on frailty, more attention should be focused on oral health.
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Affiliation(s)
- Min-gu Kang
- Department of Internal Medicine, Chonnam National University Bitgoeul Hospital, Gwangju, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea,Correspondence: Hee-Won Jung, Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea, Tel +82 10 2318 3490, Email
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Lin YK, Chen CY, Cheung DST, Montayre J, Lee CY, Ho MH. The relationship between physical activity trajectories and frailty: a 20-year prospective cohort among community-dwelling older people. BMC Geriatr 2022; 22:867. [DOI: 10.1186/s12877-022-03493-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/28/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
Studies on examining the relationship between physical activity patterns and frailty are lacking. This study examined physical activity patterns in older people and investigated the relationship between physical activity and frailty as well as identifying the predictors of frailty.
Methods
We used a nationally representative longitudinal database, the Taiwan Longitudinal Study of Aging (TLSA) database, and data for a 20-year period were extracted and analyzed. A total of 5131 participants aged ≥ 60 years in 1996 were included in the current analysis. Information regarding demographic characteristics, frailty, physical activity, comorbidities, oral health, and depressive symptoms was extracted from the TLSA database. Physical activity patterns were examined using group-based trajectory modeling from 1996 to 2015. Potential predictors were examined by performing multivariate logistic regression.
Results
Four trajectories of the physical activity pattern were found: consistently physically inactive (33.7%), consistently physically active (21.5%), incline (21.6%), and decline (23.2%). Throughout the period, the trajectories of the four groups significantly differed from each other at year 2015, with the incline and decline groups exhibiting the lowest and highest frailty scores, respectively (p < 0.001). Older age, male, poor oral health, diabetes, chronic kidney disease, and depressive symptoms were identified as risk factors for frailty.
Conclusion
Physical activity reduces the risk of chronic conditions, which contributes to healthy longevity. This study can guide the development of future research and interventions to manage frailty in older people, particularly in considering previous physical activity trajectories within the life course.
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Dibello V, Lozupone M, Sardone R, Ballini A, Dibello A, Daniele A, Panza F. Clinical Indicators of Oral Frailty: A Domain-Specific Frailty Phenotype. Curr Top Med Chem 2022; 22:2391-2394. [PMID: 35708086 DOI: 10.2174/1568026622666220615145647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/09/2022] [Accepted: 03/18/2022] [Indexed: 01/20/2023]
Affiliation(s)
- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Rodolfo Sardone
- Department of Epidemiology, Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario "Ernesto Quagliariello", University of Bari Aldo Moro, Bari, Italy
| | - Antonio Dibello
- Accident and Emergency Department (AED), F. Perinei Hospital, Altamura, Bari, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy.,Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Francesco Panza
- Department of Epidemiology, Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology 'Saverio de Bellis', Research Hospital, Castellana Grotte, Bari, Italy
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74
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Liu F, Song S, Ye X, Huang S, He J, Wang G, Hu X. Oral health-related multiple outcomes of holistic health in elderly individuals: An umbrella review of systematic reviews and meta-analyses. Front Public Health 2022; 10:1021104. [PMID: 36388333 PMCID: PMC9650948 DOI: 10.3389/fpubh.2022.1021104] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/29/2022] [Indexed: 01/28/2023] Open
Abstract
Background and aims Along with an aging population, exploring the impact of oral health on holistic health and determining exact outcomes in elderly individuals are important in both scientific research and clinical practice. Significant increase in the number of systematic reviews shows that oral health can directly or indirectly affect the overall health of elderly people physically, mentally and socially. To systematically collate, appraise, and synthesize the current evidence, we carried out an umbrella review of the impacts of oral health on holistic health in elderly individuals. Methods A systematic reviews and meta-analyses search was performed in the major databases PubMed, MEDLINE, Web of Science and the Cochrane Library from inception to February 1, 2022, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The JBI (Joanna Briggs Institute) Critical Appraisal Checklist for Systematic Reviews and Research Syntheses was referred to assess methodological quality, and the GRADE (Grading of Recommendations, assessment, Development, and Evaluation working group classification) was used to assess the quality of evidence for each outcome included in the umbrella review. Results Out of 1,067 records, a total of 35 systematic reviews were included. Respiratory diseases, malnutrition, age-related oral changes, frailty, cognitive impairment, depression and poor quality of life were identified as seven key outcomes that affect the physical, mental and social health of elderly individuals. Meanwhile, three intervention measures of oral health were summarized as (i) more rigorous and universal scales, (ii) dental cleaning and denture installation, and (iii) improving self-awareness regarding oral care. Conclusions Evidence showed that oral health can significantly affect holistic health, and the diverse oral diseases directly lead to multiple health outcomes in elderly individuals. Clear high-quality evidence revealed that oral health is strongly associated with seven health outcomes covering physical, mental, and social levels, which directly corresponds to holistic health, and impacts the quality of life of elderly individuals. Such the results remind the importance of oral care in public health, and further studies need to be conducted to verity more specific association between oral health and other chronic diseases. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier: CRD42022315315.
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Affiliation(s)
- Fan Liu
- West China School of Nursing, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Siping Song
- West China School of Nursing, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Ye
- West China School of Nursing, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shuqi Huang
- West China School of Nursing, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing He
- West China School of Nursing, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Guan Wang
- Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Xiuying Hu
- Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Xiuying Hu
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75
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Yamamoto T, Tanaka T, Hirano H, Mochida Y, Iijima K. Model to Predict Oral Frailty Based on a Questionnaire: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13244. [PMID: 36293822 PMCID: PMC9603718 DOI: 10.3390/ijerph192013244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
A statistical model to predict oral frailty based on information obtained from questionnaires might help to estimate its prevalence and clarify its determinants. In this study, we aimed to develop and validate a predictive model to assess oral frailty thorough a secondary data analysis of a previous cross-sectional study on oral frailty conducted on 843 patients aged ≥ 65 years. The data were split into training and testing sets (a 70/30 split) using random sampling. The training set was used to develop a multivariate stepwise logistic regression model. The model was evaluated on the testing set and its performance was assessed using a receiver operating characteristic (ROC) curve. The final model in the training set consisted of age, number of teeth present, difficulty eating tough foods compared with six months ago, and recent history of choking on tea or soup. The model showed good accuracy in the testing set, with an area of 0.860 (95% confidence interval: 0.806-0.915) under the ROC curve. These results suggested that the prediction model was useful in estimating the prevalence of oral frailty and identifying the associated factors.
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Affiliation(s)
- Tatsuo Yamamoto
- Department of Dental Sociology, Kanagawa Dental University, Yokosuka 238-8580, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashi-ku, Tokyo 173-0015, Japan
| | - Yuki Mochida
- Department of Dental Sociology, Kanagawa Dental University, Yokosuka 238-8580, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Bunkyo-ku, Tokyo 113-8656, Japan
- Institute for Future Initiatives, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
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76
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Kojima G, Taniguchi Y, Iwasaki M, Aoyama R, Urano T. Associations between self-reported masticatory dysfunction and frailty: A systematic review and meta-analysis. PLoS One 2022; 17:e0273812. [PMID: 36084116 PMCID: PMC9462797 DOI: 10.1371/journal.pone.0273812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
Background Oral health is a key factor of overall health and closely associated with well-being and quality of life. Mastication is one the most important oral functions and may deteriorate with aging. Evidence on association between masticatory dysfunction and frailty in the literature is scarce and not coherent. Methods A search strategy was developed to conduct a systematic review of the literature in PubMed, CINAHL, and AMED in accordance with the PRISMA 2020 guidelines. We searched for studies published in 2000 or later that examined associations between self-reported masticatory dysfunction and frailty risk. The reference lists of the relevant articles were reviewed for additional studies. We calculated pooled odds ratios (OR) of association between self-reported masticatory dysfunction and the risk of frailty by fixed-effects meta-analysis. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess risk of bias. Publication bias was assessed by visually inspecting a funnel plot. Results A total of 285 studies were identified by the literature search. Among 5 studies selected for this review, 4 cross-sectional studies including a total of 7425 individuals were used for meta-analysis. The pooled results by a fixed-effects model showed that there was a significant association between self-reported masticatory dysfunction and frailty risk (pooled OR = 1.83, 95%CI = 1.55–2.18, p<0.00001). There was no evidence of publication bias observed. Conclusions This systematic review and meta-analysis highlighted pooled cross-sectional evidence that community-dwelling older people who report masticatory dysfunction are significantly more likely to be frail than those who do not. The limitations of this study are: inclusion of only cross-sectional studies, no gold standard to measure masticatory functions, self-reported information on masticatory function, and the limited number of included studies. More longitudinal studies are warranted for further understanding of the causal pathways and elucidate underlying mechanisms. Registration: PROSPERO CRD42021277173
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Affiliation(s)
- Gotaro Kojima
- Department of Research, Dr. AGA Clinic, Tokyo, Japan
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | | | - Reijiro Aoyama
- Department of Japanese Studies, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Tomohiko Urano
- Department of Geriatric Medicine, International University of Health and Welfare, Chiba, Japan
- * E-mail:
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77
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McGRATH C, SUEN RPC, McKENNA G, MOORE C, WONG MCM. Oral Health and Successful Ageing - The PROS and dPROS: A Scoping Review. J Evid Based Dent Pract 2022; 22:101714. [DOI: 10.1016/j.jebdp.2022.101714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/23/2021] [Accepted: 01/09/2022] [Indexed: 11/24/2022]
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78
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Henni SH, Skudutyte-Rysstad R, Ansteinsson V, Hellesø R, Hovden EAS. Oral health and oral health-related quality of life among older adults receiving home health care services: A scoping review. Gerodontology 2022; 40:161-171. [PMID: 35943193 DOI: 10.1111/ger.12649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/25/2022] [Accepted: 07/19/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To map the literature on subjective and objective oral health indicators and oral health-related quality of life (OHRQoL) in older adults receiving home health care services (HHCS). BACKGROUND The proportion of older adults in need of HHCS will increase in the coming years. Previous studies indicate that frail and dependent older adults are at increased risk for oral diseases, due to challenges with daily oral hygiene and regular access to dental services. MATERIALS AND METHODS Four databases were searched in November 2020 for relevant literature. Search terms included a comprehensive list of terms for adults 65 years or older receiving HHCS, clinical and subjective oral health indicators, and OHRQoL. The literature was reviewed based on inclusion and exclusion criteria. RESULTS Of the 3114 sources identified, 18 were included. Data on oral diseases and symptoms among older adults receiving HHCS were limited and heterogeneous. Overall, older adults often lacked some of their natural teeth and often had removable dentures that needed repair. In addition, plaque, caries, xerostomia, and chewing and swallowing problems were common among the population group. Data on OHRQoL were scarce and indicated a positive association with a higher number of present teeth, while decayed teeth, root remnants, and dry mouth had substantial negative impacts on the daily activities of older adults receiving HHCS. CONCLUSION This scoping review show that older adults above 65 years receiving HHCS generally have poor oral health status and that there is a knowledge gap regarding their OHRQoL.
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Affiliation(s)
- Silje Havrevold Henni
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Rasa Skudutyte-Rysstad
- Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway.,Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Vibeke Ansteinsson
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.,Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway
| | - Ragnhild Hellesø
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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79
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Chávez EM, Kossioni A, Fukai K. Policies Supporting Oral Health in Ageing Populations Are Needed Worldwide. Int Dent J 2022; 72:S27-S38. [PMID: 36031323 PMCID: PMC9437798 DOI: 10.1016/j.identj.2022.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 12/19/2022] Open
Abstract
This literature review examines the need to develop appropriate policies specific to the oral health needs of older people that are individualised, cost-effective, and sustainable. Poor oral health and impaired oral function negatively affect the health and quality of life of older adults. Developing care systems that aim to meet patients' normative needs as well as their perceived needs and expectations is one factor in successful delivery of appropriate dental care. Cost is another significant driver of utilisation, and many older adults worldwide lack adequate resources for dental care. Failure to address these issues results in poor outcomes and increased costs of dental and medical care. Disease prevention and control at early stages can preserve public and private financial resources as well as quality of life and well-being for older adults at any stage of life.
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Affiliation(s)
- Elisa M Chávez
- University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, USA.
| | - Anastassia Kossioni
- Dental School, National and Kapodistrian University of Athens, Athens, Greece
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80
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Aida J, Takeuchi K, Furuta M, Ito K, Kabasawa Y, Tsakos G. Burden of Oral Diseases and Access to Oral Care in an Ageing Society. Int Dent J 2022; 72:S5-S11. [PMID: 36031325 PMCID: PMC9437805 DOI: 10.1016/j.identj.2022.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/05/2022] [Accepted: 06/17/2022] [Indexed: 12/03/2022] Open
Abstract
Objective The total years lived with disability among older people, and the concomitant burden of tooth loss in ageing societies have increased. This study is an overview of the burden of oral diseases and access to oral care in an ageing society. Methods We selected key issues related to the burden of oral diseases and access to oral care and reviewed the relevant literature. Results The rising number of older people with teeth increases their oral health care needs. To improve access to oral care, affordability of care is a great concern with respect to universal health coverage. In addition, accessibility is a crucial issue, particularly for vulnerable older adults. To improve oral care access, attempts to integrate oral health care into general care are being made in ageing countries. For this purpose, provision of professional oral care at home through domiciliary visits and provision of daily oral health care by non-dental professional caregivers are important. Oral health care for older people reduces general diseases such as pneumonia and malnutrition, which in turn could reduce further healthcare costs. Conclusions To address the growing burden of oral care in ageing societies, special provision of oral health care to vulnerable older people, and integration of oral care with primary care will be required.
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Affiliation(s)
- Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan; Division of Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Kyushu University Faculty of Dental Science, Fukuoka, Japan
| | - Kanade Ito
- Department of Oral Care for Systemic Health Support, Health Sciences and Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuji Kabasawa
- Department of Oral Care for Systemic Health Support, Health Sciences and Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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81
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Tan LF, Chan YH, Merchant RA. Association between dentition and frailty and cognitive function in community-dwelling older adults. BMC Geriatr 2022; 22:614. [PMID: 35879659 PMCID: PMC9310464 DOI: 10.1186/s12877-022-03305-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
Objectives To evaluate dentition status amongst community-dwelling older adults and its association with frailty and cognitive impairment. Methodology One thousand forty-seven community-dwelling older adults aged ≥65 years were surveyed in an epidemiologic population-based cohort study in Singapore between April 2015 and August 2016. Data on demographics, dentition status, chronic diseases, activities and instrumental activities on daily-living, cognition (age- and education-specific MMSE cut-offs), frailty (FRAIL scale), perceived health and functional status were collected. Multiple logistic regression was performed to examine the association between dentition, frailty and cognition. Results Mean age of participants was 71.2 ± 5.5 years. The prevalence of denture use was 70.7% and edentulism 7.9%. Compared to edentulousness, having teeth was associated with lower odds of cognitive impairment and higher odds of being robust or pre-frail. Denture-wearers compared with edentulous persons were less likely to be male, had higher education level and more likely be robust or pre-frail. Conclusion and implications There were significant associations between dentition status, frailty and cognition in our study where those with remining teeth and / or dentures had better overall outcomes. As oral health, frailty and cognitive impairments are all modifiable risk factors for healthy ageing, countries should consider population level screening for oral health, frailty and cognitive impairment.
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Affiliation(s)
- Li Feng Tan
- Healthy Ageing Programme, Alexandra Hospital, 378 Alexandra Rd, Singapore, 159964, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Reshma A Merchant
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. .,Division of Geriatric Medicine, Department of Medicine, National University Hospital, National University Health System, 1E Kent Ridge Road, Singapore, 119228, Singapore.
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82
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Weening-Verbree LF, Schuller AA, Zuidema SU, Hobbelen JSM. Evaluation of an Oral Care Program to Improve the Oral Health of Home-Dwelling Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127251. [PMID: 35742500 PMCID: PMC9223830 DOI: 10.3390/ijerph19127251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/04/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the impact of the implementation of an Oral Care Program on home care nurses’ attitudes and knowledge about oral health (care) and the impact on older people’s oral health. A pre–post study, without a control group, was conducted. A preventive Oral Care Program (OCP) was designed, focusing on home care nurses and older people, in collaboration with dental hygienists. Implementation was measured with questionnaires at baseline and after 6 months for home care nurses; for older people, implementation was measured at baseline and after 3 months with the Oral Health Assessment Tool and a questionnaire about oral (self) care between January 2018 and September 2019. Although the study design has limitations, the oral health of older people improved significantly after 3 months and the OCP was most beneficial for people with full dentures. The OCP improved knowledge and attitude of home care nurses. The program fitted well with the daily work routines of home care nurses. Individual-centered care plans for older people, education of home care nurses and the expertise of the dental hygienists have added value in home care nursing. Future implementations should focus on older people with natural teeth.
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Affiliation(s)
- Lina F. Weening-Verbree
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands;
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, A. Deusinglaan 1, FB 21, 9713 AV Groningen, The Netherlands;
- Correspondence:
| | - Annemarie A. Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, A. Deusinglaan 1, FB 21, 9713 AV Groningen, The Netherlands;
- TNO the Netherlands Organisation for Applied Scientific Research, Schipholweg 77-89, 2316 ZL Leiden, The Netherlands
| | - Sytse U. Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, FA21, P.O. Box 196, 9700 AD Groningen, The Netherlands;
| | - Johannes S. M. Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands;
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, FA21, P.O. Box 196, 9700 AD Groningen, The Netherlands;
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83
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Fan Y, Shu X, Leung KCM, Lo ECM. Associations of general health conditions with masticatory performance and maximum bite force in older adults: A systematic review of cross-sectional studies. J Dent 2022; 123:104186. [PMID: 35691453 DOI: 10.1016/j.jdent.2022.104186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES To give an overview of the current evidence on the associations of general health conditions with masticatory performance and maximum bite force in older adults. DATA/SOURCES Three electronic databases (Medline via PubMed, Embase via Ovid and CINAHL Plus via EBSCOhost) were searched up to September 2021 for cross-sectional studies on general health conditions and masticatory performance or maximum bite force in older adults. Methodological quality of the included studies was independently evaluated based on Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies. Data on the associations between general health conditions and masticatory performance or maximum bite force were extracted. STUDY SELECTION Of the 5133 records identified, 39 studies (43 articles) were included in this review. Significant negative associations were found between masticatory performance and stroke, sarcopenia, amyotrophic lateral sclerosis, chronic obstructive pulmonary disease, dyspepsia, dysphagia, anorexia, and carotid atherosclerosis. Significant negative association was found between maximum bite force and sarcopenia. There were equivocal results on the association between masticatory performance and diabetes mellitus, and between maximum bite force and stroke, and amyotrophic lateral sclerosis. There was no significant association between masticatory performance and metabolic syndrome, and between maximum bite force and progress of Parkinson's disease. Most studies revealed positive associations of physical function with masticatory performance and maximum bite force. CONCLUSIONS Negative associations between masticatory function of older adults and presence of several systemic diseases have been reported in a number of studies while there are positive associations between masticatory function and some physical function indicators. CLINICAL SIGNIFICANCE This study provides valuable information on the association of masticatory function with general health, which draws clinicians' attention to the masticatory function of older adults who suffer from certain systemic diseases or physical dysfunction, and to the need to improve their masticatory ability to achieve healthy aging.
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Affiliation(s)
- Yanpin Fan
- Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Xin Shu
- Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Katherine Chiu Man Leung
- Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Edward Chin Man Lo
- Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong.
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84
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Lyu W, Tanaka T, Son BK, Akishita M, Iijima K. Associations of multi-faceted factors and their combinations with frailty in Japanese community-dwelling older adults: Kashiwa Cohort Study. Arch Gerontol Geriatr 2022; 102:104734. [DOI: 10.1016/j.archger.2022.104734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 04/29/2022] [Accepted: 05/11/2022] [Indexed: 12/31/2022]
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85
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Kim H, Lee E, Lee SW. Association between oral health and frailty: results from the Korea National Health and Nutrition Examination Survey. BMC Geriatr 2022; 22:369. [PMID: 35477396 PMCID: PMC9044774 DOI: 10.1186/s12877-022-02968-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Previous research has suggested that poor oral health is positively associated with frailty. The objective of this study was to explore associations of key oral diseases (periodontal disease, tooth loss), and oral hygiene and management behaviors with the level of frailty in community-dwelling older Korean adults using national representative survey data. Methods This study used cross-sectional, 6th and 7th Korea National Health and Nutrition Examination Survey (KNHANES VI, VII) data. Adults aged 50+ years were included. Frailty was measured using frailty phenotype (FP) and frailty index (FI). FP was determined using five frailty criteria, i.e., weight loss, weakness, exhaustion, slowness, or low physical activity, and the level of frailty was classified with the number of criteria present (robust, none; pre-frail, 1–2; frail, 3+). FI was determined using a 44-item FI constructed according to a standard protocol, and the level of frailty was classified as robust (FI: ≤ 0.08), pre-frail (FI: 0.08–0.25), and frail (FI: ≥ 0.25). Multiple ordinal regression analyses were conducted with each type of frailty as the outcome variable. Independent variables of interest were the periodontal status, number of teeth, and practices on oral hygiene and management. Analyses were additionally adjusted for participants’ socioeconomic, diet, and behavioral characteristics. Results The prevalence of frailty was 4.38% according to the FP classification (n = 4156), 10.74% according to the FI classification (n = 15,073). In the final adjusted model, having more teeth and brushing after all three meals were significantly associated with lower odds of being more frail (in both frailty models); no significant association was observed between periodontal disease and frailty. Conclusions Findings from this study show having more teeth and practicing adequate brushing are significantly associated with frailty. Due to limitations of the study design, well-designed longitudinal studies are needed to confirm these findings. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02968-x.
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Affiliation(s)
- Hyunjoo Kim
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - Euni Lee
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.
| | - Seok-Woo Lee
- Department of Dental Education and Periodontology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, 61186, Republic of Korea.
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Xerostomia as a key predictor of physical frailty among community-dwelling older adults in Japan: a five-year prospective cohort study from The Otassha Study. Arch Gerontol Geriatr 2022; 99:104608. [DOI: 10.1016/j.archger.2021.104608] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/21/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022]
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87
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Dai M, Yue J, Zhang J, Wang H, Wu C. Functional dentition is a modifier of the association between vitamin D and the frailty index among Chinese older adults: a population-based longitudinal study. BMC Geriatr 2022; 22:159. [PMID: 35220949 PMCID: PMC8883641 DOI: 10.1186/s12877-022-02857-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Backgrounds
Although vitamin D and dentition status are each associated with frailty, their combined effects on frailty have not been studied. This study aimed to evaluate the combined effects of vitamin D and dentition status on frailty in old Chinese adults.
Methods
Baseline data were obtained from the 2011–2012 wave of the Chinese Longitudinal Healthy Longevity Survey. A total of 1074 participants ≥65 years who were non-frail or prefrail at baseline were included; follow-up was conducted in the 2014 wave. Frailty was assessed by a 40-item frailty index (FI) and classified into frail (FI > 0.21), prefrail (FI: 0.1–0.21), and non-frail (FI ≤0.1). Vitamin D was assessed by 25-Hydroxyvitamin D (25(OH)D) and categorized into quartiles and dichotomies (normal: ≥50 nmol/L vs. low: < 50 nmol/L). The presence of ≥20 natural teeth was defined as functional dentition, otherwise as non-functional dentition. We used bivariate logistic regression and restricted cubic splines to examine the association between vitamin D, dentition status, and frailty. We created a multiplicative interaction between vitamin D and dentition status to test for their combined effect.
Results
A total of 205 (19.1%) incident frailty were identified during the 3-year follow-up. Participants with the lowest quartile of plasma 25(OH) D were more likely to be frail (odds ratio [OR] 2.45, 95% confidence interval [CI]: 1.38 to 4.35) than those in the highest quartile. Older adults with the lowest quartile of 25(OH) D and non-functional dentition had the highest odds of frailty (OR = 3.67, 95% CI: 1.02 to 13.12). We also observed that a lower vitamin D level was associated with an increased risk of frailty with a threshold of 40.37 nmol/L using restricted cubic spline models. However, vitamin D levels were not significantly associated with frailty among participants with functional dentition.
Conclusions
Low vitamin D levels were associated with an increased risk of frailty in older adults. Functional dentition modified the association of vitamin D with frailty.
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88
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Oral Factors as Predictors of Frailty in Community-Dwelling Older People: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031145. [PMID: 35162167 PMCID: PMC8834726 DOI: 10.3390/ijerph19031145] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this prospective cohort study was to identify predictors for frailty among possible oral factors in community-dwelling older people. Ninety-seven participants (≥60 years old) without frailty at baseline were included and assigned to either the robust or the frailty group after 2-year follow-up. The frailty was defined using the Japan Cardiovascular Health Study index. The numbers of present and functional teeth and periodontal disease severity were recorded. Bacterial counts on the dorsum of the tongue, oral moisture, tongue pressure, occlusal force, masticatory ability, and the oral diadochokinesis (ODK) rate were measured. Swallowing function, along with psychosocial status, relationships with communities and people, nutritional status, medical history, and comorbidities were evaluated using a questionnaire. The newly identified frailty group at follow-up showed significantly lower values in the number of teeth present, ODK/ta/sound and ODK/ka/sound rates, and clinical attachment level at baseline compared to the robust group. A logistic regression model showed a significantly negative association between the ODK/ta/sound rate at baseline and the incidence of frailty. Articulatory oral motor skill was found to be a predictor of frailty after two years.
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van der Heijden EM, Klüter WJ, van der Maarel-Wierink CD, Gobbens RJJ. Exploring associations between multidimensional frailty and oral health in community-dwelling older people. A pilot study. SPECIAL CARE IN DENTISTRY 2022; 42:361-368. [PMID: 35014046 PMCID: PMC9545350 DOI: 10.1111/scd.12691] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 12/02/2022]
Abstract
Objective To determine the associations between four validated multidimensional self‐report frailty scales and nine indices of oral health in community‐dwelling older persons. Materials and Methods This pilot study was conducted in a sample of 208 older persons aged 70 years and older who visited two dental practices in the Netherlands. Frailty status was measured by four different self‐report frailty questionnaires: Tilburg Frailty Indicator (TFI), Groningen Frailty Indicator (GFI), Sunfrail Checklist (SC), and the Sherbrooke Postal Questionnaire (SPQ). Oral health was assessed by two calibrated examiners. Results The prevalence of frailty according to the four frailty measures TFI, GFI, SC, and SPQ was 32.8%, 31.5%, 24.5%, and 49.7%, respectively. The SC correlated with four oral health variables (DMFT, number of teeth, percentage of occlusal contacts, Plaque Index), the TFI with three (number of teeth, percentage of occlusal contacts, Plaque Index), the GFI only with DPSI, and the SPQ with the number of teeth and the number of occlusal contacts. Conclusion Of the studied multidimensional frailty scales, the SC and TFI were correlated with most oral health variables (four and three, respectively). However, it should be noticed that these correlations were small. Clinical relevance The SC and TFI might help to identify older people with risk of poor oral health so that preventive care can be used to ensure deterioration of oral health and maintenance of quality of life. Vice versa early detection of frailty by oral care professionals could contribute to interprofessional management of frailty.
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Affiliation(s)
| | - Wim J Klüter
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,College of Dental Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Claar D van der Maarel-Wierink
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Robbert J J Gobbens
- BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Nijmegen, Netherlands.,Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, Netherlands.,Zonnehuisgroep Amstelland, Amstelveen, Netherlands.,Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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90
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Salivary IL-6 Concentration Is Associated with Frailty Syndrome in Older Individuals. Diagnostics (Basel) 2022; 12:diagnostics12010117. [PMID: 35054284 PMCID: PMC8775035 DOI: 10.3390/diagnostics12010117] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/29/2021] [Accepted: 12/31/2021] [Indexed: 01/15/2023] Open
Abstract
Background: One of the physiological changes that is most closely associated with frailty is the increase in pro-inflammatory cytokines, and IL-6 in particular. Most studies have demonstrated this association using blood samples. We analyzed the relationship between frailty syndrome, individual frailty criteria, and IL-6 levels obtained by saliva tests. Methods: A cross-sectional pilot study was performed among women institutionalized in nursing homes. Frailty was defined as having three or more of the following components: low lean mass, weakness, self-reported exhaustion, low activity level, and slow walking speed; prefrailty was defined as having one or two of those components. Results: There was a significant and positive correlation between the frailty score and salivary IL-6 concentration. Regarding the associations between IL-6 and individual dichotomized frailty criteria, there were significant differences in salivary IL-6 concentration in two frailty criteria: weight loss (p = 0.002) and low physical activity (p = 0.007). Receiver operating characteristic curve analysis showed that IL-6 concentration significantly (p < 0.05) (although moderately) discriminated patients that progressed in the frailty syndrome (the area under the curve value was 0.697 with 95% CI 0.566–0.827). Conclusions: Salivary IL-6 concentration can be used as potential biomarker of frailty syndrome and as a tool to monitor the effects of interventions in frail individuals.
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Diaz-Toro F, Petermann-Rocha F, Parra-Soto S, Troncoso-Pantoja C, Concha-Cisternas Y, Lanuza F, Dreyer Arroyo E, Celis A, Celis-Morales C. Association between Poor Oral Health and Frailty in Middle-Aged and Older Individuals: A Cross-Sectional National Study. J Nutr Health Aging 2022; 26:987-993. [PMID: 36437766 DOI: 10.1007/s12603-022-1858-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Older adults with poor oral health may be at higher risk of being pre-frail or frail. However, very few studies have examined this association in Latin American countries and middle-aged individuals. Therefore, we aimed to investigate the association between oral health and frailty status among Chilean adults ≥40 years. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS We included 3,036 participants ≥40 years from the Chilean National Health Survey 2016-2017. METHODS Frailty status was assessed with a 49-item frailty index, while the number of teeth, self-reported oral health, tooth decay, use of prostheses, and oral pain were the oral health conditions included. To assess the association between oral health conditions and frailty, we used multinomial logistic regression models status adjusted for sociodemographic and lifestyle variables. RESULTS Overall, 40.6% and 11.8% of individuals were classified as pre-frail and frail, respectively. After adjusting for confounders, individuals with ≤20 teeth had a higher likelihood of being frail (odds ratio (OR): 1.94 [95% CI: 1.18-3.20]) than people with >20 teeth. Moreover, people with bad or very bad oral health, as well as oral pain, had a higher likelihood of being pre-frail (OR: 2.04 [95% CI: 1.40-2.97] and OR: 2.92 [95% CI: 1.58-5.39], respectively). Middle-aged individuals with fewer teeth and poor self-reported oral health had a higher likelihood of being pre-frail and frail than people ≥60. CONCLUSIONS AND IMPLICATIONS Individuals with poor global oral health were more likely to be pre-frail or frail. This association seems to be stronger in people <60 years old. Our results are consistent with previously published reports.
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Affiliation(s)
- F Diaz-Toro
- Fanny Petermann-Rocha, PhD, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile, , Phone: +56 2 26768968
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Arenas-Márquez MJ, Tôrres LHDN, Borim FSA, Yassuda MS, Neri AL, Sousa MDLRD. Perda de função mastigatória e risco de fragilidade em idosos vivendo em domicílios familiares no Estado de São Paulo. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2022. [DOI: 10.1590/1981-22562022025.210234.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Verificar se a perda de função mastigatória aumenta o risco de fragilidade em idosos vivendo em domicílios familiares no Estado de São Paulo. Métodos Foi adotado um delineamento de coorte prospectivo sobre a base de dados do estudo FIBRA (Fragilidade em Idosos Brasileiros), com linha de base realizada em 2008-2009 e seguimento em 2016-2018, transcorrendo em média 100,2 ± 9,2 meses. A variável desfecho foi a incidência de fragilidade, a variável de exposição foi a função mastigatória conforme a condição de edentulismo e autorrelato de dificuldade mastigatória. As variáveis de ajuste foram condições sociodemográficas, comportamentais e de saúde geral. Foi utilizado um modelo de regressão de Poisson, com variância robusta, estimando o risco relativo Resultados a incidência acumulada de fragilidade aos oito anos em média foi de 30 casos a cada 100 participantes edêntulos com dificuldade mastigatória, que apresentaram maior risco de desenvolver fragilidade (RR:1,75 IC 95% 1,09-2,81) do que os idosos dentados sem dificuldade mastigatória, independentemente de tabagismo (RR: 1,71 IC 95% 1,07-2,73) e de condição socioeconômica (RR: 1,72 IC 95% 1,13-2,62). Conclusão A perda de função mastigatória aumentou o risco de fragilidade em idosos.Futuras pesquisas deverão estudar se a reabilitação da função mastigatória contribui para diminuir esse risco.
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Arenas-Márquez MJ, Tôrres LHDN, Borim FSA, Yassuda MS, Neri AL, Sousa MDLRD. Masticatory function loss and frailty risk in community-dwelling older people in the State of São Paulo. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2022. [DOI: 10.1590/1981-22562022025.210234.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective To verify if the loss of masticatory function increases the risk of frailty in community-dwelling older people in the state of São Paulo. Methods A prospective cohort design was adopted based on the FIBRA study database (Fragility in Brazilian Elderly), with a baseline performed in 2008-2009 and follow-up in 2016-2018, elapsed on average 100.2 ± 9.2 months. The outcome variable was the incidence of frailty. The exposure variable was masticatory function according to edentulism and self-reported chewing difficulty. Adjustment variables were sociodemographic, behavioral, and general health conditions. A Poisson regression model with robust variance was used to estimate the relative risk. Results the cumulative incidence of frailty over eight years was 30 cases per 100 edentulous participants with chewing difficulties, who had a higher risk of developing frailty (RR: 1.75 95% CI 1.09-2.81) than the dentate elderly without chewing difficulties, regardless of smoking (RR: 1.71 95% CI 1.07-2.73) and socioeconomic status (RR: 1.72 95% CI 1.13-2.62) Conclusion Loss of masticatory function increases the risk of frailty in older people. Future research should study whether the rehabilitation of oral function reduces this risk.
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MORALES A, MUÑOZ G, CORRAL C, ESPINOZA I, FUENTES AD, CAVALLA F, BAEZA M, JARA G, GIACAMAN RA, SUAZO C, BEVENSEE I, GAMONAL J. Developing a protocol for a preventive oral health exam for elderly people (EDePAM) using E-Delphi methodology. Braz Oral Res 2022; 36:e013. [DOI: 10.1590/1807-3107bor-2022.vol36.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 06/06/2021] [Indexed: 11/22/2022] Open
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An R, Li S, Li Q, Luo Y, Wu Z, Liu M, Chen W. Oral Health Behaviors and Oral Health-Related Quality of Life Among Dental Patients in China: A Cross-Sectional Study. Patient Prefer Adherence 2022; 16:3045-3058. [PMID: 36387048 PMCID: PMC9651070 DOI: 10.2147/ppa.s385386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND PURPOSE Oral health plays an important role in overall health. But little is known about the problems with oral health behaviors and oral health-related quality of life (OHRQoL) among dental patients in China. This study aimed to investigate oral health behaviors and OHRQoL, as well as to examine the effects of oral health behaviors and associated factors on OHRQoL among dental patients. METHODS This cross-sectional study was conducted from June 2022 to July 2022 in the Department of Stomatology of the First Mobile General Hospital of Armed Police, Hebei, China. The five-item short form of the Oral Health Impact Profile (OHIP-5) was used to evaluate OHRQoL. Oral health behaviors were assessed by a 16-items oral health behavior questionnaire, and socio-demographic data were collected by a socio-demographic questionnaire. The t-test, one-way ANOVA, and multiple linear regression analysis were used to investigate the associations between the study variables. RESULTS 186 participants were included in the study. The average age of the participants was 24.62 years (SD = 10.67). The mean OHIP-5 score was 4.31 (SD =3.35). Oral health-related quality of life differed significantly by smoking history, history of alcohol consumption, work status, economic pressure, self-rated oral health status, daily brushing frequency, dental caries condition, and whether they take the initiative to learn about oral health. Multivariate analysis found that the self-rated oral health status and work status were significantly associated with the OHIP scores. The retired people and those with poor self-rated oral health displayed poor OHRQoL. CONCLUSION In general, dental patients' oral health needs to be improved, the majority of patients reported practicing poor oral health behaviors, among which the retired population and hose with poor self-rated oral health showed poor OHRQoL. OHRQoL in dental patients is a complex issue associated with social and behavioral factors.
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Affiliation(s)
- Ran An
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Siyu Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China
| | - Qianqian Li
- The First Mobile Corps Hospital of the Chinese People’s Armed Police Force, Baoding, Hebei Province, People’s Republic of China
| | - Yuan Luo
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Zitong Wu
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Meizi Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Wenfeng Chen
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University
- Correspondence: Wenfeng Chen, Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University, No. 87 Xiangya Road, Kaifu District, 410008, Email
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Chen Y, Luo Z, Sun Y, Zhou Y, Han Z, Yang X, Kang X, Lin J, Qi B, Lin WW, Guo H, Guo C, Go K, Sun C, Li X, Chen J, Chen S. The effect of denture-wearing on physical activity is associated with cognitive impairment in the elderly: A cross-sectional study based on the CHARLS database. Front Neurosci 2022; 16:925398. [PMID: 36051648 PMCID: PMC9425833 DOI: 10.3389/fnins.2022.925398] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/18/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Currently, only a few studies have examined the link between dental health, cognitive impairment, and physical activity. The current study examined the relationship between denture use and physical activity in elderly patients with different cognitive abilities. METHODS The study data was sourced from the 2018 China Health and Retirement Longitudinal Study (CHARLS) database, which included information on denture use and amount of daily physical activity undertaken by older persons. Physical activity was categorized into three levels using the International Physical Activity General Questionnaire and the International Physical Activity Scale (IPAQ) rubric. The relationship between denture use and physical activity in middle-aged and older persons with varying degrees of cognitive functioning was studied using logistic regression models. RESULTS A total of 5,892 older people with varying cognitive abilities were included. Denture use was linked to physical activity in the cognitively healthy 60 + age group (p = 0.004). Denture use was positively related with moderate physical activity in the population (odds ratio, OR: 1.336, 95% confidence interval: 1.173-1.520, p < 0.001), according to a multivariate logistic regression analysis, a finding that was supported by the calibration curve. Furthermore, the moderate physical activity group was more likely to wear dentures than the mild physical activity group among age-adjusted cognitively unimpaired middle-aged and older persons (OR: 1.213, 95% CI: 1.053-1.397, p < 0.01). In a fully adjusted logistic regression model, moderate physical activity population had increased ORs of 1.163 (95% CI: 1.008-1.341, p < 0.05) of dentures and vigorous physical activity population had not increased ORs of 1.016 (95% CI: 0.853-1.210, p > 0.05), compared with mild physical activity population. CONCLUSION This findings revealed that wearing dentures affects physical activity differently in older persons with different cognitive conditions. In cognitively unimpaired older adults, wearing dentures was associated with an active and appropriate physical activity status.
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Affiliation(s)
- Yisheng Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhiwen Luo
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yaying Sun
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yifan Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Ophthalmology, Putuo People’s Hospital, Tongji University, Shanghai, China
| | - Zhihua Han
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaojie Yang
- Department of Stomatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xueran Kang
- Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jinrong Lin
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Beijie Qi
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Wei-Wei Lin
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Haoran Guo
- Chinese PLA Medical School, Beijing, China
| | - Chenyang Guo
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ken Go
- St. Marianna Hospital, Tokyo, Japan
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, Chicago, IL, United States
| | - Xiubin Li
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Shanghai, China
- Xiubin Li,
| | - Jiwu Chen
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Jiwu Chen,
| | - Shiyi Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Shiyi Chen,
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Zhang XM, Wu X, Chen W. The Association between Number of Teeth and Cognitive Frailty in Older Adults: A Cross-Sectional Study. J Nutr Health Aging 2022; 26:430-438. [PMID: 35587754 DOI: 10.1007/s12603-022-1783-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to explore the association between number of teeth and cognitive frailty in American older adults. DESIGN Cross-sectional study. SETTING Community. PARTICIPANTS The participants were 1,531 community-dwelling older adults aged 60 or older from the NHANES database. METHODS Frailty was assessed using a 49-item frailty index, with a cut-off value for frailty of more than 0.21. Cognitive dysfunction was evaluated by the Digit-Symbol Coding Test (DSCT), with the cut-off being below the lowest interquartile range (scores ≤37). Cognitive frailty was defined as participants who suffered from both frailty and cognitive dysfunction. Oral health indicators included number of teeth and other factors, such as the presence of gum disease, daily use of dental floss, daily use of mouthwash and self-rated oral health. Multivariable logistic regression models were used to explore the relationship between number of teeth and cognitive frailty. RESULTS The mean age of the total sample was 69.67 (SD=6.60) years, and 52.71% (n=807) were female. Our study suggests there was a negative association between number of teeth and cognitive frailty (OR =0.98,95%CI:0.96-0.99, P=0.044) after controlling for potential confounding factors. In addition, older adults with 20 or more teeth had lower odds of being cognitively frail (OR=0.66,95%CI:0.44-0.99, P=0.046) than individuals who had less than 20 teeth. CONCLUSION This study suggests that older adults who have more teeth are associated with a lower risk of cognitive frailty. This finding highlights the importance of maintaining as many teeth as possible throughout life and into old age. Cohort studies will be required in the future to determine this relationship.
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Affiliation(s)
- X-M Zhang
- Xinjuan Wu and Wei Chen, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital (Dongdan campus), Beijing, 100730, China, Xinjuan Wu: ; Wei Chen:
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Kim SH, Che X, Park HJ, Kim TI. Hopeless tooth and less posterior occlusion is related to a greater risk of low handgrip strength: A population-based cross-sectional study. PLoS One 2021; 16:e0260927. [PMID: 34941935 PMCID: PMC8700057 DOI: 10.1371/journal.pone.0260927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 11/21/2021] [Indexed: 12/15/2022] Open
Abstract
The effect of severely compromised teeth on masticatory function has not been properly evaluated in previous studies, as they were often considered equivalent to the healthy tooth or excluded as if absent in the dentition. Hopeless teeth, which refer to non-salvageable teeth that require extraction, can interfere with masticatory function. As posterior occlusion is directly related to the masticatory function, we evaluated pairs opposing posterior teeth (POPs) that reflect the arrangement as well as the number of remaining posterior teeth. This study investigated the relationship of a hopeless tooth to handgrip strength according to POPs in the elderly. This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey (KNHANES). Among the data of 23,466 participants from 2015 to 2018, participants aged 60 years or older (n = 4,729) were included. In males with POPs scores of 0-7, considered poor posterior occlusion, the association with low handgrip strength persisted in the multivariate logistic regression model adjusted for all confounding variables. The odds ratio (OR) in the absence of hopeless teeth (OR = 1.91, 95% CI: 1.02-3.59) increased in the presence of a hopeless tooth (OR = 2.78, 95% CI: 1.42-5.47). Even with POPs scores of 8-11, considered good posterior occlusion, the association was significantly high in the presence of a hopeless tooth (OR = 2.82, 95% CI: 1.06-7.52). In females, the association disappeared in adjusted models. The fewer pairs of natural posterior teeth with occlusion, the greater the risk of low handgrip strength. Dentition containing hopeless teeth increases the risk of low handgrip strength, even in dentition with sufficient posterior occlusion. Preserving the posterior teeth in a healthy condition through personal oral hygiene and regular dental management is essential for maintaining components of physical function such as handgrip strength.
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Affiliation(s)
- Sul-Hee Kim
- Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Xianhua Che
- Department of Health Policy Research, Daejeon Public Health Policy Institute, Daejeon, Korea
| | - Hee-Jung Park
- Department of Dental Hygiene, Kangwon National University, Samcheok, Korea
- * E-mail: (T-IK); (H-JP)
| | - Tae-Il Kim
- Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
- * E-mail: (T-IK); (H-JP)
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Bastos RS, Sá LM, Velasco SRM, Teixeira DF, Paino LS, Vettore MV. Frailty and oral health-related quality of life in community-dwelling older adults: a cross-sectional study. Braz Oral Res 2021; 35:e139. [PMID: 34932668 DOI: 10.1590/1807-3107bor-2021.vol35.0139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 07/14/2021] [Indexed: 12/26/2022] Open
Abstract
Poor oral health has been associated with frailty among older adults. However, limited evidence has been available on whether frailty can affect oral health-related quality of life (OHRQoL) in older adults. This study aimed to investigate the relationship between frailty and OHRQoL among community-dwelling older adults. A household-based cross-sectional study involving community-dwelling older adults aged 65 years and older was conducted in the city of Bauru, Brazil. Data on frailty status, sociodemographic characteristics, self-perceived dental care needs, and OHRQoL (OHIP-14) were collected through individual interviews. The use of and the need for total dental prostheses were assessed through clinical examinations. Logistic regression was used to determine whether frailty status and covariates were associated with OHRQoL prevalence measures (OHIP-14 total score ≥ 1 and OHIP-14 fairly/very often ≥ 1). The sample comprised 334 participants, among whom 58.7% and 41.3% were between 65-74 and 75-102 years old, respectively. The prevalence of moderate to severe frailty was 12.3%. Moderate to severe frailty (OR = 4.49; 95%CI 1.29-15.66), the need for lower dental prosthesis (OR = 2.20; 95%CI 1.27-3.81), and self-perceived dental care need (OR = 3.90; 95%CI 2.14-7.14) were associated with OHIP-14 total score ≥1. Moderate to severe frailty (OR = 2.95; 95%CI 1.33-6.55), being female (OR = 2.24; 95%CI 1.34-3.75), and self-perceived dental care need (OR = 4.80; 95%CI 2.86-8.03) were associated with OHIP-14 fairly/very often ≥1. Overall, our results showed that moderate to severe frailty was significantly associated with poor OHRQoL in community-dwelling older adults.
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Affiliation(s)
- Roosevelt Silva Bastos
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatrics Dentistry, Orthodontics and Public Health, Bauru, SP, Brazil
| | - Leticia Marques Sá
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatrics Dentistry, Orthodontics and Public Health, Bauru, SP, Brazil
| | | | - Debora Foger Teixeira
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Stomatology, Bauru, SP, Brazil
| | | | - Mario Vianna Vettore
- University of Agder - UiA, Department of Health and Nursing Sciences, Agder, Norway
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100
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Oral Assessment and Preventive Actions within the Swedish Quality Register Senior Alert: Impact on Frail Older Adults' Oral Health in a Longitudinal Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413075. [PMID: 34948684 PMCID: PMC8701784 DOI: 10.3390/ijerph182413075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 12/24/2022]
Abstract
Poor oral health is common among older people in nursing homes. To identify and prevent oral health problems among the residents, ROAG-J (Revised Oral Assessment Guide–Jönköping), a risk-assessment instrument, is used by nursing staff routinely, and the outcome is registered in the web-based Swedish quality register Senior Alert. This study aims to investigate the preventive actions registered when oral health problems are identified and the effect of these actions longitudinally. ROAG-J data registered at nursing homes in Sweden during 2011–2016 were obtained from the Senior Alert database. Out of 52,740 residents (≥65 years), 41% had oral health problems, of whom 62% had preventive actions registered. The most common action was “Assistance with cleaning teeth”. Longitudinally, during the five-year observation period, a slight increase in oral health problems assessed with ROAG-J was found. Registered preventive actions, however, led to significant improvement in the subsequent assessment for the ROAG items lips, tongue, and dentures. Standardised risk assessments like ROAG-J provide an opportunity to detect problems early and establish preventive actions. The study, however, indicates a further need for structured education and a continuous follow-up in ROAG-J. Moreover, increased collaboration between nursing and dental care to improve oral health for older residents at nursing homes is needed.
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