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Xin T, Hu F, Xu L, Kong F, Yang H, Li L, Qin A, Bao B, Chen C, Lan J. Association and mediators between the impact of oral health-related quality of life and depression. Oral Dis 2024; 30:4001-4010. [PMID: 38071189 DOI: 10.1111/odi.14832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/27/2023] [Accepted: 11/24/2023] [Indexed: 09/03/2024]
Abstract
OBJECTIVES Our research intended to explore the association and mediators (perceived social support and sleep quality) between the impact of oral health-related quality of life (OHRQoL) and depression among Chinese older adults. METHODS A stratified, multi-stage random sampling approach was used in our study. A total of 3896 older individuals aged 60 years and older were included. Process macro 3.5 for SPSS was utilized for testing mediation hypotheses. RESULTS The mean score of the OHRQoL of the elderly was 3.26 ± 7.15. The correlation coefficient between OHRQoL and depression was 0.25 (p < 0.001). Perceived social support (β = 0.009, 95% CI = 0.006, 0.012) and sleep quality (β = 0.073, 95% CI = 0.074, 0.093) mediated the relationship between OHRQoL and depression, respectively. The association between OHRQoL and depression was mediated sequentially by perceived social support and sleep quality (β = 0.004, 95% CI = 0.002, 0.006). CONCLUSIONS The participants reported relatively good OHRQoL. OHRQoL and depression showed a significant positive correlation. The relationship between OHRQoL and depression among Chinese seniors was mediated by perceived social support and sleep quality. Both directly and indirectly, OHRQoL can affect depression.
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Affiliation(s)
- Tianjiao Xin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Fangfang Hu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Haifeng Yang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Lei Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Afei Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Binghong Bao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Chiqi Chen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jing Lan
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, Shandong, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
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Qi X, Zhu Z, Wang K, Zheng Y, Li A, Wu B. Association of Gum Treatment with Cognitive Decline and Dementia Risk among Older Adults with Periodontal Symptoms: A 12-Year Prospective Cohort Study. Neuroepidemiology 2024:1-10. [PMID: 39053434 DOI: 10.1159/000540086] [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: 03/14/2024] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION This study examines the associations of gum treatment with cognitive decline and dementia risk among older adults with periodontal symptoms in the USA. METHODS A cohort of 866 adults aged ≥50 with periodontal symptoms was recruited for the 2008 Health and Retirement Study "Dental Health Experimental Module" and followed until 2020. Cognitive function was assessed with the Telephone Interview for Cognitive Status (TICS). Dementia status was ascertained with the Langa-Weir algorithm based on TICS scores and proxy assessments. Linear mixed-effects model and multivariable Cox regression models were utilized to analyze the associations of gum treatment with cognitive decline and the risk of dementia, respectively. RESULTS Of 866 participants (mean age 67.7, 61.4% women), 105 (12.1%) developed dementia with a median follow-up of 9 (IQR, 6-10) years. The dementia incidence rates were lower in the group with gum treatment (7.4 vs. 12.9 per 1,000 person-years). Compared with participants who did not have gum treatment, those with gum treatment experienced a decline in TICS score that was on average 0.025 (95% CI, 0.005-0.044) points less per year and a 38% lower incidence of dementia (hazard ratio, 0.62; 95% CI, 0.41-0.93). These associations were consistent across participants with a different severity of periodontal symptoms and sociodemographic characteristics (age, sex, race, ethnicity, and education) except for income levels. CONCLUSION Prompt gum treatment for older adults with periodontal symptoms may be beneficial for their cognitive health.
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Affiliation(s)
- Xiang Qi
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Zheng Zhu
- Rory Meyers College of Nursing, New York University, New York, New York, USA
- School of Nursing, Fudan University, Shanghai, China
| | - Katherine Wang
- Trinity College of Arts and Sciences, Duke University, Durham, North Carolina, USA
| | - Yaguang Zheng
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - An Li
- Department of Periodontology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York, USA
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Plas X, Bruinsma B, van Lissa CJ, Vermetten E, van Lutterveld R, Geuze E. Long-term trajectories of depressive symptoms in deployed military personnel: A 10-year prospective study. J Affect Disord 2024; 354:702-711. [PMID: 38537760 DOI: 10.1016/j.jad.2024.03.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/07/2024] [Accepted: 03/24/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Military missions, especially those involving combat exposure, are associated with an increased risk of depression. Understanding the long-term course of depressive symptoms post-deployment is important to improve decision-making regarding deployment and mental health policies in the military. This study investigates trajectories of depressive symptoms in the Dutch army, exploring the influence of factors such as demographics, early-life trauma, posttraumatic stress disorder (PTSD) symptoms, and deployment stressors. METHODS A cohort of 1032 military men and women deployed to Afghanistan (2005-2008) was studied from pre- to 10 years post-deployment. Depressive and PTSD symptoms were assessed using the Symptom CheckList-90 and the Self-Rating Inventory for PTSD. Demographics, early trauma, and deployment experiences were collected at baseline and after deployment, respectively. Latent Class Growth Analysis was used to explore heterogeneity in trajectories of depressive symptoms over time. RESULTS Four trajectories were found: resilient (65%), intermediate-stable (20%), symptomatic-chronic (9%), and late-onset-increasing (6%). The resilient group experienced fewer deployment stressors, while the symptomatic-chronic group reported more early life traumas. Trajectories with elevated depressive symptoms consistently demonstrated higher PTSD symptoms. LIMITATIONS Potential nonresponse bias and missing information due to the longitudinal design and extensive follow-up times. CONCLUSIONS This study identified multiple trajectories of depressive symptoms in military personnel up to 10 years post-deployment, associated with early trauma, deployment stressors, adverse life events and PTSD symptoms. The prevalence of the resilient trajectory suggests a substantial level of resilience among deployed military personnel. These findings provide valuable insights and a foundation for further research.
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Affiliation(s)
- Xandra Plas
- Department of Psychiatry, University Medical Centre Utrecht Brain Centre, Utrecht, the Netherlands; Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands.
| | - Bastiaan Bruinsma
- Department of Psychiatry, University Medical Centre Utrecht Brain Centre, Utrecht, the Netherlands; Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
| | - Caspar J van Lissa
- Department of Methodology and Statistics, Tilburg University, Tilburg, the Netherlands
| | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Centre, Leiden, the Netherlands
| | - Remko van Lutterveld
- Department of Psychiatry, University Medical Centre Utrecht Brain Centre, Utrecht, the Netherlands; Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
| | - Elbert Geuze
- Department of Psychiatry, University Medical Centre Utrecht Brain Centre, Utrecht, the Netherlands; Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
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Zhao Y, Liu Q, Chen Y, Kwok TCY, Leung JCS, Feng H, Wong SYS. Trajectories of depressive symptom and its association with air pollution: evidence from the Mr. OS and Ms. OS Hong Kong cohort study. BMC Geriatr 2024; 24:318. [PMID: 38580934 PMCID: PMC10996234 DOI: 10.1186/s12877-024-04731-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 01/19/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Depression is a global health priority. Maintaining and delaying depressive symptoms in older adults is a key to healthy aging. This study aimed to identify depressive symptom trajectories, predictors and mortality, while also exploring the relationship between air quality and depressive symptoms in older adults in the Hong Kong community over 14 years. METHODS This study is a longitudinal study in Hong Kong. The target population was community-dwelling older adults over age 65. Depressive symptoms were measured by the Geriatric Depression Scale (GDS-15). Group-based trajectory model was used to identify heterogeneity in longitudinal changes over 14 years and examine the associations between baseline variables and trajectories for different cohort members using multinomial logistic regression. The Kaplan-Meier method was employed to conduct survival analysis and explore the variations in survival probabilities over time among different trajectory group. Linear mixed model was used to explore the relationship between air quality and depressive symptoms. RESULTS A total of 2828 older adults were included. Three different trajectories of depressive symptoms in older people were identified: relatively stable (15.4%), late increase (67.1%) and increase (17.5%). Female, more number of chronic diseases, poor cognitive function, and poor health-related quality of life (HRQOL) were significantly associated with other less favorable trajectories compared with participants with stable levels of depressive symptoms. The late increase group had a lower mortality rate than the relatively stable and increased groups. Lower baseline ambient air pollutant exposure to NO2 over 14 years was significantly associated with fewer depressive symptoms. CONCLUSIONS In this study, we found that a late increase in depressive symptoms was the predominant trend in older Chinese people in Hong Kong. Poorer HRQOL was predictive of less favorable trajectories of depressive symptoms. Ambient air pollution was associated with depressive symptoms. This novel observation strengthens the epidemiological evidence of longitudinal changes in depressive symptoms and associations with late-life exposure to air pollution.
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Affiliation(s)
- Yinan Zhao
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Qingcai Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Yifei Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Timothy C Y Kwok
- Department of Medicine & Therapeutics, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China.
| | - Jason C S Leung
- Department of Medicine & Therapeutics, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China.
- Xiangya-Oceanwide Health Management Research Institute, Central South University, Changsha, Hunan Province, China.
| | - Samuel Yeung Shan Wong
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR, China
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Lee S, Kang M, Lee J, Lee HJ. Long-term effects of childhood difficulties on depressive symptoms among older adults: Role of adulthood income and income satisfaction. Geriatr Gerontol Int 2024; 24 Suppl 1:246-252. [PMID: 38351713 DOI: 10.1111/ggi.14833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/16/2024] [Accepted: 01/29/2024] [Indexed: 03/27/2024]
Abstract
AIM This study examines how childhood difficulties are associated with late-life depression. Using the concept of agency within the structure of the life course perspective, this study investigates how subjective income satisfaction in adulthood plays a role in the relationship between adulthood objective income and late-life depressive symptoms among older adults who have experienced childhood difficulties. METHODS Using data from two waves (2006, 2021) of the Korean Welfare Panel Study (N = 1822), we identified respondents with and without childhood difficulties, and performed a series of hierarchical zero-inflated Poisson regression models. RESULTS Childhood difficulties (β, 0.07; 95% confidence interval [CI], 0.04-0.11), adulthood low income (β, 0.17; 95% CI, 0.13-0.21), and low income satisfaction (β, 0.16; 95% CI, 0.12-0.21) are associated with an increased level of depressive symptoms in late life. In the context of the association between objective income level and late-life depressive symptoms, the buffering effect of income satisfaction in adulthood was found among the respondents who had experienced childhood difficulties (β, 0.22; 95% CI, 0.09-0.34). CONCLUSIONS Childhood difficulties are a critical risk factor impacting late-life psychological well-being. How an individual subjectively evaluates his or her economic status in adulthood plays a major role in mitigating the negative impact of childhood difficulties on late-life health inequality. Interventions to reduce the risk of childhood difficulties and their negative long-lasting impact may alleviate individuals' exposure to depression in late life. Geriatr Gerontol Int 2024; 24: 246-252.
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Affiliation(s)
- Seolah Lee
- Department of Child and Family Studies, Human Life & Innovation Design, Yonsei University, Seoul, Republic of Korea
| | - Miseon Kang
- Department of Child and Family Studies, Human Life & Innovation Design, Yonsei University, Seoul, Republic of Korea
| | - Jungup Lee
- Department of Social Work, National University of Singapore, Singapore, Singapore
| | - Hyo Jung Lee
- Department of Child and Family Studies, Human Life & Innovation Design, Yonsei University, Seoul, Republic of Korea
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Zwick L, Schmitz N, Shojaa M. Oral health-related quality of life and depressive symptoms in adults: longitudinal associations of the English Longitudinal Study of Ageing (ELSA). BMC Oral Health 2023; 23:1029. [PMID: 38124069 PMCID: PMC10734100 DOI: 10.1186/s12903-023-03722-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Little is known about the relationship between oral health status and depressive symptoms in adults in England. The aim of this study was to examine the longitudinal association between oral health parameters and depressive symptoms in adults in England. METHODS Data were obtained from the English Longitudinal Study of Aging (ELSA), which included information on self-rated oral health, oral impairment in daily life (Oral Impacts on Daily Performances, OIDP), and depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D) in 6790 adults aged ≥ 50 years. Wave 3 data were used as baseline, while Waves 5 and 7 were used for follow-up assessments. Logistic regression was used to determine whether depressive symptoms at baseline anticipated self-rated oral health and OIDP and whether oral health status (at baseline) was associated with the development of depressive symptoms at follow-up assessment. RESULTS Participants with poor self-rated oral health were at higher risk of developing depressive symptoms, even after adjusting for behavioral, clinical, and sociodemographic characteristics (OR = 1.69, 95% CI 1.38-2.07). Similarly, having oral impacts on daily performances were associated with the development of depressive symptoms: The OR for developing depressive symptoms at Wave 5 or 7 was 2.19 (95% CI 1.62-2.96) after adjustment for all covariates. Participants with depressive symptoms at baseline were more likely to report poor self-rated oral health (OR = 1.93, 95% CI 1.52-2.44) or one or more oral impacts (OR = 1.86, 95% CI 1.45-2.40) at follow-up than those without depressive symptoms at baseline, even after adjusting for confounders. CONCLUSIONS In the present study, a bidirectional association was found between depressive symptoms and poor oral health in older adults. Maintaining good oral health in older adults may be a protective factor against depressive symptoms. Therefore, more attention should be paid to promoting oral health awareness in older adults, including encouraging regular dental checkups, proper toothbrushing and flossing techniques, and healthy lifestyles.
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Affiliation(s)
- Luisa Zwick
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany
| | - Norbert Schmitz
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany
| | - Mahdieh Shojaa
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany.
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Xie Y, Ma M, Wang W. Trajectories of depressive symptoms and their predictors in Chinese older population: Growth Mixture model. BMC Geriatr 2023; 23:372. [PMID: 37328803 PMCID: PMC10276362 DOI: 10.1186/s12877-023-04048-0] [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: 08/29/2022] [Accepted: 05/17/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Given the rapidly rising proportion of the older population in China and the relatively high prevalence of depressive symptoms among this population, this study aimed to identify the trajectories of depressive symptoms and the factors associated with the trajectory class to gain a better understanding of the long-term course of depressive symptoms in this population. METHODS Data were obtained from four wave's survey of the China Health and Retirement Longitudinal Study (CHARLS). A total of 3646 participants who aged 60 years or older during baseline survey, and completed all follow-ups were retained in this study. Depressive symptoms were measured using the 10-item version of the Center for Epidemiologic Studies Depression Scale (CES-D-10). Growth mixture modelling (GMM) was adopted to identify the trajectory classes of depressive symptoms, and both linear and quadratic functions were considered. A multivariate logistic regression model was used to calculate the adjusted odds ratios (ORs) of the associated factors to predict the trajectory class of participants. RESULTS A four-class quadratic function model was the best-fitting model for the trajectories of depressive symptoms in the older Chinese population. The four trajectories were labelled as increasing (16.70%), decreasing (12.31%), high and stable (7.30%), and low and stable (63.69%), according to their trends. Except for the low and stable trajectory, the other trajectories were almost above the threshold for depressive symptoms. The multivariate logistic regression model suggested that the trajectories of chronic depressive symptoms could be predicted by being female, living in a village (rural area), having a lower educational level, and having chronic diseases. CONCLUSIONS This study identified four depressive symptom trajectories in the older Chinese population and analysed the factors associated with the trajectory class. These findings can provide references for prevention and intervention to reduce the chronic course of depressive symptoms in the older Chinese population.
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Affiliation(s)
- Yaofei Xie
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
- Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, Hubei, China
| | - Mengdi Ma
- Wuhan Blood Center, Wuhan, Hubei, China.
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Marchini L, Ettinger RL. The Prevention, Diagnosis, and Treatment of Rapid Oral Health Deterioration (ROHD) among Older Adults. J Clin Med 2023; 12:jcm12072559. [PMID: 37048643 PMCID: PMC10094847 DOI: 10.3390/jcm12072559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
The world’s population is aging. Older adults are at risk for multiple chronic medical problems as they age. The management of these diseases requires these people to take a variety of medications, which may have undesired side effects. These medical issues can impact oral healthcare and result in a precipitous decline in oral health. A standardized teaching model has been developed to help novice dental practitioners learn how to access and treat oral health problems in older adults. This model is called rapid oral health deterioration (ROHD) risk assessment. The model has four steps for assessment and four categories of risk. This paper describes the components of the ROHD risk assessment, and how it can be used to prevent, diagnose and treat ROHD among older adults.
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Immergluck LC, Geng R, Li C, Edelson M, Lin X, Waller LA, Rust G, Xu J, Leong T, Baltrus P. Space-Time Trends of Community Onset Staphylococcus aureus Infections in Children: A Group Based Trajectory Modeling Approach. Ann Epidemiol 2023:S1047-2797(23)00045-5. [PMID: 36905976 DOI: 10.1016/j.annepidem.2023.03.001] [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: 10/06/2022] [Revised: 03/04/2023] [Accepted: 03/05/2023] [Indexed: 03/11/2023]
Abstract
PURPOSE Staphylococcus aureus (S. aureus) remains a serious cause of infections in the U.S. and worldwide. In the U.S., methicillin resistant S. aureus (MRSA) is the leading cause of skin and soft tissue infections. This study identifies 'best' to 'worst' infection trends from 2002 to 2016, using group-based trajectory modelling approach. METHODS Electronic health records of children living in the southeastern U.S. with S. aureus infections from 2002-2016 were retrospectively studied, by applying a group-based trajectory model to estimate infection trends (low, high, very high), and then assess spatial significance of these trends at the census tract level; we focused on community onset (CO) infections and not those considered healthcare acquired. RESULTS Three methicillin sensitive (MSSA) infection trends (low, high, very high) and three MRSA trends (low, high, very high) were identified from 2002-2016. Among census tracts with community onset (CO) S. aureus cases, 29% of tracts belonged to the best trend (low infection) for both MRSA and MSSA; higher proportions occurring in the less densely populated areas. Race disparities were seen with the worst MRSA infection trends and were more often in urban areas. CONCLUSIONS Group based trajectory modeling identified unique trends of S. aureus infection rates over time and space, giving insight into the associated population characteristics which reflect these trends of community onset infection.
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Affiliation(s)
- Lilly Cheng Immergluck
- Morehouse School of Medicine, Department of Microbiology/Biochemistry/Immunology; Clinical Research Center -Pediatric Clinical & Translational Research Unit,720 Westview Dr., Atlanta, Georgia 30310, USA.
| | - Ruijin Geng
- Morehouse School of Medicine, Department of Microbiology/Biochemistry/Immunology; Clinical Research Center -Pediatric Clinical & Translational Research Unit,720 Westview Dr., Atlanta, Georgia 30310, USA
| | - Chaohua Li
- Morehouse School of Medicine, National Center for Primary Care, 720 Westview Dr., Atlanta, Georgia 30310, USA.
| | - Mike Edelson
- Interdev, 900 Holcomb Woods Parkway, Roswell, Georgia 30076 USA.
| | - Xiting Lin
- Morehouse School of Medicine, Department of Microbiology/Biochemistry/Immunology; Clinical Research Center -Pediatric Clinical & Translational Research Unit,720 Westview Dr., Atlanta, Georgia 30310, USA.
| | - Lance A Waller
- Emory University, Rollins School of Public Health, Department of Biostatistics & Bioinformatics, 201 Dowman Drive, Atlanta Georgia 30322, USA.
| | - George Rust
- Florida State University, Center for Medicine & Public Health, 1115 West Call Street, Tallahassee, Florida 32306, USA.
| | - Junjun Xu
- Ningbo Consulting, Inc, 1813 Cromwell Walk, Atlanta, Georgia 30338, USA.
| | - Traci Leong
- Emory University, Rollins School of Public Health, Department of Biostatistics & Bioinformatics, 201 Dowman Drive, Atlanta Georgia 30322, USA.
| | - Peter Baltrus
- Morehouse School of Medicine, National Center for Primary Care, 720 Westview Dr., Atlanta, Georgia 30310, USA.
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Zhao B, Jiang X, Kong F, Nam EW. Relationship between Cognition, Depression, and Oral health status in Older adults: A longitudinal cross-lagged analysis. J Affect Disord 2023; 330:158-164. [PMID: 36870454 DOI: 10.1016/j.jad.2023.02.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 02/10/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND The world's population is aging increasingly, and older adults' physical and mental health needs to be prioritized. Although several studies have explored the relationship between cognition, depression, and oral health in older adults, the exact nature and direction of this relationship are poorly understood. Moreover, most studies to date have been cross-sectional, with fewer longitudinal studies. The current longitudinal study explored the relationship between cognition, depression, and oral health in older adults. METHODS We used data from two waves (2018, 2020) of the Korean Longitudinal Study of Aging, which included 4543 older adults aged 60 years and older. General socio-demographic characteristics were analyzed using descriptive analysis, and study variables were described using t-tests. Generalized Estimating Equations (GEE) and cross-lagged models were used to examine the longitudinal associations between cognition, depression, and oral health. RESULTS The GEE results suggested that better cognition and less depression over time were associated with better oral health in older adults. Cross-lagged models further validated the effect of depression on oral health over time. LIMITATIONS The directionality of the influence of cognition on oral health could not be determined. CONCLUSIONS Although there were several limitations, our study provided novel ideas for verifying the effects of cognition and depression on oral health in older adults.
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Affiliation(s)
- Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 26493, Republic of Korea; Yonsei Global Health Center, Yonsei University, 1 Yonseidae-gil, Wonju-si 26493, Republic of Korea
| | - Xiaoxu Jiang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China.
| | - Eun Woo Nam
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 26493, Republic of Korea; Yonsei Global Health Center, Yonsei University, 1 Yonseidae-gil, Wonju-si 26493, Republic of Korea.
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Kong D, Lu P, Solomon P, Woo J, Shelley M. Depressive Symptom Trajectories and Cognition Among Older American Couples: A Dyadic Perspective. J Aging Health 2023; 35:282-293. [PMID: 36113097 DOI: 10.1177/08982643221125838] [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] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This study examined whether trajectories of depressive symptoms of one spouse are associated with the other spouse's memory. METHODS Longitudinal data from the Health and Retirement Study (2004-2016) were used (N = 5690 heterosexual couples). Latent-class growth analysis and structural equation models examined the actor and partner effects of depressive symptom trajectories on memory. RESULTS Four depressive symptom trajectories were identified (i.e., persistently low, increasing, decreasing, and persistently high). Compared to the low trajectory group, the increasing and persistently high trajectories were associated with worse memory for both men and women. While none of the wives' depressive symptom trajectories was significantly associated with husbands' memory (p > .05), husbands' decreasing trajectory was linked to wives' better memory (β = 0.498, 95% CI = 0.106, 0.890). DISCUSSION Older adults with increasing and persistently high depressive symptoms may experience worse memory. Psychosocial interventions targeting depressive symptoms among older men may be beneficial to their spouses' memory.
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Affiliation(s)
- Dexia Kong
- Department of Social Work, 26451The Chinese University of Hong Kong, Hong Kong, China
| | - Peiyi Lu
- Department of Epidemiology, Mailman School of Public Health, 5798Columbia University, New York, NY, USA
| | - Phyllis Solomon
- School of Social Policy and Practice, 6572University of Pennsylvania, Philadelphia, PA, USA
| | - Jean Woo
- The Jockey Club Institute of Ageing, 26451The Chinese University of Hong Kong, Hong Kong, China
| | - Mack Shelley
- Department of Political Science, Department of Statistics, and School of Education, 1177Iowa State University, Ames, IA, USA
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12
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Milton-Cole R, Ayis S, O'Connell MDL, Smith T, Sheehan KJ. Trajectories of Depressive Symptoms Among Older Adults and in Adults With Hip Fracture: Analysis From the English Longitudinal Study of Ageing. J Gerontol A Biol Sci Med Sci 2022; 77:2453-2458. [PMID: 36073633 PMCID: PMC9799186 DOI: 10.1093/gerona/glac182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND This study aimed to determine trajectories of depressive symptoms among older adults in England, overall and for those with hip fracture. The study aimed to explore the differential characteristics of each trajectory identified. METHODS Analysis of adults aged 60 years or more (n = 7 050), including a hip fracture subgroup (n = 384), from the English Longitudinal Study of Ageing. Latent class growth mixture modeling was completed. Depressive symptom prevalence was estimated at baseline. Chi-square tests were completed to compare baseline characteristics across trajectories. RESULTS Three trajectories of depressive symptoms (no, mild, and moderate-severe) were identified overall and for those with hip fracture. The moderate-severe trajectory comprised 13.7% and 7% of participants for overall and hip fracture populations, respectively. The proportion of participants with depressive symptoms in the moderate-severe trajectory was 65.4% and 85.2% for overall and hip fracture populations, respectively. Depressive symptoms were stable over time, with a weak trend toward increasing severity for the moderate-severe symptom trajectory. Participants in the moderate-severe symptom trajectory were older, more likely to be female, live alone, and had worse health measures than other trajectories (p < .001). CONCLUSIONS Older adults, and those with hip fracture, follow one of the 3 trajectories of depressive symptoms that are broadly stable over time. Depressive symptoms' prevalence was higher for those with hip fracture and, when present, the symptoms were more severe than the overall population. Results suggest a role of factors including age, gender, and marital status in depressive symptom trajectories.
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Affiliation(s)
- Rhian Milton-Cole
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
| | - Salma Ayis
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
| | - Matthew D L O'Connell
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
| | - Toby Smith
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Katie Jane Sheehan
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
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13
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Mallett J, Redican E, Doherty AS, Shevlin M, Adamson G. Depression trajectories among older community dwelling adults: Results from the Irish Longitudinal Study on Ageing (TILDA). J Affect Disord 2022; 298:345-354. [PMID: 34715192 DOI: 10.1016/j.jad.2021.10.114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/20/2021] [Accepted: 10/24/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study investigated the role of a large range psychological, attitudinal and health related variables as predictors of depression trajectories amongst older adults over a 4-year time period. METHODS Data from three consecutive waves of the TILDA survey of older community dwelling adults aged 50+ in Ireland were combined for analysis. Depression symptom scores were assessed using the Center for Epidemiological Studies- Depression scale (CES-D). Changes in depression scores over three time points were modelled as distinct trajectory classes using group-based trajectory modelling, whilst simultaneously controlling for demographic, attitudinal and health related predictors of these trajectory classes using multinomial regression. RESULTS Four distinct depression trajectories were identified as (1) a stable low symptom level group (79%), (2) a moderate but deteriorating symptoms group (7.6%), (3) a moderate but improving group (10.1%) and (4) a vulnerable group with consistently high symptoms (3.1%). Multinomial logistic regression indicated that limiting pain, mobility impairments, perceived stress and loneliness predicted membership of the moderate and higher depressive symptom classes. Retirement status and higher reported levels of worry were associated with a greater likelihood of membership of the moderate symptom classes only. LIMITATIONS Use of the CES-D is open to bias due to subjective nature of respondent reporting. CONCLUSIONS Results concur with previous studies on the development of depression among older people and highlight the key health related and psychological variables that may inform interventions aimed at mitigating risks of developing depression among older adults.
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Affiliation(s)
- John Mallett
- School of Psychology, Ulster University, Cromore Road, Coleraine BT52 1SA, United Kingdom.
| | - Enya Redican
- School of Psychology, Ulster University, Cromore Road, Coleraine BT52 1SA, United Kingdom
| | - Ann Sinéad Doherty
- Department of General Practice, RCSI University of Medicine and Health Sciences, 123St. Stephen's Green, Dublin 2, Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Cromore Road, Coleraine BT52 1SA, United Kingdom
| | - Gary Adamson
- School of Psychology, Ulster University, Cromore Road, Coleraine BT52 1SA, United Kingdom
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14
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Hajek A, König HH. Oral health-related quality of life, probable depression and probable anxiety: evidence from a representative survey in Germany. BMC Oral Health 2022; 22:9. [PMID: 35034663 PMCID: PMC8761375 DOI: 10.1186/s12903-022-02047-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is limited knowledge regarding the association between oral health-related quality of life and probable depression and anxiety. Our objective was to examine the association between oral health-related quality of life and probable depression and anxiety in the German population (stratified by sex). METHODS In sum, n = 3,075 individuals took part in a nationally representative survey (August/September 2021). The well-established Patient Health Questionnaire-9 (PHQ-9; cut-off of 10) and the Generalized Anxiety Disorder-7 (GAD-7; cut-off of 10) were used to quantify probable depression and anxiety, respectively. RESULTS The likelihood of probable depression was significantly associated with lower oral health-related quality of life in the total sample (OR: 1.21, 95% CI: 1.18-1.25) and in both women and men. Additionally, the likelihood of probable anxiety was significantly associated with lower oral health-related quality of life in the total sample (OR: 1.17, 95% CI: 1.14-1.21) and in both women and men. CONCLUSIONS Our study emphasized the association between lower oral health-related quality of life and probable depression as well as anxiety in the general adult population in Germany. Future longitudinal studies are required to confirm our findings.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
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15
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Xu X, Zhao Y, Gu D, Pei Y, Wu B. Health Behaviors and Self-Reported Oral Health among Centenarians in Nanjing, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7285. [PMID: 34299735 PMCID: PMC8304003 DOI: 10.3390/ijerph18147285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 11/01/2022]
Abstract
The role of health behaviors in oral health conditions in individuals of extremely old age remains understudied. This study included 185 participants aged 100 years or older from the Nanjing Centenarians Study (NCS) to examine the associations between health behaviors and oral health and investigate the potential moderating role of education and living arrangements in such relationships. The oral health status as an outcome included the self-reported oral health status and edentulous status. Health behavior variables included smoking, eating fruits, eating vegetables, participating in leisure activities, and practicing oral hygiene behaviors. Sociodemographic characteristics and health status were considered as confounders. Descriptive statistics, ordinal regression, and logistic regression models were used to address the research questions. Results showed that better oral health was reported by centenarians who were non-smokers, participated in more leisure activities, and practiced higher frequency of oral hygiene behaviors. Those who ate fruits daily and practiced more frequently oral hygiene behaviors were more likely to be dentate. The positive association of oral hygiene behaviors was stronger for centenarians who were formally educated and co-resided with family members. The results suggest that effective interventions should consider health behaviors and living arrangements in this growing population to improve their oral health status.
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Affiliation(s)
- Xin Xu
- Population Research Institute, Nanjing University of Posts and Telecommunications, Nanjing 210042, China;
| | - Yuan Zhao
- Population Research Institute, Nanjing University of Posts and Telecommunications, Nanjing 210042, China;
- Ginling College, Nanjing Normal University, Nanjing 210023, China
| | - Danan Gu
- Independent Researcher, New York, NY 10010, USA;
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA;
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA;
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16
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Ohi T, Murakami T, Komiyama T, Miyoshi Y, Endo K, Hiratsuka T, Satoh M, Asayama K, Inoue R, Kikuya M, Metoki H, Hozawa A, Imai Y, Watanabe M, Ohkubo T, Hattori Y. Oral health-related quality of life is associated with the prevalence and development of depressive symptoms in older Japanese individuals: The Ohasama Study. Gerodontology 2021; 39:204-212. [PMID: 34009675 DOI: 10.1111/ger.12557] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/01/2021] [Accepted: 04/26/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This prospective study investigated the cross-sectional association between impaired oral health-related quality of life (OHRQoL) and the prevalence of depressive symptoms, and the longitudinal association between impaired OHRQoL and development of depressive symptoms among older adults. BACKGROUND Previous studies have shown a relationship between poor oral health and depression among older adults; however, findings are inconsistent. MATERIALS AND METHODS Participants were 669 community-dwelling older Japanese individuals aged≥55 years (mean: 67.8 ± 7.2 years). Data of 296 participants were used for longitudinal analyses. OHRQoL was evaluated using the Oral Impacts on Daily Performances scale. Impaired OHRQoL was defined as the presence of at least one impact on the scale. Depressive symptoms were assessed using the Japanese version of the Zung self-rating depression scale with a cut-off score of 40. RESULTS The cross-sectional logistic regression model demonstrated that impaired OHRQoL was significantly associated with depressive symptoms (odds ratio [OR], 5.17; 95% confidence interval [CI], 2.99-8.95) independent of age, sex, body mass index, hypertension, cerebrovascular/cardiovascular disease, smoking, drinking alcohol, education, cognitive function, objective oral health (dentition status) and oral health behaviour (dental visit within 1 year). Similarly, impaired OHRQoL predicted the development of depressive symptoms within 4 years in a fully adjusted longitudinal model (OR, 6.00; 95% CI, 1.38-26.09). CONCLUSION Impaired OHRQoL was identified as a potential comorbidity of depressive symptoms and a predictor for depressive disorder later in life. OHRQoL may be a useful clinical outcome for elder patients with regard to their mental and oral health.
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Affiliation(s)
- Takashi Ohi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Takahisa Murakami
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takamasa Komiyama
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yoshitada Miyoshi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kosei Endo
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takako Hiratsuka
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Ryusuke Inoue
- Department of Medical Information Technology Center, Tohoku University Hospital, Sendai, Japan
| | - Masahiro Kikuya
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Makoto Watanabe
- Research Institute of Living and Environmental Sciences, Miyagi Gakuin Women's University, Sendai, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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17
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Wojciechowski T. Presentation of Borderline Personality Disorder Symptoms in Adulthood: Development of Depression Mediates the Effect of Childhood and Adolescent Exposure to Violence. J Nerv Ment Dis 2021; 209:283-290. [PMID: 33346599 DOI: 10.1097/nmd.0000000000001291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Past research has linked the development of borderline personality disorder to earlier exposure to violence. However, the causal link by which this relationship exists has not yet been fully identified. The present study sought to examine how exposure to violence predicted heterogeneity in the development of depressive systems and results in the arousal of borderline personality disorder symptoms in adulthood. The Pathways to Desistance data were used in the analyses. This data set consisted of the responses of 1354 juvenile offenders followed across 7 years. Group-based trajectory modeling was used to identify latent trajectories of depressive symptoms. Ordinary least squares regression was used to model covariate effects on borderline personality disorder symptoms in adulthood. Results indicated that a three-group depression trajectory model best fit the data. Direct victimization early in life was associated with increased borderline personality disorder symptoms in adulthood. When trajectory group assignment was accounted for in the model, the relationship between direct victimization and borderline personality disorder symptoms was attenuated by around 30%. Implications are discussed.
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18
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Venturelli R, Blokland A, de Oliveira C, Machuca C, Watt RG. Oral health and depressive symptoms: findings from the English Longitudinal Study of Ageing. Br Dent J 2021:10.1038/s41415-021-2603-1. [PMID: 33574578 DOI: 10.1038/s41415-021-2603-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/23/2020] [Indexed: 11/09/2022]
Abstract
Aim We assessed the cross-sectional association between depressive symptoms and oral health using a nationally representative sample of older adults aged 50 years and older living in England.Methods Data came from wave 7 (2014-2015) of the English Longitudinal Study of Ageing. Multiple logistic regression analyses were conducted to assess the association between depressive symptoms, measured through the eight-item Centre for Epidemiologic Studies Depression Scale and three oral health outcomes, namely self-rated oral health, edentulousness and oral impacts.Results The analytical sample comprised 3,617 individuals. The proportion of participants that reported poor self-rated oral health, being edentate and having at least one oral health impact in the last six months was 19.8%, 7.7% and 8.9%, respectively. Around a tenth of the participants reported having depressive symptoms (10%). All unadjusted associations between depressive symptoms and the oral health measures were statistically significant. However, after accounting for potential confounders, only the relationship between depressive symptoms and self-rated oral health remained significant (OR = 1.38; 95% CI 1.01-1.89). Socioeconomic and general health-related variables appeared to influence the associations between depressive symptoms and oral health, particularly edentulousness and oral impacts.Conclusion Depressive symptoms were associated with poor self-rated oral health in older English adults.
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Affiliation(s)
- Renato Venturelli
- Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, WC1E 6BT, London, UK.
| | - Alex Blokland
- Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, WC1E 6BT, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, WC1E 6BT, London, UK
| | - Carolina Machuca
- Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, WC1E 6BT, London, UK
| | - Richard G Watt
- Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, WC1E 6BT, London, UK
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Hirosaki M, Ohira T, Shirai K, Kondo N, Aida J, Yamamoto T, Takeuchi K, Kondo K. Association between frequency of laughter and oral health among community-dwelling older adults: a population-based cross-sectional study in Japan. Qual Life Res 2021; 30:1561-1569. [PMID: 33432445 DOI: 10.1007/s11136-020-02752-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Oral health has been reported to have an impact on the activities of daily life such as chewing, eating, and laughing, while psychological factors such as depression and loneliness have been reported to affect oral health. Little is known, however, about the association between laughter and oral health in older adults. This study examined the bidirectional association between the frequency of daily laughter and oral health in community-dwelling older Japanese adults. METHODS Our cross-sectional study employed data from the 2013 Japan Gerontological Evaluation Study's self-reported survey, which included 11,239 male and 12,799 female community-dwelling independent individuals aged 65 years or older. We defined the oral health status by the number of remaining teeth. The association between the self-reported frequency of laughter (almost every day, 1-5 days per week, 1-3 days per month, or almost never) and oral health was examined using logistic regression analysis. RESULTS The participants with 10 or more teeth were significantly more likely to laugh compared with the edentulous participants, after adjusting for all covariates. Compared with those who almost never laughed, those who laughed 1-5 days per week were significantly less likely to be edentulous. After stratifying by sex, similar results were found only in the men for both analyses. CONCLUSION There was a significant bidirectional association between frequency of laughter and oral health that was independent of socioeconomic and lifestyle factors among older adults.
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Affiliation(s)
- Mayumi Hirosaki
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan. .,Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
| | - Tetsuya Ohira
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan.,Department of Public Health, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kokoro Shirai
- Department of Public Health, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Naoki Kondo
- School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi, Japan
| | - Tatsuo Yamamoto
- Department of Disaster Medicine and Dental Sociology, Graduate School of Dentistry, Kanagawa Dental University, Kanagawa, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Aichi, 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, Aichi, Japan
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20
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Al-Zahrani MS, Alhassani AA, Melis M, Zawawi KH. Depression is related to edentulism and lack of functional dentition: An analysis of NHANES data, 2005-2016. J Public Health Dent 2020; 81:206-213. [PMID: 33349927 DOI: 10.1111/jphd.12433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/03/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Depression and tooth loss are significant health problems that affect individuals' functionality and quality of life. Comorbidity between depression and oral diseases has been reported. The aim of this study was to investigate the association between depression and tooth loss in a US representative adult sample. METHODS This study included data from 22,532 adults ≥18 years by combining six 2-year cross-sectional cycles of the National Health and Nutrition Examination Survey (NHANES) administered between 2005 and 2016. Data were analyzed using descriptive statistics and multinomial logistic regression adjusted for gender, age, race/ethnicity, smoking, education, socioeconomic status, body mass index, diabetes, and alcohol intake. RESULTS Of the total sample, 4.5 percent were edentulous, 10.3 percent were lacking functional dentition (1-19 remaining teeth) and 85.2 percent had functional dentition (≥20 remaining teeth); among whom, the prevalence of depression was 12.4, 11.7, and 5.9 percent, respectively. Compared to individuals without depression, those with depression were more likely to be edentulous or lacking functional dentition versus having functional dentition (adjusted odds ratios (95% CI): 1.48 (1.16-1.89) and 1.43 (1.18-1.75), respectively). CONCLUSIONS Depression was associated with edentulism and a lack of functional dentition. Further longitudinal and interventional studies are needed to elucidate the nature and direction of the relationship between depression and tooth loss.
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Affiliation(s)
- Mohammad S Al-Zahrani
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed A Alhassani
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Marcello Melis
- Department of Orthodontics, School of Dentistry, University of Cagliari, Cagliari, Italy
| | - Khalid H Zawawi
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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21
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Barriers Affecting the Oral Health of People Diagnosed with Depression: A Systematic Review. Zdr Varst 2020; 59:273-280. [PMID: 33133284 PMCID: PMC7583427 DOI: 10.2478/sjph-2020-0034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 09/17/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction The problems of oral health of people diagnosed with depression are not adequately recognized, either in developed or developing countries. Social stigma, lack of self-interest, or even inadequate approaches of dental doctors towards the unique situation of this group of people this lead to excessive oral health problems. Methods The bibliographic database PubMed/Medline, Google Scholar, and Whiley online library were searched using the following text and MeSH as separate key terms and in combination: depression and oral health/dental caries/periodontal disease/tooth loss/utilization of oral health services/and barriers. The content of documents was analysed using qualitative methodology. Results Twenty-six original studies were included in the review. Level/severity of depression, medication and medical comorbidity are the most important medical barriers influencing the oral health of people diagnosed with depression. Dental fear and anxiety are mostly combined with low oral hygiene and bad oral health. Socioeconomic status, dental insurance, bad habits and education also have important roles in the oral health status of people diagnosed with depression. Conclusion Including individuals with depression and oral health problems in national health programs, creating specific prevention programs, or subsidizing the cost of treatment are some of the recommendations suggested as solutions.
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Han JY, Lee JS, Lee JH, Jin MH, Kim SH. Associations between dietary habits, emotional state and subjective oral symptoms in 62,276 South Korean adolescents. Int Dent J 2020; 70:347-359. [PMID: 32478418 DOI: 10.1111/idj.12573] [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: 11/29/2022] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the associations between dietary habits, emotional states, and subjective oral symptoms in Korean adolescents. METHODS Data from 62,276 adolescents were derived from the 13th Korean Youth Risk Behavior Web-based Survey, conducting from June 1, 2017 to June 30, 2017. Oral symptoms were assessed by asking students whether they had experienced any of following symptoms within the last 12 months: (i) have you had a crack in your teeth or had any broken teeth not caused by exercise or other accidents?, (ii) have you experienced any toothaches while drinking or eating cold or hot beverages or foods?, (iii) have you ever felt throbbing in your teeth?, and (iv) have you experienced any gum pain or gum bleeding? A multivariable Poisson regression model for prevalence ratio (PR) was conducted. RESULTS Of the participants, 53.1% experienced subjective oral symptoms. After adjusting for confounders, participants with consumption of sweet drinks more than five times weekly in dietary behaviors (PR: 1.17 [95% confidence interval (CI); 1.13-1.21]), feeling stress in the emotional state (PR: 1.27 [95% CI; 1.24-1.31]), and never brushing teeth (PR: 1.22 [95% CI; 1.14-1.30]) in the frequency of toothbrushing had higher risks of having oral symptoms compared to the reference group. CONCLUSION Many adolescents in Korea experienced oral symptoms. The consumption of sweet drinks, infrequent toothbrushing, and a negative emotional state adversely affected perceived oral symptoms. Public concern about the oral health of adolescents is warranted.
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Affiliation(s)
- Jae Young Han
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Jun Hwa Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Mi Hyeon Jin
- Department of Biostatistics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Sung Hoon Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Wu B, Pei Y, Zhang W, Northridge M. Immigrant Status, Resilience, and Perceived Oral Health Among Chinese Americans in Hawaii. Res Aging 2020; 42:186-195. [PMID: 32195629 DOI: 10.1177/0164027520912493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES This study aims to examine the associations among immigrant status, resilience, and perceived oral health for Chinese American older adults in Hawaii. METHOD Data derived from 430 Chinese American adults aged 55 years and older residing in Honolulu, HI. We compared the self-rated oral health and oral health problems between U.S.-born Chinese Americans and foreign-born Chinese Americans by using ordered logistic regression and ordinary least squares regression models. RESULTS Findings suggest that immigrant status and lower levels of resilience are associated with poorer self-rated oral health and more oral health problems for Chinese American older adults in Hawaii. Resilience is more strongly associated with self-rated oral health for U.S.-born Chinese American than for foreign-born Chinese Americans, but this pattern was not evident for oral health problems. DISCUSSION Older Chinese American immigrants in Hawaii are disadvantaged in terms of their oral health. Understanding their susceptibilities may lead to targeted interventions.
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Affiliation(s)
- Bei Wu
- Rory Meyers College of Nursing, New York University, NY, USA
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, NY, USA
| | - Wei Zhang
- Department of Sociology, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Mary Northridge
- NYU Grossman School of Medicine, New York University, NY, USA
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Marchini L, Reynolds JC, Caplan DJ, Sasser S, Russell C. Predictors of having a dentist among older adults in Iowa. Community Dent Oral Epidemiol 2020; 48:240-247. [DOI: 10.1111/cdoe.12521] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/19/2019] [Accepted: 01/16/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Leonardo Marchini
- Department of Preventive and Community Dentistry University of Iowa College of Dentistry and Dental Clinics Iowa City Iowa
| | - Julie C. Reynolds
- Department of Preventive and Community Dentistry University of Iowa College of Dentistry and Dental Clinics University of Iowa Public Policy Center Iowa City Iowa
| | - Daniel J. Caplan
- Department of Preventive and Community Dentistry University of Iowa College of Dentistry and Dental Clinics Iowa City Iowa
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de la Torre-Luque A, Ayuso-Mateos JL, Sanchez-Carro Y, de la Fuente J, Lopez-Garcia P. Inflammatory and metabolic disturbances are associated with more severe trajectories of late-life depression. Psychoneuroendocrinology 2019; 110:104443. [PMID: 31610452 DOI: 10.1016/j.psyneuen.2019.104443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 12/26/2022]
Abstract
Late-life depression is a highly prevalent mental health condition with devastating consequences even from its earliest stages. Alterations in physiological functions, such as inflammatory and metabolic, have been described in patients with depression. However, little is known on the association between depression symptom course and metabolic and inflammation dysregulation. This study aimed to depict the course of depression symptoms while ageing, taking into consideration inter-individual heterogeneity. Moreover, it intended to study the associations between inflammatory and metabolic risk profiles and symptom trajectories. To do so, data from 13,203 adults aged 50-90 years (52.75% women; mean age at baseline = 65.07, SD = 10.00) were used. Blood sample and blood pressure measures were taken from 1536 participants (56.58% women; mean age at baseline = 61.73 years, sd = 7.64). Depression symptoms were assessed every two years across a 10-year follow-up. Trajectories were identified by means of latent class mixed modelling. Inflammation and metabolic risk profile scores were obtained from plasma and diagnostic-based indicators in the follow-up, using a robust latent-factor approach. Multigroup modelling was used to study the associations between the profiles and symptom trajectories. As a result, three heterogeneous trajectories of symptoms were identified (low-symptom, moderate-symptom and high-symptom trajectory). Participants depicting a high-symptom trajectory showed the greatest inflammation profile score and high metabolic risk. Moderate-symptom trajectory was also related to high inflammation and metabolic risk. To sum up, at-risk trajectories of symptoms were associated with high inflammation and risk of metabolic diseases. This study provides valuable evidence to advance personalised medicine and mental health precision, considering person-specific profiles and physiological concomitants.
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Affiliation(s)
- Alejandro de la Torre-Luque
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain
| | - Jose Luis Ayuso-Mateos
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain.
| | - Yolanda Sanchez-Carro
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain
| | - Javier de la Fuente
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain
| | - Pilar Lopez-Garcia
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain
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Practical Guidelines for Physicians in Promoting Oral Health in Frail Older Adults. J Am Med Dir Assoc 2019; 19:1039-1046. [PMID: 30471798 DOI: 10.1016/j.jamda.2018.10.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 10/01/2018] [Accepted: 10/05/2018] [Indexed: 11/24/2022]
Abstract
Good oral health in old age is particularly important for maintaining adequate oral function, preventing pain and discomfort, controlling localized or systemic inflammation, sustaining social interaction, and preserving quality of life. Given that oral health is an integral part of general health and well-being, and that major chronic systemic and oral diseases share common risk factors, oral health prevention and promotion should be embedded within routine medical assessment and care provision. The role of medical physicians, particularly primary care physicians, geriatricians, and elderly care physicians, in community and long-term care facilities in assessing and promoting oral health in frail older adults is critical and has been emphasized in recent European recommendations. All physicians should appreciate the importance of oral health and incorporate an initial oral health screening into routine medical assessment and care. A short interview with patients and carers on current oral health practices may help to assess the risk for rapid oral health deterioration. The interview should be followed by an oral health assessment, using validated tools, for nondental health care providers. Based on these findings, the physician should decide on necessary follow-up procedures, which may include oral health counseling and/or dental referral. Oral health counseling should include advice on daily oral, mucosal, and denture hygiene; denture maintenance; dietary advice; smoking cessation; limitation of harmful alcohol consumption; management of xerostomia; and frequent dental review. To enable physicians to perform the tasks recommended in this publication, appropriate teaching at both undergraduate and postgraduate levels must be delivered in addition to provision of appropriate continuing education courses.
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Baltrus P, Malhotra K, Rust G, Levine R, Li C, Gaglioti AH. Identifying County-Level All-Cause Mortality Rate Trajectories and Their Spatial Distribution Across the United States. Prev Chronic Dis 2019; 16:E55. [PMID: 31050636 PMCID: PMC6513472 DOI: 10.5888/pcd16.180486] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION All-cause mortality in the United States declined from 1935 through 2014, with a recent uptick in 2015. This national trend is composed of disparate local trends. We identified distinct groups of all-cause mortality rate trajectories by grouping US counties with similar temporal trajectories. METHODS We used all-cause mortality rates in all US counties for 1999 through 2016 and estimated discrete mixture models by using county level mortality rates. Proc Traj in SAS was used to detect how county trajectories clustered into groups on the basis of similar intercepts, slopes, and higher order terms. Models with increasing numbers of groups were assessed on the basis of model fit. We created county-level maps of mortality trajectory groups by using ArcGIS. RESULTS Eight unique trajectory groups were detected among 3,091 counties. The average mortality rate in the most favorable trajectory group declined 29.4%, from 592.3 deaths per 100,000 in 1999 to 418.2 in 2016. The least favorable mortality trajectory group declined 3.4% over the period, from 1,280.3 deaths per 100,000 to 1,236.9. We saw significant differences in the demographic and socioeconomic profiles and geographic patterns across the trajectory categories, with favorable mortality trajectories in the Northeast, Midwest, and on the West Coast and unfavorable trajectories concentrated in the Southeast. CONCLUSIONS County-level disparities in all-cause mortality rates widened over the past 18 years. Further investigation of the determinants of the trajectory groupings and the geographic outliers identified by our research could inform interventions to achieve equitable distribution of county mortality rates.
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Affiliation(s)
- Peter Baltrus
- National Center for Primary Care, Morehouse School of Medicine, Atlanta, Georgia
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia
- Morehouse School of Medicine, 720 Westview Dr, SW, Atlanta, GA 30310.
| | - Khusdeep Malhotra
- Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania
| | - George Rust
- Department of Behavioral Sciences and Social Medicine, Florida State University School of Medicine, Tallahassee, Florida
| | - Robert Levine
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas
| | - Chaohua Li
- National Center for Primary Care, Morehouse School of Medicine, Atlanta, Georgia
| | - Anne H Gaglioti
- National Center for Primary Care, Morehouse School of Medicine, Atlanta, Georgia
- Department of Family Medicine, Morehouse School of Medicine, Atlanta, Georgia
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Marchini L, Ettinger R, Caprio T, Jucan A. Oral health care for patients with Alzheimer's disease: An update. SPECIAL CARE IN DENTISTRY 2019; 39:262-273. [PMID: 30964560 DOI: 10.1111/scd.12375] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/14/2019] [Accepted: 03/24/2019] [Indexed: 12/11/2022]
Abstract
Alzheimer's disease and related disorders (ADRD) are among the age-associated chronic conditions that are most challenging to health care systems around the globe, as patients with dementia require full-time, intensive care for multiple years. Oral health care is negatively impacted by cognitive decline, and consequently poor oral health is common among people with ADRD. Poor oral health status is linked with many undesirable consequences for the well-being of people with ADRD, from excruciating local pain to life-threatening conditions, as aspiration pneumonia. In this paper, the authors provide an update on the most current concepts about Alzheimer's disease epidemiology, etiology, and management, current oral health care for patients with Alzheimer's disease, oral health promotion strategies for this population, as well as current research and future direction for improving oral health care for patients with Alzheimer's disease. It concludes that oral health care should be included in the patient's routine health care as early as possible in the progression of Alzheimer's disease for preventing rapid oral health deterioration. Establishing oral hygiene routines and providing dental treatment that is customized to the patients' individual needs and disease stage are important to achieve good oral health outcomes and prevent quality of life decline.
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Affiliation(s)
- Leonardo Marchini
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa
| | - Ronald Ettinger
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa
| | - Thomas Caprio
- Departments of Medicine, Public Health Science and Nursing, University of Rochester Medical Center, Rochester, New York
| | - Adina Jucan
- Departments of Dentistry and Medicine, University of Rochester Medical Center, Rochester, New York
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Cademartori MG, Gastal MT, Nascimento GG, Demarco FF, Corrêa MB. Is depression associated with oral health outcomes in adults and elders? A systematic review and meta-analysis. Clin Oral Investig 2018; 22:2685-2702. [PMID: 30191327 DOI: 10.1007/s00784-018-2611-y] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/23/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To systematically review the literature in order to investigate association between depression and oral diseases. MATERIAL AND METHODS Electronic searches were performed in five databases. Studies testing associations between depression and oral diseases as either exposure or outcome were included. Oral disease variable included any tooth loss or edentulism, periodontal disease, and dental caries. RESULTS A total of 2504 articles were identified in the electronic database search. Sixteen studies were included in this systematic review being 14 included in the meta-analyses. Eleven studies considered oral health as outcome, whereas three studies considered depression as an outcome variable. Depression was associated to dental caries, tooth loss, and edentulism. Pooled estimates showed that depression increased the odds of dental caries (OR 1.27; 95% CI 1.13-1.44), tooth loss (OR 1.31; 95% CI 1.24-1.37), and edentulism (OR 1.17; 95% CI 1.02-1.34), respectively. When the oral diseases were tested as independent variable and depression as outcome, associations with both edentulism (OR 1.28; 95% CI 1.06-1.55) and periodontal disease (HR 1.73; 95% CI 1.58-1.89) were found. CONCLUSIONS The results of our systematic review and meta-analyses show a positive association between depression and oral diseases, specifically dental caries, tooth loss, and edentulism, in adults and elders. More longitudinal studies are required to test causal and temporal relationship between depression and oral health status. CLINICAL RELEVANCE Mental and oral health are among the main disabilities worldwide. This article helps to understand more about the relationship between both conditions, highlighting the importance for both clinicians and policy makers of considering individual's psychological status in management of oral health.
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Affiliation(s)
| | - Márcia Torres Gastal
- Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, RS, Brazil
| | | | - Flavio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, RS, Brazil
| | - Marcos Britto Corrêa
- Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, RS, Brazil.
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Caplan DJ, Li Y, Wang W, Kang S, Marchini L, Cowen HJ, Yan J. Dental Restoration Longevity among Geriatric and Special Needs Patients. JDR Clin Trans Res 2018; 4:41-48. [PMID: 30931764 DOI: 10.1177/2380084418799083] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Although the population is aging and retaining more teeth, there is a lack of studies that address the longevity of dental restorations placed among older adults. OBJECTIVES This study aimed to describe the survival trajectory of dental restorations placed in an outpatient population of geriatric and adult special needs patients over a 15-y span, with particular interest in the longevity of subsequent restorations in teeth that received multiple restorations over time. METHODS Dental restorations of different types and sizes in patients aged ≥65 y treated between 2000 and 2014 at the University of Iowa College of Dentistry were followed until they incurred an event (i.e., restoration replacement, extraction of the tooth, or endodontic treatment of the tooth). Survival analysis and extended Cox regression models were used to generate hazard ratios for selected predictor variables. RESULTS AND CONCLUSION A total of 9,184 restorations were followed among 1,551 unique patients. During the follow-up period, 28.7% of these restorations incurred an event, and overall the restorations had a median life span of 6.2 y. In multivariable regression models, after controlling for sex and age, a greater number of restoration surfaces were associated with higher risks of failure, and the initial restoration recorded in the database for each participant tended to have a lower risk of failure than that of restorations that included any of those same surfaces that were placed later. This information could be helpful to older adult patients considering various restorative treatment options during the dental treatment-planning and informed consent process. KNOWLEDGE TRANSFER STATEMENT Informed decision making with regard to potential treatment options is an important component of health and well-being. The present study could contribute to the improved health of older adult dental patients by providing baseline information that clinicians can use as they discuss different restorative treatment options with these patients and their caregivers during the informed consent process.
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Affiliation(s)
- D J Caplan
- 1 Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Y Li
- 2 Department of Statistics, University of Connecticut, Storrs, CT, USA
| | - W Wang
- 2 Department of Statistics, University of Connecticut, Storrs, CT, USA
| | - S Kang
- 3 Department of Applied Statistics, Yonsei University, Seoul, Republic of Korea
| | - L Marchini
- 1 Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - H J Cowen
- 1 Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - J Yan
- 2 Department of Statistics, University of Connecticut, Storrs, CT, USA
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Luo H, Hybels CF, Wu B. Acculturation, depression and oral health of immigrants in the USA. Int Dent J 2018; 68:245-252. [DOI: 10.1111/idj.12364] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Ward JB, Robinson WR, Pence BW, Maselko J, Albrecht SS, Haan MN, Aiello AE. Educational Mobility Across Generations and Depressive Symptoms Over 10 Years Among US Latinos. Am J Epidemiol 2018; 187:1686-1695. [PMID: 29762643 DOI: 10.1093/aje/kwy056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 03/09/2018] [Indexed: 01/19/2023] Open
Abstract
Few studies have collected intergenerational data to assess the association between educational mobility across multiple generations and offspring depression. Using data from the Sacramento Area Latino Study on Aging (1998-2008), we assessed the influence of intergenerational education on depressive symptoms over 10 years among 1,786 Latino individuals (mean age = 70.6 years). Educational mobility was classified as stable-low (low parental/low offspring education), upwardly mobile (low parental/high offspring education), stable-high (high parental/high offspring education), or downwardly mobile (high parental/low offspring education). Depressive symptoms were measured with the Center for Epidemiological Studies-Depression Scale (CES-D); higher scores indicated more depressive symptoms. To quantify the association between educational mobility and CES-D scores over follow-up, we used generalized estimating equations to account for repeated CES-D measurements and adjusted for identified confounders. Within individuals, depressive symptoms remained relatively stable over follow-up. Compared with stable-low education, stable-high education and upward mobility were associated with significantly lower CES-D scores (β = -2.75 and -2.18, respectively). Downwardly mobile participants had slightly lower CES-D scores than stable-low participants (β = -0.77). Our results suggest that sustained, low educational attainment across generations may have adverse mental health consequences, and improved educational opportunities in underresourced communities may counteract the adverse influence of low parental education on Latino depression.
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Affiliation(s)
- Julia B Ward
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Whitney R Robinson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Brian W Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Sandra S Albrecht
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
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Ge S, Wu B, Dong X. Associations Between Acculturation and Oral Health Among Older Chinese Immigrants in the United States. Gerontol Geriatr Med 2018; 4:2333721418778197. [PMID: 30035202 PMCID: PMC6050624 DOI: 10.1177/2333721418778197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Indexed: 11/16/2022] Open
Abstract
Background: The aim of this study was to understand the associations between acculturation and oral health among older Chinese immigrants in the United States. Method: We used data from the PINE study, which included the foreign-born older Chinese immigrants (N = 3,128). We measured acculturation by measuring participants' length of stay and behavioral acculturation. Participants' tooth and gum symptoms were the outcome variables. Results: Longer stay in the United States was significantly associated with fewer gum symptoms but not with tooth symptoms. Behavioral acculturation was not significantly associated with either tooth or gum symptoms. The middle tertile of behavioral acculturation, compared with its upper and lower tertiles, deemed to be a more significant risk factor of tooth/gum symptoms. In addition, older immigrants with more social interactions with the Americans were more likely to have tooth symptoms. Discussion: In the future, we will conduct a study using longitudinal data to help us better understand the relationship between acculturation and oral health in Chinese American population.
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Affiliation(s)
| | - Bei Wu
- New York University, New York City, NY, USA
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Zhang W, Yan Wu Y, Wu B. Does Oral Health Predict Functional Status in Late Life? Findings From a National Sample. J Aging Health 2018; 30:924-944. [PMID: 28553812 PMCID: PMC6457448 DOI: 10.1177/0898264317698552] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study aims to examine the association between oral health and the decline in functional status among middle-aged and older adults in the United States. METHOD Generalized estimation equation (GEE) Poisson regression models with robust standard errors were used to analyze the longitudinal panel data (2008-2014) from the Health and Retirement Study ( N = 1,243). Oral health was evaluated using self-rated oral health, poor mouth condition, and tooth loss. Decline in functional status was assessed by disabilities in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). RESULTS Respondents with poor oral health were more likely to experience decline in ADLs/IADLs. Adjusting for sociodemographics and comorbidities attenuated the effects of oral health. DISCUSSION Findings suggest that oral health might be one of the important predictors of functioning decline in late life, after adjusting sociodemographics and comorbidities.
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Affiliation(s)
- Wei Zhang
- University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Yan Yan Wu
- University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Bei Wu
- New York University, New York, NY, USA
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Marchini L, Hartshorn JE, Cowen H, Dawson DV, Johnsen DC. A Teaching Tool for Establishing Risk of Oral Health Deterioration in Elderly Patients: Development, Implementation, and Evaluation at a U.S. Dental School. J Dent Educ 2017; 81:1283-1290. [PMID: 29093141 DOI: 10.21815/jde.017.086] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 08/24/2017] [Indexed: 01/09/2023]
Abstract
The aim of this study was to develop and evaluate a learning strategy using critical thinking to teach dental students how to assess the risk of rapid oral health deterioration (ROHD) among elderly patients. A learning guide was developed using risk factors identified in the literature and the steps that expert faculty members apply in their clinical decision making, summarized in a set of ten steps. A new system of labeling risk was developed for the elderly population, which correlates the level of risk with the amount of disease. Participants in the study were all 91 fourth-year dental students in two subsequent classes who took part in a five-week Geriatrics and Special Needs Clinic rotation in the spring of 2015 and 2016. The students were introduced to the ROHD concept and asked to use the guide in a presentation during their rotation. The students were graded on an A, G, or M scale (Applied concept, Grasped and applied concept, or Missed application of concept). Students were also asked to assess their learning experience, and their answers were thematically grouped and analyzed. For eight of the ten steps, at least 93% of the students were graded A or G. The exceptions were the steps about developing a communications plan, which was missed by 23.1%, and self-assessment, which was missed by 30.8%. Interexaminer agreement on students' applying (A + G grades) versus missing the step was moderate or high on six of ten items. Nearly all the students (98.7%) considered assessing the risk of ROHD an important or very important skill. In this study, a learning strategy to teach dental students how to assess the risk of ROHD among elderly patients was developed and successfully implemented.
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Affiliation(s)
- Leonardo Marchini
- Dr. Marchini is Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Hartshorn is Clinical Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Cowen is Clinical Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Dawson is Professor and Director of Division of Biostatistics and Research Design, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics; and Dr. Johnsen is Professor and Dean, University of Iowa College of Dentistry and Dental Clinics.
| | - Jennifer E Hartshorn
- Dr. Marchini is Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Hartshorn is Clinical Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Cowen is Clinical Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Dawson is Professor and Director of Division of Biostatistics and Research Design, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics; and Dr. Johnsen is Professor and Dean, University of Iowa College of Dentistry and Dental Clinics
| | - Howard Cowen
- Dr. Marchini is Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Hartshorn is Clinical Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Cowen is Clinical Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Dawson is Professor and Director of Division of Biostatistics and Research Design, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics; and Dr. Johnsen is Professor and Dean, University of Iowa College of Dentistry and Dental Clinics
| | - Deborah V Dawson
- Dr. Marchini is Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Hartshorn is Clinical Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Cowen is Clinical Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Dawson is Professor and Director of Division of Biostatistics and Research Design, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics; and Dr. Johnsen is Professor and Dean, University of Iowa College of Dentistry and Dental Clinics
| | - David C Johnsen
- Dr. Marchini is Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Hartshorn is Clinical Assistant Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Cowen is Clinical Professor, Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics; Dr. Dawson is Professor and Director of Division of Biostatistics and Research Design, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry and Dental Clinics; and Dr. Johnsen is Professor and Dean, University of Iowa College of Dentistry and Dental Clinics
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Almomani FM, Bani-issa W. The incidence of depression among residents of assisted living: prevalence and related risk factors. Clin Interv Aging 2017; 12:1645-1653. [PMID: 29070943 PMCID: PMC5640406 DOI: 10.2147/cia.s147436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM This study aims to recognize and estimate the prevalence of depression and its risk factors among residents of assisted living facilities (ALs) in Jordan. BACKGROUND Depression is commonly experienced by residents of ALs. The condition is, however, often misunderstood as a part of normal aging and may be overlooked by health care professionals. Little is known about the extent of depression and its risk factors among AL residents in Jordan. SUBJECTS AND METHODS A national representative sample of 221 residents selected from all AL units across Jordan was recruited to the study. Data on expected risk factors for depression were collected, including sociodemographics; smoking status; number of roommates; number of family members; assessments for cognitive functioning, for lower limb functioning, for hand, shoulder, and arm impairments; and oral health status. Levels of depression among the sample respondents were also assessed. RESULTS The study found that around 60% of the participants reported depressive manifestations, with 48.0% of AL residents exhibiting impaired cognitive functions, one-third (33.2%) having >50% upper limb disability, two-thirds (63.2%) being at moderate risk of falls, and 69.7% having fair to poor oral health status. Being female, and having a higher level of education, disability of the upper limbs, and impairment of cognitive functions were found to be independent risk factors for depression in participants. CONCLUSION Depression is relatively common among residents of AL units in Jordan. Health care professionals, nurses, physiotherapists, and dentists working in these facilities need to work cooperatively to identify the manifestations of depression in residents and collaboratively implement the best practice in the treatment of depression and circumvent its long-term impacts on the health of residents.
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Affiliation(s)
- Fidaa M Almomani
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Wegdan Bani-issa
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Singhal A, Borrelli B. Dental Disparities and Psychological Distress Among Mobility-Impaired Adults. Am J Prev Med 2017; 52:645-652. [PMID: 27989449 DOI: 10.1016/j.amepre.2016.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 10/03/2016] [Accepted: 10/14/2016] [Indexed: 12/01/2022]
Abstract
INTRODUCTION More than one in five American adults has a disability, the most common being mobility impairment (MI). People with MI face significant barriers to healthcare access and are more likely to experience psychological distress. This study examined disparities in access to medical and dental care among people with MI and examine the mediational role of psychological distress on this relationship. METHODS Analyses were conducted on 36,697 adults (aged ≥18 years) responding to the 2014 National Health Interview Survey (analyzed in 2015). MI was defined as needing special equipment and having difficulty walking a quarter mile without equipment. Outcomes included having lost all natural teeth (edentulous), unmet dental needs, annual dental visit, and annual medical visit. Psychological distress was measured using the Kessler psychological distress (K6) scale. RESULTS Compared with adults without MI, adults with MI had greater odds of being edentulous (OR=2.10, 95% CI=1.82, 2.43), having unmet dental needs (OR=1.99, 95% CI=1.66, 2.40), and lower odds of having annual dental visits (OR=0.62, 95% CI=0.54, 0.71). However, adults with MI were significantly more likely to have annual medical visits (OR=2.31, 95% CI=1.90, 2.81) than adults without MI. Psychological distress partially, yet significantly, mediated the relationship between MI and outcomes. CONCLUSIONS People with MI have significant oral health needs and poor access to dental care, which are partially mediated by psychological distress. Results suggest that mental health services should be considered for inclusion in interventions and medical visits can be leveraged to improve oral health outcomes in this population.
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Affiliation(s)
- Astha Singhal
- Health Policy and Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, Boston, Massachusetts;.
| | - Belinda Borrelli
- Division of Behavioral Science Research, Health Policy and Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, Boston, Massachusetts
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Musliner KL, Munk-Olsen T, Laursen TM, Eaton WW, Zandi PP, Mortensen PB. Heterogeneity in 10-Year Course Trajectories of Moderate to Severe Major Depressive Disorder: A Danish National Register-Based Study. JAMA Psychiatry 2016; 73:346-53. [PMID: 26934026 PMCID: PMC6015228 DOI: 10.1001/jamapsychiatry.2015.3365] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Evidence suggests that long-term trajectories of major depressive disorder (MDD) are heterogeneous. The Danish Psychiatric Central Research Register (DPCRR) provides a rare opportunity to examine patterns and correlates of long-term trajectories in a large sample of patients with moderate to severe MDD. OBJECTIVE To characterize patterns and correlates of 10-year course trajectories of MDD in the DPCRR. DESIGN, SETTING, AND PARTICIPANTS A cohort containing 11 640 individuals born in Denmark in 1955 or later with their first recorded MDD diagnosis in the DPCRR between 1995 and 2002 was established. Patients were followed for 10 years from the date of their initial MDD diagnosis. Data were obtained from Danish civil and psychiatric national registers in June 2013 and were analyzed from April 4, 2014, to December 17, 2015. Correlates of trajectory class membership were sex, characteristics of the first recorded MDD episode (ie, age, severity, inpatient treatment, and record of suicide attempt or self-harm), and psychiatric diagnoses in parents (ie, depression, bipolar disorder, schizophrenia-spectrum disorders, substance abuse, and anxiety or somatoform disorders). MAIN OUTCOMES AND MEASURES The outcome variable was past-year contact at a psychiatric hospital with a main diagnosis of MDD during each of the 10 years following the initial MDD diagnosis. Trajectories were modeled using latent class growth analysis. RESULTS The sample included 11 640 individuals (7493 [64.4%] women) aged 18 to 48 years (mean [SD], 31.4 [7.3]) at their first recorded MDD diagnosis. Four trajectory classes were identified: brief contact (77.0%) (characterized by low probability of contact after 2 years); prolonged initial contact (12.8%) (characterized by high decreasing probability of contact during the first 5 years); later reentry (7.1%) (characterized by moderate probability of contact during the second 5 years); and persistent contact (3.1%) (characterized by high or moderate probability of contact throughout). Female sex (odds ratio [OR] range, 1.82-2.22), inpatient treatment (OR range, 1.40-1.50), and severity at first recorded MDD episode (OR range: moderate, 1.61-1.84; severe, 1.93-2.23; and psychotic, 2.73-3.07) were associated with more severe trajectories. Parental anxiety (OR, 1.34 [95% CI, 1.10-1.63]) and depression (OR, 1.63 [95% CI, 1.28-2.09]) were associated with the prolonged initial contact and later reentry classes, respectively. Parental schizophrenia was associated with the persistent contact class (OR range, 2.55-3.04). CONCLUSIONS AND RELEVANCE Most people treated for moderate to severe MDD in Danish psychiatric hospitals do not receive additional MDD treatment after 2 years; however, a minority receive specialty treatment for up to a decade. Observable heterogeneity in the course may be indicative of underlying etiologic differences.
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Affiliation(s)
- Katherine L Musliner
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark2The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark3Department of Mental Health, The Johns
| | - Trine Munk-Olsen
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark2The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
| | - Thomas M Laursen
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark2The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
| | - William W Eaton
- Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Peter P Zandi
- Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Preben B Mortensen
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark2The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
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Musliner KL, Munk-Olsen T, Eaton WW, Zandi PP. Heterogeneity in long-term trajectories of depressive symptoms: Patterns, predictors and outcomes. J Affect Disord 2016; 192:199-211. [PMID: 26745437 PMCID: PMC4761648 DOI: 10.1016/j.jad.2015.12.030] [Citation(s) in RCA: 184] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 12/16/2015] [Accepted: 12/19/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Evidence suggests that long-term trajectories of depressive symptoms vary greatly throughout the population, with some individuals experiencing few or no symptoms, some experiencing transient symptoms and others experiencing chronic depression. The goal of this paper is to review studies that examined heterogeneity in long-term trajectories of depressive symptoms and summarize the current knowledge regarding (a) the number and patterns of trajectories and (b) antecedents and outcomes associated with different trajectory patterns. METHODS We conducted a systematic review of literature in the Medline and PsychINFO databases. Articles were included if they (a) modeled trajectories of depressive symptoms, (b) used a group-based trajectory modeling approach, (c) followed participants for 5+ years and (d) had a sample size of at least 200. RESULTS We identified 25 studies from 24 separate cohorts. Most of the studies identified either 3 or 4 distinct trajectory classes. Trajectories varied in terms of severity (low, medium, high) and stability (stable, increasing, decreasing). In most studies, the majority of participants had consistently few or no depressive symptoms, but a notable minority (usually <10%) reported persistent symptoms. Predictors of trajectories with greater symptom burden included female gender, lower income/education and non-white race. Other predictors were specific to different populations (e.g. mothers, older adults). High symptom burden trajectories were associated with poor psychiatric and social outcomes. LIMITATIONS Comparisons between studies were qualitative. CONCLUSIONS Trajectories of depression symptoms in the general population are heterogeneous, with most individuals showing minimal symptoms but a notable minority experiencing chronic high symptom burden.
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Affiliation(s)
- Katherine L Musliner
- National Centre for Register-Based Research, University of Aarhus, Aarhus, Denmark; Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD, USA.
| | - Trine Munk-Olsen
- National Centre for Register-Based Research, University of Aarhus, Aarhus, Denmark
| | - William W Eaton
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD, USA
| | - Peter P Zandi
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD, USA
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