Functional dentition and well-being among Chilean 80-year-olds

BACKGROUND

The Decade of Healthy Aging 2021-2030 calls for a strengthening of the policies for older people in Latin America. An example of successful oral aging is the Japanese "8020" campaign, which achieved 50% of people aged 80 years having ≥20 teeth by 2016.

OBJECTIVE

To evaluate the association between having a functional dentition (≥20 teeth) and cognitive health, social participation, and quality of life in people aged ≥80 years.

METHODS

Cross-sectional data from 299 complete observations (weighted N = 436 981) of individuals aged ≥80 years from Chile's National Health Survey 2016-2017 were included (3% of the population; total = 5520 clinical observations/weighted N = 14 518 969). Generalised structural equation models (GSEM) evaluated the association between having a functional dentition and cognitive health, measured with the Mini-mental score, between having a functional dentition and social participation, and between having a functional dentition and quality of life, measured with the EQ-5D-3L. Models included the effect of mediators (daily fruit and vegetable consumption; oral health-related quality of life score) and controlled for the exposure-induced mediator-outcome variables: sex, educational level, and location. Data were analysed using the STATA-17 survey module. Statistical significance was set at P < .05 (95% confidence interval [CI]).

RESULTS

The sample was mostly female, had <8 years of education, and lived in urban areas. The prevalence of a functional dentition was 9.2% (95% CI 3.6,21.3/n = 21). GSEM demonstrated that the association between functional dentition and cognitive health was mediated by daily fruits and vegetables consumption (β = 0.12/95% CI 0.02,0.21/P = .015), with moderate strength of evidence. Additionally, there was strong evidence of an association between functional dentition and social participation frequency (β = 2.76/95% CI 0.60,4.73/P = .009). Finally, the association between functional dentition and quality of life was mediated by cognitive health (β =0.05/95% CI 0.02,0.09/P = .002) and oral health-related quality of life (β = -0.04/95% CI -0.08 to -0.01/P = .025), with strong and moderate evidence, respectively.

CONCLUSION

Given the beneficial implications of functional dentition in social participation, nutritional benefits and quality of life and well-being of individuals aged ≥80 years.

Bayesian inference for Cox proportional hazard models with partial likelihoods, nonlinear covariate effects and correlated observations

We propose a flexible and scalable approximate Bayesian inference methodology for the Cox Proportional Hazards model with partial likelihood. The model we consider includes nonlinear covariate effects and correlated survival times. The proposed method is based on nested approximations and adaptive quadrature, and the computational burden of working with the log-partial likelihood is mitigated through automatic differentiation and Laplace approximation. We provide two simulation studies to show the accuracy of the proposed approach, compared with the existing methods. We demonstrate the practical utility of our method and its computational advantages over Markov Chain Monte Carlo methods through the analysis of Kidney infection times, which are paired, and the analysis of Leukemia survival times with a semi-parametric covariate effect and spatial variation.

The other blue: Role of sky in the perception of nature

Nature is frequently operationalized as greenery or water to estimate the restorativeness of the environment. Pursuing a deeper understanding of the connection between representation of naturalness and its relationship with restoration, we conducted an experiment aimed to investigate if the sky is perceived as an element of nature. The main goal of this study was to understand how the composition of the environment guides people’s selection of sky as nature in an explicit task. Moreover, we investigated how the amount of visible sky determines this relationship. One hundred five participants participated in a novel explicit judgment task conducted online. In this task, we prepared a set of images trimmed out of 360-degree high dynamic range images. The images were classified according to two primary independent variables representing type of environment (four levels: Nature, Some Nature, Some Urban and Urban) and horizon level (three levels: Low, Medium and High). Each participant was asked to select, by clicking on the image, what they consider as “nature.” In addition, they were asked to judge images on five visual analogue scales: emotional response, aesthetic preference, feeling of familiarity, the openness of the space and naturalness. For analysis, images were segmented into 11 semantic categories (e.g., trees, sky, and water) with each pixel being assigned one semantic label. Our results show that, sky is associated with selections of nature in a specific pattern. The relationship is dependent on the particular set of conditions that are present in the environment (i.e., weather, season of the year) rather than the type of the environment (urban, nature). The availability of sky on the image affects the selection of other nature labels with selections more likely when only a small amount of sky was available. Furthermore, we found that the amount of sky had a significant positive association with the naturalness rating of the whole image, but the effect was small. Our results also indicate that subjective selections of sky predict the naturalness better than trees and water. On the other hand, objective presence of trees and water has a stronger positive association with naturalness while objective presence of sky is positively associated with naturalness. The results show that, relative to its availability sky is considered as nature.