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Hong D, Kim JI, Yoon S, Kang B. Gender differences in the association between transitions in depressive symptoms and oral health among older adults with chronic conditions. J Affect Disord 2024; 361:581-588. [PMID: 38897302 DOI: 10.1016/j.jad.2024.06.052] [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: 01/15/2024] [Revised: 06/07/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Oral health influences the quality of life of older adults. Further, depression is negatively associated with oral health. However, little is known about this relationship among older adults with chronic health conditions. Additionally, since oral health and depression differ between genders, this study aimed to investigate the effect of transitions in depressive symptoms on oral health among older adults with chronic health conditions by gender. METHODS We used data from the Korean Longitudinal Study of Aging (2020-2022). The study sample comprised 2836 older adults (1104 men; 1732 women). We adopted multiple linear regression to examine the association between depressive symptom transitions and oral health by gender. RESULTS The new onset depression symptoms were significantly associated with the deterioration of oral health in men (β = -5.4308) and women (β = -4.8328). Our study showed a gender-specific association between new onset depressive symptoms and particular domains of oral health. For men, the association was slightly more negative in psychosocial function (β = -2.1177) while women presented lower GOHAI scores in both the physical function domain (β = -1.8800) and the psychosocial function domain (β = -1.8801). LIMITATIONS The data used in this study were self-reported via a survey; thus, self-report bias may be a relevant concern. CONCLUSION To prevent deterioration in oral health, depressive symptoms must be detected and addressed early among older adults with chronic conditions. This study underscores the importance of interventions that consider gender differences in the association between depressive symptoms and psychosocial and physical functioning.
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Affiliation(s)
- Dahye Hong
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea; Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Jennifer Ivy Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Seolah Yoon
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea; Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea.
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Yang C, Gao Y, An R, Lan Y, Yang Y, Wan Q. Oral frailty: A concept analysis. J Adv Nurs 2024; 80:3134-3145. [PMID: 38214108 DOI: 10.1111/jan.16042] [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: 04/05/2023] [Revised: 11/20/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024]
Abstract
AIM To clarify the concept of oral frailty to provide a clear and standardized conceptual basis for further research in older people. DESIGN Rodgers and Knafl's evolutionary concept analysis approach. METHODS The narrative analysis detailedly extracted and synthesized the attributes of oral frailty, as well as its antecedents, consequences and related terms under the guidance of Rodgers' evolutionary method. DATA SOURCES Multiple databases including Pubmed, CINAHL and Cochrane were searched using selected search terms 'oral frail*', 'oral health' and 'aged' respectively. Articles written between 2013 and 2023 were included, and grey literature was excluded. RESULTS A total of 32 articles were included for further analysis and synthesis. The attributes of oral frailty were hypofunction, predisposing in nature, non-specific and multidimensional. Antecedents of prefrailty were classified into four categories, namely, sociodemographic characteristics, comorbidity, physical function and psychosocial factors. Consequences of oral frailty include three themes: increased risk of adverse outcomes, poor nutritional status and possibility of social withdrawal. Related terms that had shared attributes with oral frailty were oral health, functional dentition, oral hypofunction and deterioration of oral function. CONCLUSIONS Oral frailty is an age-related phenomenon reflected in decreased oral function. The findings of this concept analysis are conducive to understanding and clarifying the oral frailty, which can help clinicians or other healthcare providers to consider how to distinguish oral frailty in older adults and further promote the development of this field. IMPACT Oral frailty is increasingly recognized as an age-related phenomenon reflected in decreased oral function. As it is newly proposed, no consensus has been reached regarding the theoretical and operational concept of it. Through clarifying the concept, this paper will guide future healthcare research on oral frailty regarding the influencing factors, mechanisms and interventions, thus raising the awareness with regard to oral health among older adults. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: In the context of older adults, oral frailty is a concept that requires further research to guide future theoretical development, and the influencing factors, mechanisms and interventions need to be further studied. Raise awareness with regard to oral health among older people and more attention will be paid to the early identification and intervention of oral frailty, so as to further improve the quality of life of older adults.
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Affiliation(s)
- Chengfengyi Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Yajing Gao
- School of Nursing, Peking University, Beijing, China
| | - Ran An
- School of Nursing, Peking University, Beijing, China
| | - Yue Lan
- School of Nursing, Peking University, Beijing, China
| | - Yue Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China
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Cecchin-Albertoni C, Deny O, Planat-Bénard V, Guissard C, Paupert J, Vaysse F, Marty M, Casteilla L, Monsarrat P, Kémoun P. The oral organ: A new vision of the mouth as a whole for a gerophysiological approach to healthy aging. Ageing Res Rev 2024; 99:102360. [PMID: 38821417 DOI: 10.1016/j.arr.2024.102360] [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: 01/25/2024] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
This article brings a new perspective on oral physiology by presenting the oral organ as an integrated entity within the entire organism and its surrounding environment. Rather than considering the mouth solely as a collection of discrete functions, this novel approach emphasizes its role as a dynamic interphase, supporting interactions between the body and external factors. As a resilient ecosystem, the equilibrium of mouth ecological niches is the result of a large number of interconnected factors including the heterogeneity of different oral structures, diversity of resources, external and internal pressures and biological actors. The manuscript seeks to deepen the understanding of age-related changes within the oral cavity and throughout the organism, aligning with the evolving field of gerophysiology. The strategic position and fundamental function of the mouth make it an invaluable target for early prevention, diagnosis, treatment, and even reversal of aging effects throughout the entire organism. Recognizing the oral cavity capacity for sensory perception, element capture and information processing underscores its vital role in continuous health monitoring. Overall, this integrated understanding of the oral physiology aims at advancing comprehensive approaches to the oral healthcare and promoting broader awareness of its implications on the overall well-being.
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Affiliation(s)
- Chiara Cecchin-Albertoni
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Olivier Deny
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Valérie Planat-Bénard
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Christophe Guissard
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Jenny Paupert
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Frédéric Vaysse
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France
| | - Mathieu Marty
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; LIRDEF, Faculty of Educational Sciences, Paul Valery University, Montpellier CEDEX 5 34199, France
| | - Louis Casteilla
- RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France
| | - Paul Monsarrat
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France; Artificial and Natural Intelligence Toulouse Institute ANITI, Toulouse, France
| | - Philippe Kémoun
- Oral Medicine Department and CHU de Toulouse, Toulouse Institute of Oral Medicine and Science, Toulouse, France; RESTORE Research Center, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse, France.
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Al Shammary NH. Exploring the impact of oral health on the quality of life in older patients: a cross-sectional study. BDJ Open 2024; 10:60. [PMID: 39034313 PMCID: PMC11271468 DOI: 10.1038/s41405-024-00244-1] [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: 03/26/2024] [Revised: 06/27/2024] [Accepted: 07/01/2024] [Indexed: 07/23/2024] Open
Abstract
OBJECTIVE To investigate the significant impact of oral health on the quality of life of older individuals in Riyadh, Saudi Arabia, across various socioeconomic and demographic contexts. METHODS A cross- sectional study was conducted, involving the distribution of a translated online questionnaire based on the OHQoL-UK® tool to evaluate oral health-related quality of life OHRQoL. This included utilizing the Oral Health Quality of Life Scale to assess overall quality of life. RESULTS A total of 586 participants were involved in the study, with the majority being over 60 years old (77.1%). The mean score of OHRQoL was 3.79. The Social Dental Scale SDS had a mean score of 0.71. The General Oral Health Assessment GOHS scored 3.51 on average. The mean score of Dental Impact Profile DIP was 3.12. The Subjective Oral Health Status Indicators SOHSIs had a mean score of 3.82. The mean score of Oral Health Benefit of Life Inventory OHBLI averaged at 4.04, and Dental Impact on Daily Living DIDL scored an average of 4.05. The mean scores of OHRQoL and Oral Impacts on Daily Performance OIDP were 3.90 and 3.89 respectively. Cronbach's Alpha values ranged from 0.854 to 0.939, with an overall questionnaire reliability of 0.977, indicating a good reliability of the study's tool. CONCLUSION Older adults exhibited lower OHRQoL compared to younger adults, particularly influenced by factors such as health insurance coverage, monthly income, and educational level. It is essential to develop health programs specifically tailored for senior adults to safeguard their overall health and quality of life. Making health and medical insurance obligatory and accessible to all individuals is crucial for enhancing their QoL and reducing the diseases.
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Affiliation(s)
- Nawaf H Al Shammary
- Department of Preventive Dentistry, College of Dentistry, University of Ha'il, P.O. Box 2440, Ha'il, 81481, Saudi Arabia.
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Komiyama T, Gallagher JE, Hattori Y. Relationship between tooth loss and progression of frailty: Findings from the English longitudinal study of aging. Arch Gerontol Geriatr 2024; 127:105572. [PMID: 39003834 DOI: 10.1016/j.archger.2024.105572] [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: 04/02/2024] [Revised: 07/04/2024] [Accepted: 07/06/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE The objective of the present study was to investigate the relationship between indicators of oral health status (number of teeth; denture use) and the progression of frailty amongst adults in England. METHODS The subjects were participants of the English Longitudinal Study of Aging [ELSA] aged 50 years and older. We used panel data from three waves of the study (Waves 7-9). Indicators of oral health comprised the number of teeth (≥20; 10-19; 1-9; 0) and combination of removable denture usage and the number of teeth. Frailty was assessed by the 32-item Frailty Index (FI). Covariates were age, sex, education, marital status, smoking, alcohol, and physical activity. The longitudinal relationship between oral health indicators and change in FI were investigated using linear mixed-effect models considering frailty as a time-varying variable. RESULTS Among the 7,557 participants, compared to those people with 20 or more teeth, change in frailty over time was significantly higher among those with less than 20 teeth: 10-19 teeth (β: 0.249, 95 %CI: 0.116 to 0.382), and 1-9 teeth (β: 0.238, 95 %CI: 0.053 to 0.423) and being edentate (β: 0.286, 95 %CI: 0.106 to 0.465) when adjusting for co-variates. The rise in frailty over time was significantly higher among those with fewer teeth (<20 teeth), including those using dentures. CONCLUSIONS AND IMPLICATIONS This longitudinal analysis suggests that tooth loss is associated with accelerated progression of frailty and utilizing dentures did not reduce the trend in frailty. Thus, maintaining a functional natural dentition is important in healthy ageing.
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Affiliation(s)
- Takamasa Komiyama
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, SE5 9RS, United Kingdom; Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, 980-8575, Japan.
| | - Jennifer E Gallagher
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, SE5 9RS, United Kingdom
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, 980-8575, Japan
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Yang H, Chen L, Ye D, Wu Y, Zhang H. Oral Health and Its Associated Factors Among the Elderly in the Emergency Department: A Latent Class Analysis. J Multidiscip Healthc 2024; 17:3141-3153. [PMID: 39006876 PMCID: PMC11244057 DOI: 10.2147/jmdh.s469086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/03/2024] [Indexed: 07/16/2024] Open
Abstract
Purpose The objective of this study was to investigate latent classes of oral health and the factors associated with them in acutely admitted elderly inpatients. Patients and Methods A cross-sectional study was conducted using purposive sampling to survey Chinese older-adult acutely inpatients. Data was collected utilizing several instruments, including a general information questionnaire, Brief Oral Health Status Examination (BOHSE), Oral Frailty Index-8 (OFI-8), Mini-Nutritional Assessment Short Form (MNA-SF), and Frailty Screening Questionnaire (FSQ). Latent class analysis was applied to identify distinct categories of oral health among elderly inpatients, and multinomial logistic regression was employed to analyze the factors associated with different oral health categories. Results In this study, a total of 504 elderly patients were ultimately included, leading to the identification of three latent classes of oral health: "oral health-low level group (41.27%)", "oral health-moderate level group (25.4%)", and "oral health-high level group (33.33%)". The findings revealed that patients with advanced age, elevated neutrophil percentage, and higher C-reactive protein (CRP) values were more likely to be classified in the low oral health group. Additionally, individuals experiencing malnutrition and frailty had a higher risk of falling into the low oral health category. Those with comorbidities and oral frailty were more prevalent in the moderate oral health group. At the same time, elderly patients with higher BMI (22.95±3.043) ratios were more likely to be categorized in the high oral health group. Conclusion This study sheds light on three distinct latent classes of oral health among acutely admitted elderly inpatients. These findings underscore the importance of healthcare professionals focusing on the assessment and health education of elderly patients' oral health. Furthermore, personalized interventions should be developed to promote healthy aging, with particularly attention to enhancing oral health outcomes in this population.
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Affiliation(s)
- Heng Yang
- Department of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, People’s Republic of China
| | - Lixia Chen
- Department of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, People’s Republic of China
| | - Danjuan Ye
- Department of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, People’s Republic of China
| | - Ying Wu
- Department of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, People’s Republic of China
| | - Huafang Zhang
- Department of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, People’s Republic of China
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Kino S, Tamada Y, Takeuchi K, Nakagomi A, Shiba K, Kusama T, Yamamoto T, Aida J. Exploring the relationship between oral health and multiple health conditions: An outcome-wide approach. J Prosthodont Res 2024; 68:415-424. [PMID: 37574274 DOI: 10.2186/jpr.jpr_d_23_00091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
PURPOSE A growing body of evidence suggests that oral health is associated with a wide range of health outcomes; however, opinions tend to vary because of inconsistent findings. This study aimed to simultaneously examine the association between oral health status and multiple health and well-being indicators using outcome-wide epidemiology. METHODS Data were obtained from the Japan Gerontological Evaluation Study. Oral health status was categorized as: ≥20 teeth, 10-19 teeth with dental prosthesis, 0-9 teeth with prosthesis, 10-19 teeth without prosthesis, and 0-9 teeth without prosthesis. We examined the associations between oral health status in 2013 and 35 health and well-being outcomes in 2019, including physical/cognitive health, psychological distress, subjective health, social well-being, prosocial/altruistic behaviors, and health behaviors, using two databases (n=32,827 and 15,905). RESULTS Compared to individuals with ≥20 teeth, those with <20 teeth had a 10-33% higher risk of mortality and a 6-14% higher risk of functional disability six years later. Additionally, individuals with fewer than 20 teeth tended to go out less frequently and eat fewer vegetables and fruits. Furthermore, individuals with 0-9 teeth without a prosthesis were more likely to have severe functional disability (risk ratio (RR):1.17, 95% confidence interval (CI):1.05-1.31), engage in fewer intellectual activities (standardized difference: 0.17, 95% CI: 0.10-0.24), and feel more hopeless (RR: 1.21, 95% CI: 1.04-1.41). CONCLUSIONS The prevention of tooth loss and prosthodontic treatment may be associated with reduced mortality and functional disability, as well as maintenance of intellectual ability, frequency of going out, and improvements in dietary lifestyle.
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Affiliation(s)
- Shiho Kino
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yudai Tamada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Atsushi Nakagomi
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Koichiro Shiba
- Department of Epidemiology, Boston University School of Public Health, Boston, the United States
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takafumi Yamamoto
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Ito Y, Tanaka Y, Daidoji A, Al Khalili H, Hattori Y. Relationship between texture perception and oral function: A preliminary study in young, healthy adults. J Oral Rehabil 2024; 51:1229-1235. [PMID: 38641861 DOI: 10.1111/joor.13702] [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: 11/30/2023] [Revised: 03/05/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Oral frailty, characterised by reduced oral function, is associated with systemic health issues in older adults. Although the criteria for diminished oral function often focus on motor and secretory abilities, texture perception also plays a crucial role in health due to its impact on food intake and palatability. OBJECTIVE This study aimed to explore the relationship between thickness discrimination ability (TDA) and oral motor and secretory functions in healthy young individuals. METHODS Twenty-eight adults were assessed for texture perception using eight concentrations of aqueous xanthan gum solutions to determine TDA scores. Measurements of occlusal force, masticatory performance, tongue pressure, stimulated salivary flow rate and tongue-lip motor function were conducted. Spearman's correlation analysis was used to evaluate the relationship between TDA scores and oral functions. Participants were divided into high-sensitivity and low-sensitivity groups based on their TDA scores to compare oral function test results. RESULTS The TDA scores varied among the participants, with higher scores correlating with higher masticatory performance (r = 0.41, p < .05). Masticatory performance in the high-sensitivity group was significantly higher than in the low-sensitivity group (211.9 ± 59.2 mg/dL vs. 157.9 ± 43.0 mg/dL, p = .013), with no significant differences in other oral functions. CONCLUSION Masticatory performance was correlated with TDA, suggesting a link between the selection function of mastication and thickness discrimination. These findings highlight the potential relevance of texture perception in oral function and indicate the need for further exploration, particularly in older adults with declining oral health.
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Affiliation(s)
- Yuki Ito
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yasue Tanaka
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Akinari Daidoji
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Hala Al Khalili
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Singh A, Purohit BM, Purohit A. Risk factors and associated pathway for rural and urban unmet dental prosthetic needs among older adults in Central India. SPECIAL CARE IN DENTISTRY 2024; 44:1182-1190. [PMID: 38302807 DOI: 10.1111/scd.12967] [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: 06/30/2023] [Revised: 01/18/2024] [Accepted: 01/20/2024] [Indexed: 02/03/2024]
Abstract
AIM This study was undertaken to evaluate the risk factors and associated pathways for unmet dental prosthetic needs among older adult population in Central India. METHODS A total of 11,145 randomly selected older adults participated in the study; 4613 from urban region and 6532 form rural region. Oral examinations were conducted at individual households for recording dental caries, periodontal disease, prosthetic status and needs. Structural Equation Modelling (SEM) was used to examine relationship between a set of exogenous variables and unmet dental prosthetic needs with variables that remained significant in the adjusted multilevel logistic model. Path coefficients were calculated for all variables with 95% confidence interval. Goodness of fit of the model was assessed by several indices. RESULTS A total of 8433 (75.7%) participants had never visited a dentist and 9139 (82%) had unmet dental prosthetic needs. Dental caries was observed among 3207 (69.5%) and 4644 (71.1%) study participants from urban and rural regions respectively (p < .05). Low utilization of dental services was associated with high dental prosthetic needs in upper arch and lower arch (PC = -0.05, 0.001) and DMFT was associated with lower utilization of dental services (PC = -0.09, 0.001). DMFT was also associated with age, annual income, level of education, paternal education, type of family, tobacco consumption and CPI score in the hypothesized model. The fit indices used indicated that the model was adequate. CONCLUSIONS Dental prosthetic needs in the proposed pathway model was associated with low utilization of dental services, dental caries, periodontal disease and other socio-demographic factors.
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Affiliation(s)
- Abhinav Singh
- Department of Dentistry, Nodal Officer, Regional Training Centre for Oral Health Promotion, All India Institute of Medical Sciences, Bhopal, India
| | - Bharathi M Purohit
- Division of Public Health Dentistry, Centre for Dental Education and Research, WHO Collaborating Centre for Oral Health Promotion, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Abhishek Purohit
- Department of Dentistry, Regional Training Centre for Oral Health Promotion, All India Institute of Medical Sciences, Bhopal, India
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Reiner A, Steinhoff P. The association of social networks and depression in community-dwelling older adults: a systematic review. Syst Rev 2024; 13:161. [PMID: 38902787 PMCID: PMC11188217 DOI: 10.1186/s13643-024-02581-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Depression is a globally prevalent mental condition, particularly among older adults. Previous research has identified that social networks have a buffering effect on depression. Existing systematic reviews have either limited their research to specific geographic areas or provided evidence from over a decade ago. The vast body of recent literature particularly from the last decade emphasizes the need for a comprehensive review. This systematic review aims to analyze the association of structural aspects of social networks and depression in older adults. METHODS The electronic databases APA PsycINFO, ProQuest, PSYINDEX, PubMed, Scopus, SocINDEX, and Web of Science were searched from date of data base inception until 11 July 2023. Studies were eligible for inclusion if they reported on community-dwelling older adults (defined as a mean age of at least 60 years old), had an acceptable definition for depression, referred to the term social network in the abstract, and were published in English. Quality was appraised using the Newcastle Ottawa Scale for cross-sectional and longitudinal studies. Outcome data were extracted independently from each study and analyzed by direction of the relationship, social network domain and cross-sectional or longitudinal study design. RESULTS In total, 127 studies were included. The study categorizes structural network aspects into seven domains and finds that larger and more diverse networks, along with closer social ties, help mitigate depression. The literature on the relationships between depression and network density, homogeneity, and geographical proximity is scarce and inconclusive. DISCUSSION AND IMPLICATIONS: Despite inconsistent findings, this review highlights the importance of quantifying complex social relations of older adults. Limitations of this review include publication and language bias as well as the exclusion of qualitative research. Further research should use longitudinal approaches to further investigate the reciprocal relationship between social networks and depression. Following this review, interventions should promote the integration of older adults in larger and more diverse social settings. Other: This work was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Grant [454899704]. This systematic review was pre-registered. The review-protocol can be accessed at https://doi.org/10.17605/OSF.IO/6QDPK .
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Affiliation(s)
- Amelie Reiner
- Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany.
| | - Paula Steinhoff
- Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany
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Chen Y, Ku E, Tsai P, Lin C, Ko N, Huang S, Wang J, Yang Y. The relationship between oral frailty and oral dysbiosis among hospitalized patients aged older than 50 years. Clin Exp Dent Res 2024; 10:e890. [PMID: 38816943 PMCID: PMC11139674 DOI: 10.1002/cre2.890] [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: 12/14/2023] [Revised: 03/15/2024] [Accepted: 04/24/2024] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVE This study aimed to clarify the relationship between oral frailty and oral dysbiosis among hospitalized patients aged ≥ 50 years. METHODS A prospective observational study was conducted. Number of teeth, masticatory ability, articulatory oral motor skill, tongue pressure, swallowing pressure, and choking were used to assess oral frailty. Saliva samples were collected from the oral cavity for bacterial culture. RESULTS A total 103 in patients enrolled and 53.4% suffered from oral frailty. Oral frailty was found to have a 3.07-fold correlation with the presence of Enterobacterales in the oral cavity (p = 0.037), especially in poor articulatory oral motor skill, which showed at greater risk of Enterobacterales isolated from the oral cavity by 5.58-fold (p = 0.01). CONCLUSION Half of hospitalized patients was found to have oral frailty that was related to more Enterobacterales in the oral cavity. This evidence suggests that the enhancement of articulatory oral motor skills may serve as a potential strategy for mitigating the presence of Enterobacterales within the oral cavity.
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Affiliation(s)
- Yen‐Chin Chen
- College of MedicineNational Sun Yat‐sen UniversityKaohsiungTaiwan
- Department of Nursing, College of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - En‐Ni Ku
- Department of NursingLinkou Chang Gung Memorial HospitalTaipeiTaiwan
| | - Pei‐Fang Tsai
- Department of Pathology, National Cheng Kung University Hospital, College of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Che‐Wei Lin
- Department of Biomedical Engineering, College of EngineeringNational Cheng Kung UniversityTainanTaiwan
| | - Nai‐Ying Ko
- Department of Nursing, College of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Shun‐Te Huang
- Division of Pediatric Dentistry and Special Care DentistryKaohsiung Medical University HospitalKaohsiungTaiwan
| | - Jiun‐Ling Wang
- Department of Medicine, College of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Internal Medicine, National Cheng Kung University HospitalCollege of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Yi‐Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Family Medicine, College of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Geriatric and Gerontology, National Cheng Kung University HospitalCollege of Medicine, National Cheng Kung UniversityTainanTaiwan
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12
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Salazar J, Andersen C, Øzhayat EB. Effect of oral health interventions for dependent older people-A systematic review. Gerodontology 2024; 41:200-219. [PMID: 37847812 DOI: 10.1111/ger.12720] [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] [Accepted: 10/04/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND There is an increasing proportion of older people in the population worldwide, with a large group being dependent on the care of others. Dependent older people are more vulnerable to oral diseases, which can heavily impact their quality of life (OHRQoL) and general health. OBJECTIVE The purpose of this systematic review was to comprehensively assess interventions to improve oral health or guarantee access and adherence to dental treatment of dependent older people. METHODS We searched MEDLINE, EMBASE, CENTRAL and clinical trial registries. Two reviewers performed the selection, data extraction, risk of bias evaluation using the Cochrane Risk of Bias tool and assessment of certainty of the evidence. When possible, we conducted a meta-analysis to calculate effect estimates and their 95%CIs. Primary outcomes were OHRQoL, oral/dental health, and use of the oral care system. RESULTS We included a total of 30 randomised clinical trials assessing educational and non-educational interventions for community-dwelling older people (n = 2) and those residing in long-term care facilities (n = 28). Most studies assessed oral hygiene and showed that interventions may result in a reduction in dental plaque in the short term (with low certainty of evidence), but there is limited evidence for long-term effectiveness. Only one study assessed OHRQoL, and none evaluated changes in the use of the oral health care system. CONCLUSION Our findings do not provide strong conclusions in favour of any specific intervention, mainly due to study quality and imprecision. There is limited information about the long-term effect of interventions, and further research is needed, especially targeting community-dwelling older people. PROSPERO ID CRD42021231721.
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Affiliation(s)
- Josefina Salazar
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christina Andersen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Esben Boeskov Øzhayat
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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13
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Khan S, Chen Y, Crocombe L, Ivey E, Owen AJ, McNeil JJ, Woods RL, Wolfe R, Freak-Poli R, Britt C, Gasevic D. Self-reported oral health status, edentulism and all-cause mortality risk in 12 809 Australian older adults: a prospective cohort study. Aust Dent J 2024; 69:82-92. [PMID: 37916480 DOI: 10.1111/adj.12987] [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] [Accepted: 10/04/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To investigate the association between oral health status and all-cause mortality in older adults using prospective cohort study design. SETTING AND PARTICIPANTS In total, 12 809 adults aged ≥70 years (54.3% females) were participants of the ASPREE Longitudinal Study of Older Persons (ALSOP). METHODS Participants self-reported the presence of natural teeth and oral health status. The association of self-reported oral health, edentulism and the integrative measure of the two with all-cause mortality were explored using the Cox-regression models adjusted for age, gender, socio-economic status, health-related behaviours, weight status, aspirin and polypharmacy. Hazard ratios (HRs) and 95% confidence intervals (CIs) were reported. RESULTS In total, 22.2% of participants reported edentulism and 13.8% had fair/poor oral health. After adjustment for confounders, risk of all-cause mortality was higher among those with edentulism (vs. no edentulism) HR (95% CI) 1.43 (1.18, 1.73); and those with edentulism and reporting poor/fair oral health HR (95% CI) 1.69 (1.02, 2.82), or with no edentulism but reporting poor/fair oral health HR (95% CI) 1.46 (1.19-1.80) vs. no edentulism and reporting good/very good/excellent oral health. No association was observed between self-reported oral health alone and all-cause mortality. CONCLUSIONS The risk of all-cause mortality was 69% higher among older adults reporting both edentulism and poor/fair oral health compared with those with teeth and more favourable self-reported oral health. © 2023 Australian Dental Association.
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Affiliation(s)
- S Khan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, Victoria, Australia
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Y Chen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - L Crocombe
- University Department of Rural Health, La Trobe University, Bendigo, Victoria, Australia
| | - E Ivey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - A J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - J J McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - R L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - R Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - R Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - C Britt
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - D Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
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14
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Nakagawa S, Miura K, Arai E, Taira K, Watanabe Y, Shirobe M, Motokawa K, Ohara Y, Iwasaki M, Hirano H, Ono T, Adachi A, Watanabe T, Yamazaki Y. Oral frailty, appetite and dietary variety in late-stage older adults: A cross-sectional study (the STudy of lAte-stage oldeR adulTs in Tottori; START Tottori). Geriatr Gerontol Int 2024; 24:626-633. [PMID: 38714504 DOI: 10.1111/ggi.14892] [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: 12/15/2023] [Revised: 02/19/2024] [Accepted: 04/23/2024] [Indexed: 05/10/2024]
Abstract
AIM Efforts to combat frailty and preserve good health in older adults have highlighted oral frailty as an early indicator of overall frailty. Individuals showing oral frailty are at an elevated risk of insufficient nutritional intake compared with those without oral frailty; however, underlying mechanisms remain poorly explored. In this cross-sectional study, we aimed to examine the link between oral frailty and undernutrition, especially regarding poor appetite and low dietary diversity. METHODS The analysis included 2727 late-stage older adults (mean age 79.9 ± 4.3 years) who underwent dental checkups in a prefecture in Japan from 2016 to 2020. The examination involved a questionnaire survey (covering basic information, frailty screening index, appetite index: Simplified Nutritional Appetite Questionnaire; and dietary variety: Dietary Variety Score) and a measurement survey (including intraoral confirmation, oral diadochokinesis and masticatory efficiency test). Individuals with three or more indications of poor oral function, identified through oral function assessment, were defined as showing oral frailty. Binomial logistic regression and path analyses examined associations among oral frailty, Simplified Nutritional Appetite Questionnaire and Dietary Variety Score. RESULTS Among those analyzed, 1208 (44.3%) participants were categorized into the oral frailty group. Binomial logistic regression analysis showed that Simplified Nutritional Appetite Questionnaire (odds ratio for oral frailty per 1-point increase 0.88, 95% confidence interval 0.84-0.93) and Dietary Variety Score (odds ratio 0.95, 95% confidence interval 0.92-0.98) were significantly associated with oral frailty. The path analysis showed individual associations between each examined factor. CONCLUSIONS Oral frailty was associated with decreased appetite and dietary variety in late-stage older adults. Geriatr Gerontol Int 2024; 24: 626-633.
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Affiliation(s)
- Sayuri Nakagawa
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kazuhito Miura
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Eri Arai
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kenshu Taira
- Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Maki Shirobe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Masanori Iwasaki
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Takahiro Ono
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | | | | | - Yutaka Yamazaki
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
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15
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Sekundo C, Frese C, Alich N, Langowski E, Awounvo S, Wolff D, Zenthöfer A. Very old age impacts masticatory performance: a study among sexagenarians to centenarians. Clin Oral Investig 2024; 28:349. [PMID: 38822870 PMCID: PMC11144126 DOI: 10.1007/s00784-024-05742-y] [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: 11/17/2023] [Accepted: 05/24/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVE This cross-sectional pilot study evaluated the impact of age on masticatory performance among individuals aged 65 to 106 years, as part of the Heidelberg Dental Centenarian Study (HD-100Z) conducted in South-Western Germany. MATERIALS AND METHODS A total of 31 centenarians were recruited, alongside 31 individuals each from the age groups 75-99 and 65-74, matched based on sex, prosthetic status, and number of teeth. Masticatory performance was assessed using a two-colored chewing gum test and digital image processing. Multiple linear regression analysis was performed to assess the effect of age, sex, number of teeth, type of prosthesis on the masticatory performance. RESULTS Masticatory performance, as measured by the standard deviation of hue in the chewing gum test, decreased significantly in centenarians compared to individuals aged 75-99 years (-0.112, p = 0.037) and those aged 65-74 years (-0.274, p < 0.001). The effects of sex, number of teeth, and type of prosthesis on masticatory performance were not significant associations (p ≥ 0.135). CONCLUSION The findings suggest that age may have a significant influence on masticatory performance in the studied age groups, challenging previous notions that aging itself has little impact on masticatory ability. The inclusion of centenarians in the study highlights the need for further investigation into masticatory function in age groups reaching up to 100 years or more. CLINICAL RELEVANCE This study contributes to the understanding of how ageing affects oral function, which may guide dental treatment approaches for older individuals, and set the stage for more in-depth investigations in this field in the future.
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Affiliation(s)
- Caroline Sekundo
- Heidelberg University, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany.
| | - Cornelia Frese
- Heidelberg University, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Niklas Alich
- Heidelberg University, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Eva Langowski
- Heidelberg University, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Sinclair Awounvo
- Institute of Medical Biometry, Heidelberg University, Heidelberg, Germany
| | - Diana Wolff
- Heidelberg University, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas Zenthöfer
- Heidelberg University, Department of Prosthodontics, University Hospital Heidelberg, Heidelberg, Germany
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16
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McGrath C, Suen RPC, Wong MCM, Yeung AWK, McKenna G, Moore C. Operationalisation of Successful Ageing in the Oral Health Context: A Citation Analysis. Int Dent J 2024:S0020-6539(24)00124-2. [PMID: 38762370 DOI: 10.1016/j.identj.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/10/2024] [Accepted: 04/13/2024] [Indexed: 05/20/2024] Open
Abstract
OBJECTIVES The rapidly ageing world has placed considerable demands on health and social care. To address this, the World Health Organization (WHO) and United Nations (UN) have declared action for this decade (2021-2030) to promote healthy ageing. Operationalisation of successful ageing in the oral health context in terms of its dimensions and their interconnectedness was determined. METHODS A citation analysis was conducted following a scoping review to determine oral health's relationship with 5 key dimensions of successful ageing. This included examining the occurrence and co-occurrence amongst dimensions and over time. Specific consideration of citations by country, journal type, and authors through overlay visualisation was performed to map their interconnectedness. RESULTS The scoping review identified 263 publications covering 1730 specific terms. There was a growing interest in successful ageing in the oral health context, mostly in the past decade (2010 onwards; 65.8%, 173 publications). The dimension of key consideration was "health and ADLs" (activities of daily living); this dimension appeared in 97.3% of publications (n = 256) and was found earliest to emerge, with the greatest link strengths compared to other dimensions. Country-level variations in citation data were observed, and there was good citation interconnectedness between them. Key oracles for dissemination have been medical rather than dental-specific journals. Amongst authors, there was considerable interconnectedness in the field. CONCLUSIONS Findings highlight how successful ageing in the oral health context has been studied, with implications for addressing the significance of oral health to older peoples' lives in line with the WHO and UN's agenda. Citation analyses identified the "known unknowns" area for further consideration, and these findings have the potential to inform how dental research may best move forward with the successful ageing agenda to bring about translational impact.
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Affiliation(s)
- Colman McGrath
- Applied Oral Sciences and Community Dental Care Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
| | - Rita P C Suen
- Applied Oral Sciences and Community Dental Care Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - May C M Wong
- Applied Oral Sciences and Community Dental Care Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Andy W K Yeung
- Applied Oral Sciences and Community Dental Care Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Gerry McKenna
- Restorative Dentistry Department, School of Dentistry, Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - Ciaran Moore
- Restorative Dentistry Department, School of Dentistry, Royal Victoria Hospital, Belfast, Northern Ireland, UK
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17
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Núñez MDRR, Engel FD, Cardoso M, Castro RG, Montoya JAG, de Mello ALSF. Oral hygiene prior to cardiac surgery to prevent infections: Randomized clinical trial. Int J Dent Hyg 2024; 22:384-393. [PMID: 36546871 DOI: 10.1111/idh.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
CONTEXT It is not clear if an oral hygiene protocol to control biofilm applied before cardiac surgery can reduce infection rates. OBJECTIVE We aim to verify the effectiveness of an oral hygiene protocol in reducing postoperative infections when compared to usual practices, in patients admitted to a cardiology unit, prior to cardiac surgery. DESIGN, SETTING AND PARTICIPANTS Randomized, blind, controlled clinical trial, with 107 participants who expected to undergo cardiac surgery, randomized into two groups: Experimental Group (EG) standardized oral hygiene protocol (54) and Control Group (CG), usual practices performed in patients admitted (53). INTERVENTION a standardized oral hygiene protocol, 1 day before surgery: professional prophylaxis with a portable ultrasound device, tooth brushing and flossing plus a 0.12% chlorhexidine gluconate solution (0.12% CHX) mouth rinsing. When applicable, removable prostheses cleaning. PRIMARY OUTCOME the presence of infection. RESULTS The occurrence of postoperative infection was higher in CG = 7 (13.2%) than in EG = 5 (9.3%); but no statistical difference was found between protocols (p = 0.518). The length of stayed from surgery to discharge presented a statistical difference (p = 0.047; RR = 4.9; CI = 1.01-24.33); the percentage of postoperative infection was almost five times higher in those participants who stayed 11 or more days. CONCLUSION The standardized oral hygiene protocol with mechanical and chemical cleaning, 1 day before cardiac surgery, was not more effective than the usual practices performed regarding the reduction of postoperative infections. Other interventions regarding oral hygiene procedures before cardiac surgery must be studied to contribute to the reduction of adverse post-surgical events. CLINICAL TRIAL REGISTRATION Site Ensaclinicos.gov.br number U1111-1214-2862. DESCRIPTORS Healthcare Associated Infections, Cardiovascular Diseases, Periodontal Diseases, Dental Biofilm, Cardiovascular Surgery.
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18
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Genç FZ, Uslu A. The relationship and affecting factors between oral health and frailty in the older people: A cross-sectional study. Public Health Nurs 2024; 41:438-445. [PMID: 38450845 DOI: 10.1111/phn.13300] [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: 09/10/2023] [Revised: 01/19/2024] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE To investigate the connection between oral health and frailty in older people and to determine the affecting factors. DESIGN The research was a community-based cross-sectional study. SAMPLE A Family Health Center conducted a study on 321 older people. MEASUREMENTS Data were collected face-to-face using the Personal Information Form, Geriatric Oral Health Assessment Index, and Edmonton Frailty Scale. Factors affecting oral health and frailty were examined using the MANOVA test and the relationship between them was examined using Pearson's correlation test. RESULTS It was determined that 52.6% of the participants had poor oral health and 56.1% had different levels of frailty. Education was effective on the Geriatric Oral Health Assessment Index scale score. The presence of chronic disease, frequency of tooth/denture brushing, age, education, and sex were effective on the Edmonton Frailty Scale. When the partial eta square values were examined, it was determined that the variable that had the highest impact on the GOHAI and EFS scale scores was educational status. It was determined that there was a significant negative relationship between participants' oral health and frailty scores (r = -0.539, p < .001). CONCLUSIONS It was determined that more than half of the older individuals included in the study had poor subjective oral health and varying levels of frailty. The influencing factors were determined through multivariate advanced analysis. This relationship and affecting factors are important in providing appropriate early detection and care to older people.
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Affiliation(s)
- Fatma Zehra Genç
- Department of Public Health Nursing, Offıce of Publications Coordination, Necmettin Erbakan University, Konya, Turkey
| | - Arzu Uslu
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Harran University, Şanlıurfa, Turkey
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19
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Seo HJ, Ahn SK, Choi MJ. Temporal trends and the association between self-rated oral health and falls in community-dwelling older adults in South Korea: a secondary analysis of survey data. BMJ Open 2024; 14:e081549. [PMID: 38658001 PMCID: PMC11043713 DOI: 10.1136/bmjopen-2023-081549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/27/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE This study aims to examine temporal trends and the association between falls and self-rated oral health (SROH) status in community-dwelling older Korean adults. DESIGN Secondary analysis of a serial cross-sectional study. METHODS We analysed biennial data from 314 846 older adults in South Korea from 2011 to 2019 using data from the Korea Community Health Survey. Self-reported fall experience data came from the injury questionnaire question, 'Have you fallen in the past year (slipping, tripping, stumbling and falling)?'. For SROH, the participants were asked, 'How do you feel about your oral health, such as teeth and gums, in your own opinion?'. The association between SROH and falls was examined using a weighted multivariable logistic regression model adjusted for sociodemographic characteristics, health status and behaviours, and psychological factors. RESULTS Those who reported poor SROH had a lower declining slope than the other groups, although all groups showed a significantly decreasing trend in both men and women from 2011 to 2019 (p for trend<0.001). Older adults who reported having poor SROH had a more significant history of fall accidents than the good SROH groups, controlling for potential confounding variables (adjusted OR 1.16 (95% CI 1.10 to 1.21) in men; adjusted OR 1.17 (95% CI 1.13 to 1.21) in women). CONCLUSIONS Older adults with poor SROH, especially women, had more fall accidents, making them a priority target for fall prevention strategies. This study suggests considering SROH status when identifying fall risk factors in community-dwelling older adults.
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Affiliation(s)
- Hyun-Ju Seo
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Soon-Ki Ahn
- Department of Preventive Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Min-Jung Choi
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
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20
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Park HJ, Jung EH, Kim SM, Park SC, Jo MJ, Lee YS, Kim SH, Han SY. Assessment of oral hypofunction and its association with age among Korean community-dwelling older adults. BMC Oral Health 2024; 24:441. [PMID: 38600517 PMCID: PMC11007876 DOI: 10.1186/s12903-024-04180-2] [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] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Due to the increasing proportion of older adults in Korea and growing interest in aging, the concepts of oral aging and oral hypofunction have recently been introduced. Thus, it is necessary to investigate the age-specific oral function levels of Korean older adults and develop expert intervention methods for healthy aging. METHODS Dysphagia, independence of daily living, and oral hypofunction were assessed in 206 older adults living in Wonju, Gangwon State, South Korea. Subjective dysphagia was assessed through self-report questionnaires using the Dysphagia Handicap Index (DHI), the Korean version of Eating Assessment Tool-10, and the Korean version of the Modified Barthel Index. In addition, the oral hypofunction assessment items included decreased chewing ability, occlusal pressure, tongue pressure, oral dryness, and oral cleanliness. RESULTS DHI increased significantly with age, with those in their 80 s reporting the most difficulty swallowing. Oral function in terms of chewing ability (maximum occlusal pressure and number of remaining teeth), maximum occlusal pressure, and maximum tongue pressure also declined with increasing age. While there was no significant difference in oral dryness by age, those in their 80 s had dry mouth according to the criteria of the oral moisture checking device. CONCLUSIONS In an assessment of oral function in community-dwelling, independent Korean older adults, the number of items that were assessed as oral hypofunction increased with age. The findings can be used to standardize the oral hypofunction assessment item and develop age-based individualized intervention plans for the early management of oral health and individual oral myofunctional rehabilitation in Korean community-dwelling older adults.
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Affiliation(s)
- Hye-Jin Park
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Eun-Ha Jung
- Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Soo-Min Kim
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Seong-Chan Park
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Min-Ji Jo
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Yun-Seon Lee
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Sung-Hoon Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Republic of Korea
| | - Sun-Young Han
- Oral Science Laboratory, Department of Dental Hygiene, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea.
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Li T, Shen Y, Leng Y, Zeng Y, Li L, Yang Z, Wang S, Jiang Y. The prevalence of oral frailty among older adults: a systematic review and meta‑analysis. Eur Geriatr Med 2024:10.1007/s41999-023-00930-7. [PMID: 38528284 DOI: 10.1007/s41999-023-00930-7] [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: 10/18/2023] [Accepted: 12/29/2023] [Indexed: 03/27/2024]
Abstract
BACKGROUND In recent years, oral frailty was proposed as a new concept regarding dental and oral health in older adults. Poor oral health is linked to preserving general health and has become a geriatric public health problem that deeply affects healthy aging. While in present, evidence on the prevalence associated with oral frailty in older adults remains unclear. OBJECTIVE To systematically evaluate the prevalence of oral frailty among older adults, stratified by relevant factors such as gender, source, study design, region, and the evaluation scales for oral frailty and provide an evidence-based foundation for healthcare professionals and policymakers to formulate relevant measures. METHODS Ten electronic databases were systematically searched from inception to September 2023, including PubMed, Web of Science, Embase, PsycINFO, The Cochrane Library, CINAHL, China National Knowledge Infrastructure Database (CNKI), Chinese Biomedical Database (Sinomed), Weipu Database, and Wanfang database. Based on the Stata 15.0 software package, a random effect model was used to calculate the pooled prevalence of oral frailty among older adults. In addition, sensitivity analysis, subgroup analysis, and meta-regression were conducted based on different study characteristics to detect heterogeneity sources. Funnel plots, Begg's and Egger's tests were used to evaluate the publication bias. RESULTS Eighteen studies with a total of 12,932 older adults were included for meta-analysis. The pooled prevalence of oral frailty and oral pre-frailty was 24% (95% CI: 20-28%) and 57% (95% CI: 52-61%) respectively. Based on different assessment tools of oral frailty, the pooled prevalence of oral frailty was higher when using the OFI-8 scale (44.1%; 95% CI: 35.4-52.8%) than the OFI-6 scale (18.3%; 95% CI: 15.8-20.8%) or OF checklist (22.1%; 95% CI: 17.4-26.7%). The prevalence of oral frailty was higher among older adults in females (23.8%; 95% CI: 18.4-29.2%), hospital settings (31%, 95% CI: 16.6-45.5%), cross-sectional design (26.7%, 95% CI: 19.2-34.2%), and China (45.9%, 95% CI: 34.4-57.3%). CONCLUSIONS Our study showed that oral frailty was common among older adults and various characteristics may affect its prevalence. Thus, healthcare professionals and policymakers should take oral frailty seriously in clinical practice and program planning and develop more preventive measures for oral frailty among older adults.
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Affiliation(s)
- Tao Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Yinli Shen
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Yingjie Leng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - You Zeng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Long Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Zijiang Yang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Siyu Wang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Yunlan Jiang
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
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Yin Y, Zhao Y, Fei Y, Liu Y, Ji Y, Shan E, Niu S, Xing Y, Ding J, Li X. Epidemiology and risk factors of oral frailty among older people: an observational study from China. BMC Oral Health 2024; 24:368. [PMID: 38515048 PMCID: PMC10958975 DOI: 10.1186/s12903-024-04149-1] [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: 12/20/2023] [Accepted: 03/15/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVES This study aimed to compare the prevalence of oral frailty among community-dwelling older people in Nanjing, China with the usage of different measurements, and to investigate the potential risk factors of oral frailty. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A total of 338 community-dwelling older people in Nanjing, China were recruited. METHODS Oral frailty was measured based on the Oral Frailty Index-8 (OFI-8) scale and other measurement methods including the number of natural teeth (TN), repetitive saliva-swallowing test (RSST), and oral diadochokinesis (ODK). The chi-square test and the binary logistic regression analysis were performed to identify potential risk factors for oral frailty. RESULTS There were 310 participants included in the analysis. Prevalence of oral frailty by using the OFI-8, OFI-8 + TN, OFI-8 + ODK, OFI-8 + TN + ODK and RSST measurement methods were 69.0%, 27.4%, 51.9%, 21.0% and 2.9%, respectively. Passive smoking (OR = 2.04; 95%CI 1.03-4.03), being widowed/unmarried (OR1 = 2.53; 95%CI 1.25-5.10; OR2 = 2.94; 95%CI 1.12-7.77), pre-frailty (OR = 1.76; 95%CI 1.03-3.01), frailty (OR = 3.01; 95%CI 1.39-6.54), and aged 80 years and above (OR = 3.99; 95%CI 1.35-11.81) were found to be risk factors of oral frailty by the usage of the four kinds of measurement methods. CONCLUSIONS AND IMPLICATIONS The definition and diagnostic criteria of oral frailty are strongly needed to be unified in future research. Only subjective assessment is not enough for assessing oral frailty. Among objective indicators, RSST is not suitable as a screening method for oral frailty. In addition, objective indicators including TN and ODK should be valued for early screening and preventive interventions. The risk factors of oral frailty include physical frailty, passive smoking, and being widowed.
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Affiliation(s)
- Yueheng Yin
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Yue Zhao
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Yang Fei
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Ying Liu
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Yun Ji
- Chunhua Community Health Service Centre, Nanjing, 211166, Jiangsu, China
| | - Enfang Shan
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Shuzhen Niu
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Ying Xing
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Jingjing Ding
- Sir Run Run Hospital of Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - XianWen Li
- School of Nursing, Nanjing Medical University, No.101 Longmian Avenue, Nanjing, 211166, Jiangsu, China.
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Xia X, Yang Z, Xu Z, Tang J, Zhang G, Dong B, Liu X. Nutrition Status Plays a Partial Mediation Role in the Relationship between Number of Teeth and Frailty: A Cross-Sectional Multicenter Study. Gerontology 2024; 70:572-584. [PMID: 38461811 DOI: 10.1159/000538181] [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: 11/01/2023] [Accepted: 03/01/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION Although the relationship between the number of teeth and frailty has been extensively studied, the mediating role of nutrition status in the association between the number of teeth and frailty remains to be clarified. METHODS A number of 6,664 participants lived in the communities of West China were analyzed in our study. Physical frailty was determined based on the phenotype established by Fried. Nutrition status was evaluated using the Mini Nutrition Assessment-Short Form (MNA-SF) scale. Multiple linear regression was employed to evaluate the direct relationships between the number of teeth, nutrition, and frailty. Mediation models and structural equation model (SEM) pathway analysis were used to test the mediating role of nutrition status in the relationship between the number of teeth and frailty. RESULTS Among the 6,664 participants aged over 50 years old, the prevalence of frailty was 6.2%. Multiple linear regression analysis showed a significant total relationship between the number of teeth (β = -0.359, 95% CI: -0.473 to -0.244, p < 0.001) and frailty. After adjusting for MNA-SF scores, the relationship between the number of teeth and frailty remained significant (β = -0.327, 95% CI: -0.443 to -0.211, p < 0.001), indicating a partial mediating effect of nutrition. Mediation analysis verified that nutrition partially mediated the relationship between the number of teeth and frailty (indirect effect estimate = -0.0121, bootstrap 95% CI: -0.0151 to -0.0092; direct effect estimate = -0.0874, bootstrap 95% CI: -0.1086 to -0.0678) in the fully adjusted model. This mediating effect occurred through influencing weight loss, low level of physical activity, and debility. SEM framework pathway analysis confirmed the association between the number of teeth, nutrition, and frailty. CONCLUSIONS Our findings demonstrated that frailty was correlated with the number of teeth and poorer nutritional status, with nutrition partially mediating the correlation between the number of teeth and frailty. Our results supported early nutritional evaluation and intervention in oral health to decrease the risk of frailty.
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Affiliation(s)
- Xin Xia
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, China
| | - Zhongli Yang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, China
| | - Zhigang Xu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Jingyi Tang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Department of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Gongchang Zhang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, China
| | - Birong Dong
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, China
| | - Xiaolei Liu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, China
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Mohd Khairuddin AN, Bogale B, Kang J, Gallagher JE. Impact of dental visiting patterns on oral health: A systematic review of longitudinal studies. BDJ Open 2024; 10:18. [PMID: 38448428 PMCID: PMC10917741 DOI: 10.1038/s41405-024-00195-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 03/08/2024] Open
Abstract
AIM To systematically review longitudinal studies investigating the impact of dental visiting patterns on oral health across the life course. METHODS Five databases (MEDLINE, Embase, Scopus, Web of Science, CINAHL) were searched up to March 2023. Results were screened based on eligibility criteria in a two-stage process: title and abstract, and full-text review. A backward search of reference lists and a forward search of citations of the included papers was also conducted. The quality of the included papers was assessed using the Newcastle-Ottawa Scale. Key study information was extracted and a narrative synthesis of the findings was performed. RESULTS Eleven papers from five longitudinal studies in five countries (Australia, Brazil, China, New Zealand, Sweden) met the inclusion criteria. Studies of moderate to high quality consistently reported that regular dental attendance was associated with having less dental caries experience, fewer missing teeth and better oral health-related quality of life. Inconsistent findings were observed for decayed teeth, and no association was found for periodontal condition. CONCLUSIONS This review highlights an association between regular dental visiting pattern and improved oral health, notably less dental caries experience and better oral health-related quality of life. Dental attendance emerges as an important predictor of oral health across the life course, underscoring the importance of routine dental care. REGISTRATION INFORMATION The PROSPERO registration number is CRD42023396380.
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Affiliation(s)
- Aina Najwa Mohd Khairuddin
- Dental Public Health, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Birke Bogale
- Dental Public Health, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
- Department of Dental and Maxillofacial Surgery, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Jing Kang
- Oral Clinical Research Unit, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
- Oral Biology, School of Dentistry, University of Leeds, Leeds, UK
| | - Jennifer E Gallagher
- Dental Public Health, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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Lyu W, Tanaka T, Bo-Kyung S, Yoshizawa Y, Akishita M, Iijima K. Integrated effects of nutrition-related, physical, and social factors on frailty among community-dwelling older adults: A 7-year follow-up from the Kashiwa cohort study. Geriatr Gerontol Int 2024; 24 Suppl 1:162-169. [PMID: 37984854 DOI: 10.1111/ggi.14734] [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: 08/24/2023] [Revised: 10/10/2023] [Accepted: 10/29/2023] [Indexed: 11/22/2023]
Abstract
AIM To investigate the impact of nutrition-related, physical, and social factors as well as their transitions on frailty over a 7-year follow-up period among community-dwelling older adults. METHODS Participants were 868 non-frail older adults. Frailty was assessed using the Cardiovascular Health Study index. Nutrition-related, physical, and social factors have been defined in our previous study. Cox regression analysis was conducted to investigate the association between the three factors at baseline and new-onset frailty during a 7-year follow-up period. Furthermore, transitions in the three factors over two/three consecutive years and their association with frailty were investigated using lagged generalized estimating equations. RESULTS The mean age was 73.8 ± 4.8 years (women, 47.0%), and the incidence of frailty was 12.5% during the 7-year follow-up period. Compared with participants who met the three factors' criteria at baseline, those who met two, one, and none showed associations with greater adjusted hazard ratios of new-onset frailty (1.73, 95% confidence interval 0.87-3.42; 2.04 [1.01-4.12]; and 5.69 [2.82-11.47]). Generalized estimating equation analysis showed that, compared with older adults who maintained all the three criteria met, those who improved the quantity of criteria met, who maintained the less than three criteria met, and who decreased the quantity of criteria met showed (marginally) significant associations with greater adjusted odds ratios of frailty (2.86 [0.88-9.31], 3.70 [1.10-12.45], and 4.75 [1.42-15.85]). CONCLUSIONS Practicing and maintaining all three factors in daily life are crucial for frailty prevention. Future research should explore strategies to motivate behavioral modifications in these factors at the population level. Geriatr Gerontol Int 2024; 24: 162-169.
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Affiliation(s)
- Weida Lyu
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Son Bo-Kyung
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Yasuyo Yoshizawa
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Department of Healthy Life Expectancy, Graduate School of Medicine Juntendo University, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
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Ayoob A, Janakiram C. Prevalence of physical and oral frailty in geriatric patients in Kerala, India. J Oral Biol Craniofac Res 2024; 14:158-163. [PMID: 38347898 PMCID: PMC10859288 DOI: 10.1016/j.jobcr.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/12/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
Background Physical frailty is a condition where a person has decreased physical reserve and resilience to stressors. Oral frailty, on the other hand, refers to a decline in oral function in conjunction with reductions in cognitive and physical functioning. Poor oral health, encompassing factors such as functional, physiological, psychosocial, and therapeutic aspects, can lead to physical frailty. Objectives Assess the prevalence of physical and oral frailty in geriatric patients attending health centres in Kerala, India. Methodology . Design Cross-sectional study. Setting Amrita Institute of Medical Sciences (Kochi), Amrita Kripa Charitable Hospital (Wayanad) and Amrita Urban Health Centre in (Kaloor). Participants 250 geriatric participants above 60 years. Measurements The participants' physical frailty was evaluated using Fried's Frailty Phenotype, the Reported Edmonton Frail Scale, and sarcopenia screening. The assessment of oral frailty was based on several factors such as current dental status, chewing ability, tongue pressure, the Repetitive Saliva-Swallowing Test, Oral Diadokinetic rates, Xerostomia, and the Oral and Maxillofacial Index. The evaluation was using a questionnaire and clinical examination. Bivariate analysis was performed for additional variables, and multivariate analysis was utilized to examine the relationship between oral and physical frailty. Results 56 % of study participants were males, and the mean age was 68 ± 6.02 years. 34.4 % were physically frail, and the remaining were pre-frail using Fried Frailty Phenotype. 67 % showed oral frailty using the Oral and Maxillofacial Frailty Index (OMFI). Using six domains of the oral frailty status (Tanaka) showed that 74 % of individuals had an increased risk of new onset of physical frailty. In the adjusted model, individuals with mild oral frailty had lesser chances of being frail (OR = 0.509, 95 % CI = 0.274-1.946, p-value = 0.033). Conclusion The prevalence of physical frailty was 34.4 %, and oral frailty status was 74 %. The findings implied a need to include oral frailty assessments in the comprehensive general health screening for geriatric patients.
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Affiliation(s)
- Aneesa Ayoob
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, 682041, India
| | - Chandrashekar Janakiram
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, 682041, India
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Suzuki F, Okamoto S, Nakai S, Miyagi S, Tsujiguchi H, Hara A, Nguyen TTT, Shimizu Y, Hayashi K, Suzuki K, Kasahara T, Nakamura M, Takazawa C, Ogawa A, Shibata A, Kannon T, Tajima A, Tsuboi H, Ogino N, Konoshita T, Takamura T, Sato K, Nakamura H. Association between animal protein intake, oral frailty and calf circumference in middle-aged and older adults: a cross-sectional analysis from the Shika study. BMJ Open 2024; 14:e078129. [PMID: 38365294 PMCID: PMC10875535 DOI: 10.1136/bmjopen-2023-078129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/03/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE To investigate the relationship between oral frailty (OF), nutrient intake and calf circumference (CC) in middle-aged and older adults. DESIGN Cross-sectional study. SETTING Residents of four model districts of Shika town, Ishikawa Prefecture, Japan, using data from November 2017 to February 2018. PARTICIPANTS One hundred and ninety-four residents aged ≥50 years in four model districts of Shika town. The OF total score ≥3 was defined as OF. Participants were divided into OF and non-OF groups and divided into the low-CC/kg and the high-CC/kg groups. OUTCOME MEASURES The primary outcome is to use a two-way analysis of covariance to analyse the interaction between the two CC/kg groups and the two OF groups on nutrition intake. The secondary outcome is to use multiple regression analysis to investigate the nutrients significantly related to CC/kg when stratified by OF, with age, sex, body mass index, drinking status, smoking status and regular exercise as input covariates. RESULTS A two-way analysis of covariance revealed a significant interaction between the two CC/kg groups and the two OF groups on animal protein intake (p=0.039). Multiple comparisons using the Bonferroni analysis revealed a significantly lower animal protein intake in the OF group than in the non-OF group with a low CC/kg (p=0.033) but not in the group with a high CC/kg. The multiple regression analysis stratified by OF revealed a positive correlation between animal protein intake and CC/kg (p=0.002). CONCLUSIONS The present results revealed a significantly lower animal protein intake in the OF group than in the non-OF group in the low-CC/kg group, but no such difference was observed in the high-CC/kg group. Further longitudinal studies are needed to elucidate this relationship.
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Affiliation(s)
- Fumihiko Suzuki
- Department of Geriatric Dentistry, Ohu University School of Dentistry, Koriyama, Japan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Shigefumi Okamoto
- Laboratory of Medical Microbiology and Microbiome, Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University, Suita, Osaka, Japan
| | - Shingo Nakai
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Akinori Hara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Thao Thi Thu Nguyen
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Viet Nam
| | - Yukari Shimizu
- Faculty of Health Sciences, Department of Nursing, Komatsu University, Komatsu, Japan
| | - Koichiro Hayashi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Keita Suzuki
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Tomoko Kasahara
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Chie Takazawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Aya Ogawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Aki Shibata
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Takayuki Kannon
- Department of Biomedical Data Science, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Atsushi Tajima
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Hirohito Tsuboi
- Graduate School of Human Nursing, The University of Shiga Prefecture, Hikone, Japan
| | - Noriyoshi Ogino
- Department of Environmental Medicine, Faculty of Medicine, Kochi University, Kochi, Japan
- Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tadashi Konoshita
- Division of Diabetes Endocrinology and Metabolism, Yachiyo Medical Center, Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - Toshinari Takamura
- Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kuniko Sato
- Laboratory of Clinical Cognitive Neuroscience, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan
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Baek W, Kang M. The moderating effect of oral health on the association between exercise and frailty in patients with musculoskeletal disorders: Findings from the Korean Longitudinal Study of Aging. Arch Gerontol Geriatr 2024; 117:105180. [PMID: 37690257 DOI: 10.1016/j.archger.2023.105180] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE This study aimed to examine the effects of exercise and oral health on frailty and to investigate the moderating effect of oral health on the relationship between exercise and frailty among patients with musculoskeletal disorders. METHODS This descriptive, cross-sectional study used data from the seventh wave of the Korean Longitudinal Study of Aging. Frailty index based on 41 deficits across seven domains was used, and oral health was assessed using the Geriatric Oral Health Assessment Index. Hierarchical regression analysis was performed to confirm the moderating effect of oral health, and PROCESS macro model 1 by Hayes was applied to examine an inference test of the conditional effect of the moderator. RESULTS Data on 1,812 participants with musculoskeletal disorders (mean age 75.0 ± 8.6 years) was analyzed. Compared with no exercise, regular exercise (β= -2.39, 95% confidence interval [CI]= -3.42; -1.34) was significantly associated with lower frailty level. Good oral health (β= -0.38, 95% CI= -0.44, -0.32) was significantly associated with lower frailty level. A significant moderating effect of oral health on the relationship between regular exercise and frailty was detected (β= 0.18, 95% CI= 0.05, 0.30). CONCLUSIONS The beneficial effects of regular exercise on frailty were greater in participants with poor oral health than in those with good oral health. Healthcare providers should actively encourage older patients with musculoskeletal disorders and poor oral health to exercise regularly. Combined exercise and oral healthcare interventions may be the most effective strategy for managing frailty in older patients with musculoskeletal disorders.
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Affiliation(s)
- Wonhee Baek
- College of Nursing, Gyeongsang National University, South Korea
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Kamide N, Ando M, Murakami T, Sawada T, Hata W, Sakamoto M. The association of oral frailty with fall risk in community-dwelling older adults: a cross-sectional, observational study. Eur Geriatr Med 2024; 15:279-283. [PMID: 37697213 DOI: 10.1007/s41999-023-00863-1] [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: 06/15/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE This cross-sectional study examined the direct association of oral frailty with falls in community-dwelling older adults, controlling for the effects of sarcopenia and physical performance. METHODS The participants were 237 community-dwelling older people (age: 76.0 ± 5.7 years, male: 23.6%). Oral frailty was assessed using the Oral Frailty Index-8. History of falls, timed up and go test (TUG), and sarcopenia were also assessed. The association between oral frailty and fall incidence was analyzed using multivariate logistic regression analysis adjusted for TUG and sarcopenia. RESULTS Forty-six (19.4%) participants fell, and 130 (54.9%) had a risk of oral frailty. On multivariate logistic regression analysis, oral frailty was significantly associated with fall incidence (odds ratio = 2.38, 95% confidence interval 1.11-5.07), even after adjusting for TUG and sarcopenia. CONCLUSION Oral frailty is a possible fall risk factor, independent of sarcopenia and physical performance, in community-dwelling older people.
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Affiliation(s)
- Naoto Kamide
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
- Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Masataka Ando
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Takeshi Murakami
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
- Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Takuya Sawada
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Wakana Hata
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
- Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Miki Sakamoto
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
- Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
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van Noort HHJ, Harderwijk A, Everaars B, Akkermans R, van der Putten GJ, Waal GHD. The Dutch version of the Oral Health Assessment Tool: Translation and inter-rater reliability among community nurses. Int J Dent Hyg 2024; 22:140-147. [PMID: 37093920 DOI: 10.1111/idh.12678] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 02/02/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVES Translating the Oral Health Assessment Tool (OHAT) into Dutch and assessing the inter-rater reliability among community nurses. METHODS The original version of the OHAT was translated following the five stages of the 'Guidelines for the Process of Cross-Cultural Adaptation'. After a forward and backward translation, consensus on the pre-final version was obtained in an expert panel discussion. This version was pre-tested on its comprehensibility among 31 nurses and hereafter finalized. Then, inter-rater reliability of the OHAT-NL was determined by two trained nurses during oral assessments of 37 care-dependent community-dwelling older people. Intraclass correlation coefficient (ICC) and the Cohen's kappa statistic for individual items were estimated. RESULTS Feedback from nurses in the pre-test did lead to minor changes of the OHAT-NL. Inter-rater reliability was good (ICC 0.79; 95% CI 0.63-0.89) on the total score. Agreement on item level ranged from fair to very good, the kappa ranged from 0.36-0.89. CONCLUSIONS OHAT is now available in Dutch having good inter-rater reliability among trained community nurses. Future research can further validate the OHAT-NL and develop intervention according to total OHAT-NL scores.
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Affiliation(s)
- Harm H J van Noort
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Nutrition, Physical Activity and Sports, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Anne Harderwijk
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nursing Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Babette Everaars
- Research Group Innovations in Preventive Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Reinier Akkermans
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Gert-Jan van der Putten
- Medical Department, Orpea Dagelijks Leven, Apeldoorn, The Netherlands
- Department of Oral Function and Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
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Hakeem FF, AlQobaly L, Mubarak AM, Almuzaini SA. Validity of self-reported number of teeth among Saudi older adults: A public health perspective. J Taibah Univ Med Sci 2024; 19:122-129. [PMID: 37964862 PMCID: PMC10641271 DOI: 10.1016/j.jtumed.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/07/2023] [Accepted: 10/03/2023] [Indexed: 11/16/2023] Open
Abstract
Objectives This study aimed to evaluate the agreement between self-reported and clinically measured numbers of teeth in older adults from Almadinah Almunawwarah, KSA, and to identify factors associated with self-reporting accuracy. Methods This study included 337 older adults (≥60 years). Participants completed a survey assessing sociodemographic characteristics, self-rated oral and general health, and the self-reported number of teeth. Clinical examination was conducted using the 2013 criteria published by the World Health Organization. Bland-Altman plots and correlation coefficients were used to assess the agreement between self-reported and clinically measured teeth. Results The mean age of the study participants was 67.1 (SD = 6.5) years, and the majority were males (71.2%). The self-reported teeth count was higher than the clinically measured number, and only 47.7% (n = 161) of the sample showed complete agreement between the two measures. The mean difference between the self-reported and clinically recorded number of teeth was 0.41 teeth, and almost two-thirds of the study participants reported their number of teeth within an error margin of two teeth (p < 0.001). Both Spearman's and Pearson's correlation methods revealed a significant positive correlation between the two measures. Specifically, the Spearman's rho was 0.91, while Pearson's r coefficient was 0.96. Conclusion Among Saudi older adults, the self-reported number of teeth correlated with the clinically measured numbers of teeth. This suggests that self-reports can be a reliable and cost-effective method for assessing oral health in large-scale surveys, potentially guiding health policies and interventions for older adults.
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Affiliation(s)
- Faisal F. Hakeem
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Almadinah Almunawwarah, KSA
- Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK
| | - Lina AlQobaly
- King Fahad Hospiatal, Ministry of Health, Almadinah Almunawwarah, KSA
| | - Arwa M. Mubarak
- College of Dentistry, Taibah University, Almadinah Almunawwarah, KSA
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Kengne Talla P, Rodrigues A, Hachey S, Affoo R, Basiren Q, Bouferguene S, Syed M, Emami E. Oral health care and living environment for older people: a scoping review protocol. JBI Evid Synth 2024; 22:314-324. [PMID: 37799097 DOI: 10.11124/jbies-22-00415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
OBJECTIVE This scoping review will map the literature on the extent of knowledge on living environment oral health care (LIVEOR) by examining its different terminologies, its description, the stakeholders involved, the implementation characteristics, and the outcomes reported by the authors. INTRODUCTION Older people want to receive oral health care in their current living environment. Although several authors have explored some aspects of LIVEOR for older people, there are still inconsistent findings regarding the extent of this model of care. INCLUSION CRITERIA This scoping review will include quantitative, qualitative, and mixed method studies, as well as any type of knowledge synthesis on LIVEOR involving people aged 60 years and over. The search will not be limited by language, time frame, geographic location, or publication date. METHODS We will use the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). The search will include MEDLINE, CINAHL, Embase, Web of Science, and the Cochrane Library. A hand-search of the references of the included studies, and a gray literature search will also be conducted. Two independent reviewers will screen titles, abstracts, and full texts of selected studies, and perform data extraction. Findings are expected to explore what is known of LIVEOR targeting older people and to identify any knowledge gaps for future studies. We will disseminate our findings mostly through peer-reviewed publications. REVIEW REGISTRATION Open Science Framework https://osf.io/e7fm2.
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Affiliation(s)
- Pascaline Kengne Talla
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
| | - Anisha Rodrigues
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
| | - Shauna Hachey
- School of Dental Hygiene, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
| | - Rebecca Affoo
- School of Communication Sciences and Disorders, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Quentin Basiren
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
| | - Sabrina Bouferguene
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
| | - Mahidul Syed
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
| | - Elham Emami
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
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Yu J, Zhu H, Zhang Y, Wang D, Guo H, Liu X, Lai J, Zhang H, Xu H, Bai B. The relationship between dysphagia and frailty among Chinese hospitalized older patients: a serial mediation model through self-perceived oral health and self-reported nutritional status. BMC Geriatr 2024; 24:110. [PMID: 38287262 PMCID: PMC10826207 DOI: 10.1186/s12877-024-04684-0] [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: 05/13/2023] [Accepted: 01/08/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Frailty contributes to adverse outcomes in older adults and places a heavy burden on healthcare resources. Dysphagia is associated with frailty, but the mechanisms by which dysphagia affects frailty in older adults are unclear. This study aimed to investigate a serial mediating effect of self-perceived oral health and self-reported nutritional status in the relationship between dysphagia and frailty among hospitalized older patients in China. METHODS This cross-sectional study included 1200 patients aged ≥ 65 years in the Department of Geriatrics, Shaanxi Provincial People's Hospital. A structured face-to-face interview was used to survey the following questionnaires: General Information Questionnaire, Tilburg Frailty Indicators (TFI), Eating Assessment Tool-10 (EAT-10), 30mL Water Swallow Test (WST), Geriatric Oral Health Assessment Index (GOHAI), and Short-Form Mini-Nutritional Assessment (MNA-SF). A total of 980 participants with complete data were included in the analysis. Statistical analysis was performed using SPSS 26.0 and Amos 28.0 software. Spearman's correlation analysis was used for correlation analysis of study variables. The results of the multivariate linear regression analysis for frailty were used as covariates in the mediation analysis, and the structural equation model (SEM) was used to analyze the mediating effects among the study variables. RESULTS Dysphagia, self-perceived oral health, self-reported nutritional status, and frailty were significantly correlated (P<0.001). Dysphagia was found to directly affect frailty (β = 0.161, 95%CI = 0.089 to 0.235) and through three significant mediation pathways: (1) the path through self-perceived oral health (β = 0.169, 95%CI = 0.120 to 0.221), accounting for 36.98% of the total effect; (2) the path through self-reported nutritional status (β = 0.050, 95%CI = 0.023 to 0.082), accounting for 10.94% of the total effect; (3) the path through self-perceived oral health and self-reported nutritional status (β = 0.077, 95%CI = 0.058 to 0.102), accounting for 16.85% of the total effect. The total mediation effect was 64.77%. CONCLUSIONS This study indicated that dysphagia was significantly associated with frailty. Self-perceived oral health and self-reported nutritional status were serial mediators of this relationship. Improving the oral health and nutritional status of hospitalized older patients may prevent or delay the frailty caused by dysphagia.
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Affiliation(s)
- Jianjiao Yu
- School of Nursing, Xi'an Jiaotong University, 76 Yanta West Road, 710061, Xi'an, China
| | - Huolan Zhu
- Department of Geriatrics, Shaanxi Provincial People's Hospital, 256 Youyi West Road, 710068, Xi'an, China.
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Shaanxi Provincial People's Hospital, 256 Youyi West Road, 710068, Xi'an, China.
| | - Yulian Zhang
- Director's Office, Shaanxi Provincial People's Hospital, 256 Youyi West Road, 710068, Xi'an, China.
| | - Dan Wang
- Department of Nursing, Shaanxi Provincial People's Hospital, 256 Youyi West Road, 710068, Xi'an, China
| | - Hua Guo
- Department of Nursing, Shaanxi Provincial People's Hospital, 256 Youyi West Road, 710068, Xi'an, China
| | - Xiaomei Liu
- Department of Nursing, Shaanxi Provincial People's Hospital, 256 Youyi West Road, 710068, Xi'an, China
| | - Jin Lai
- School of Nursing, Shaanxi University of Chinese Medicine, Xixian Road, 712046, Xi'an, China
| | - Huiying Zhang
- School of Nursing, Yan'an University, 580 Shengdi Road, 716000, Yan'an, China
| | - Huanhuan Xu
- School of Nursing, Yan'an University, 580 Shengdi Road, 716000, Yan'an, China
| | - Bingyue Bai
- School of Nursing, Yan'an University, 580 Shengdi Road, 716000, Yan'an, China
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Albandar JM. Disparities and social determinants of periodontal diseases. Periodontol 2000 2024. [PMID: 38217495 DOI: 10.1111/prd.12547] [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: 10/19/2023] [Accepted: 12/08/2023] [Indexed: 01/15/2024]
Abstract
Periodontal diseases are highly prevalent in populations worldwide and are a major global public health problem, with major negative impacts on individuals and communities. This study investigates evidence of disparities in periodontal diseases by age groups, gender, and socioeconomic factors. There is ample evidence that these diseases disproportionally affect poorer and marginalized groups and are closely associated with certain demographics and socioeconomic status. Disparities in periodontal health are associated with social inequalities, which in turn are caused by old age, gender inequality, income and education gaps, access to health care, social class, and other factors. In health care, these factors may result in some individuals receiving better and more professional care compared to others. This study also reviews the potential causes of these disparities and the means to bridge the gap in disease prevalence. Identifying and implementing effective strategies to eliminate inequities among minorities and marginalized groups in oral health status and dental care should be prioritized in populations globally.
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Affiliation(s)
- Jasim M Albandar
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, Pennsylvania, USA
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Julkunen L, Saarela R, Roitto HM, Kautiainen H, Pitkälä K, Mäntylä P, Hiltunen K. Oral frailty among dentate and edentate older adults in long-term care. BMC Geriatr 2024; 24:48. [PMID: 38212720 PMCID: PMC10782602 DOI: 10.1186/s12877-023-04605-7] [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: 06/04/2023] [Accepted: 12/15/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The objectives of this study were to compare oral frailty (OFr) among edentate and dentate older adults living in long-term care facilities (LTCF) and to clarify how edentulism and oral disease burden (ODB) of dentate older adults are associated with OFr. METHODS The population of this study comprised 94 edentate and 209 dentate residents in LTCF in Helsinki, Finland, who had previously participated in a nutritional study. The participants underwent a clinical oral examination. The dentate residents were further divided into three ODB groups based on asymptotic dental score. The edentate and different ODB groups were compared with each other regarding demographics and oral and medical findings. OFr was defined as ≥ 2 of following: having a diet of soft/pureed food, residue of food in the oral cavity, inability to keep the mouth open during examination, unclearness of speech, dry mouth. The association between OFr and edentulousness and various levels of ODB was analyzed by a multivariate logistic model. RESULTS Participants with low ODB had significantly less OFr than their edentate peers (p = 0.009). Furthermore, the edentate and dentate with high ODB had similar odds for OFr. CONCLUSIONS Edentulousness and high ODB are equally harmful conditions and may predispose to OFr. This study suggests that maintaining healthy natural teeth and good oral health (low ODB) may protect against OFr. TRIAL REGISTRATION The Ethics Committee of the Hospital District of Helsinki and Uusimaa approved the protocols for the nutritional status and oral healthcare studies and the merging of the data, including patient medical records (Register number HUS/968/2017).
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Affiliation(s)
- Lina Julkunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Riitta Saarela
- Social Services, Health Care and Rescue Services Division, Oral Health Care, City of Helsinki, Finland
| | - Hanna-Maria Roitto
- Faculty of Medicine (Clinicum), University of Helsinki, Helsinki, Finland
- Geriatric Clinic, Helsinki Hospital, Helsinki, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Kaisu Pitkälä
- Department of General Practice, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Päivi Mäntylä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
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Davies R, Doshi M. Prevention of oral diseases for the older person (Part 1). Br Dent J 2024; 236:35-41. [PMID: 38225311 DOI: 10.1038/s41415-023-6610-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Older adults often experience poorer levels of oral health than younger adults, especially if they have become dependent on a third party to support their daily oral care routine. However, the deterioration of oral health does not need to be a part of the ageing process. Most oral diseases are largely preventable with the daily removal of dental plaque that forms on teeth and dentures, using a fluoride toothpaste, eating a healthy diet and reducing any tobacco consumption. The dental team have a duty of care to ensure that older people receive evidence-based oral health preventative advice tailored to the individual, taking into account individual risk factors that can increase with age. This can include the clinical application of topical fluoride and minimally invasive dentistry. Older people at an increased risk of poor oral health include those with cognitive conditions, physical impairments and certain medical conditions. Care home residents face particular barriers to attaining a satisfactory standard of oral care which are discussed herein. Good oral health preventative routines must be established early after the diagnosis of progressive chronic conditions and will help to prevent the need for dental intervention later in life when treatment can be more difficult to tolerate. Inclusion of oral health prevention within health policy and legislation is necessary to improve the oral health for older people living in all health and care settings.
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Affiliation(s)
| | - Mili Doshi
- Dental and Maxillofacial, Surrey and Sussex Healthcare NHS Trust, Surrey, United Kingdom.
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Yang H, Xiao J, Cui S, Zhang L, Chen L. Oral Health Assessment Tools for Elderly Adults: A Scoping Review. J Multidiscip Healthc 2023; 16:4181-4192. [PMID: 38148947 PMCID: PMC10750773 DOI: 10.2147/jmdh.s442439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose The aim of this study was to synthesize the Oral Health Assessment Tool for elderly adults and determine its psychosocial properties. Methods We conducted a scoping review. The Arkey and O'Malley methodology was employed to conduct scoping reviews involving the exploration of both national and international databases, as well as a manual search of the reference lists of the selected studies. We focused on oral health assessment tools for elderly adults (>60 years). The review report adhered to the standards outlined in the PRISMA-ScR guidelines. The study protocol was officially filed with the Open Science Framework. Results A total of 19 documents were included. The literature search included a time frame ranging from 1995 to 2023 and covered a diverse range of 13 countries. Of the 19 assessment tools examined, it was found that only the Oral Assessment Sheet had multidimensional characteristics, while the remaining tools were unidimensional in nature. The evaluation of oral health assessment tools was conducted across several contexts, including nursing homes, geriatric facilities, communities, and hospitals. A total of eleven studies underwent reliability testing, whereas two studies were alone validated for validity and did not undergo reliability testing. Additionally, seven studies were exclusively validated for reliability and did not undergo validity testing. Conclusion Multidimensional oral health assessment tools for elderly adults that integrate social and psychological aspects need to be developed and validated. It is necessary to develop oral health assessment tools based on hospitalized elderly patients to meet the oral and dental health needs of elderly patients.
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Affiliation(s)
- Heng Yang
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Jiechenming Xiao
- Department of Nursing, Huangyan Hospital, Wenzhou Medical University, Taizhou, Zhejiang, People’s Republic of China
| | - Shaomei Cui
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Liyan Zhang
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Lixia Chen
- Department of Nursing, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
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Okada M, Hama Y, Futatsuya R, Sasaki Y, Noritake K, Yamaguchi K, Matsuzaki M, Kubota C, Hosoda A, Minakuchi S. Association between Masticatory Performance, Nutritional Intake, and Frailty in Japanese Older Adults. Nutrients 2023; 15:5075. [PMID: 38140333 PMCID: PMC10746083 DOI: 10.3390/nu15245075] [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: 10/28/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
The older adult population in Japan is expected to increase. Therefore, long-term care and frailty prevention are important. However, the relationship between masticatory performance, nutritional intake, and frailty remains unclear. This cross-sectional study aimed to examine energy, protein, and vitamin D intake and its association with frailty and masticatory performance in older adults. Patients between January 2022 and January 2023 were recruited and divided into robust and frail groups. Masticatory performance, nutrition, frailty, and other data, such as age and sex, were evaluated through onsite measurements and a questionnaire. Logistic regression analysis was conducted with frailty as a dependent variable and masticatory performance as an independent variable, adjusting for age, sex, skeletal muscle mass, living alone, energy intake, protein-energy ratio, and vitamin D intake. No significant differences were observed between the groups regarding age or sex. The robust group showed significantly better results for protein-energy ratio, vitamin D intake, and subjective and objective masticatory performance than the frail group. Logistic regression analysis revealed a significant correlation between skeletal muscle mass, protein-energy ratio, and objective masticatory performance with frailty. Masticatory performance was associated with frailty, independent of the intake of nutrients such as energy, protein, and vitamin D.
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Affiliation(s)
- Mitsuzumi Okada
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Yohei Hama
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Ryota Futatsuya
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Yoshiyuki Sasaki
- Clinical Dental Research Promotion Unit, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo 113-8549, Japan;
| | - Kanako Noritake
- Oral Diagnosis and General Dentistry, Tokyo Medical and Dental University Hospital, Tokyo 113-8549, Japan;
| | - Kohei Yamaguchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Mayuko Matsuzaki
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Chieko Kubota
- Department of Oral Health Sciences, Meikai University, Chiba 279-8550, Japan;
| | - Akemi Hosoda
- Division of Medical Nutrition, Faculty of Healthcare, Tokyo Healthcare University, Tokyo 141-8648, Japan;
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
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Poser M, Sing KEA, Ebert T, Ziebolz D, Schmalz G. The rosetta stone of successful ageing: does oral health have a role? Biogerontology 2023; 24:867-888. [PMID: 37421489 PMCID: PMC10615965 DOI: 10.1007/s10522-023-10047-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: 01/17/2023] [Accepted: 06/19/2023] [Indexed: 07/10/2023]
Abstract
Ageing is an inevitable aspect of life and thus successful ageing is an important focus of recent scientific efforts. The biological process of ageing is mediated through the interaction of genes with environmental factors, increasing the body's susceptibility to insults. Elucidating this process will increase our ability to prevent and treat age-related disease and consequently extend life expectancy. Notably, centenarians offer a unique perspective on the phenomenon of ageing. Current research highlights several age-associated alterations on the genetic, epigenetic and proteomic level. Consequently, nutrient sensing and mitochondrial function are altered, resulting in inflammation and exhaustion of regenerative ability.Oral health, an important contributor to overall health, remains underexplored in the context of extreme longevity. Good masticatory function ensures sufficient nutrient uptake, reducing morbidity and mortality in old age. The relationship between periodontal disease and systemic inflammatory pathologies is well established. Diabetes, rheumatoid arthritis and cardiovascular disease are among the most significant disease burdens influenced by inflammatory oral health conditions. Evidence suggests that the interaction is bi-directional, impacting progression, severity and mortality. Current models of ageing and longevity neglect an important factor in overall health and well-being, a gap that this review intends to illustrate and inspire avenues for future research.
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Affiliation(s)
- Maximilian Poser
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
| | - Katie E A Sing
- Department of Medicine, Royal Devon and Exeter Hospital, University of Exeter Medical School, Exeter, EX2 5DW, UK
| | - Thomas Ebert
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
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Song J, Wu Y, Ma H, Zhang J. Association between muscle quality index and periodontal disease among American adults aged ≥ 30 years: a cross-sectional study and mediation analysis. BMC Oral Health 2023; 23:918. [PMID: 38001472 PMCID: PMC10675865 DOI: 10.1186/s12903-023-03520-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 10/10/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE The muscle quality index (MQI) is a measurement of muscle quality that is directly related to overall health. There has been little study on the relationship between the muscle quality index and periodontitis in American people beyond 30 years. Therefore, this study aimed to explore the link between periodontitis and Muscle quality index (MQI) in older Americans. METHODS Three thousand two hundred fifty-eight individuals (aged 30 to 59) who participated in the National Health and Nutrition Examination Survey (NHANES) 2011-2014 were considered eligible for the cross-sectional investigation. A hand dynamometer was used to determine the handgrip strength (HGS). Dual-energy X-ray absorptiometry was employed to calculate ASM (DXA). MQIArm was calculated by dividing the dominant hand's HGS by the dominant arm's ASM (in kg/kg). MQIApp was calculated by dividing the dominant hand's HGS by the ASM (in kg/kg). MQItotal was calculated by dividing the sum of the dominant and non-dominant hands by the ASM (in kg/kg). To investigate the link between muscle quality index and periodontal disease, the weighted multivariable logistic regression models were used. Using generalized additive models, it was determined if a nonlinear connection existed. Then, we developed a two-piece linear regression model and calculated the inflection point using a recursive approach. A mediation study was performed to determine how much of the impact of MQItotal on periodontitis was mediated by potential variables. RESULTS Three thousand two hundred fifty-eight participants from the United States were enrolled. The OR (95% CI) for the relationship between MQItotal and periodontitis in the regression model with fully adjusted variables was 0.69 (0.53-0.91), for the connection between MQIArm and periodontitis was 0.90 (0.84-0.97), and for the association between MQIApp and periodontitis was 0.49 (0.30-0.80). MQItotal and periodontitis were shown to have a J-shaped relationship with a change point of 3.64. Before the change point, the OR (95% CI) was 0.69 (0.58, 0.82). In the analysis of drinking and married status, the interaction was statistically significant. Analysis of mediation showed that alcohol use was responsible for 0.4% (0.10 to 1.2) of the effect of MQItotal on periodontitis. CONCLUSION In American adults aged over 30, the Muscle Quality Index (MQI) exhibited an independent negative correlation with moderate to severe periodontitis, demonstrating a J-shaped relationship. Furthermore, alcohol consumption may act as a mediator in the association between MQI and periodontitis.
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Affiliation(s)
- Jukun Song
- Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Guizhou Medical University, Guizhou, 550002, China
| | - Yadong Wu
- Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Guizhou Medical University, Guizhou, 550002, China
| | - Hong Ma
- Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Guizhou Medical University, Guizhou, 550002, China.
| | - Junmei Zhang
- Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Guizhou Medical University, Guizhou, 550002, China.
- Department of Orthodontics, the Affiliated Stomatological Hospital of Guizhou Medical University, Guiyang, China.
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Cao C, Liao S, Cao W, Guo Y, Hong Z, Ren B, Hu Z, Bai Z. Differences in the association of oral health knowledge, attitudes, and practices with frailty among community-dwelling older people in China. BMC Oral Health 2023; 23:782. [PMID: 37875820 PMCID: PMC10594714 DOI: 10.1186/s12903-023-03477-y] [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: 06/05/2023] [Accepted: 10/01/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Oral health and frailty are significantly related and should be well examined, especially in late life. Few studies have explored the relationship of oral health knowledge, attitudes, and practices with frailty and examined sociodemographic variations in this association. This study aimed to examine the association between oral health knowledge, attitudes, practices and frailty, with a special focus on comparing differences in their association among the Chinese community-dwelling older population. METHODS This study included 4218 community-dwelling older adults (aged ≥ 60 years) who participated in a cross-sectional survey. Sociodemographic characteristics, oral health knowledge, attitudes, practices, and frail status (non-frailty, pre-frailty, and frailty) were collected with a face-to-face questionnaire-based interview. Multivariate logistic regression models were used to evaluate the association of oral health knowledge, attitudes, and practices with frailty. RESULTS Of the 4218 participants, 36.2% (n = 1527) and 18.8% (n = 792) were classified as pre-frailty and frailty. Age, gender and educational attainments differences existed in the association of oral health knowledge with frailty. Urban-rural differences in the association of oral health knowledge and practices with frailty were also found. Specifically, oral health knowledge was significantly related to frailty only among participants aged 70-79 years (adjusted odds ratio [95% confidence interval]) (1.08 [1.02-1.15]), females (1.05 [1.00-1.10]), rural residents (1.06 [1.01-1.12]), and those who were primary school and lower education (1.06 [1.01-1.11]), whereas oral health practices were related to frailty only among urban participants (0.96 [0.92-1.00]). CONCLUSION This study confirmed the different associations of oral health knowledge and practices with frailty among community-dwelling older people in China. Further research is needed to better understand the abovementioned differences and public health strategies are required to improve oral health literacy and thereby contain the development of frailty in later life.
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Affiliation(s)
- Chenglin Cao
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Shengdong Liao
- Academic Affairs Office, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Wenwen Cao
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Ying Guo
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Zixuan Hong
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Bohua Ren
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, Guangdong, 523808, China
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, WV1 1QU, UK
| | - Zhi Hu
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China.
| | - Zhongliang Bai
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, China.
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, WV1 1QU, UK.
- Key Laboratory of Public Health Social Governance, Philosophy and Social Sciences of Anhui Province, Hefei, Anhui, 230032, China.
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Åstrøm AN, Mastrovito B, Sannevik J, Tsakos G. Role of behavioural and age-related factors in the long-term impact of tooth loss on oral health-related quality of life: A 25-year follow-up of Swedish older adults. Community Dent Oral Epidemiol 2023; 51:918-926. [PMID: 36036439 DOI: 10.1111/cdoe.12788] [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: 04/26/2022] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The primary aim of this study was to assess any long-term association between tooth loss at age 50 and subsequent impaired oral health-related quality of life, OHRQoL, at age 65, 70 and 75, adjusted for time invariant socio-demographic-and time variant behavioural and age-related factors in terms of disadvantages with functional, social, health and psychological concerns. As a second aim, this study examined whether behavioural- and age-related factors played a role in explaining any long-term association between early tooth loss and subsequent OHRQoL. METHODS In 1992, 6346 residents, aged 50, consented to participate in a prospective cohort study and 3060 completed postal questionnaire follow-ups every fifth year (six in total) until 2017. Information on tooth loss was assessed at baseline at age 50. Behavioural- and age-related covariates were assessed repeatedly at ages 65, 70 and 75. OHRQoL was the repeated outcome measure assessed by the Oral Impact on Daily Performance, OIDP at age 65, 70 and 75. Generalized Estimating Equations, GEE, with binomial logit function was used to test the association between tooth loss and prevalence of oral impacts (OIDP) adjusting for counfounders and potential mediators. The role of behavioural and age-related factors in explaining the association between early tooth loss and OHRQoL was tested using the change in estimate approach. RESULTS Tooth loss and time variant behavioural- and age-related covariates associated independently with higher odds of impaired OHRQoL across time. The long-term impact of tooth loss seemed to be partly explained by time variant covariates related to functional and psychological concerns. Participants who had excessive tooth loss at age 50 were 2.5 times more likely to experience oral impacts before adjustment of covariates. After adjustment of functional- and psychological-covariates, participants were, respectively, 1.6 times and 1.4 times more likely to experience oral impacts. CONCLUSION This study revealed that early tooth loss at age 50 was independently associated with subsequent impaired OHRQoL at ages 65, 70 and 75. The aspects of behavioural- and age-related factors in terms of disadvantages in functional and psychological concerns seemed to play a role in explaining the long-term impact of tooth loss on impaired OHRQoL. A mid-life approach to the prevention of tooth loss for the protection of subsequent adverse health outcomes should guide health promotion interventions and also be recognized by oral health care providers both for patient interaction and clinical decision making.
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Affiliation(s)
- Anne Nordrehaug Åstrøm
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | | | - Josefine Sannevik
- Tandvårdsenheten, Region Örebro län, Örebro, Sweden
- Department of Dentistry, Örebro, Sweden
| | - Georgios Tsakos
- Research Department of Epidemiology and Public Health, WHO Collaborating Center for Oral Health Inequalities and Public Health, University College London, London, UK
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Jun NR, Kim JH, Jang JH. Association of Denture Use and Chewing Ability with Cognitive Function Analysed Using Panel Data from Korea Longitudinal Study of Aging (2006-2018). Healthcare (Basel) 2023; 11:2505. [PMID: 37761702 PMCID: PMC10531446 DOI: 10.3390/healthcare11182505] [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: 07/16/2023] [Revised: 09/02/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
This study aimed to investigate the association between denture use, chewing ability, and cognitive function in Korean middle-aged adults, using samples representing middle-aged people at the national level. This longitudinal study included 9998 middle-aged adults using the Korea Longitudinal Study of Aging 7th special survey data. Denture use, chewing ability, health-related factors, and general characteristics were assessed using the Computer-Assisted Personal Interview. After controlling for general characteristics using a generalized estimating equation model, the association of denture use and Mini-Mental State Examination (MMSE) scores with the chewing ability of those with or without dentures and MMSE scores were analysed. Among them, 24% of participants wore dentures, and 35.1% complained of difficulty chewing when wearing dentures. Among the participants who did not wear dentures, 16.4% complained of difficulty chewing. MMSE scores were lower among denture wearers than non-denture wearers (β = -0.026, p < 0.001). In both groups, MMSE scores decreased with chewing difficulty and were significantly reduced among non-denture wearers (p < 0.05). Chewing ability was closely associated with cognitive functioning. Therefore, in order to prevent cognitive decline, chewing discomfort while wearing dentures must be eliminated, and oral health must be maintained.
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Affiliation(s)
- Nu-Ri Jun
- Department of Public Health Science, Graduate School, Dankook University, Cheonan-si 31116, Republic of Korea;
| | - Jae-Hyun Kim
- Department of Health Administration, Dankook University, Cheonan-si 31116, Republic of Korea;
| | - Jong-Hwa Jang
- Department of Public Health Science, Graduate School, Dankook University, Cheonan-si 31116, Republic of Korea;
- Department of Dental Hygiene, College of Health Science, Dankook University, Cheonan-si 31116, Republic of Korea
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Castrejón-Pérez RC, Wanyonyi KL, García-Vázquez PE, Cruz-Hervert LP, Ramírez-Aldana R, Borges-Yáñez SA. Frailty index and ten oral conditions in the Coyoacan cohort study: A cross-sectional analysis. Gerodontology 2023; 40:372-381. [PMID: 36358062 DOI: 10.1111/ger.12665] [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: 01/19/2022] [Revised: 10/12/2022] [Accepted: 10/24/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To analyse the relationship between the Frailty Index and 10 oral conditions controlling for nutritional status among Mexican community-dwelling older people. BACKGROUND Studies suggest that the association between frailty and oral conditions are mediated by nutrition. MATERIALS AND METHODS This cross-sectional analysis includes 487 community-dwelling men and women aged ≥70 years old. Interview and clinical examinations were performed at participants' homes. Objective (number of natural teeth, root remnants, dental condition, utilisation and functionality of removable dental prostheses and periodontitis) and subjective (utilisation of dental services, self-rated oral health, chewing difficulties and xerostomia) oral variables were collected by trained personnel. The Frailty Index was calculated considering 35 deficits. Nutritional status measured with the Mini-Nutritional assessment (MNA), age, sex, education, and marital status were included as covariates. We fitted 11 multivariate generalised linear models (one for each oral condition), assuming gamma distribution for Frailty Index as the outcome. RESULTS Participants average age was 78.1 years, 52.1% were women. We observed a higher Frailty Index among those rating their oral health as worse than others their age (5.1%), reporting chewing difficulties often (4.9%) and fairly and very often (7.0%), and xerostomia (4.8%). Age, gender and MNA were consistently associated with the Frailty Index. CONCLUSION Subjective oral conditions are compatible with the Frailty Index after controlling for older people's nutritional status and covariates.
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Affiliation(s)
| | | | - Paola E García-Vázquez
- Postgraduate and Research Studies Division, Dentistry School, National Autonomous University of Mexico, Mexico City, Mexico
| | - Luis Pablo Cruz-Hervert
- Postgraduate and Research Studies Division, Dentistry School, National Autonomous University of Mexico, Mexico City, Mexico
| | - Ricardo Ramírez-Aldana
- Instituto Nacional de Geriatría, National Institutes of Health, Ministry of Health, Mexico City, Mexico
| | - S Aída Borges-Yáñez
- Postgraduate and Research Studies Division, Dentistry School, National Autonomous University of Mexico, Mexico City, Mexico
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Janssens B, Tsakos G, De Visschere L, Verté D, De Witte N. Frailty as a determinant of dental attendance among community-dwelling older adults. Gerodontology 2023; 40:363-371. [PMID: 36336964 DOI: 10.1111/ger.12664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/05/2022] [Accepted: 10/24/2022] [Indexed: 08/15/2023]
Abstract
OBJECTIVES The aim of this study was to assess the association between different levels of frailty and dental attendance among home-dwelling older adults, in Belgium. BACKGROUND While many determinants of dental attendance among older adults have been identified, no study has focused on the role of frailty. MATERIALS AND METHODS This was a cross-sectional study on a random sample of home-dwelling adults aged 60 and over from two Belgian cities. Data were collected with a structured questionnaire through a participatory peer-research method. Time since the last dental attendance was the dependent variable. The independent variable was frailty, assessed with the Comprehensive Frailty Assessment Instrument, including physical, psychological, social, and environmental subdomains. Covariates were age, gender, having a partner, educational level, and household income, as well as self-perceived oral health. Data analysis included descriptive, bivariate (Chi-Square, ANOVA, and Kruskal-Wallis), and binomial logistic regression analyses. RESULTS The sample consisted of 1329 older adults with a mean age of 72.5 years (SD 8.9, range 60-103). In the low frailty group, 73% attended the dentist in the previous 12 months, while it was 62% and 54% in the medium and high frailty groups, respectively. In the fully adjusted model, the initial gradient in the relationship between overall frailty and dental attendance remained; those in the medium and the high frailty groups were respectively 1.46 (95% CI: 1.09, 1.95) and 1.67 (95% CI: 1.15, 2.43) times more likely to report no dental attendance in the previous year than the low frailty group. Similar associations could be seen in the physical and environmental frailty subdomains. CONCLUSION Frailty is consistently associated with less favourable dental attendance, independent from age, gender, socioeconomic factors, family composition, and self-perceived oral health. Once frailty has been detected, good interprofessional communication and care are needed to avoid the drop-out of older adults from the oral healthcare system.
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Affiliation(s)
- Barbara Janssens
- Department of Oral Health Sciences, Gerodontology, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University, Gent, Belgium
| | - Georgios Tsakos
- UCL Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Luc De Visschere
- Department of Oral Health Sciences, Gerodontology, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University, Gent, Belgium
| | - Dominique Verté
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussel, Belgium
| | - Nico De Witte
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussel, Belgium
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussels, Brussel, Belgium
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Onuki W, Magara J, Ito K, Ita R, Kawada S, Tsutsui Y, Nakajima Y, Sakai H, Tsujimura T, Inoue M. Evaluating the effect of management on patients with oral hypofunction: A longitudinal study. Gerodontology 2023; 40:308-316. [PMID: 36065761 DOI: 10.1111/ger.12655] [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: 04/06/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Declining oral function may affect subsequent physical frailty in the older population. The aim of this longitudinal study was to summarise data on patients who underwent functional oral examination and evaluate the impact of management on patients with oral hypofunction (OHF). METHODS Dental outpatients aged over 65 years at their initial visit to the Niigata University Hospital received detailed assessment of seven oral function items to diagnose oral hypofunction using diagnostic criteria defined by the Japanese Society of Gerodontology. Patients with OHF at the first assessment received management including oral health guidance for low function and dental treatment. They were re-evaluated approximately 6 months later and the two assessments were compared. According to the results of the second assessment, the patients were divided into two groups: OHF improved and OHF re-diagnosed. RESULTS Of the 273 patients who underwent the first assessment, 86 (31.5%) were diagnosed with OHF and received management. Of those, 42 (48.8%) completed the second assessment. Comparing the first and second assessment, significant improvement was observed in oral hygiene, occlusal force, tongue-lip motor function of /pa/, mastication and swallowing. The change in values from the first assessment demonstrated a significant difference between the OHF improved and re-diagnosed groups only in occlusal force. CONCLUSION Management for patients with OHF can contribute to the improvement of poor oral function, and an increase in occlusal force was notable in the recovery from OHF.
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Affiliation(s)
- Wakana Onuki
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Unit of Dysphagia Rehabilitation, Niigata University Medical & Dental Hospital, Niigata, Japan
| | - Jin Magara
- Unit of Dysphagia Rehabilitation, Niigata University Medical & Dental Hospital, Niigata, Japan
| | - Kayoko Ito
- Oral Rehabilitation, Niigata University Medical & Dental Hospital, Niigata, Japan
| | - Reiko Ita
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Satomi Kawada
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuhei Tsutsui
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuta Nakajima
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Haruka Sakai
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takanori Tsujimura
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Makoto Inoue
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Unit of Dysphagia Rehabilitation, Niigata University Medical & Dental Hospital, Niigata, Japan
- Oral Rehabilitation, Niigata University Medical & Dental Hospital, Niigata, Japan
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Hag Mohamed S, Sabbah W. Is tooth loss associated with multiple chronic conditions? Acta Odontol Scand 2023; 81:443-448. [PMID: 36634031 DOI: 10.1080/00016357.2023.2166986] [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: 11/20/2021] [Revised: 09/07/2022] [Accepted: 01/04/2023] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To examine the relationship between tooth loss and co-occurrence of multiple chronic conditions (MCC) among American adults at working age. MATERIALS AND METHODS Data was from the Behavioural Risk Factor Surveillance System 2018, a cross-sectional telephone-based, nationally representative survey of American adults. We included participants aged 25-64 years. The survey included sociodemographic data, reported diagnosis of chronic conditions, the number of missing teeth and health behaviours. An aggregate variable of chronic conditions was created which included heart attack, angina, stroke, cancer, chronic pulmonary disease, diabetes, asthma, arthritis, depression, and kidney diseases. The association between the number of missing teeth and the aggregate of chronic conditions was assessed adjusting for confounders. RESULTS The analysis included 202,809 participants. The mean number of MCC was 0.86 (95% Confidence Interval 'CI':0.85,0.87). Tooth loss was significantly associated with MCC with rate ratio 1.18 (95% CI:1.15,1.21), 1.53 (95% CI:1.48,1.59) and 1.62 (95% CI:1.55,1.69) for those reporting losing 1-5 teeth, 6 or more but not all, and all teeth, respectively after adjusting for demographic, socioeconomic, and behavioural factors. CONCLUSION Tooth loss could be an early marker for the co-occurrence of multiple chronic conditions among adults of working age. The association could be attributed to common risk factors for oral and general health.
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Kragh Ekstam A, Andersson P. Oral Health Status Using the Revised Oral Assessment Guide and Mortality in Older Orthopaedic Patients: A Cross-Sectional Study. Clin Interv Aging 2023; 18:1103-1113. [PMID: 37489127 PMCID: PMC10363347 DOI: 10.2147/cia.s410577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/27/2023] [Indexed: 07/26/2023] Open
Abstract
Purpose Orthogeriatric hospitalised patients with fractures of the lower limb constitute a vulnerable population with increased risk of morbidity, polypharmacy, and mortality as well as impaired oral health. The aim of this cross-sectional study was to investigate whether any relationship existed between oral health issues in older orthopaedic patients and mortality. Material and Methods The study population consisted of older orthopedic patients emergently admitted to a hospital in southern Sweden due to mainly fractures of the hip. Their oral health at admission was assessed by trained nurses using the revised oral assessment guide (ROAG), as well as examined by dental hygienists. Medical and demographic data were collected from medical records and mortality from the national population registry. Comorbidity was assessed using the Charlson Comorbidity Index (CCI). Data were analysed using foremost dichotomized data derived from mean values and then processed using multiple logistic regression adjusted for identified probable confounders. Results Of the 187 study patients (≥65 years) with a mean age of 81 (SD 7.9) years, 71% were women, mean CCI score was 6.7 and 90-days mortality 12.3%. Oral health issues (ROAG >8, 73%) consisted mainly of problems with teeth/dentures (41%), tongue (36%), lips (35%), and saliva (28%). In patients with any oral health impairment (ROAG >8) the 90-days mortality was significantly increased (p=0.040), using logistic regression analysis adjusted for age, gender, comorbidity, and use of ≥5 drugs. In patients with a ROAG score ≥10 (≥mean) the association remained at 90-days (p=0.029) and 180-days (p=0.013). Decayed teeth were present in 24% and was significantly associated with ROAG >8 (p=0.020). Conclusion The main finding of this study was a possible relationship between oral health impairment at admission and early mortality in orthogeriatric hospitalised patients. The opportunity to identify their oral health problems can help improving further care planning and care.
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Affiliation(s)
- Annika Kragh Ekstam
- Department of Orthopaedics, Region Skåne Office for Hospitals in North-Eastern Skåne, Kristianstad, SE-291 85, Sweden
| | - Pia Andersson
- Department of Health Sciences, Kristianstad University, Kristianstad, SE-291 88, Sweden
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Eaton K, Barkvoll P. Dirty Mouths Kill ! The need for interprofessional education. Nurse Educ Pract 2023; 70:103673. [PMID: 37328308 DOI: 10.1016/j.nepr.2023.103673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
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Kovács N, Liska O, Idara-Umoren EO, Mahrouseh N, Varga O. Trends in dental care utilisation among the elderly using longitudinal data from 14 European countries: A multilevel analysis. PLoS One 2023; 18:e0286192. [PMID: 37294829 PMCID: PMC10256212 DOI: 10.1371/journal.pone.0286192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 05/11/2023] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND The use of dental care among older people is low compared to other forms of health care, with significant health consequences. However, the evidence on the extent to which countries' welfare systems and socio-economic factors influence the uptake of dental care by older people is limited. This study aimed to describe trends of dental care utilisation, and to compare use of dental care with other types of healthcare services among the elderly, considering different socio-economic factors and welfare systems in European countries. METHODS Multilevel logistic regression analysis was performed using longitudinal data from four waves (between Wave 5 and 8) of the Survey of Health, Ageing and Retirement in Europe database, with a follow-up period of 7 years. The study sample included 20,803 respondents aged 50 years or older from 14 European countries. RESULTS The annual dental care attendance was the highest in Scandinavian countries (85.7%), however, improving trends of dental attendance was recognized in Southern and Bismarckian countries (p<0.001). The difference in use of dental care services between socio-economic groups was expanding over time regarding low- and high-income level and residential area. A more marked difference was observed between social groups in dental care utilisation compared to other forms of care. Income level and unemployed status had significant effect on forgoing dental care due to cost and unavailability. CONCLUSION The observed differences between socioeconomic groups may highlight the health consequences of the different organization and financing of dental care. The elderly population could benefit from adopting policies aiming to reduce the financial barriers to dental care usage, especially in Southern and Eastern European countries.
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Affiliation(s)
- Nóra Kovács
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Orsolya Liska
- Faculty of Dentistry, Clinical Center, University of Debrecen, Debrecen, Hungary
| | | | - Nour Mahrouseh
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Office for Supported Research Groups, Eötvös Loránd Research Network, Budapest, Hungary
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