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Kudo Y, Takeuchi K, Kusama T, Kojima T, Waguri-Nagaya Y, Nagayoshi M, Kondo K, Mizuta K, Osaka K, Kojima M. Differences in prevalence of self-reported oral hypofunction between older adult patients with rheumatoid arthritis and the general older population: A cross-sectional study using propensity score matching. J Oral Rehabil 2024; 51:924-930. [PMID: 38356183 DOI: 10.1111/joor.13658] [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: 06/22/2023] [Revised: 12/14/2023] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE To examine the association between rheumatoid arthritis (RA) and oral hypofunction (OHF) using propensity score matching (PSM) to adjust for differences between older adults with RA and the general older adult population. METHODS We conducted a cross-sectional survey among 189 older adults with RA in 2019 (mean age, 71.9 ± 3.6) and 47 178 independent older adult residents in 2016 (mean age, 71.6 ± 4.0), respectively. The questionnaire covered information on socio-demographic characteristics and OHF for both groups. Age, sex, educational level and smoking history were used to determine PSM. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of self-reported OHF (fewer remaining teeth, decreased masticatory function, deterioration of swallowing function and oral dryness) were estimated using Poisson regressions. RESULT OHF was observed in 44.4% of patients with RA and 27.5% of residents. Before PSM, the prevalence of OHF among patients with RA was higher than that of residents (PR, 1.75; 95% CI, 1.50-2.05). After PSM, there were 189 patients with RA and residents, and the prevalence of OHF among patients with RA was still higher (PR, 1.61; 95% CI, 1.22-2.13). Poisson regression showed that the prevalence of 19 or fewer teeth (PR, 1.06; 95% CI, 0.82-1.36), difficulties eating tough foods (PR, 1.18; 95% CI, 0.90-1.55), difficulties swallowing tea or soup (PR, 1.77; 95% CI, 1.19-2.63), and dry mouth (PR, 2.79; 95% CI, 1.90-4.07) was higher among patients with RA than residents. CONCLUSION Compared with the general older adult population, patients with RA have a higher prevalence of self-reported OHF.
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Affiliation(s)
- Yoko Kudo
- Division of Dento-Oral Anesthesiology, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kenji Takeuchi
- 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
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - 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
| | - Toshihisa Kojima
- Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya, Japan
- Department of Orthopedic Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yuko Waguri-Nagaya
- Department of Orthopedic Surgery, Nagoya City University East Medical Center, Nagoya, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsunori Kondo
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Social Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Kentaro Mizuta
- Division of Dento-Oral Anesthesiology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masayo Kojima
- Nagoya City University, Nagoya, Japan
- Department of Frailty, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Sato Y, Yoshioka E, Saijo Y. Association of rotating night shift work with tooth loss and severe periodontitis among permanent employees in Japan: a cross-sectional study. PeerJ 2024; 12:e17253. [PMID: 38646481 PMCID: PMC11027908 DOI: 10.7717/peerj.17253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/26/2024] [Indexed: 04/23/2024] Open
Abstract
Background The modern 24/7 society demands night shift work, which is a possible risk factor for chronic diseases. This study aimed to examine the associations of rotating night shift work duration with tooth loss and severe periodontitis. Methods This cross-sectional study used data from a self-administered questionnaire survey conducted among 3,044 permanent employees aged 20-64 years through a Japanese web research company in 2023. The duration of rotating night shift work was assessed using a question from the Nurses' Health Study. Tooth loss was assessed based on self-reported remaining natural teeth count. Severe periodontitis was assessed using a validated screening questionnaire comprising four questions related to gum disease, loose tooth, bone loss, and bleeding gums. We employed linear regression models for tooth loss and Poisson regression models for severe periodontitis, adjusting for demographic, health and work-related variables and socioeconomic status. Results Among participants included, 10.9% worked in rotating night shifts for 1-5 years, while 11.0% worked in such shifts for ≥6 years. In fully adjusted models, rotating night shift work duration of 1-5 years was associated with tooth loss (beta -0.74, 95% confidence interval (CI) [-1.55 to 0.08]) and severe periodontitis (prevalence ratio 1.80, 95% CI [1.33-2.43]); however, the association with tooth loss was not statistically significant. Conclusions This study supports that employees who work short-term rotating night shifts may experience poor oral conditions. Further research is needed to determine whether long-term rotating night shift work is associated with deteriorated oral health.
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Affiliation(s)
- Yukihiro Sato
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Eiji Yoshioka
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yasuaki Saijo
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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Matsuyama Y, Aida J, Kondo K, Shiba K. Heterogeneous Association of Tooth Loss with Functional Limitations. J Dent Res 2024; 103:369-377. [PMID: 38533640 DOI: 10.1177/00220345241226957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
Tooth loss is prevalent in older adults and associated with functional capacity decline. Studies on the susceptibility of some individuals to the effects of tooth loss are lacking. This study aimed to investigate the heterogeneity of the association between tooth loss and higher-level functional capacity in older Japanese individuals employing a machine learning approach. This is a prospective cohort study using the data of adults aged ≥65 y in Japan (N = 16,553). Higher-level functional capacity, comprising instrumental independence, intellectual activity, and social role, was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The scale ranged from 0 (lowest function) to 13 (highest function). Doubly robust targeted maximum likelihood estimation was used to estimate the population-average association between tooth loss (having <20 natural teeth) and TMIG-IC total score after 6 y. The heterogeneity of the association was evaluated by estimating conditional average treatment effects (CATEs) using the causal forest algorithm. The result showed that tooth loss was statistically significantly associated with lower TMIG-IC total scores (population-average effect: -0.14; 95% confidence interval, -0.18 to -0.09). The causal forest analysis revealed the heterogeneous associations between tooth loss and lower TMIG-IC total score after 6 y (median of estimated CATEs = -0.13; interquartile range = 0.12). The high-impact subgroup (i.e., individuals with estimated CATEs of the bottom 10%) were significantly more likely to be older and male, had a lower socioeconomic status, did not have a partner, and had poor health conditions compared with the low-impact subgroup (i.e., individuals with estimated CATEs of the top 10%). This study found that heterogeneity exists in the association between tooth loss and lower scores on functional capacity. Implementing tooth loss prevention policy and clinical measures, especially among vulnerable subpopulations significantly affected by tooth loss, may reduce its burden more effectively.
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Affiliation(s)
- Y Matsuyama
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - J Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - K Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Chiba, Japan
| | - K Shiba
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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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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Tan LF, Chan YH, Merchant RA. Association between dentition and frailty and cognitive function in community-dwelling older adults. BMC Geriatr 2022; 22:614. [PMID: 35879659 PMCID: PMC9310464 DOI: 10.1186/s12877-022-03305-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
Objectives To evaluate dentition status amongst community-dwelling older adults and its association with frailty and cognitive impairment. Methodology One thousand forty-seven community-dwelling older adults aged ≥65 years were surveyed in an epidemiologic population-based cohort study in Singapore between April 2015 and August 2016. Data on demographics, dentition status, chronic diseases, activities and instrumental activities on daily-living, cognition (age- and education-specific MMSE cut-offs), frailty (FRAIL scale), perceived health and functional status were collected. Multiple logistic regression was performed to examine the association between dentition, frailty and cognition. Results Mean age of participants was 71.2 ± 5.5 years. The prevalence of denture use was 70.7% and edentulism 7.9%. Compared to edentulousness, having teeth was associated with lower odds of cognitive impairment and higher odds of being robust or pre-frail. Denture-wearers compared with edentulous persons were less likely to be male, had higher education level and more likely be robust or pre-frail. Conclusion and implications There were significant associations between dentition status, frailty and cognition in our study where those with remining teeth and / or dentures had better overall outcomes. As oral health, frailty and cognitive impairments are all modifiable risk factors for healthy ageing, countries should consider population level screening for oral health, frailty and cognitive impairment.
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Affiliation(s)
- Li Feng Tan
- Healthy Ageing Programme, Alexandra Hospital, 378 Alexandra Rd, Singapore, 159964, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Reshma A Merchant
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. .,Division of Geriatric Medicine, Department of Medicine, National University Hospital, National University Health System, 1E Kent Ridge Road, Singapore, 119228, Singapore.
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Atanda AJ, Livinski AA, London SD, Boroumand S, Weatherspoon D, Iafolla TJ, Dye BA. Tooth retention, health, and quality of life in older adults: a scoping review. BMC Oral Health 2022; 22:185. [PMID: 35585618 PMCID: PMC9118621 DOI: 10.1186/s12903-022-02210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This scoping review describes the relationship between tooth retention, health, and quality of life in older adults. METHODS Seven databases were searched for English language articles for subjects ≥ 65 y from 1981 to 2021. Exposure was tooth retention (≥ 20), and outcomes were general/systemic health and quality of life. Methodological quality was assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias 2.0 tool. RESULTS 140 articles were included, only four were randomized trials. Inter-rater agreement (κ) regarding study inclusion was 0.924. Most were assessed with low risk of bias (n = 103) and of good quality (n = 96). Most studies were conducted in Japan (n = 60) and Europe (n = 51) and only nine in the US. Tooth retention was referred to as "functional dentition" in 132 studies and "shortened dental arch" in 19 studies. Study outcomes were broadly synthesized as (1) cognitive decline/functional dependence, (2) health status/chronic diseases, (3) nutrition, and (4) quality of life. DISCUSSION There is a positive relationship between tooth retention, overall health, and quality of life. Older adults retaining ≥ 20 teeth are less likely to experience poorer health. Having < 20 teeth increases the likelihood for functional dependence and onset of disability, and may affect successful ageing. This review supports the general finding that the more teeth older adults retain as they age, the less likely they are to have adverse health outcomes. However, significant knowledge gaps remain which can limit decision-making affecting successful ageing for many older adults. This review highlights the need to consider, as an important marker of oral health and function, the retention of a functional minimum of a natural dentition, rather than a simple numeric score of missing teeth.
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Affiliation(s)
- Adejare Jay Atanda
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA.
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA.
| | - Alicia A Livinski
- National Institutes of Health Library, Office of Research Services, OD, National Institutes of Health, Bethesda, MD, USA
| | - Steven D London
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
- School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Shahdokht Boroumand
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
| | | | - Timothy J Iafolla
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
| | - Bruce A Dye
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA.
- School of Dental Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
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Cho HA, Shin H. Effects of tooth loss on functional impairment in elderly: a secondary data analysis of elderly cohort in the South Korea. Int J Dent Hyg 2021; 20:534-542. [PMID: 34919786 DOI: 10.1111/idh.12569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/25/2021] [Accepted: 12/09/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study aimed to assess the association of tooth loss with physical and cognitive impairments in the elderly aged over 65 years. METHODS The Elderly Cohort database (2008-2013) of National Health Insurance Services in South Korea was used; 1,485 individuals who underwent physical impairment evaluation and 1,410 individuals who underwent cognitive impairment evaluation were analyzed. The dependent variables were the standardized physical and cognitive function score. The generalized estimating equation method was used for repeated measures. The total number of teeth lost during the study period, sex, age, Charlson Comorbidity Index, income, medical aid, long-term care facility residence, living alone, and long-term care beneficiary were used as covariates. RESULTS Differences between the baseline and endpoint standardized function scores of the participants with impaired physical function and impaired cognitive function were 13.6 and 20.1, respectively. The magnitude of functional impairment due to tooth loss was greater for cognitive function than for physical function. The number of teeth lost was associated with approximately 1.4- and 1.7-point decrease in physical and cognitive function, respectively (both p < 0.001). CONCLUSIONS These findings suggest that the oral health status is essential for maintaining physical and cognitive function and that oral health services can be effective in delaying functional impairment among the elderly residing in coordinated long-term care facilities.
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Affiliation(s)
- Han-A Cho
- Departments of Dental Hygiene, Shinhan University, Uijeongbu-si, Gyeonggi-do, 11644, Republic of Korea
| | - Hosung Shin
- Department of Social and Humanity in Dentistry, Wonkwang University School of Dentistry, 460 Iksan Dearo, Iksan, North Jula, 54538, Republic of Korea
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Wang CC, Chen YY, Hung KC, Wu SJ, Yen YF, Chen CC, Lai YJ. Association between teeth loss and nasogastric tube feeding dependency in older adults from Taiwan: a retrospective cohort study. BMC Geriatr 2021; 21:640. [PMID: 34772343 PMCID: PMC8588643 DOI: 10.1186/s12877-021-02596-x] [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: 06/03/2021] [Accepted: 10/27/2021] [Indexed: 11/27/2022] Open
Abstract
Background To examine the association between teeth loss and nasogastric tube feeding dependency in older people. Methods The National Health Interview Survey (NHIS) 2005, 2009, and 2013 in Taiwan. Participants were selected by a multistage stratified sampling method and baseline characteristics, including socioeconomic status and health habits, were obtained by well-trained interviewers. The NHIS was linked with the National Health Insurance research database 2000–2016 and the National Deaths Dataset, which contains all the medical information of ambulatory and inpatient care. Cox regression was used to examine the association between the number of teeth lost and nasogastric tube feeding dependency. Results There were 6165 adults older than 65 years old enrolled in the analysis, with 2959 male (48%) and the mean (SD) age was 73.95(6.46) years old. The mean follow-up duration was 6.5(3.3) years. Regarding the teeth loss categories, 1660 (26.93%), 2123 (34.44%), and 2382 (38.64%) of participants were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. During 39,962 person-years of follow-up, new-onset nasogastric feeding dependency was recognized in 220(13.25%), 256(12.06%), and 461(19.35%) participants who were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. Kaplan-Meier curves demonstrated significant findings (Log-rank P < 0.01). After potential confounders were adjusted, compared with those without teeth loss, older adults who had lost 10–28 teeth had significantly increased risks of occurrence nasogastric feeding dependency (AHR, 1.31; 95% CI, 1.05–1.62; p-value = 0.02). Furthermore, a significant dose-response relation between the number of teeth lost and increased risk of nasogastric feeding was found (p for trend< 0.01). Conclusions Older adults who had lost 10–28 teeth had a significantly increased risk of nasogastric tube feeding dependency. Early identification of the oral disease is crucial for the prevention of the occurrence of teeth loss and the following nutrition problems, which would reduce risk of nasogastric tube feeding dependency.
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Affiliation(s)
- Chun-Chieh Wang
- Division of Chest Medicine, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan.,Department of Eldercare, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Yu-Yen Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, 402, Taiwan.,Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,National Chung Hsing University, Taichung, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Shang-Jung Wu
- Department of Nursing, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan.,College of Nursing Taichung, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Yung-Feng Yen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, No.365, Ming-te Road, Peitou District, Taipei City, 112, Taiwan.,Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Chu-Chieh Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, No.365, Ming-te Road, Peitou District, Taipei City, 112, Taiwan.
| | - Yun-Ju Lai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Health Care Management, National Taipei University of Nursing and Health Sciences, No.365, Ming-te Road, Peitou District, Taipei City, 112, Taiwan. .,Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan. .,Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, No.1, Rongguang Rd, Puli Township, Nantou County, 545, Taiwan.
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Association between denture use, chewing ability, and all-cause mortality in middle-aged and older adults who exercised regularly in Korea. Sci Rep 2021; 11:6061. [PMID: 33723333 PMCID: PMC7961023 DOI: 10.1038/s41598-021-85440-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/24/2021] [Indexed: 11/16/2022] Open
Abstract
Herein, using data from the Korean Longitudinal Study of Aging (2006–2018), we evaluated denture use and chewing ability to determine the status of oral health in middle-aged adults who exercised regularly; further, we investigated the relationship of oral health with all-cause mortality. From the basic survey conducted in 2006, we interviewed 10,254 participants who were followed up until death. The participants were grouped based on regular exercise into REG (n = 3921) and non-REG (n = 6290) groups. The mortality rate was higher in the non-REG group than in the REG group (35.8% versus 26.9%; p < 0.001). The mortality rate was higher in denture users (versus non-denture users), non-drinkers (versus alcohol drinkers), and those on medical aid (versus national health insurance). The mortality rate was higher in participants with poor masticatory ability, lower education level, and poor subjective health perception (p < 0.001). Denture use and masticatory discomfort were not significant risk factors for mortality in the non-REG group (p > 0.05). In conclusion, masticatory discomfort was a risk factor for increased mortality in middle-aged Korean adults who exercised regularly, at least once a week. Thus, assessment of masticatory ability could be a useful indicator of life expectancy in middle-aged adults.
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Hartshorn JE, Cowen HJ, Comnick CL. Cluster randomized control trial of nursing home residents' oral hygiene following the Mouth Care Matters education program for certified nursing assistants. SPECIAL CARE IN DENTISTRY 2021; 41:372-380. [PMID: 33587781 PMCID: PMC8248067 DOI: 10.1111/scd.12577] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 12/16/2022]
Abstract
Aims The purpose of this study was to determine if the number of certified nursing assistants (CNAs) trained with the Mouth Care Matters (MCM) oral health educational program had an impact on nursing facility (NF) resident oral health. Materials and methods Three NFs participated in a cluster randomized control trial. In NF‐A: all CNAs were offered the MCM program, NF‐B: 3 CNAs were offered the MCM program, and NF‐C: Control (no CNAs were offered the MCM program). Demographic information, systemic health data, and oral health data at baseline, 3‐month, and 6‐month intervals were collected and analyzed using Kruskal‐Wallis, Wilcoxon signed‐rank and Wilcoxon rank‐sum tests. A total of 24 dentate residents participated in this study. Plaque control record scores for NF‐A were significantly reduced compared to NF‐B and NF‐C (P < .001 and P = .002 respectively) and gingival bleeding index for NF‐A were significantly reduced compared to NF‐B and NF‐C (P = .002 and P < .001 respectively). Conclusion Increasing the number of CNA's trained in the Mouth Care Matters educational program positively impacted NF residents’ oral hygiene.
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Affiliation(s)
| | - Howard J Cowen
- Preventive and Community Dentistry, University of Iowa, Iowa City, Iowa
| | - Carissa L Comnick
- Division of Biostatistics and Computational Biology, University of Iowa, Iowa City, Iowa
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Matsuyama Y, Listl S, Jürges H, Watt RG, Aida J, Tsakos G. Causal Effect of Tooth Loss on Functional Capacity in Older Adults in England: A Natural Experiment. J Am Geriatr Soc 2021; 69:1319-1327. [PMID: 33496349 DOI: 10.1111/jgs.17021] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/22/2020] [Accepted: 12/14/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND/OBJECTIVES Tooth loss is associated with reduced functional capacity, but so far, there is no relevant causal evidence reported. We investigated the causal effect of tooth loss on the instrumental activities of daily living (IADL) among older adults in England. DESIGN Natural experiment study with instrumental variable analysis. SETTING The English Longitudinal Study of Aging (ELSA) combined with the participants' childhood exposure to water fluoride due to the community water fluoridation. PARTICIPANTS Five thousand six hundred and thirty one adults in England born in 1945-1965 participated in the ELSA wave seven survey (conducted in 2014-2015; average age: 61.0 years, 44.6% men). MEASUREMENTS The number of natural teeth predicted by the exogenous geographical and historical variation in exposure to water fluoride from age 5 to 20 years old (instrumental variable) was used as an exposure variable. The outcome, having any limitations in IADL (preparing a hot meal, shopping for groceries, making telephone calls, taking medications, doing work around the house or garden, or managing money), was assessed by self-reported questionnaires. RESULTS Linear probability model with Two-Stage Least Squares estimation was fitted. Being exposed to fluoridated water was associated with having more natural teeth in later life (coefficient: 0.726; 95% confidence interval (CI) = 0.311, 1.142; F = 11.749). Retaining one more natural tooth reduced the probability of having a limitation in IADL by 3.1 percentage points (coefficient: -0.031; 95% CI = -0.060, -0.002). CONCLUSION Preventing tooth loss maintains functional capacity among older adults in England. Given the high prevalence of tooth loss, this effect is considerable. Further research on the mechanism of the observed causal relationship is needed.
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Affiliation(s)
- Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan.,Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Stefan Listl
- Department of Dentistry - Quality and Safety of Oral Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Conservative Dentistry, Translational Health Economics Group, Heidelberg University, Heidelberg, Germany
| | - Hendrik Jürges
- Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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12
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Badewy R, Singh H, Quiñonez C, Singhal S. Impact of Poor Oral Health on Community-Dwelling Seniors: A Scoping Review. Health Serv Insights 2021; 14:1178632921989734. [PMID: 33597810 PMCID: PMC7841244 DOI: 10.1177/1178632921989734] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/31/2020] [Indexed: 12/29/2022] Open
Abstract
The aim of this scoping review was to determine health-related impacts of poor oral health among community-dwelling seniors. Using MeSH terms and keywords such as elderly, general health, geriatrics, 3 electronic databases-Medline, CINAHL, and Age Line were searched. Title and abstracts were independently screened by 3 reviewers, followed by full-texts review. A total of 131 articles met our inclusion criteria, the majority of these studies were prospective cohort (77%, n = 103), and conducted in Japan (42 %, n = 55). These studies were categorized into 16 general health outcomes, with mortality (24%, n = 34), and mental health disorders (21%, n = 30) being the most common outcomes linked with poor oral health. 90% (n = 120) of the included studies reported that poor oral health in seniors can subsequently lead to a higher risk of poor general health outcomes among this population. Improving access to oral healthcare services for elderly can help not only reduce the burden of oral diseases in this population group but also address the morbidity and mortality associated with other general health diseases and conditions caused due to poor oral health. Findings from this study can help identify shortcomings in existing oral healthcare programs for elderly and develop future programs and services to improve access and utilization of oral care services by elderly.
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Affiliation(s)
- Rana Badewy
- Faculty of Dentistry, University of
Toronto, Toronto, ON, Canada
| | | | - Carlos Quiñonez
- Faculty of Dentistry, Director of
Graduate Program in Dental Public Health, University of Toronto, Toronto, ON,
Canada
| | - Sonica Singhal
- Faculty of Dentistry, University of
Toronto, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON,
Canada
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13
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Iwasaki M, Yoshihara A. Dentition status and 10-year higher-level functional capacity trajectories in older adults. Geriatr Gerontol Int 2020; 21:48-53. [PMID: 33233024 DOI: 10.1111/ggi.14099] [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: 06/27/2020] [Revised: 09/25/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022]
Abstract
AIM The effect of dentition status on higher-level functional capacity patterns over time remains unclear. We aimed to identify distinct higher-level functional capacity trajectories in individuals aged 70-80 years, and examine whether dentition status at 70 years predicted the trajectory. METHODS The study included 551 community-dwelling adults aged 70 years at baseline. Higher-level functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) up to the age of 80 years. A higher TMIG-IC score indicated a higher level of competence. Group-based trajectory modeling was used to identify distinct TMIG-IC trajectories. The number of teeth, use of dentures, sex and education were added as baseline group membership predictors. Dental visits, health behaviors, body mass index and comorbidities during observation were added as time-varying covariates. RESULTS Three TMIG-IC trajectories were identified: "high/stable" (65.3%), "middle/decline" (24.5%) and "low/decline" (10.2%). A lower number of teeth and non-denture use were associated with increased odds of a low/decline trajectory relative to a high/stable trajectory (odds ratio 1.09, 95% confidence interval 1.04-1.14 [per one decrease] and odds ratio 3.96, 95% confidence interval 1.54-10.16, respectively). CONCLUSIONS Older adults with fewer teeth and those without dentures at the age of 70 years were more likely to follow a trajectory toward functional decline with low baseline TMIG-IC scores, which further declines by the age of 80 years. These findings suggest that preserving natural teeth later in life, as well as using dentures, could contribute toward maintaining a higher-level functional competence. Geriatr Gerontol Int 2021; 21: 48-53.
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Affiliation(s)
- Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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14
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Nomura Y, Kakuta E, Okada A, Otsuka R, Shimada M, Tomizawa Y, Taguchi C, Arikawa K, Daikoku H, Sato T, Hanada N. Impact of the Serum Level of Albumin and Self-Assessed Chewing Ability on Mortality, QOL, and ADLs for Community-Dwelling Older Adults at the Age of 85: A 15 Year Follow up Study. Nutrients 2020; 12:nu12113315. [PMID: 33137946 PMCID: PMC7692472 DOI: 10.3390/nu12113315] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/20/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022] Open
Abstract
Quality of life (QOL) and mortality are true endpoints of epidemiological or medical research, especially for community-dwelling older adults. Nutritional status and activities of daily living (ADLs) are associated with QOL and mortality. Good oral health status supports a good nutritional status. The aim of this study was to elucidate the complex structure of these important health-related factors. We surveyed 354 healthy older adults at the age of 85. Nutritional status was evaluated by the serum level of albumin. QOL, ADLs, self-assessed chewing ability, serum albumin level, and mortality during the 15 year follow up period were analyzed. Self-assessed chewing ability was associated with QOL and ADLs. Self-assessed chewing ability for slight-hard foods was associated with mortality in men. However, it was not associated with the serum albumin level. The serum albumin level was associated with mortality in women. These results indicate that maintaining good oral function is not enough. Nutritional instruction in accordance with oral function is indispensable for health promotion in older adults. When planning health promotion strategies for older adults, different strategies are needed for men and women.
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Affiliation(s)
- Yoshiaki Nomura
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (A.O.); (R.O.); (N.H.)
- Correspondence: ; Tel.: +81-45-580-8462
| | - Erika Kakuta
- Department of Oral bacteriology, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan;
| | - Ayako Okada
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (A.O.); (R.O.); (N.H.)
| | - Ryoko Otsuka
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (A.O.); (R.O.); (N.H.)
| | - Mieko Shimada
- Chiba Prefectural University of Health Sciences, Chiba 261-0014, Japan;
| | - Yasuko Tomizawa
- Department of Cardiovascular Surgery, Tokyo Women’s Medical University, Tokyo 162-8666, Japan;
| | - Chieko Taguchi
- Department of Preventive and Public Oral Health, Nihon University School of Dentistry at Matsudo, Matsudo 470-2101, Japan; (C.T.); (K.A.)
| | - Kazumune Arikawa
- Department of Preventive and Public Oral Health, Nihon University School of Dentistry at Matsudo, Matsudo 470-2101, Japan; (C.T.); (K.A.)
| | - Hideki Daikoku
- Iwate Dental Association, Morioka 020-0045, Japan; (H.D.); (T.S.)
| | - Tamotsu Sato
- Iwate Dental Association, Morioka 020-0045, Japan; (H.D.); (T.S.)
| | - Nobuhiro Hanada
- Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan; (A.O.); (R.O.); (N.H.)
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Does the Association between Guardians' Sense of Coherence and their Children's Untreated Caries Differ According to Socioeconomic Status? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051619. [PMID: 32138204 PMCID: PMC7084832 DOI: 10.3390/ijerph17051619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/17/2020] [Accepted: 02/27/2020] [Indexed: 11/16/2022]
Abstract
Untreated caries is the most prevalent disease in the world. A sense of coherence (SOC) is believed to contribute to oral health. We aimed to clarify the association between guardians' SOC and their children's caries based on socioeconomic status (SES) in Japan. This study's subjects were Japanese public junior high schoolers (N = 1730), aged 12-15, and their guardians in Kosai City. We administered a questionnaire survey among guardians in 2016 to assess their SOC and family environment. With their students' consent, public junior high schools shared the results of the dental examinations that were part of their school physicals. Multivariate logistic regression was conducted to clarify the association between guardians' SOC and their children's untreated decayed permanent teeth. We also conducted a stratified analysis according to a relative poverty line. We observed in the multivariate regression a significant inverse association between children's untreated decay and their guardians' SOC (OR 0.93, 95%CI 0.87-1.00). The association of SOC was stronger in the low economic group (OR 0.64, 95%CI 0.43-0.95). Guardians with higher SOC were associated with children having fewer caries. Guardians' SOC is a factor for the prevalence of caries and access to dental care, especially among children with low economic status.
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16
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Miura S, Nakamura T, Hasegawa T, Miura Y, Takiguchi G, Urakawa N, Hasegawa H, Yamamoto M, Kanaji S, Matsuda Y, Yamashita K, Matsuda T, Oshikiri T, Suzuki S, Akashi M, Kakeji Y. Tooth Loss Predicts Long-Term Prognosis of Esophageal Cancer After Esophagectomy. Ann Surg Oncol 2019; 27:683-690. [PMID: 31605330 DOI: 10.1245/s10434-019-07903-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Oral health is associated with various diseases, including cancer. Tooth loss is a simple and objective index of oral health. OBJECTIVE The purpose of this study was to investigate the association between preoperative tooth loss and esophageal cancer prognosis after esophagectomy. METHODS This study included 191 patients who underwent esophagectomy for esophageal cancer after perioperative dental evaluation and oral care at Kobe University Hospital from April 2011 to March 2016. Patients were divided into two groups: Group A (tooth loss < 7) and Group B (tooth loss ≥ 7). Three-year overall survival (OS) and multivariate analysis were performed, along with subgroup analysis for elderly patients (age ≥ 65 years). RESULTS The 3-year OS rate was 68.1% in Group A (104 patients) and 49.2% in Group B (87 patients). Group A had significantly higher OS than Group B (p = 0.002), and there were no significant differences in sex and clinical T or N stage between the two groups. However, the mean age of Group A was younger than that of Group B (64.2 vs. 68.5 years; p = 0.0002). Among elderly patients, the 3-year OS rate was 68.2% in Group A (55 patients) and 45.1% in Group B (65 patients) [p = 0.003]. Multivariate analysis that included age demonstrated that tooth loss is an independent prognostic factor (hazard ratio 1.87, 95% confidence interval 1.22-2.87), in addition to clinical T stage and preoperative serum albumin. CONCLUSION Tooth loss is an independent prognostic factor for esophageal cancer after esophagectomy.
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Affiliation(s)
- Susumu Miura
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan.
| | - Tetsu Nakamura
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Yukiko Miura
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan
| | - Gosuke Takiguchi
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan
| | - Naoki Urakawa
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan
| | - Hiroshi Hasegawa
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan
| | - Masashi Yamamoto
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan
| | - Shingo Kanaji
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan
| | - Yoshiko Matsuda
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan
| | - Kimihiro Yamashita
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan
| | - Takeru Matsuda
- Division of Minimally Invasive Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Taro Oshikiri
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan
| | - Satoshi Suzuki
- Division of Community Medicine and Medical Network, Department of Social Community Medicine and Health Science, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan
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17
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Kotronia E, Wannamethee SG, Papacosta AO, Whincup PH, Lennon LT, Visser M, Weyant RJ, Harris TB, Ramsay SE. Oral Health, Disability and Physical Function: Results From Studies of Older People in the United Kingdom and United States of America. J Am Med Dir Assoc 2019; 20:1654.e1-1654.e9. [PMID: 31409558 DOI: 10.1016/j.jamda.2019.06.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/05/2019] [Accepted: 06/13/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Studies examining the associations between oral health and disability have limited oral health measures. We investigated the association of a range of objectively and subjectively assessed oral health markers with disability and physical function in older age. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional analyses were based on the British Regional Heart Study (BRHS) comprising men aged 71 to 92 years (n = 2147) from 24 British towns, and the Health, Aging, and Body Composition (HABC) Study comprising men and women aged 71 to 80 years (n = 3075) from the United States. Assessments included oral health (periodontal disease, tooth count, dry mouth, and self-rated oral health), disability, and physical function (grip strength, gait speed, and chair stand test). RESULTS In the BRHS, dry mouth, tooth loss, and cumulative oral health problems (≥3 problems) were associated with mobility limitations and problems with activities of daily living and instrumental activities of daily living; these remained significant after adjustment for confounding variables (for ≥3 dry mouth symptoms, odds ratio (OR) 2.68, 95% confidence interval (CI) 1.94-3.69; OR 1.76, 95% CI 1.15-2.69; OR 2.90, 95% CI 2.01, 4.18, respectively). Similar results were observed in the HABC Study. Dry mouth was associated with the slowest gait speed in the BRHS, and the weakest grip strength in the HABC Study (OR 1.75, 95% CI 1.22, 2.50; OR 2.43, 95% CI 1.47-4.01, respectively). CONCLUSIONS AND IMPLICATIONS Markers of poor oral health, particularly dry mouth, poor self-rated oral health, and the presence of more than 1 oral health problem, were associated with disability and poor physical function in older populations. Prospective investigations of these associations and underlying pathways are needed.
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Affiliation(s)
- Eftychia Kotronia
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, United Kingdom.
| | - S Goya Wannamethee
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - A Olia Papacosta
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, London, United Kingdom
| | - Lucy T Lennon
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Earth and Life Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Robert J Weyant
- Department of Dental Public Health, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, MD
| | - Sheena E Ramsay
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, United Kingdom; Department of Primary Care and Population Health, University College London, London, United Kingdom
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18
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Yoshida D, Ohara T, Hata J, Shibata M, Hirakawa Y, Honda T, Uchida K, Takasugi S, Kitazono T, Kiyohara Y, Ninomiya T. Dairy consumption and risk of functional disability in an elderly Japanese population: the Hisayama Study. Am J Clin Nutr 2019; 109:1664-1671. [PMID: 31075788 DOI: 10.1093/ajcn/nqz040] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 02/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Little is known about the association between dairy intake and risk of functional disability in the elderly. OBJECTIVES We examined the influence of dairy intake on the development of declining functional capacity and activities of daily living (ADL) in a prospective cohort study of an elderly population. METHODS A total of 859 community-dwelling Japanese residents, aged ≥65 y without functional disability, were followed up for 7 y. Functional capacity impairment was defined as a Tokyo Metropolitan Institute of Gerontology Index of Competence score of ≤12, and ADL disability was defined as a Barthel Index score of ≤95. Dairy intake was evaluated using a 150-item semiquantitative food frequency questionnaire, grouped into quartiles. The RR of dairy intake on incident functional disability was computed using a Poisson regression model. RESULTS The multivariable-adjusted RR of impaired functional capacity decreased significantly with increasing dairy intake levels (RR [95% CI]: quartile 1, 1.00 [reference]; quartile 2, 0.85 [0.71, 1.02]; quartile 3, 0.81 [0.68, 0.98]; and quartile 4, 0.74 [0.61, 0.90]; P-trend = 0.001). Regarding the three subscales of functional capacity, the inverse association between dairy intake and risk for impairment of intellectual activity and social role remained significant (P-trend = 0.0009 and 0.02, respectively), but such an association was not observed for instrumental ADL. The multivariable-adjusted risk of ADL disability also decreased weakly but significantly with elevating dairy intake (P-trend = 0.04). A similar association was seen for severity of functional disability (P-trend = 0.002). However, the magnitude of these associations was attenuated after further adjustment for protein intake. CONCLUSION Our findings suggest that higher dairy intake is associated with a lower risk of functional disability and its progression in the elderly, probably via an increase in protein intake.
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Affiliation(s)
- Daigo Yoshida
- Department of Epidemiology and Public Health, Fukuoka, Japan
| | | | - Jun Hata
- Department of Epidemiology and Public Health, Fukuoka, Japan
| | | | - Yoichiro Hirakawa
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Fukuoka, Japan
| | - Kazuhiro Uchida
- Department of Health Promotion, School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan
| | | | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yutaka Kiyohara
- Hisayama Research Institute for Lifestyle Diseases, Fukuoka, Japan
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19
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Matsuyama Y, Jürges H, Listl S. The Causal Effect of Education on Tooth Loss: Evidence From United Kingdom Schooling Reforms. Am J Epidemiol 2019; 188:87-95. [PMID: 30203091 DOI: 10.1093/aje/kwy205] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 09/05/2018] [Indexed: 12/11/2022] Open
Abstract
Associations between education and oral health have frequently been reported, but until now there has been no causal evidence. Exploiting exogenous variation in the duration of schooling due to 1947 and 1972 reforms in mandatory schooling in the United Kingdom, we examined the causal relationship between education and tooth loss in older age. We conducted a cross-sectional study using data from waves 3 (2006-2007), 5 (2010-2011), and 7 (2014-2015) of the English Longitudinal Study of Ageing. We used a 2-stage least squares instrumental variable approach and included 5,667 respondents (average age = 67.8 years; 44.4% were men) in the analyses, of whom 819 (14.5%) had no teeth. The schooling reforms increased the duration of education by an average of 0.624 years (95% confidence interval: 0.412, 0.835). For respondents born within ±6 years of the pivotal cohorts, a 1-year increment of education causally reduced the probability of edentulism by 9.1 (95% confidence interval: 1.5, 16.8) percentage points. The effects were stronger for the 1947 reform than for the 1972 reform. Results were robust to broadening of the cohort bandwidth and functional form of the cohort trend. The findings suggest that investment in education produces improved oral health later in life.
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Affiliation(s)
- Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyō-ku, Tokyo, Japan
- Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
- Department of Quality and Safety of Oral Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hendrik Jürges
- Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - Stefan Listl
- Department of Quality and Safety of Oral Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
- Section for Translational Health Economics, Heidelberg University Hospital, Heidelberg, Germany
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20
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Zhang W, Yan Wu Y, Wu B. Does Oral Health Predict Functional Status in Late Life? Findings From a National Sample. J Aging Health 2018; 30:924-944. [PMID: 28553812 PMCID: PMC6457448 DOI: 10.1177/0898264317698552] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study aims to examine the association between oral health and the decline in functional status among middle-aged and older adults in the United States. METHOD Generalized estimation equation (GEE) Poisson regression models with robust standard errors were used to analyze the longitudinal panel data (2008-2014) from the Health and Retirement Study ( N = 1,243). Oral health was evaluated using self-rated oral health, poor mouth condition, and tooth loss. Decline in functional status was assessed by disabilities in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). RESULTS Respondents with poor oral health were more likely to experience decline in ADLs/IADLs. Adjusting for sociodemographics and comorbidities attenuated the effects of oral health. DISCUSSION Findings suggest that oral health might be one of the important predictors of functioning decline in late life, after adjusting sociodemographics and comorbidities.
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Affiliation(s)
- Wei Zhang
- University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Yan Yan Wu
- University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Bei Wu
- New York University, New York, NY, USA
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21
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Cavalcante DDS, Pinto-Quidute AR, Alves-Martins MR, Walter-de-Aguiar AS, Lima-Cid AMP, Silva PGB, Cavalcante RF, Costa FWG. Dental status, salivary flow, and sociodemographic aspects in Sheehan Syndrome patients. Med Oral Patol Oral Cir Bucal 2018; 23:e436-e442. [PMID: 29924763 PMCID: PMC6051684 DOI: 10.4317/medoral.22377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/25/2018] [Indexed: 11/17/2022] Open
Abstract
Background Sheehan’s syndrome (SS) is one of the leading causes of hypopituitarism in developing countries. It occurs after postpartum necrosis of the pituitary gland, and it is considered a significant public health problem. This paper, apparently unpublished, aimed to perform an analysis on oral aspects in patients with SS. Material and Methods A cross-sectional study was performed with 23 women diagnosed with SS at the Division of Endocrinology and Diabetes (Walter Cantídio University Hospital, Fortaleza, Brazil). Results Data on sociodemographic, dental and salivary flow aspects were collected through a clinical approach and a panoramic radiograph request. The mean age was 64 ± 11.5 years old, with the sample consisting mainly of married women (56.5%), socioeconomic class C2 or D / E (78.2%) and years of education up to 8 years (69.5%). The presence of horizontal bone loss (p<0.001) and bilateral pneumatization of the maxillary sinus (p=0.015) were significant data. The mean number of absent teeth considering all subjects was 23.17±9.7, being statistically significant (p<0.001). In relation to age, the mean number of missing teeth was higher in individuals over 65 years old (p=0.048). Reduced salivary flow was observed in 78.3% of the patients. In a bivariate analysis, considering the outcome variables “missing teeth” and “reduced salivary flow”, it was observed that economic class (p<
0.001), family income (0.037) and maxillary sinus pneumatization (0.032) were statistically significant. Conclusions In brief, patients with SS showed severe teeth loss, reduced salivary flow, and low educational status. This study addressed important aspects regarding oral findings in SS and highlighted the importance of researches in oral medicine. Key words:Sheehan’s Syndrome, hypopituitarism, tooth loss, salivary flow.
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Affiliation(s)
- D-D-S Cavalcante
- Alexandre Barauna, 949 Rodolfo Teofilo, 60430-160 Fortaleza, Ceara, Brazil, Federal University of Ceara, Department of Clinical Dentistry, School of Dentistry,
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22
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Jou YT. Dental deafferentation and brain damage: A review and a hypothesis. Kaohsiung J Med Sci 2018; 34:231-237. [PMID: 29655412 DOI: 10.1016/j.kjms.2018.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/07/2017] [Accepted: 01/12/2018] [Indexed: 01/04/2023] Open
Abstract
In the last few decades, neurobiological and human brain imaging research have greatly advanced our understanding of brain mechanisms that support perception and memory, as well as their function in daily activities. Knowledge of the neurobiological mechanisms behind the deafferentation of stomatognathic systems has also expanded greatly in recent decades. In particular, current studies reveal that the peripheral deafferentations of stomatognathic systems may be projected globally into the central nervous system (CNS) and become an associated critical factor in triggering and aggravating neurodegenerative diseases. This review explores basic neurobiological mechanisms associated with the deafferentation of stomatognathic systems. Further included is a discussion on tooth loss and other dental deafferentation (DD) mechanisms, with a focus on dental and masticatory apparatuses associated with brain functions and which may underlie the changes observed in the aging brain. A new hypothesis is presented where DD and changes in the functionality of teeth and the masticatory apparatus may cause brain damage as a result of altered cerebral circulation and dysfunctional homeostasis. Furthermore, multiple recurrent reorganizations of the brain may be a triggering or contributing risk factor in the onset and progression of neurodegenerative conditions such as Alzheimer's disease (AD). A growing understanding of the association between DD and brain aging may lead to solutions in treating and preventing cognitive decline and neurodegenerative diseases.
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Affiliation(s)
- Yi-Tai Jou
- Department of Endodontics School of Dental Medicine University of Pennsylvania Philadelphia, Pennsylvania, USA.
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23
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Tanaka T, Takahashi K, Hirano H, Kikutani T, Watanabe Y, Ohara Y, Furuya H, Tetsuo, T, Akishita M, Iijima K. Oral Frailty as a Risk Factor for Physical Frailty and Mortality in Community-Dwelling Elderly. J Gerontol A Biol Sci Med Sci 2017; 73:1661-1667. [DOI: 10.1093/gerona/glx225] [Citation(s) in RCA: 247] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tomoki Tanaka
- Institute of Gerontology, University of Tokyo, Tokyo
- Department of Geriatric Medicine, University of Tokyo, Tokyo
| | - Kyo Takahashi
- Institute of Gerontology, University of Tokyo, Tokyo
| | | | - Takeshi Kikutani
- Division of Clinical Oral Rehabilitation, Nippon Dental University Graduate School of Life Dentistry at Tokyo, Tokyo
| | | | - Yuki Ohara
- Department of Oral Health Care Education, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyasu Furuya
- Division of Clinical Oral Rehabilitation, Nippon Dental University Graduate School of Life Dentistry at Tokyo, Tokyo
| | - Tsuji Tetsuo,
- Institute of Gerontology, University of Tokyo, Tokyo
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24
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Takeuchi K, Furuta M, Okabe Y, Suma S, Takeshita T, Akifusa S, Adachi M, Kinoshita T, Kikutani T, Yamashita Y. Swallowing disorders and 1-year functional decline in community-dwelling older adults receiving home care. J Oral Rehabil 2017; 44:982-987. [DOI: 10.1111/joor.12577] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 11/30/2022]
Affiliation(s)
- K. Takeuchi
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - M. Furuta
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - Y. Okabe
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - S. Suma
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - T. Takeshita
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
- OBT Research Center; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - S. Akifusa
- Department of Health Management; School of Oral Health Science; Kyushu Dental College; Kitakyushu Japan
| | - M. Adachi
- Itoshima Dental Association; Itoshima Japan
| | | | - T. Kikutani
- Rehabilitation Clinic for Speech and Swallowing Disorders; The Nippon Dental University Hospital; Tokyo Japan
| | - Y. Yamashita
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
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25
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Iwasaki M, Yoshihara A, Sato M, Minagawa K, Shimada M, Nishimuta M, Ansai T, Yoshitake Y, Miyazaki H. Dentition status and frailty in community-dwelling older adults: A 5-year prospective cohort study. Geriatr Gerontol Int 2017; 18:256-262. [PMID: 28944598 DOI: 10.1111/ggi.13170] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/28/2017] [Accepted: 07/23/2017] [Indexed: 11/29/2022]
Abstract
AIM To examine the longitudinal association between dentition status and incidence of frailty in older adults. METHODS The present prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Dental examinations, biochemical blood examinations, physical performance and anthropometric measurements, and structured questionnaires were carried out at baseline. The presence of ≥20 teeth with nine or more occluding pairs of teeth was defined as functional dentition. Annual follow-up examinations, including physical performance, anthropometric measurements and structured questionnaires, were carried out over a 5-year period to determine the incidence of frailty, defined as three or more of the following five components derived from the Cardiovascular Health Study: weight loss, weakness, slowness, poor energy and low physical activity level. Adjusted hazard ratios of frailty incidence according to dentition status were calculated from Cox proportional hazards regression analyses. RESULTS At baseline, 118 participants (36.6%) were defined as having functional dentition. During the follow up, 48 participants (14.9%) developed frailty. The adjusted hazard ratio for frailty in participants with functional dentition was 0.50 (95% confidence interval 0.25-0.98) compared with participants without functional dentition, after adjusting for sex, income, education, smoking status, body mass index, serum biomarkers and comorbidities. CONCLUSIONS Functional dentition was significantly associated with a lower risk of frailty defined by the Cardiovascular Health Study frailty index in older Japanese adults. These results suggest that maintaining healthy and functional dentition into later life is important for frailty prevention. Geriatr Gerontol Int 2018; 18: 256-262.
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Affiliation(s)
- Masanori Iwasaki
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Division of Community Oral Health Development, Kyushu Dental University, Kitakyushu, Japan
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Misuzu Sato
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kumiko Minagawa
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Mieko Shimada
- Chiba Prefectural University of Health Sciences, Chiba, Japan
| | | | - Toshihiro Ansai
- Division of Community Oral Health Development, Kyushu Dental University, Kitakyushu, Japan
| | | | - Hideo Miyazaki
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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26
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Takeuchi K, Ohara T, Furuta M, Takeshita T, Shibata Y, Hata J, Yoshida D, Yamashita Y, Ninomiya T. Tooth Loss and Risk of Dementia in the Community: the Hisayama Study. J Am Geriatr Soc 2017; 65:e95-e100. [PMID: 28272750 DOI: 10.1111/jgs.14791] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To clarify the effect of tooth loss on development of all-cause dementia and its subtypes in an elderly Japanese population. DESIGN Prospective cohort study. SETTING The Hisayama Study, Japan. PARTICIPANTS Community-dwelling Japanese adults without dementia aged 60 and older (N = 1,566) were followed for 5 years (2007-2012). MEASUREMENTS Participants were classified into four categories according to baseline number of remaining teeth (≥20, 10-19, 1-9, 0). The risk estimates of the effect of tooth loss on the development of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) were computed using a Cox proportional hazards model. RESULTS During follow-up, 180 (11.5%) subjects developed all-cause dementia; 127 (8.1%) had AD, and 42 (2.7%) had VaD. After adjusting for potential confounders, there was a tendency for the multivariable-adjusted hazard ratio of all-cause dementia to increase with decrease in number of remaining teeth (P for trend = .04). The risk of all-cause dementia was 1.62 times as great in subjects with 10 to 19 teeth, 1.81 times as great in those with one to nine teeth, and 1.63 times as great in those with no teeth as in those with 20 teeth or more. An inverse association was observed between number of remaining teeth and risk of AD (P for trend = .08), but no such association was observed with risk of VaD (P for trend = .20). CONCLUSION Tooth loss is associated with an increased risk of all-cause dementia and AD in the Japanese population.
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Affiliation(s)
- Kenji Takeuchi
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yukie Shibata
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daigo Yoshida
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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27
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Yamamoto T, Aida J, Kondo K, Fuchida S, Tani Y, Saito M, Sasaki Y. Oral Health and Incident Depressive Symptoms: JAGES Project Longitudinal Study in Older Japanese. J Am Geriatr Soc 2017; 65:1079-1084. [DOI: 10.1111/jgs.14777] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Tatsuo Yamamoto
- Division of Dental Sociology; Department of Oral Science; Graduate School of Dentistry; Kanagawa Dental University; Kanagawa Japan
| | - Jun Aida
- Department of International and Community Oral Health; Tohoku University Graduate School of Dentistry; Miyagi Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences; Chiba University; Chiba Japan
- Center for Well-being and Society; Nihon Fukushi University; Aichi Japan
- Department of Gerontological Evaluation; Center for Gerontology and Social Science; National Center for Geriatrics and Gerontology; Aichi Japan
| | - Shinya Fuchida
- Division of Dental Sociology; Department of Oral Science; Graduate School of Dentistry; Kanagawa Dental University; Kanagawa Japan
| | - Yukako Tani
- Department of Global Health Promotion; Tokyo Medical and Dental University; Tokyo Japan
- Research Fellow of Japan Society for the Promotion of Science; Tokyo Japan
| | - Masashige Saito
- Center for Well-being and Society; Nihon Fukushi University; Aichi Japan
- Department of Social Welfare; Nihon Fukushi University; Aichi Japan
| | - Yuri Sasaki
- Center for Preventive Medical Sciences; Chiba University; Chiba Japan
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