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Gu L, Zhang J, Chen W, Weng Y, Chen L, Zhang L. Feasibility of an oral health promotion program among older people in geriatric care facilities, Shanghai, China: a pre/post-implementation study. BMC Geriatr 2024; 24:272. [PMID: 38504192 PMCID: PMC10953076 DOI: 10.1186/s12877-024-04870-0] [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: 04/11/2023] [Accepted: 03/04/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The oral health of older people is closely related to their overall health. Timely and effective intervention in oral issues is necessary to maintain their overall health. This study aimed to evaluate the feasibility and effectiveness of an Oral Health Promotion Program (OHPP) in Geriatric Care Facilities (GCFs). METHODS The OHPP was implemented in two GCFs and evaluated using a pre/post-design. Questionnaires on self-efficacy and attitude for providing oral care were sent to 42 nurse participants before and three months after the implementation of the OHPP. Outcomes of 295 patient participants were assessed at four time points (T1-baseline, T2-one month, T3-two months, and T4-three months post-implementation) including Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Oral Health Assessment Tool (OHAT). RESULTS The oral health and daily activity ability of patient participants showed an improving trend at four time points pre/post-implementation of the OHPP. The proportion of patients with healthy mouths (OHAT: 0-3 points) increased from 29.8 to 67.8% and their scores of OHAT and ADL were significantly better at T4 compared to T1, T2, and T3 (p < 0.001). Self-efficacy (SE-PMC: T1 = 18.93 ± 3.18, T4 = 28.83 ± 6.56, p < 0.001) and attitude (A-PMC: T1 = 18.78 ± 3.09, T4 = 28.20 ± 6.03, p < 0.001) for oral care among nurse participants improved after the implementation of the OHPP. CONCLUSIONS This study highlights the feasibility of implementing OHPP within GCFs, potentially enhancing the oral health and daily living activities of older individuals. Integrating the OHPP into routine care in geriatric settings is not only practical but also widely acceptable, offering a proactive approach to address oral health disparities among older residents. Stakeholders can maximize the impact of the OHPP by fostering collaboration among healthcare professionals, administrators, and residents, ultimately improving oral health outcomes and overall quality of life of older residents. TRIAL REGISTRATION ChiCTR2000035236 (registration date: 04/08/2020).
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Affiliation(s)
- Liyan Gu
- Department of Neurology, NO. 905 Hospital of PLA Navy, Naval Medical University, 1328 Huashan Road, 200052, Shanghai, China
- Key Laboratory of Ministry of Education for Geriatric Long-term Care, Shanghai, China
| | - Jingwen Zhang
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China
| | - Wenyao Chen
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China
| | - Yanqiu Weng
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China
| | - Lan Chen
- Nursing Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.
| | - Lingjuan Zhang
- Key Laboratory of Ministry of Education for Geriatric Long-term Care, Shanghai, China.
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China.
- Shanghai Quality Control Center of Geriatric Care, 168 Changhai Road, Shanghai, 200043, China.
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Li Y, Huang CL, Lu XZ, Tang ZQ, Wang YY, Sun Y, Chen X. Longitudinal association of edentulism with cognitive impairment, sarcopenia and all-cause mortality among older Chinese adults. BMC Oral Health 2023; 23:333. [PMID: 37244990 DOI: 10.1186/s12903-023-03015-w] [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: 02/21/2023] [Accepted: 05/04/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Tooth loss may be a surrogate for systemic health and aging. However, no previous studies have systematically assessed multiple outcomes relevant to aging trajectory in this area, and many important confounders were not adjusted in most previous studies. This study aims to prospectively evaluate the associations of complete tooth loss (edentulism) with broad markers of sarcopenia, cognitive impairment and mortality. METHODS Data were derived from the China Health and Retirement Longitudinal Study, a nationally representative household study of the Chinese population aged 45 years and older. Multivariate Weibull proportional hazards regression was used to assess the association between edentulism with sarcopenia and all-cause mortality. Average changes in cognitive function by edentulism was estimated by mixed-effects linear regression models. RESULTS During the 5-year follow-up, the prevalence of edentulism among adults aged 45 and over was 15.4%. Participants with edentulism had a greater decline in cognitive function compared to those without (β=-0.70, 95%CI:-1.09, -0.31, P < 0.001). The association of edentulism and all-cause mortality for 45-64 age group (HR = 7.50, 95%CI: 1.99, 28.23, P = 0.003), but not statistically significant for the ≥ 65 age group (HR = 2.37, 95%CI: 0.97, 5.80, P = 0.057). Effects of edentulism on sarcopenia are statistically significant for all age groups (45-64 age group: HR = 2.15, 95%CI: 1.27, 3.66, P = 0.005; ≥65 age group: HR = 2.15, 95%CI: 1.27, 3.66, P = 0.002). CONCLUSIONS These findings could have important clinical and public health implications, as tooth loss is a quick and reproducible measurement that could be used in clinical practice for identifying persons at risk of accelerated aging and shortened longevity, and who may benefit most from intervention if causality is established.
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Affiliation(s)
- Yang Li
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China
| | - Chuan-Long Huang
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China
| | - Xiu-Zhen Lu
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China
| | - Zi-Qing Tang
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China
| | - Yuan-Yin Wang
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China
| | - Ying Sun
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China.
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei, Anhui Province, 230032, China.
| | - Xin Chen
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China.
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Liu G, Lu Z, Shan Y, Wang J, Shi X, Zong D, Li S, Kong F. Association between self-reported oral health and cognitive function among the community-dwelling elderly in Jinan, China: the mediating effect of life satisfaction. Front Psychol 2023; 14:1116325. [PMID: 37303887 PMCID: PMC10248475 DOI: 10.3389/fpsyg.2023.1116325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Background Deterioration of self-reported oral health and decline in cognitive function are two main adverse health outcomes experienced by the older adults. Little evidence was found on the psychosocial mechanism between self-reported oral health and cognitive function. This study explores the association between self-reported oral health and cognitive function and examines the mediating effect of life satisfaction among the community-dwelling elderly in Jinan, China. Methods A total of 512 older individuals (60+) were included in the study. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination scale (MMSE), and self-reported oral health was measured using the Chinese version of the Geriatric Oral Health Assessment Index (GOHAI). Pearson correlation analysis was used to determine the relationship between self-reported oral health, life satisfaction, and cognitive function. Multivariate linear regression analysis was conducted to explore the possible effect of covariates. Structural equation modelling and Bootstrap analyses were conducted to verify the mediating role of life satisfaction. Results The mean MMSE score was 25.65 ± 4.42. Better self-reported oral health was significantly associated with a higher level of life satisfaction, and those with higher life satisfaction experienced better cognitive function. Age, educational level and source of living expenses were found to be cofounding variables. Life satisfaction partially mediated the effect of self-reported oral health on cognitive function (95% confidence interval [CI]: 0.010 to 0.075). The mediating effect of life satisfaction accounted for 24% of the total effect. Conclusion The level of cognitive function was relatively high. Self-reported oral health was positively associated with cognitive function, and the mediating effect of life satisfaction was proven to exist in the community-dwelling older individuals. Early screening for oral diseases and a greater focus on life satisfaction are recommended.
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Affiliation(s)
- Guangwen Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Zhongqian Lu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Ying Shan
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xinfei Shi
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Di Zong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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Chen H, Wu YY, Zhang W. Age accelerated effect of tooth loss on cognitive function among Chinese older adults. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2022.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Nakamura M, Imaoka M, Tazaki F, Nakao H, Hida M, Kono R, Kanemoto H, Takeda M. Association between Bone-Related Physiological Substances and Oral Function in Community-Dwelling Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10677. [PMID: 36078393 PMCID: PMC9518358 DOI: 10.3390/ijerph191710677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Oral dysfunction is related to long-term cares including activities of daily living. The objective of this study was to determine the association between oral function and the bone-related physiological substances osteocalcin (OC) and insulin-like growth factor-1 (IGF-1). METHODS The study participants were 139 community-dwelling older people in Japan. Evaluation of oral dysfunction was based on subjective judgment by each participant. Blood analysis included OC, IGF-1, and albumin. RESULTS Univariate and multiple logistic analyses showed that IGF-1 was significantly associated with a "decline in masticatory function" (p = 0.0074 and p = 0.0308, respectively). Receiver operating characteristic curve analysis of IGF-1 levels revealed a threshold score of 108 ng/mL (p < 0.01) for discriminating a "decline in masticatory function". Logistic regression analysis revealed that participants with an IGF-1 level ≤108 ng/mL had an odds ratio of 4.31 (p < 0.05) for a "decline in masticatory function". No significant association was found between the OC level and oral dysfunction. CONCLUSIONS These results suggest a possible relationship between lower serum IGF-1 levels and a decline in masticatory dysfunction in community-dwelling older people.
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Affiliation(s)
- Misa Nakamura
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka 597-0104, Osaka, Japan
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka 597-0104, Osaka, Japan
| | - Masakazu Imaoka
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka 597-0104, Osaka, Japan
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka 597-0104, Osaka, Japan
| | - Fumie Tazaki
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka 597-0104, Osaka, Japan
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka 597-0104, Osaka, Japan
| | - Hidetoshi Nakao
- Department of Physical Therapy, Josai International University, Tougane 283-0002, Chiba, Japan
| | - Mitsumasa Hida
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka 597-0104, Osaka, Japan
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka 597-0104, Osaka, Japan
| | - Ryohei Kono
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka 597-0104, Osaka, Japan
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka 597-0104, Osaka, Japan
| | - Hideki Kanemoto
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Suita 565-0871, Osaka, Japan
| | - Masatoshi Takeda
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka 597-0104, Osaka, Japan
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Choi SE, Mo E, Palmer N, Fox K, Da Silva JD, Nagai S, Barrow JR. Cognitive impairment and edentulism among older adults: an observational study using claims data. BMC Geriatr 2022; 22:278. [PMID: 35379177 PMCID: PMC8981850 DOI: 10.1186/s12877-022-02985-w] [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: 06/24/2021] [Accepted: 03/28/2022] [Indexed: 12/01/2022] Open
Abstract
Background The scientific link between mastication strength and cognitive function has not yet been strongly corroborated in population studies. Utilizing large-scale claims, we aim to investigate the association between edentulism and cognitive impairment in older American adults. Methods Using de-identified claims from a commercial insurer from 2015–2019, we conducted a retrospective cohort study using multilevel regression models to evaluate the association between denture status and clinically diagnosed cognitive impairment. Secondary analysis included symptomatic cognitive impairment in the outcome. Results Adjusting for individual-level risk factors, denture status was significantly associated with clinical cognitive impairment with odds ratios of 1.13 (95%CI: 1.02–1.25) and 1.26, (95%CI: 1.09–1.45) for complete dentures on one or both jaws, respectively. Including symptomatic cognitive impairment in the analysis did not substantially change our fundamental findings. Conclusion Prevention and treatment of oral diseases should be considered a key component in preserving the overall wellness of older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02985-w.
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Affiliation(s)
- Sung Eun Choi
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, 188 Longwood Avenue REB 204, Boston, MA, 02115, USA.
| | - Emily Mo
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, 188 Longwood Avenue REB 204, Boston, MA, 02115, USA
| | - Nathan Palmer
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Kathe Fox
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - John D Da Silva
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Boston, MA, USA
| | - Shigemi Nagai
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Jane R Barrow
- Office of Global and Community Health, Harvard School of Dental Medicine, Boston, MA, USA
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Glycemic control and number of natural teeth: analysis of cross-sectional Japanese employment-based dental insurance claims and medical check-up data. Diabetol Int 2021; 13:244-252. [DOI: 10.1007/s13340-021-00533-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/16/2021] [Indexed: 02/08/2023]
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Xu X, Zhao Y, Gu D, Pei Y, Wu B. Health Behaviors and Self-Reported Oral Health among Centenarians in Nanjing, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7285. [PMID: 34299735 PMCID: PMC8304003 DOI: 10.3390/ijerph18147285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 11/01/2022]
Abstract
The role of health behaviors in oral health conditions in individuals of extremely old age remains understudied. This study included 185 participants aged 100 years or older from the Nanjing Centenarians Study (NCS) to examine the associations between health behaviors and oral health and investigate the potential moderating role of education and living arrangements in such relationships. The oral health status as an outcome included the self-reported oral health status and edentulous status. Health behavior variables included smoking, eating fruits, eating vegetables, participating in leisure activities, and practicing oral hygiene behaviors. Sociodemographic characteristics and health status were considered as confounders. Descriptive statistics, ordinal regression, and logistic regression models were used to address the research questions. Results showed that better oral health was reported by centenarians who were non-smokers, participated in more leisure activities, and practiced higher frequency of oral hygiene behaviors. Those who ate fruits daily and practiced more frequently oral hygiene behaviors were more likely to be dentate. The positive association of oral hygiene behaviors was stronger for centenarians who were formally educated and co-resided with family members. The results suggest that effective interventions should consider health behaviors and living arrangements in this growing population to improve their oral health status.
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Affiliation(s)
- Xin Xu
- Population Research Institute, Nanjing University of Posts and Telecommunications, Nanjing 210042, China;
| | - Yuan Zhao
- Population Research Institute, Nanjing University of Posts and Telecommunications, Nanjing 210042, China;
- Ginling College, Nanjing Normal University, Nanjing 210023, China
| | - Danan Gu
- Independent Researcher, New York, NY 10010, USA;
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA;
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA;
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Dong X. Advancing Asian Health Equity: Multimodal Approach to Translate Research into Practice and Policy. J Am Geriatr Soc 2020; 67:S476-S478. [PMID: 31403206 DOI: 10.1111/jgs.16110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 07/15/2019] [Indexed: 11/30/2022]
Affiliation(s)
- XinQi Dong
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey
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