Tooth loss and associated self-rated health and psychological and subjective wellbeing among community-dwelling older adults: A cross-sectional study in India

Tooth loss and depression in Chilean participants of the National Health Survey 2016-2017: Oral and social functions mediation analysis

BACKGROUND

Previous studies have indicated the association between poor oral health and depression in adults. This study evaluated oral and social functions contribution to the association between tooth loss and depressive symptoms in Chilean individuals.

METHODS

We used data from the Chilean National Health Survey. The number of remaining teeth (≤19 versus ≥20 teeth) and anterior tooth losses were the exposure variables. Outcome was depression, measured through a self-report question and with the Composite International Diagnostic Interview - Short Form (CIDI SF). Mediating variables were determined by five questions, including problems regarding "speaking", "pain and suffering", "eating", "daily activities", and "social relationships". We performed logistic regression models adjusted by multiple confounders variables. Finally, we calculated indirect, direct effect, total effect, and the proportion mediated (PM).

RESULTS

We included 5383 participants. The self-reported depression and suspected depression prevalence were 22,1 % and 14,0 % respectively. The total effect of fewer remaining teeth (≤19) on self-reported depression was 1.21 (95 % CI 1.02-1.44), and 1.09 (95 % CI 0.90-1.33) for suspected depression. All five variables of oral and social functions significantly mediated the association between tooth loss and depression. Feeling uncomfortable when speaking or eating discomfort were the most significant mediators.

LIMITATIONS

The mediation analysis should be interpreted with caution due to the cross-sectional design.

CONCLUSIONS

Deterioration of oral and social functions was a significant mediator in the association between tooth loss and depression, in particular feeling uncomfortable when speaking or eating. This mechanism should be considered in interventions to improve mental health.

Relationship between the number of lost teeth and the occurrence of depressive symptoms in middle-aged adults: a cross-sectional study

BACKGROUND

Many recent studies suggest the existence of a relationship between oral health and the occurrence of depressive symptoms. The aim of this study was to assess the relationship between the number of lost teeth and the occurrence of depressive symptoms in middle-aged adults.

METHODS

An analysis was performed on the data obtained from the PONS project (POlish-Norwegian Study), conducted in the Świętokrzyskie Province in Poland in 2010-2011. The research material included the cross-sectional data of 11,901 individuals aged 40-64 years (7967 women). Depressive symptoms, used as outcome variables, were assessed with a questionnaire. The participants provided the responses to questions concerning the occurrence of eight symptoms over the last 12 months. The answers were scored as 1 point or 0 points. The participants were divided into three tercile groups based on their total scores: no or mild (0-2 points), moderate (3-5 points), and severe depressive symptoms (6-8 points). The self-reported number of lost teeth was analysed according to the following categories: 0-4, 5-8, 9-27, and a complete lack of natural teeth. Multivariable logistic regression analysis for depressive symptoms was used in relation to the number of lost teeth. The following covariates were included in the adjusted model: age, sex, place of residence, education, marital status, BMI, diabetes status, stressful life events in the last year, use of antidepressants, smoking, and sugar and sweet consumption.

RESULTS

The likelihood of both moderate (OR = 1.189; 95%CI: 1.028-1.376; p < .020) and severe (OR = 1.846; 95%CI: 1.488-2.290; p < .001) depressive symptoms showed the strongest relationship with a total lack of natural teeth. A loss of more than 8 natural teeth was also significantly associated (OR = 1.315; 95%CI: 1.075-1.609; p < .008) with the occurrence of severe depressive symptoms.

CONCLUSIONS

The loss of natural teeth was positively related to the occurrence of depressive symptoms in middle-aged adults. Thus, there is an urgent need to intensify stomatological prophylaxis, education and treatment for middle-aged individuals.

Association between tooth loss-related speech and psychosocial impairment with cognitive function: A pilot study in Hong Kong's older population

BACKGROUND

Tooth loss has been associated with cognitive decline, but the underlying mechanisms involving speech and psychosocial impairment remain unclear.

OBJECTIVES

To investigate the impact of tooth loss-related speech and psychosocial impairment on cognitive function in Hong Kong's older population.

METHODS

Seventy-six Cantonese-speaking participants between the ages of 51-92 were classified into three groups: patients with complete dentures (CD), partially edentulous patients with less than 10 occluding tooth pairs (OU <10), and at least 10 occluding tooth pairs (OU ≥10). Cognitive function was assessed using the Montreal Cognitive Assessment Hong Kong Version, One-minute Verbal Fluency Task and Hayling Sentence Completion Test. Objective and subjective speech assessments were carried out using artificial intelligence speech recognition algorithm and a self-designed speech questionnaire. The impact of tooth loss on psychosocial condition was evaluated by the Reading the Mind in the Eyes Test and a self-designed questionnaire. Statistical analyses (one-way ANOVA, ANCOVA, Kruskal-Wallis test, Spearman correlation test) were performed.

RESULTS

Tooth loss was significantly associated with lower cognitive function (p = .008), speech accuracy (p = .018) and verbal fluency (p = .001). Correlations were found between cognitive function and speech accuracy (p < .0001). No significant difference in tooth loss-related psychosocial impact was found between the three groups.

CONCLUSION

While warranting larger sample sizes, this pilot study highlights the need for further research on the role of speech in the association between tooth loss and cognitive function. The potential cognitive impact of tooth retention, together with its known biological and proprioceptive benefits, supports the preservation of the natural dentition.

Lifestyle factors and subjective well‑being among older adults in China: A national community-based cohort study

There has been limited research on the relationship between health habits and subjective well-being (SWB) among Chinese oldest older adults. This study aims to explore lifestyle factors associated with SWB in this population. We analyzed data from three waves (2008-2014) of the CLHLS, including 28,683 older adults. Lifestyle factors analyzed included fruit and vegetable intake, smoking, alcohol consumption, physical exercise, and social participation. Results suggested that high frequency of fruit and vegetable intake, current and past physical exercise, and high levels of social participation were associated with increased SWB. SWB was lower in older adults who never smoked compared to persistent smokers and in those who never drank alcohol or ceased drinking compared to persistent drinkers. We encourage older adults to enhance SWB through increased fruit and vegetable intake, physical exercise, and social participation. However, quitting smoking and drinking may not necessarily improve SWB, particularly in the context of China.

Social participation, subjective well-being, and cognitive function as serial mediators between tooth loss and functional limitations in older Chinese adults

BACKGROUND

Although tooth loss appears to be related to functional limitations, the mechanisms that underpin this relationship are unknown. We sought to address this knowledge gap by examining a multiple mediation hypothesis whereby tooth loss is predicted to indirectly affect functional limitations through social participation, subjective well-being, and cognitive function.

METHODS

This study included 7,629 Chinese adults from the 2017/2018 Chinese Longitudinal Healthy Longevity Survey wave. The serial mediation effects were examined using Model 6 in the Hayes' PROCESS macro for SPSS.

RESULTS

Tooth loss was significantly related to functional limitations. There was a direct (β = - 0.0308; 95% CI, - 0.0131 to - 0.0036) and indirect (β = - 0.0068; 95% CI, - 0.0096 to - 0.0041) association between tooth loss and instrumental activities of daily living (IADL) limitations, but only an indirect correlation with activities of daily living (ADL) limitations (β = - 0.0188; 95% CI, - 0.0259 to - 0.0121). Social participation, subjective well-being, and cognitive function serially mediated the relationship between tooth loss and ADL/IADL limitations.

CONCLUSION

The association between tooth loss and functional limitations is serially mediated by social participation, subjective well-being, and cognitive function. Our findings underscore the necessity of considering psychological and social factors as integrated healthcare approaches for the functional health of older adults.

In Vitro Characterization of Reversine-Treated Gingival Fibroblasts and Their Safety Evaluation after In Vivo Transplantation

Reversine is a purine derivative that has been investigated with regard to its biological effects, such as its anticancer properties and, mostly, its ability to induce the dedifferentiation of adult cells, increasing their plasticity. The obtained dedifferentiated cells have a high potential for use in regenerative procedures, such as regenerative dentistry (RD). Instead of replacing the lost or damaged oral tissues with synthetic materials, RD uses stem cells combined with matrices and an appropriate microenvironment to achieve tissue regeneration. However, the currently available stem cell sources present limitations, thus restricting the potential of RD. Based on this problem, new sources of stem cells are fundamental. This work aims to characterize mouse gingival fibroblasts (GFs) after dedifferentiation with reversine. Different administration protocols were tested, and the cells obtained were evaluated regarding their cell metabolism, protein and DNA contents, cell cycle changes, morphology, cell death, genotoxicity, and acquisition of stem cell characteristics. Additionally, their teratoma potential was evaluated after in vivo transplantation. Reversine caused toxicity at higher concentrations, with decreased cell metabolic activity and protein content. The cells obtained displayed polyploidy, a cycle arrest in the G2/M phase, and showed an enlarged size. Additionally, apoptosis and genotoxicity were found at higher reversine concentrations. A subpopulation of the GFs possessed stem properties, as supported by the increased expression of CD90, CD105, and TERT, the existence of a CD106+ population, and their trilineage differentiation capacity. The dedifferentiated cells did not induce teratoma formation. The extensive characterization performed shows that significant functional, morphological, and genetic changes occur during the dedifferentiation process. The dedifferentiated cells have some stem-like characteristics, which are of interest for RD.

Examining the rural-urban differentials in yoga and mindfulness practices among middle-aged and older adults in India: secondary analysis of a national representative survey

Physical activity and mental well-being play an important role in reducing the risk of various diseases and in promoting independence among older adults. Appropriate physical activity, including yoga and mindfulness practices, can help rectify the loss of independence due to aging and have a positive influence on physical health and functional activities. This study assessed rural-urban differences in yoga and mindfulness practices and their associated factors among middle-aged and older Indian adults. The total sample size considered for the current analysis was 72,250 middle-aged and older adults (aged ≥ 45 years). Bivariate and multivariable logistic regression analyses were used to estimate the prevalence of yoga and mindfulness practices and examine the associations of selected variables with yoga and mindfulness practices among the participants. Further, we used the Fairley decomposition technique to determine the factors contributing to rural-urban differences in the prevalence of yoga and mindfulness practices among middle-aged and older adults. More than 9% of middle-aged and older adults in rural areas and 14% in urban areas reported practicing yoga and mindfulness activities more than once per week. Adults aged ≥ 65 years were more likely to practice yoga and mindfulness activities than those who age 45-54 years were. Those with an education of ten years and above were 2.3 and 2.1 times higher likely to practice yoga in rural (AOR: 2.28; CI: 2.07-2.52) and urban (AOR: 2.13; CI: 1.91-2.37) areas compared to their uneducated peers, respectively. The largest contributors in diminishing the gap in yoga practice among participants were education (44.2%), caste (2.5%), chronic diseases such as hypertension (4.53%), diabetes (1.71%), high cholesterol (3.08%), self-reported pain (5.76%), and difficulties in instrumental activities of daily living (1.22%). The findings suggest that middle-aged and older adults in urban areas practice yoga and mindfulness activities more than their peers in rural areas do. Education level, household characteristics, and health outcomes such as chronic conditions, pain, and functional difficulties explain the observed differences in yoga and mindfulness practices across rural and urban areas. Age-appropriate healthy practices such as yoga and mindfulness should be encouraged to enhance the physical and mental well-being of middle-aged and older adults, especially in rural areas.

Association between oral condition and subjective psychological well-being among older adults attending a university hospital dental clinic: A cross-sectional study

Positive psychological well-being has a favorable impact on survival rates in both healthy and unhealthy populations. Oral health is also associated with psychological well-being, is multidimensional in nature, and includes physical, psychological, emotional, and social domains that are integral to overall health and well-being. This study aimed to identify the associations between individual and environmental characteristics, oral condition and nutritional status in relation to subjective well-being among older adults using the Wilson and Cleary conceptual model. The participants were older adults (age ≥ 60 years) attending a university hospital. Subjective well-being was assessed using the World Health Organization-5 Well-Being Index, oral condition was assessed based on the number of bacteria in the tongue coating, oral wettability, tongue pressure, occlusal force, oral diadochokinesis, and masticatory ability, and subjective swallowing function was assessed using the Eating Assessment Tool, number of remaining teeth, and number of functional teeth. In addition, factors related to well-being, including social networks, life-space mobility, nutritional status, smoking history, drinking history, and medical history were assessed. In the analysis, structural equation modeling was used to investigate the association between oral condition and subjective well-being. Confirmatory factor analysis revealed oral condition as a latent variable, including tongue pressure, oral diadochokinesis /pa/, /ta/, /ka/, occlusal force, masticatory ability, subjective swallowing function, and number of functional teeth. Structural Equation Modeling revealed that oral condition was positively correlated with nutritional status, and nutritional status was positively correlated with the World Health Organization-5 Well-Being Index. These findings suggest that oral condition may influence subjective well-being via nutritional status or social environmental factors.

Prediction Model Development and Validation of 12-Year Incident Edentulism of Older Adults in the United States

INTRODUCTION

Edentulism affects health and quality of life.

OBJECTIVES

Identify factors that predict older adults becoming edentulous over 12 y in the US Health and Retirement Study (HRS) by developing and validating a prediction model.

METHODS

The HRS includes data on a representative sample of US adults aged >50 y. Selection criteria included participants in 2006 and 2018 who answered, "Have you lost all of your upper and lower natural permanent teeth?" Persons who answered "no" in 2006 and "yes" in 2018 experienced incident edentulism. Excluding 2006 edentulous, the data set (n = 4,288) was split into selection (70%, n = 3,002) and test data (30%, n = 1,286), and Monte Carlo cross-validation was applied to 500 random partitions of the selection data into training (n = 1,716) and validation (n = 1,286) data sets. Fitted logistic models from the training data sets were applied to the validation data sets to obtain area under the curve (AUC) for 32 candidate models. Six variables were included in all models (age, race/ethnicity, gender, education, smoking, last dental visit) while all combinations of 5 variables (income, alcohol use, self-rated health, loneliness, cognitive status) were considered for inclusion. The best parsimonious model based on highest mean AUC was fitted to the selection data set to obtain a final prediction equation. It was applied to the test data to estimate AUC and 95% confidence interval using 1,000 bootstrap samples.

RESULTS

From 2006 to 2018, 9.7% of older adults became edentulous. The 2006 mean (SD) age was 66.7 (8.7) for newly edentulous and 66.3 (8.4) for dentate (P = 0.31). The baseline 6-variable model mean AUC was 0.740. The 7-variable model with cognition had AUC = 0.749 and test data AUC = 0.748 (95% confidence interval, 0.715-0.781), modestly improving prediction. Negligible improvement was gained from adding more variables.

CONCLUSION

Cognition information improved the 12-y prediction of becoming edentulous beyond the modifiable risk factors of smoking and dental care use, as well as nonmodifiable demographic factors.

KNOWLEDGE TRANSFER STATEMENT

This prediction modeling and validation study identifies cognition as well as modifiable (dental care use, smoking) and nonmodifiable factors (race, ethnicity, gender, age, education) associated with incident complete tooth loss in the United States. This information is useful for the public, dental care providers, and health policy makers in improving approaches to preventive care, oral and general health, and quality of life for older adults.

Is There an Association between the Use of Social Media and Self-Rated Health?

This study sought to determine the association between social media and self-rated health. This study used the 2022 Health Information National Trends Survey for American adults. A statistical analysis was conducted using Chi-square and multivariable logistic regression. Of the 6018 study participants, the majority reported that they were in excellent/very good and good health (82.9%, n = 4930). More than half (58.2%, n = 3268) of the respondents reported that they visited a social media site almost every day in the past 12 months, while 76.8% (n = 4843) reported that they never interacted with people who had similar health or medical issues on social media. There was no association between everyday visits to a social media site, interaction with people with similar health/medical issues on social media, or watching a health-related video on social media and self-rated health. Those who had full-time employment were more likely to rate their health as excellent/very good/good (AOR: 2.394, 95% Conf. Int: 1.820-3.149) compared to those with no full-time employment. Marital status, confidence in taking care of oneself, education, and current smoking were associated with self-rated health. This study showed that the use of social media which included the watching of health-related videos was not associated with self-rated health.

Association between number of remaining teeth and incident depression in a rural Chilean cohort

OBJECTIVES

Previous studies have established an association between tooth loss and depression. However, longitudinal evidence is scarce and needs to be verified in other populations. The aim of this study was to examine the longitudinal association between the number of remaining teeth and incident depression at 2- and 4-years follow-up in individuals enrolled in the Maule cohort (MAUCO) in Chile.

METHODS

This prospective study used the information of individuals, aged 38 to 74 years, excluding those with depression at baseline. The number of remaining teeth at baseline was determined in four groups: "20 or more teeth", "10 to 19 teeth", "1 to 9 teeth" and "no natural teeth". Depression was measured through the PHQ-9. Logistic regression was performed to calculate the odds ratios (OR) for incidence depression at both periods of follow-ups, adjusting for age, sex, educational attainment, diabetes mellitus II, and stressful events at follow-up. Also, we performed adjusted multinomial logistic models to analysis the association between the number of remaining teeth and depression severity.

RESULTS

In total individuals (n = 3335 at follow 1, n = 2461 at follow 2), all groups have ORs for incident depression above 1 considering 20 or more teeth as reference. In men, those with 10-19 teeth have 2.44 times higher odds of incident depression than those with 20 or more teeth (OR 2.44, CI 95% 1.33-4.50). Edentulous subjects at 4 years follow-up had 2.24 times higher odds of depression than those with more than 20 teeth (OR 2.24 CI 95%1.35-3.72). In women, the ORs (CI 95%) of incident depression were 2.56 (1.50-4.39), 1.56 (1.02-2.40) and 1.27 (0.90-1.81) for "none", "1-9", "10-19" respectively in comparison to the reference group. In edentulous individuals at baseline, the odds for each of the comparisons "mild vs no", "moderate vs no", "moderately severe vs no" and "severe vs no" were above 1, at both follow-ups.

CONCLUSION

Individuals with less than 20 teeth in the mouth could had higher odds of incident depression at 2- and 4-years follow-up, with differences between men and women. Also, in our study, edentulism was associated with increased odds of incident depression at 4-years follow-up in women, and with higher levels of severity of depressive symptoms.

Analysis of epidemiological trends of and associated factors for tooth loss among 35- to 44-year-old adults in Guangdong, Southern China, 1995-2015: a population-based cross-sectional survey

BACKGROUND

Tooth loss is a known marker of oral and systemic health, but large-scale population-based and cross-sectional multi-year comparative studies on tooth loss have yet to be much studied in China. This study explores the changing trends in tooth loss status and the associated factors influencing the prevalence of tooth loss over the past two decades in Guangdong, Southern China.

METHODS

Data from three cross-sectional, representative oral epidemiological surveys in Guangdong Province were analyzed, including 400 in 1995, 720 in 2005, and 288 in 2015, for a total of 1408 participants. Sample selection is based on the National Census of China published by the National Bureau of Statistics. In this study, each year, the number of missing teeth (MT) and the prevalence of tooth loss (MT > 0) were calculated. Basic demographic information, socioeconomic status, caries and periodontal status, personal lifestyle factors, and dental health care behaviors were analyzed by multivariate logistic regression to estimate their associations with tooth loss. Statistical significance was evaluated with 2-sided tests with a significance level of P < 0.05.

RESULTS

This study found that the mean number of missing teeth and the prevalence of tooth loss among adults aged 35-44 years in Guangdong Province did not change significantly in the first decade (1995-2005) but decreased significantly in the second decade (2005-2015) (0.94 and 40.8% in 1995, 0.99 and 42.9% in 2005, and 0.63 and 33.3% in 2015, respectively). The mean number of MT by tooth position was highest for the first and second molars, and both were larger in the mandible than in the maxilla. In 1995, populations with low educational attainment and the presence of caries or periodontal pocket (periodontal probing depth ≥ 4 mm) were associated with a higher chance of MT > 0. In 2005, those with low educational attainment, the presence of caries, and 40-44 years old were associated with a higher chance of MT > 0. Moreover, in 2015, females, rural residents, and those with caries or periodontal pocket were associated with a higher chance of MT > 0.

CONCLUSIONS

Although tooth retention has improved recently (2005-2015) and the preventive effect of education level on tooth loss has increased over time, efforts to prevent tooth loss in adults need to be strengthened. Particular attention should be given to preventive interventions for women, rural residents, and those suffering from caries or periodontal pocket.

Association of the number of teeth and self-rated mastication with self-rated health in community-dwelling Japanese aged 40 years and older: the Yamagata cohort study

Self-rated health (SRH) is a predictive factor for health-related prognoses such as mortality. This study aimed to comprehensively investigate the risk factors for poor SRH in the general population of Japan, focusing on the combination of the number of teeth and self-rated mastication. Individuals aged at least 40 years in Yamagata Prefecture, Japan, were surveyed from 2017 to 2021. The participants answered a self-administered postal survey on lifestyle factors, medical history, physical and mental conditions, oral health, and dietary intake, and 6739 participants were included. Multivariate logistic regression analysis showed that individuals with less than 20 teeth and who bite tightly on one side or neither side were at a 1.422- and 1.952-fold significantly higher risk, respectively, of poor SRH than individuals with at least 20 teeth and who bite tightly on both sides. Moreover, individuals who had less than 20 teeth but could bite tightly on both sides did not have a significant risk compared to those who had at least 20 teeth and could bite tightly on both sides. Regarding individuals with more than 20 teeth, there was no difference between those who could and could not bite tightly on both sides, although the odds ratios for poor SRH tended to increase for those who could bite on one side or neither side. Our results emphasize the importance of having at least 20 teeth without periodontal disease and oral rehabilitation using a type of prosthesis for SRH, even with less than 20 teeth.

Poor mental health days is associated with higher odds of poor oral health outcomes in the BRFSS 2020

Background

To test the hypothesis that among individuals in the 2020 Behavioral Risk Factor Surveillance System (BRFSS) cross-sectional anonymous health survey in the United States (US), after controlling for confounding, an increasing number of poor mental health (MH) days in the past month is associated with increasing odds of delayed oral health (OH) care utilization and poorer OH outcomes.

Methods

Adjusted logistic regression models were developed with poor MH days as the exposure to examine the association with two dependent variables (DVs): Most recent dental visit longer than one year ago (yes/no), and having lost 6 or more teeth (yes/no).

Results

Approximately one third (32%) reported most recent dental visit more than one year ago, and 17% had lost 6 or more teeth. Those in the second quartile of poor MH days had 11% higher odds of delayed dental visit, and those in the highest quartile had 26% higher odds, compared to the reference group. For having lost 6 or more teeth, compared to the reference group, those in the third quartile had 8% higher odds and those in the fourth quartile had 18% higher odds.

Conclusions

Poor MH days is independently associated with odds of poor OH utilization and OH in the US above and beyond diagnosed mental and physical conditions. Policymakers in the US should expand health insurance plans to include dental insurance, and should increase access to MH care, especially for the aging population, and those with chronic conditions.

Oral health and depressive symptoms among older adults in urban China: a moderated mediation model analysis

Background

This study explored the association between oral health and depression occurs via daily dietary satisfaction as a mediator, and that body mass index could moderate the path between daily dietary satisfaction and depression.

Methods

Data for this research were derived from a community survey adopting quota sampling in the cities of Tianjin and Shijiazhuang in mainland China in 2020 (N = 781). The moderated mediation model was tested by using bootstrapping with resampling strategies, and the Johnson-Neyman technique was used to visualize the moderating effect of body mass index.

Results

A significant negative association between oral health and depression has been indicated (B = −0.22, SE = 0.11, 95%CI [− 0.44, − 0.01]), and dietary satisfaction partially mediated the relationship between oral health and depression (B = −0.04, SE = 0.02, 95%CI [− 0.09, − 0.002]). The path was moderated by body mass index, and the effect of dietary satisfaction on depression was much greater in people with relatively low body mass index.

Conclusions

This study present evidence for policymakers and researchers that strategies to enhance oral health and daily dietary satisfaction could be important for preventing depression in Chinese older adults, and especially for the relatively fitter older groups with lower body mass index.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03542-1.

The Associations between Meeting 24-Hour Movement Guidelines (24-HMG) and Self-Rated Physical and Mental Health in Older Adults-Cross Sectional Evidence from China

BACKGROUND

This study determined the prevalence of older adults (aged 60-80 years) meeting the Canadian 24-HMG alone and in combination, and their association with the self-rated physical health and mental health of older adults.

METHODS

Participants were drawn from 4134 older adults aged 60-80 years (age, 67.37 ± 0.08 years; 46.87% male) from the China Health and Nutrition Survey (CHNS) 2015 database. Mental health and physical health scores were obtained based on self-rated mental health questionnaires and physical health of older adults. The criteria for meeting the 24-HMG were: physical activity time ≥ 150 min/week, sedentary time ≤ 480 min/day, screen time ≤ 180 min/day, sleep time 7-9 h (60-64 years) and sleep time 7-8 h (65 years and above). Logistic regression models were used to examine the association between meeting the 24-HMG guidelines number and category and older adults' self-rated mental and physical health.

RESULTS

The proportion of older people meeting three of the 24-HMG guidelines was 1.16%, the proportion meeting two guidelines was 38.19% and the proportion meeting one guideline was 49.14%. The number of people meeting 24-HMG was closely related to the self-rated physical health and mental health of older people. The category meeting 24-HMG was closely related to the self-rated physical health and mental health of older people.

CONCLUSIONS

Meeting more guidelines in the 24-HMG was strongly associated with older people's self-rated mental health and physical health. However, only a small proportion of older people met all the recommendations, highlighting the need to promote and support adherence to these movement behaviours.

Multivariate decomposition analysis of sex differences in functional difficulty among older adults based on Longitudinal Ageing Study in India, 2017-2018

OBJECTIVES

This study investigates the gender disparities in difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) and explores its contributing factors among older adults in India.

DESIGN

A cross-sectional study was conducted using country representative survey data.

SETTING AND PARTICIPANTS

The present study uses the data from the Longitudinal Ageing Study in India, 2017-2018. Participants included 15 098 male and 16 366 female older adults aged 60 years and above in India.

PRIMARY AND SECONDARY OUTCOME MEASURES

Difficulty in ADL and IADL were the outcome variables. Descriptive statistics and bivariate analysis were carried out to present the preliminary results. Multivariate decomposition analysis was used to identify the contributions of covariates that explain the group differences to average predictions.

RESULTS

There was a significant gender differential in difficulty in ADL (difference: 4.6%; p value<0.001) and IADL (difference: 17.3%; p value<0.001). The multivariate analysis also shows significant gender inequality in difficulty in ADL (coefficient: 0.046; p value<0.001) and IADL (coefficient: 0.051; p value<0.001). The majority of the gender gap in difficulty in ADL was accounted by the male-female difference in levels of work status (18%), formal education (15% contribution), marital status (13%), physical activity (9%), health status (8%) and chronic morbidity prevalence (5%), respectively. Equivalently, the major contributors to the gender gap in difficulty in IADL were the level of formal education (28% contribution), marital status (10%), alcohol consumption (9%), health status (4% contribution) and chronic morbidity prevalence (2% contribution).

CONCLUSION

Due to the rapidly increasing ageing population, early detection and prevention of disability or preservation of daily functioning for older adults and women in particular should be the highest priority for physicians and health decision-makers.

Food insecurity and associated depression among older adults in India: evidence from a population-based study

OBJECTIVE

The present study aimed to examine the associations of several indicators of food insecurity with depression among older adults in India.

DESIGN

A cross-sectional study was conducted using country-representative survey data.

SETTING AND PARTICIPANTS

The present study uses data of the Longitudinal Aging Study in India conducted during 2017-2018. The effective sample size for the present study was 31 464 older adults aged 60 years and above.

PRIMARY AND SECONDARY OUTCOME MEASURES

The outcome variable was major depression among older adults. Descriptive statistics along with bivariate analysis was presented. Additionally, binary logistic regression analysis was used to establish the association between the depression and food security factors along with other covariates.

RESULTS

The overall prevalence of major depression was 8.4% among older adults in India. A proportion of 6.3% of the older adults reduced the size of meals, 40% reported that they did not eat enough food of their choice, 5.6% mentioned that they were hungry but did not eat, 4.2% reported that they did not eat for a whole day and 5.6% think that they have lost weight due to lack of enough food in the household. Older adults who reported to have reduced the size of meals due to lack of enough food (adjusted OR (AOR): 1.76, CI 1.44 to 2.15) were hungry but did not eat (AOR: 1.35, CI 1.06 to 1.72) did not eat food for a whole day (AOR: 1.33; CI 1.03 to 1.71), lost weight due to lack of food (AOR: 1.57; CI 1.30 to1.89) had higher odds of being depressed in reference to their respective counterparts.

CONCLUSION

The findings suggest that self-reported food insecurity indicators were strongly associated with major depression among older Indian adults. The national food security programmes should be enhanced as an effort to improve mental health status and quality of life among older population.

Socioeconomic vulnerability and frailty among community-dwelling older adults: cross-sectional findings from longitudinal aging study in India, 2017-18

INTRODUCTION

The Indian population is rapidly aging with huge proportion of illiterate and socioeconomically disadvantaged people and there is a dearth of research on the relationships between factors of socioeconomic vulnerability and frailty in older people. The present study examined the cross-sectional associations between socioeconomic vulnerability and physical frailty in community-dwelling older individuals in India.

MATERIALS AND METHODS

The data for the study were obtained from the Longitudinal Aging Study in India (LASI), which was conducted in 2017-18. The effective sample size was 14,652 older males and 15,899 older females aged 60 and over. The outcome variable was physical frailty phenotype measured from exhaustion, unintentional weight loss, weak grip strength, low physical activity, and slow walking time. The main explanatory variable was vulnerability status based on education, wealth and caste. The study carried out bivariate analysis to observe the association between vulnerability status and physical frailty. Further, multivariable binary logistic regression analysis was conducted to fulfil the objective of the study.

RESULTS

A proportion of 10.5 and 14.4% of older males and females respectively were in the overall vulnerable category. The prevalence of physical frailty was high among older males from vulnerable population (31.4% vs 26.9%; p < 0.001). The adjusted estimates from multivariate analysis revealed that older adults from vulnerable category had 14% significantly higher odds of being frail in comparison to non-vulnerable category [AOR: 1.14; CI: 1.06,1.24]. The adjusted model further revealed that there were no significant gender differentials in physical frailty among older adults. Model-3 (adjusted model) revealed that older males and females from vulnerable population had 18% [AOR: 1.18; CI: 1.04,1.34] and 8% [AOR: 1.08; CI: 1.01,1.21] significantly higher odds of being physically frail in comparison to older males from non-vulnerable population respectively.

CONCLUSIONS

Adverse socioeconomic circumstances such as low education, lower wealth and caste status that are associated with increased prevalence of physical frailty raise urgent questions both for public health practitioners and clinicians. The current findings may help to adapt public policies focusing on screening physical frailty in the clinical settings, especially among vulnerable populations as a marker of a possibly reversible vulnerability to adverse outcomes in old age.