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Preisser J, Moss K, Finlayson T, Jones J, Weintraub J. Prediction Model Development and Validation of 12-Year Incident Edentulism of Older Adults in the United States. JDR Clin Trans Res 2023; 8:384-393. [PMID: 35945823 PMCID: PMC10504805 DOI: 10.1177/23800844221112062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
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.
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Affiliation(s)
- J.S. Preisser
- Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - K. Moss
- Division of Comprehensive Oral Health University of North Carolina at Chapel Hill, Adams School of Dentistry, Chapel Hill, NC, USA
| | - T.L. Finlayson
- Health Management and Policy, San Diego State University School of Public Health, San Diego, CA, USA
| | - J.A. Jones
- University of Detroit Mercy, Detroit, MI, USA
| | - J.A. Weintraub
- Division of Pediatric and Public Health, University of North Carolina at Chapel Hill, Adams School of Dentistry, Chapel Hill, NC, USA
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Kaufman H, Howell S, Stolow J, Andrinopoulos K, Anglewicz P, Burt M, Castro A. Self-perceived health of older adults in Latin America and the Caribbean: a scoping review. Rev Panam Salud Publica 2023; 47:e105. [PMID: 37363623 PMCID: PMC10289475 DOI: 10.26633/rpsp.2023.105] [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: 10/14/2022] [Accepted: 04/03/2023] [Indexed: 06/28/2023] Open
Abstract
Objective To systematically map the existing evidence on self-perceived health among adults aged 60 and older in Latin America and the Caribbean, describe the use of the single-item measure of self-perceived health with this population, and identify gaps in the existing literature. Methods Following PRISMA Extension for Scoping Reviews guidelines, eight databases were searched for publications that were published between 2009 and 2019 and reported self-perceived health of adults over 60 years old in Latin America and the Caribbean. Data on study characteristics, sample characteristics, and the use and analysis of the self-perceived health measure were charted. Results The database and secondary searches identified 516 articles. After removing duplicates and assessing titles and abstracts for inclusion, 263 full-text articles were assessed for eligibility using the inclusion criteria and an additional 89 articles were excluded. Ultimately, 174 articles were included in the scoping review. Studies included participants from 17 countries in the region, led in frequency by Brazil with 120 articles. The self-perceived health question most often included a five-category response scale (130), and response options were predominantly divided into two (86) or three (48) categories for analysis. Conclusions Information on the health and social needs of people aged 60 and older across Latin America and the Caribbean, particularly their perceptions of health, is limited. We highlight the need to expand research throughout the region, include particularly vulnerable populations, utilize data from longitudinal and qualitative studies, and call for transparency in how questions and responses are worded and analyzed. This review serves to inform future studies, programs, and policies directed at this population.
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Affiliation(s)
- Hannah Kaufman
- Tulane University School of Public Health and Tropical MedicineNew OrleansLAUnited States of AmericaTulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
| | | | - Jeni Stolow
- Tulane University School of Public Health and Tropical MedicineNew OrleansLAUnited States of AmericaTulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
| | - Katherine Andrinopoulos
- Tulane University School of Public Health and Tropical MedicineNew OrleansLAUnited States of AmericaTulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
| | - Philip Anglewicz
- Johns Hopkins University Bloomberg School of Public HealthBaltimoreMDUnited States of AmericaJohns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Martín Burt
- Fundación ParaguayaAsunciónParaguayFundación Paraguaya, Asunción, Paraguay
| | - Arachu Castro
- Tulane University School of Public Health and Tropical MedicineNew OrleansLAUnited States of AmericaTulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
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Casanova-Rosado AJ, Casanova-Rosado JF, Minaya-Sánchez M, Robles-Minaya JL, Casanova-Sarmiento JA, Márquez-Corona MDL, Pontigo-Loyola AP, Isla-Granillo H, Mora-Acosta M, Márquez-Rodríguez S, Medina-Solís CE, Maupomé G. Association of Edentulism with Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey. Healthcare (Basel) 2021; 9:healthcare9040404. [PMID: 33916223 PMCID: PMC8066655 DOI: 10.3390/healthcare9040404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 12/17/2022] Open
Abstract
Objective: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). Results: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases’ prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. Conclusions: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.
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Affiliation(s)
- Alejandro José Casanova-Rosado
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
| | - Juan Fernando Casanova-Rosado
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
- Correspondence: (J.F.C.-R.); (C.E.M.-S.)
| | - Mirna Minaya-Sánchez
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
| | - José Luís Robles-Minaya
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
| | | | - María de Lourdes Márquez-Corona
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - América Patricia Pontigo-Loyola
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Horacio Isla-Granillo
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Mariana Mora-Acosta
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Sonia Márquez-Rodríguez
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
- Advanced Studies and Research Center in Dentistry “Dr. Keisaburo Miyata”, School of Dentistry, Autonomous University of State of Mexico, Toluca 50000, Mexico
- Correspondence: (J.F.C.-R.); (C.E.M.-S.)
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University/Purdue University, Indianapolis, IN 46202, USA;
- Indiana University Network Science Institute, Bloomington, IN 47408, USA
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Pengpid S, Peltzer K. The prevalence of edentulism and their related factors in Indonesia, 2014/15. BMC Oral Health 2018; 18:118. [PMID: 29970051 PMCID: PMC6029125 DOI: 10.1186/s12903-018-0582-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 06/25/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Little information exists about the loss of all one's teeth (edentulism) among older adults in Indonesia. The aim of this study was to investigate the prevalence of edentulism and associated factors among older adults in Indonesia. METHOD This study examines the self-reported prevalence of edentulism and associated factors among older adults (50 years and older) in a cross-sectional national study using the Indonesia Family Life Survey IFLS-5, 2014/15. The community-based study uses a multi-stage stratified sampling design to interview and assess household members, with a household response rate of over 90%. RESULTS The overall prevalence of edentulism was 7.2, 29.8% in 80 years and older and 11.8% in those with no formal education. In adjusted Poisson regression analysis, older age, living in five major island groups and having functional disability were associated with edentulism. In addition, among men, having quit and current tobacco use and among women, having low social capital were associated with edentulism. Further, in adjusted analysis, among men, edentulism was positively associated with hypertension and negatively associated with diabetes, and among women, edentulism was associated with functional disability. CONCLUSIONS Results suggest that overall and/or among men or women that older age, living in five major island groups, having functional disability, tobacco quitters and users and those with low social capital was associated with edentulism. The identified associated factors of edentulism may be utilized in oral health programmes targeting older adults in Indonesia.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand
- Department of Research & Innovation, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department of Research & Innovation, University of Limpopo, Turfloop, South Africa
- HIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research Council, Private Bag X41, Pretoria, 0001 South Africa
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Kailembo A, Preet R, Stewart Williams J. Common risk factors and edentulism in adults, aged 50 years and over, in China, Ghana, India and South Africa: results from the WHO Study on global AGEing and adult health (SAGE). BMC Oral Health 2016; 17:29. [PMID: 27465011 PMCID: PMC4964081 DOI: 10.1186/s12903-016-0256-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 07/15/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Edentulism (loss of all teeth) is a final marker of disease burden for oral health common among older adults and poorer populations. Yet most evidence is from high-income countries. Oral health has many of the same social and behavioural risk factors as other non-communicable diseases (NCDs) which are increasing rapidly in low- and middle-income countries with ageing populations. The "common risk factor approach" (CRFA) for oral health addresses risk factors shared with NCDs within the broader social and economic environment. METHODS The aim is to improve understanding of edentulism prevalence, and association between common risk factors and edentulism in adults aged 50 years and above using nationally representative samples from China (N = 11,692), Ghana (N = 4093), India (N = 6409) and South Africa (N = 2985). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010). Multivariable logistic regression describes association between edentulism and common risk factors reported in the literature. RESULTS Prevalence of edentulism: in China 8.9 %, Ghana 2.9 %, India 15.3 %, and South Africa 8.7 %. Multivariable analysis: in China, rural residents were more likely to be edentulous (OR 1.36; 95 % CI 1.09-1.69) but less likely to be edentulous in Ghana (OR 0.53; 95 % CI 0.31-0.91) and South Africa (OR 0.52; 95 % CI 0.30-0.90). Respondents with university education (OR 0.31; 95 % CI 0.18-0.53) and in the highest wealth quintile (OR 0.68; 95 % CI 0.52-0.90) in China were less likely to be edentulous. In South Africa respondents with secondary education were more likely to be edentulous (OR 2.82; 95 % CI 1.52-5.21) as were those in the highest wealth quintile (OR 2.78; 95 % CI 1.16-6.70). Edentulism was associated with former smokers in China (OR 1.57; 95 % CI 1.10-2.25) non-drinkers in India (OR 1.65; 95 % CI 1.11-2.46), angina in Ghana (OR 2.86; 95 % CI 1.19-6.84) and hypertension in South Africa (OR 2.75; 95 % CI 1.72-4.38). Edentulism was less likely in respondents with adequate nutrition in China (OR 0.68; 95 % CI 0.53-0.87). Adjusting for all other factors, compared with China, respondents in India were 50 % more likely to be edentulous. CONCLUSIONS Strengthening the CRFA should include addressing common determinants of health to reduce health inequalities and improve both oral and overall health.
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Affiliation(s)
- Alexander Kailembo
- Elite Dental Clinic, 6th Floor, Oasis Office Complex, Plot No. 14/15, Haile Selassie Road, P.O Box 38394, Masaki, Dar es salaam Tanzania
| | - Raman Preet
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Jennifer Stewart Williams
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden
- Research Centre for Generational Health and Ageing, Faculty of Health, University of Newcastle, Newcastle, Australia
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Casanova-Rosado AJ, Medina-Solís CE, Casanova-Rosado JF, Vallejos-Sánchez AA, Minaya-Sánchez M, Mendoza-Rodríguez M, Márquez-Rodríguez S, Maupomé G. Tooth brushing frequency in Mexican schoolchildren and associated socio-demographic, socioeconomic, and dental variables. Med Sci Monit 2014; 20:938-44. [PMID: 24907713 PMCID: PMC4063737 DOI: 10.12659/msm.890106] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 01/06/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Tooth brushing (with fluoridated toothpaste) is the most cost-effective intervention in dentistry and it is widely recommended to preserve good oral health. We aimed to determine the frequency of tooth brushing and the variables associated with this practice in schoolchildren living in southeast Mexico. MATERIAL AND METHODS A cross-sectional study was carried out in 1644 schoolchildren, 6 to 13 years old. Questionnaires with socio-demographic, socioeconomic, and dental variables were administered to mothers/guardians of children. The dependent variable was the frequency of tooth brushing, which was categorized as 0 = tooth brushing less than once a day and 1 = tooth brushing at least once a day. A logistic regression model was used to evaluate the final results. RESULTS Mean age was 9.06±2.02 years and 49.1% were girls. The prevalence of tooth brushing at least once a day was 49.8%. In the multivariate model, characteristics related to tooth brushing frequency (p<0.05) were: older age (OR=1.11), being female (OR=1.64), having a larger family (OR=0.87), having had a visit to a dentist during the year preceding the study (OR=1.37), and having had fluoride applications by a professional (OR=1.39). CONCLUSIONS The results suggested that different variables (demographic, socioeconomic and dental) are associated with the frequency of tooth brushing. Family size (proxy variable for socioeconomic status) may indicate certain oral health inequalities in this population.
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Affiliation(s)
| | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of State of Hidalgo, Pachuca, Hidalgo, Mexico
| | | | | | - Mirna Minaya-Sánchez
- School of Dentistry, Autonomous University of Campeche, Campeche, Campeche, Mexico
| | - Martha Mendoza-Rodríguez
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of State of Hidalgo, Pachuca, Hidalgo, Mexico
| | - Sonia Márquez-Rodríguez
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of State of Hidalgo, Pachuca, Hidalgo, Mexico
| | - Gerardo Maupomé
- Indiana University/Purdue University at Indianapolis School of Dentistry. Indianapolis, IN, U.S.A
- Regenstrief Institute, Inc. Indianapolis, IN, U.S.A
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Medina-Solís CE, Pontigo-Loyola AP, Pérez-Campos E, Hernández-Cruz P, Ávila-Burgos L, Mendoza-Rodríguez M, Maupomé G. National survey of oral/dental conditions related to tobacco and alcohol use in Mexican adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:3169-84. [PMID: 24642844 PMCID: PMC3987028 DOI: 10.3390/ijerph110303169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 01/08/2014] [Accepted: 01/08/2014] [Indexed: 02/07/2023]
Abstract
Oral diseases are a major burden on individuals and health systems. The aim of this study was to determine whether consumption of tobacco and alcohol were associated with the prevalence of oral/dental problems in Mexican adults. Using data from the National Performance Evaluation Survey 2003, a cross-sectional study part of the World Health Survey, dental information from a representative sample of Mexico (n = 22,229, N = 51,155,740) was used to document self-reported oral/dental problems in the 12 months prior to the survey. Questionnaires were used to collect information related to sociodemographic, socioeconomic, and other risk factors. Three models were generated for each age group (18–30, 31–45 and 46–98 years). The prevalence of oral/dental conditions was 25.7%. Adjusting for sex, schooling, socioeconomic position, diabetes, and self-reported health, those who used tobacco (sometimes or daily) (OR = 1.15, p = 0.070; OR = 1.24, p < 0.01; and OR = 1.16, p < 0.05, for each age group respectively) or alcohol (moderate or high) (OR = 1.26, p < 0.001; OR = 1.18, p < 0.01 and OR = 1.30, p < 0.001, for each age group respectively) had a higher risk of reporting oral/dental problems. Because tobacco and alcohol use were associated with self-reported oral/dental problems in one out of four adults, it appears advisable to ascertain how direct is such link; more direct effects would lend greater weight to adopting measures to reduce consumption of tobacco and alcohol for the specific purpose of improving oral health.
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Affiliation(s)
- Carlo Eduardo Medina-Solís
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Hidalgo 42160, Mexico.
| | - América Patricia Pontigo-Loyola
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Hidalgo 42160, Mexico.
| | - Eduardo Pérez-Campos
- Research Centre in Medical and Biological Sciences, School of Medicine and Surgery, Autonomous University "Benito Juarez" of Oaxaca, Oaxaca 68020, Mexico.
| | - Pedro Hernández-Cruz
- Research Centre in Medical and Biological Sciences, School of Medicine and Surgery, Autonomous University "Benito Juarez" of Oaxaca, Oaxaca 68020, Mexico.
| | - Leticia Ávila-Burgos
- Health Systems Research Centre, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
| | - Martha Mendoza-Rodríguez
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Hidalgo 42160, Mexico.
| | - Gerardo Maupomé
- School of Dentistry, Indiana University/Purdue University at Indianapolis, Indianapolis, IN 46202, USA.
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