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Ishimura K, Sakaniwa R, Shirai K, Aida J, Takeuchi K, Kondo K, Iso H. Frequency of Going Outdoors and Risk of Poor Oral Health Among Older Japanese Adults: A Longitudinal Cohort From the Japan Gerontological Evaluation Study. J Epidemiol 2024; 34:63-69. [PMID: 36967120 PMCID: PMC10751189 DOI: 10.2188/jea.je20220221] [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: 08/08/2022] [Accepted: 01/09/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND The association between the frequency of going outdoors and the risk of poor oral health has been reported in several studies; however, the findings have been inconclusive. METHODS We conducted a 3-year longitudinal study of 19,972 Japanese adults aged ≥65 years who reported no poor oral condition at baseline in 2013. The respondents rated their frequency of going outdoors in three categories (≤1, 2-3, or ≥4 times/week), and the oral conditions reported in 2016 included tooth loss, chewing difficulty, swallowing difficulty, dry mouth, and composite outcomes. The associations between the frequency of going outdoors and the risk of poor oral health were examined as relative risk ratios (RRs) and 95% confidence intervals (CIs) using multivariable Poisson regression, while mediation analysis was performed to investigate indirect effects. RESULTS During the follow-up, 32.5% of participants developed poor oral health. In the mediation analysis, indirect effects were observed through low instrumental activities of daily living, depressive symptoms, little social network diversity, and underweight. Compared to going outdoors ≥4 times/week, the multivariable RRs of composite poor oral health conditions were 1.12 (95% CI, 1.05-1.20) for 2-3 times/week and 1.22 (95% CI, 1.07-1.39) for ≤1 time/week (P-trend < 0.001). Similar associations were observed for tooth loss, chewing difficulty, and swallowing difficulty; the corresponding RRs were 1.07 (95% CI, 0.97-1.19) and 1.36 (95% CI, 1.13-1.64) (P-trend = 0.002), 1.18 (95% CI, 1.06-1.32) and 1.30 (95% CI, 1.05-1.60) (P-trend < 0.001), and 1.15 (95% CI, 1.01-1.31) and 1.38 (95% CI, 1.08-1.77) (P-trend = 0.002), respectively. CONCLUSION The frequency of going outdoors was inversely associated with the risk of poor oral health through several modifiable risk factors in the older population.
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Affiliation(s)
- Keiko Ishimura
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ryoto Sakaniwa
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kokoro Shirai
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University Graduate School of Medical and Dental Science, Tokyo, 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
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hiroyasu Iso
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Healthcare Center Medicine, Tokyo, Japan
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Shimizu N, Ide K, Kondo K. Association between diversity levels of member composition in group activities of older adults and the occurrence of need for care: the JAGES 2013-2019 longitudinal study. BMC Geriatr 2023; 23:579. [PMID: 37730556 PMCID: PMC10510208 DOI: 10.1186/s12877-023-04261-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Participating in groups with diverse members is associated with improved health among older adults. The study examined the relationship between diversity of group members and needed support or long-term care. METHODS We conducted a longitudinal study for the Japan Gerontological Evaluation Study with 61,281 participants aged ≥ 65 years who were surveyed in 2013 and followed-up for six years. We assessed three dimensions of the diversity of the participating members (sex, age, and region of residence). We then graded the diversity level into four categories: level 0 (not in any group), level 1 (in a group without diversity or in a group with diversity in one of the three factors), level 2 (in a group with diversity in two of the three factors), or level 3 (in a group with diversity across all factors). We adjusted for 12 covariates using Cox hazard survival analysis models with hazard ratios (HRs) and 95% confidence intervals (CIs) estimated for the association between group members' diversity levels and needed support or long-term care. The same study was conducted when stratified by employment status at baseline. RESULTS Participants in social participation groups with more diverse group members had a lower incidence of needed support or long-term care as compared to their counterparts. Compared to those with no participation group, HR decreased by 14% to 24% with increasing levels of diversity. The HR for the level of care needed for participants in the social participation group with high residential diversity was 0.89 (95% CI: 0.84-0.94). For participants who were currently unemployed, HR reductions ranged from 16%-28% with increasing levels of diversity compared to the non-participating group. No association was found for employed participants. CONCLUSIONS The reason the HRs of Japanese elderly people certified as needing support or care are lower when the diversity of participating groups is higher could be owing to the presence of a variety of people and the diversification of social networks, which facilitates the building of bridging social relational capital. Public health policies that encourage participation in diverse organizations will be important in the future.
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Affiliation(s)
- Nao Shimizu
- Department of Physical Therapy, Faculty of Health Sciences, Ryotokuji University, 5-8-1 Akemi, Urayasu-Shi, Chiba, 279-8567, Japan.
- Department of Public Health, Graduate School of Medicine, Chiba University, Yayoi-Cho, Inage, Chiba, 263-8522, Japan.
| | - Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, Yayoi-Cho, Inage, Chiba, 263-8522, Japan
- Department of Community General Support, Hasegawa Hospital, Yachimata, Chiba, 289-1113, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Yayoi-Cho, Inage, Chiba, 263-8522, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu, Aichi, 474-8511, Japan
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Ho ISS, McGill K, Malden S, Wilson C, Pearce C, Kaner E, Vines J, Aujla N, Lewis S, Restocchi V, Marshall A, Guthrie B. Examining the social networks of older adults receiving informal or formal care: a systematic review. BMC Geriatr 2023; 23:531. [PMID: 37653368 PMCID: PMC10470175 DOI: 10.1186/s12877-023-04190-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/23/2023] [Indexed: 09/02/2023] Open
Abstract
PURPOSE To address the care needs of older adults, it is important to identify and understand the forms of care support older adults received. This systematic review aims to examine the social networks of older adults receiving informal or formal care and the factors that influenced their networks. METHODS A systematic review was conducted by searching six databases from inception to January 31, 2023. The review included primary studies focusing on older adults receiving long-term care, encompassing both informal and formal care. To assess the risk of bias in the included studies, validated appraisal tools specifically designed for different study types were utilized. Network analysis was employed to identify the grouping of study concepts, which subsequently formed the foundation for describing themes through narrative synthesis. RESULTS We identified 121 studies relating to the formal and informal care of older adults' networks. A variety of social ties were examined by included studies. The most commonly examined sources of care support were family members (such as children and spouses) and friends. Several factors were consistently reported to influence the provision of informal care, including the intensity of networks, reciprocity, and geographical proximity. In terms of formal care utilization, older age and poor health status were found to be associated with increased use of healthcare services. Additionally, physical limitations and cognitive impairment were identified as factors contributing to decreased social engagement. CONCLUSION This review found that older people were embedded within a diverse network. The findings of this review emphasize the importance of recognizing and incorporating the diversity of social networks in care plans and policies to enhance the effectiveness of interventions and improve the overall well-being of older adults.
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Affiliation(s)
- Iris Szu-Szu Ho
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK.
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK.
- , 47 Potterow, Bayes Centre, Edinburgh, EH8 9BT, UK.
| | - Kris McGill
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
| | - Stephen Malden
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- School of Health in Social Science, Medical School, University of Edinburgh, Doorway 6, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Cara Wilson
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Institute for Education, Community and Society, University of Edinburgh, Old Moray House, Holyrood Road, Edinburgh, EH8 8AQ, UK
| | - Caroline Pearce
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Edinburgh College of Art, University of Edinburgh, 74 Lauriston Pl, Edinburgh, EH3 9DF, UK
| | - Eileen Kaner
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Population Health Science Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
| | - John Vines
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK
| | - Navneet Aujla
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Population Health Science Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
| | - Sue Lewis
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- School of Health in Social Science, Medical School, University of Edinburgh, Doorway 6, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Valerio Restocchi
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK
| | - Alan Marshall
- School of Social and Political Science, University of Edinburgh, 15a George Square, Edinburgh, EH8 9LD, UK
| | - Bruce Guthrie
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
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Laniado N, Cloidt M, Shah P. Social support and oral health among working-age and older adults in the United States. J Public Health Dent 2023; 83:247-253. [PMID: 37303076 DOI: 10.1111/jphd.12573] [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: 10/05/2022] [Revised: 04/25/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVES The purpose of this study was to examine the association of social support with untreated dental caries and severe tooth loss in adults in the United States. METHODS This cross-sectional study was conducted by analyzing data obtained from 5,447 individuals, 40 years of age and older, in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008 who had both a complete dental examination and social support index measures. Sample characteristics, overall and by social support level, were examined through descriptive statistical analyses. Logistic regression analyses were performed to estimate the association of social support with untreated dental caries and severe tooth loss. RESULTS In this nationally representative sample (mean age 56.5 years) the prevalence of low social support was 27.5%. The prevalence of individuals with moderate-to-high social support increased with higher levels of educational attainment and income level. In fully adjusted models, relative to those who had moderate-high social support levels, individuals with low social support had 1.49 higher odds of untreated dental caries (95% CI, 1.17-1.90, p=0.002) and 1.23 higher odds of severe tooth loss (95% CI, 1.05-1.44, p=0.011). CONCLUSIONS Higher odds of untreated dental caries and severe tooth loss were found among U.S. adults with low levels of social support compared to those with moderate-to-high levels of social support. Additional studies are warranted to provide a more current perspective on the impact of social support on oral health so that programs may be developed and tailored to reach these populations.
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Affiliation(s)
- Nadia Laniado
- Department of Dentistry/OMFS and Department of Epidemiology and Population Health, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA
| | - Megan Cloidt
- Department of Dentistry/OMFS, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA
| | - Parth Shah
- Department of Epidemiology and Biostatistics, City University of New York School of Public Health, New York, New York, USA
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Yun S, Ogawa N, Izutsu M, Yuki M. The association between social isolation and oral health of community-dwelling older adults-A systematic review. Jpn J Nurs Sci 2023:e12524. [PMID: 36772867 DOI: 10.1111/jjns.12524] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/19/2022] [Accepted: 01/13/2023] [Indexed: 02/12/2023]
Abstract
AIM Social isolation and oral health problems commonly exist in older populations and can influence each other. However, evidence on this bidirectional correlation is scarce. This systematic review aimed to provide a comprehensive overview of literature in which social isolation and oral health were associated with each other separately. METHODS Electronic searches were performed through six databases. Original cross-sectional and longitudinal prospective studies that evaluated the associations between social isolation and oral health as either exposure or outcome were included. RESULTS In total, 282 articles were retrieved. Of these, 10 cross-sectional studies and one longitudinal study were included in the analysis. The level of evidence reported was generally moderate to strong. Most studies found that both stronger objective and perceived social isolation were associated with worse oral health in both directions. The frequency of meeting friends had an inconsistent association with oral health. CONCLUSIONS The results of our systematic review showed a bidirectional association between social isolation and oral health in independent community-dwelling older adults. Both objective and perceived social isolation are associated with oral health. As objective social isolation indicators, quality of social connectedness appears to play a more important role in the association with oral health.
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Affiliation(s)
- Shan Yun
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Natsuka Ogawa
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Miku Izutsu
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Michiko Yuki
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Ahn S, Lee CJ, Ko Y. Network social capital and health information acquisition. PATIENT EDUCATION AND COUNSELING 2022; 105:2923-2933. [PMID: 35637049 DOI: 10.1016/j.pec.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 04/17/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study examines the associations of network social capital with obtaining health information from health care professionals, the media, and laypeople. We also investigate whether and how the relationship between social capital and health information acquisition differs by personal health literacy. We used a position generator to measure network social capital. METHODS We conducted a survey with a nationally representative sample (N = 626) in the United States in April 2014. RESULTS Network social capital was positively associated with obtaining health information from health professionals, the media, and laypeople. Also, the associations of social capital with health information acquisition from health professionals were enhanced among those with adequate personal health literacy. However, health literacy did not moderate the relationship between social capital and health information acquisition from the media and laypeople. CONCLUSION Social capital may encourage individuals to utilize health information sources. Also, health literacy might reinforce the linkage between social capital and acquiring health information from health professionals. PRACTICE IMPLICATIONS Social capital interventions may promote health information acquisition. Also, health professionals should communicate with patients in a patient-centered way so that low-literate individuals easily understand health information. Moreover, a universal precaution approach should be employed.
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Affiliation(s)
- Suhwoo Ahn
- Department of Communication, Michigan State University, 404 Wilson Rd., Room 456, East Lansing, MI 48823, USA.
| | - Chul-Joo Lee
- Department of Communication, Seoul National University, Seoul, Republic of Korea
| | - Yena Ko
- Department of Communication, Seoul National University, Seoul, Republic of Korea
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Shu C, Wright FAC, Naganathan V, Blyth FM, Le Couteur DG, Handelsman DJ, Stanaway FF. Does social support predict increased use of dental services in older men? Aust Dent J 2022; 67:262-270. [PMID: 35373341 PMCID: PMC9790329 DOI: 10.1111/adj.12911] [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: 12/22/2021] [Revised: 03/07/2022] [Accepted: 03/27/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Past research on social support and dental visits in older people has been limited by cross-sectional design, limited social support dimensions and non-representative samples. METHODS Data came from men with natural teeth completing Waves 3 and 4 of the Concord Health and Ageing in Men Project in Sydney, Australia. The relationship between social support at Wave 3 (2011-2012) and at least one dental visit per year at Wave 4 (2014-2016) was examined by Poisson regression. Social support was measured by structural (marital status, living arrangements, family support and social interaction) and functional (social support satisfaction) domains. RESULTS About 673 men were analysed. Structural and functional social support were not associated with the pattern of usual dental visits 5 years later in univariable or multivariable analyses. The only consistent significant factor was income source, with older men who had other sources of income more likely to regularly visit the dentist than older men solely reliant on the pension for income (prevalence ratio: 1.31, 95% CI: 1.13-1.52). CONCLUSIONS We found no differences in the pattern of usual dental visits between older men with different levels and types of social support. For older Australian men, income source seems to be the most important determinant of regular dental visits. © 2022 Australian Dental Association.
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Affiliation(s)
- C‐C Shu
- Centre for Education and Research on Ageing, Department of Geriatric MedicineConcord Repatriation General HospitalSydneyNew South WalesAustralia
| | - FAC Wright
- Centre for Education and Research on Ageing, Department of Geriatric MedicineConcord Repatriation General HospitalSydneyNew South WalesAustralia
| | - V Naganathan
- Centre for Education and Research on Ageing, Department of Geriatric MedicineConcord Repatriation General HospitalSydneyNew South WalesAustralia,Concord Clinical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - FM Blyth
- School of Public Health, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - DG Le Couteur
- Centre for Education and Research on Ageing, Department of Geriatric MedicineConcord Repatriation General HospitalSydneyNew South WalesAustralia,Concord Clinical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia,ANZAC Research InstituteSydneyNew South WalesAustralia
| | - DJ Handelsman
- ANZAC Research InstituteSydneyNew South WalesAustralia
| | - FF Stanaway
- School of Public Health, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
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Vettore MV, Abreu MHNG, da Rocha Mendes S, Faerstein E. Do changes in income and social networks influence self-rated oral health trajectories among civil servants in Brazil? Evidence from the longitudinal Pró-Saúde study. BMC Oral Health 2022; 22:153. [PMID: 35488334 PMCID: PMC9052516 DOI: 10.1186/s12903-022-02191-5] [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: 02/07/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social factors are important determinants of health. However, evidence from longitudinal studies on the possible role of changes in socioeconomic circumstances on adult's oral health is scarce. This study aimed to test whether changes in income and changes in social networks of family members and friends were associated with trajectories of self-rated oral health (SROH) among adults over a 13-year period. METHODS A prospective cohort study (Pro-Saude Study) was conducted involving non-faculty civil servants at university campi in Rio de Janeiro, Brazil. Individual data was collected through self-completed questionnaires in four waves (1999, 2001, 2007 and 2012). SROH trajectories between 2001 and 2012 were "Good-stable SROH", "Changed SROH", "Poor-stable SROH". Per capita family income and social networks of family members and friends data obtained in 1999 and 2012 were grouped into "High stable", "Increase", "Decrease", "Low stable". Ordinal logistic regression using complete data of 2118 participants was used to estimate odds ratio (OR) and 95% CIs of changes in income and changes in social networks with SROH trajectories, adjusted for age, sex, skin colour and marital status. RESULTS Participants in the low income-stable and small social networks-stable groups showed 2.44 (95% CI 1.68-3.55) and 1.98 (95% CI 1.38-2.85) higher odds for worst trajectory of SRHO than those in the respective high-stable groups. Those in the decrease income group and decrease social networks group were 78% (95% CI 1.25-2.54) and 58% (95% CI 1.07-2.34) more likely to worst trajectory of SRHO than those in the high income-stable and high social networks-stable groups. CONCLUSIONS Adults reporting low income and low social networks of family members and friends over 13 years and those with income and social networks decrease during the study period were at higher risk of having worsened their self-rated oral health.
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Affiliation(s)
- Mario Vianna Vettore
- Department of Health and Nursing Sciences, University of Agder (UiA), Campus Kristiansand, Universitetsveien 25, 4630, Kristiansand, Norway.
| | | | - Suellen da Rocha Mendes
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Eduardo Faerstein
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Saito T, Nishita Y, Tange C, Nakagawa T, Tomida M, Otsuka R, Ando F, Shimokata H, Arai H. Association between intra-individual changes in social network diversity and global cognition in older adults: Does closeness to network members make a difference? J Psychosom Res 2021; 151:110658. [PMID: 34741873 DOI: 10.1016/j.jpsychores.2021.110658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/14/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Although qualitative aspects of interpersonal networks, such as diversity or closeness, can protect the health of older adults, their association with cognitive health remains unclear. This study examined the concurrent and time-lagged association between intra-individual changes in global cognition and social network diversity, while considering emotional closeness. METHODS In this 10-year study, we obtained six-wave, biennial data from the National Institute for Longevity Sciences, Longitudinal Study of Aging. Data from 808 community-dwelling, cognitively intact adults aged 65 or older at baseline were analyzed. Global cognition was assessed using the Mini-Mental State Examination (MMSE). Social network diversity scores were assessed using a social convoy model, comprising three closeness levels: inner (closest), middle (second closest), and outer (least close). RESULTS The mean age of the respondents was 72.0 ± 4.4 years at baseline, and 50.1% were male. A fixed-effects model showed that intra-individual change in total (coefficients, B: 0.10; standard error [SE]: 0.05; p = .042) and inner (B: 0.25; SE: 0.07; p < .001) social network diversity was significantly associated with MMSE score decline, even after adjusting for covariates. Yet, in time-lagged models, diversity and MMSE score changes were not significantly associated during the subsequent two years. CONCLUSION Older adults' global cognition declined when the diversity of their closest social network decreased. This may be a promising marker for early cognitive decline in older adults. Indeed, their closest networks are relatively unlikely to decline as part of normal aging or diseases except dementia.
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Affiliation(s)
- Tami Saito
- National Center for Geriatrics and Gerontology, Japan.
| | | | - Chikako Tange
- National Center for Geriatrics and Gerontology, Japan
| | | | - Makiko Tomida
- National Center for Geriatrics and Gerontology, Japan
| | - Rei Otsuka
- National Center for Geriatrics and Gerontology, Japan
| | - Fujiko Ando
- National Center for Geriatrics and Gerontology, Japan; Aichi Shukutoku University, Japan
| | - Hiroshi Shimokata
- National Center for Geriatrics and Gerontology, Japan; Nagoya University of Arts and Sciences, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Japan
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Systematic Review of the Literature on Dental Caries and Periodontal Disease in Socio-Economically Disadvantaged Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312360. [PMID: 34886085 PMCID: PMC8656978 DOI: 10.3390/ijerph182312360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 12/23/2022]
Abstract
Dental caries and periodontal disease represent a health problem and a social cost for the entire population, and in particular for socio-economically disadvantaged individuals who are less resistant to disease. The aim of this review is to estimate the prevalence and severity of the two dental pathologies, caries and periodontal disease, in the different classes of socio-economically disadvantaged subjects and to understand which of them are most affected. A systematic search of the literature was performed in MEDLINE (via PubMed), EMBASE and Web of Science after establishing a suitable search strategy for each database, using keywords related to socio-economically vulnerable classes and health outcomes. Socio-economically disadvantaged individuals are more susceptible to tooth decay and periodontal disease (with relative tooth loss) than non-vulnerable people. Additionally, when multiple vulnerabilities are combined in the same subject, these oral diseases worsen. There is no type of vulnerability more affected by caries and periodontitis than others, since overall they all have severe disease indices. The data from this systematic literature review might be useful for health policy makers looking to allocate more resources and services to socially disadvantaged individuals, resulting in making them more resilient to oral disease due to their social marginalization.
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Kiuchi S, Cooray U, Kusama T, Yamamoto T, Abbas H, Nakazawa N, Kondo K, Osaka K, Aida J. Oral Status and Dementia Onset: Mediation of Nutritional and Social Factors. J Dent Res 2021; 101:420-427. [PMID: 34796750 DOI: 10.1177/00220345211049399] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Some modifiable risk factors for dementia are closely related to oral health. Although eating and speaking abilities are fundamental oral functions, limited studies have focused on the effect of malnutrition and lack of social interaction between oral health and dementia. We investigated the mediating effects of nutritional and social factors on the association between the number of teeth and the incidence of dementia. This 6-y cohort study used data from the Japan Gerontological Evaluation Study targeting older adults aged 65 y and above. The number of teeth (exposure) and covariates in 2010 (baseline survey), mediators (weight loss, vegetable and fruit intake, homeboundness, social network) in 2013, and the onset of dementia (outcome) between 2013 and 2016 were obtained. The Karlson-Holm-Breen mediation method was applied. A total of 35,744 participants were included (54.0% women). The mean age at baseline was 73.1 ± 5.5 y for men and 73.2 ± 5.5 y for women. A total of 1,776 participants (5.0%) had dementia during the follow-up period. There was a significant total effect of the number of teeth on the onset of dementia (hazard ratio, 1.14; 95% CI, 1.01-1.28). Controlling for nutritional and social mediators, the effect of the number of teeth was reduced to 1.10 (95% CI, 0.98-1.25), leaving an indirect effect of 1.03 (95% CI, 1.02-1.04). In the sex-stratified analysis, the proportion mediated by weight loss was 6.35% for men and 4.07% for women. The proportions mediated by vegetable and fruit intake and homeboundness were 4.44% and 4.83% for men and 8.45% and 0.93% for women, respectively. Furthermore, the proportion mediated by social networks was 13.79% for men and 4.00% for women. Tooth loss was associated with the onset of dementia. Nutritional and social factors partially mediated this association.
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Affiliation(s)
- S Kiuchi
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - U Cooray
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - T Kusama
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan.,Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi, Japan
| | - T Yamamoto
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - H Abbas
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - N Nakazawa
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - K Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - K Osaka
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - J Aida
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi, Japan.,Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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12
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Shmarina E, Ericson D, Åkerman S, Axtelius B. Salutogenic factors for oral health among older people: an integrative review connecting the theoretical frameworks of Antonovsky and Lalonde. Acta Odontol Scand 2021; 79:218-231. [PMID: 33596156 DOI: 10.1080/00016357.2020.1849790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The aim of this integrative review was to describe salutogenic factors associated with oral health outcomes in older people, from the theoretical perspectives of Antonovsky and Lalonde. MATERIAL AND METHODS This study was based on a primary selection of 10,016 articles. To organize reported salutogenic factors, the Lalonde health field concept and Antonovsky's salutogenic theory were cross tabulated. RESULTS The final analysis was based on 58 studies. The following oral health outcome variables were reported: remaining teeth, caries, periodontal disease, oral function and oral health related quality of life (OHRQoL). We could identify 77 salutogenic factors for oral health and OHRQoL. Salutogenic factors were identified primarily within the fields of Human Biology (such as 'higher saliva flow', 'BMI < 30 kg/m2' and 'higher cognitive ability at age 11'), Lifestyle (such as 'higher education level', 'social network diversity' and 'optimal oral health behaviour') and Environment (such as 'lower income inequality', 'public water fluoridation' and 'higher neighbourhood education level'). In the age group 60 years and over, there was a lack of studies with specific reference to salutogenic factors. CONCLUSIONS The results provide an overview of salutogenic factors for oral health from two theoretical perspectives. The method allowed concomitant disclosure of both theoretical perspectives and examination of their congruence. Further hypothesis-driven research is needed to understand how elderly people can best maintain good oral health.
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Affiliation(s)
- Elena Shmarina
- Public Dental Service, Kalmar County Council, Oskarshamn, Sweden
- Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmo, Sweden
| | - Dan Ericson
- Department of Cariology, Faculty of Odontology, Malmö University, Malmo, Sweden
| | - Sigvard Åkerman
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmo, Sweden
| | - Björn Axtelius
- Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmo, Sweden
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13
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Hoshi M, Aida J, Kusama T, Yamamoto T, Kiuchi S, Yamamoto T, Ojima T, Kondo K, Osaka K. Is the Association between Green Tea Consumption and the Number of Remaining Teeth Affected by Social Networks?: A Cross-Sectional Study from the Japan Gerontological Evaluation Study Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062052. [PMID: 32244856 PMCID: PMC7142926 DOI: 10.3390/ijerph17062052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 01/06/2023]
Abstract
Consumption of green tea without sugar, as well as social networks, are associated with a lower risk of tooth loss. There is a possibility of confounding both factors because tea is often drunk with friends. Therefore, the present study aimed to examine whether green tea consumption is beneficially associated with the number of remaining teeth, while considering social networks. This cross-sectional study was based on the Japan Gerontological Evaluation Study (JAGES) in 2016. Self-administered questionnaires containing questions about green tea consumption were mailed to 34,567 community-dwelling residents aged ≥ 65 years. We used the number of remaining teeth as a dependent variable, and green tea consumption and the number of friends met over the past month (social network size) as independent variables. Linear regression models with multiple imputation were used. A total of 24,147 people responded (response rate = 69.9%), and 22,278 valid data were included into our analysis. Participants’ mean age was 74.2 years (standard deviation = 6.3), and 45.9% were men. Among the participants, 52.2% had ≥ 20 teeth, 34.2% drank 2–3 cups of green tea per day, and 32.6% met ≥ 10 people over the past month. After adjusting for all potential confounders, both higher green tea consumption and a larger social network size were associated with more remaining teeth (both p for trend < 0.001). The association of green tea was greater among those with smaller social networks (p for interaction < 0.05). The protective association of green tea was remarkable among people with smaller social networks.
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Affiliation(s)
- Manami Hoshi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
- Correspondence: ; Tel.: +81-22-717-7639
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
| | - Takafumi Yamamoto
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
| | - Tatsuo Yamamoto
- Department of Disaster Medicine and Dental Sociology, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan;
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan;
| | - Katsunori Kondo
- Center of Preventive Medical Sciences, Chiba University, Chiba 260-0856, Japan;
- National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.H.); (T.K.); (T.Y.); (S.K.); (K.O.)
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14
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Finkelstein J, Zhang F, Levitin SA, Cappelli D. Using big data to promote precision oral health in the context of a learning healthcare system. J Public Health Dent 2020; 80 Suppl 1:S43-S58. [PMID: 31905246 PMCID: PMC7078874 DOI: 10.1111/jphd.12354] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 10/08/2019] [Accepted: 12/02/2019] [Indexed: 12/31/2022]
Abstract
There has been a call for evidence-based oral healthcare guidelines, to improve precision dentistry and oral healthcare delivery. The main challenges to this goal are the current lack of up-to-date evidence, the limited integrative analytical data sets, and the slow translations to routine care delivery. Overcoming these issues requires knowledge discovery pipelines based on big data and health analytics, intelligent integrative informatics approaches, and learning health systems. This article examines how this can be accomplished by utilizing big data. These data can be gathered from four major streams: patients, clinical data, biological data, and normative data sets. All these must then be uniformly combined for analysis and modelling and the meaningful findings can be implemented clinically. By executing data capture cycles and integrating the subsequent findings, practitioners are able to improve public oral health and care delivery.
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Affiliation(s)
- Joseph Finkelstein
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Frederick Zhang
- Center for Bioinformatics and Data Analytics in Oral HealthCollege of Dental Medicine, Columbia UniversityNew YorkNYUSA
| | - Seth A. Levitin
- Center for Bioinformatics and Data Analytics in Oral HealthCollege of Dental Medicine, Columbia UniversityNew YorkNYUSA
| | - David Cappelli
- Department of Biomedical SciencesSchool of Dental Medicine, University of NevadaLas VegasNVUSA
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15
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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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16
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Murakami K, Aida J, Hashimoto H. Associations of social relationships with curative and preventive dental care use among young and middle-aged adults: Evidence from a population-based study in Japan. Community Dent Oral Epidemiol 2019; 47:389-397. [PMID: 31338851 DOI: 10.1111/cdoe.12487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 05/15/2019] [Accepted: 07/02/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Social relationships are important for diffusion of information and behaviours. Access to preventive dental care is more difficult than access to curative dental care under the Japanese universal healthcare system. Our objective was to examine whether social relationships were differentially associated with curative and preventive dental care use in Japan. METHODS A questionnaire survey was conducted between 2010 and 2011 among residents aged 25-50 years in Japanese metropolitan areas. Valid responses were obtained from 1919 men and 2207 women. Social relationships included social networks (membership of organizations and number of close ties) and social support (informational support and instrumental support). Poisson regression analyses with robust variance estimators were conducted to examine associations between each social relationship variable and curative dental care use or preventive dental care use, adjusted for covariates. RESULTS While 38.4% of men and 42.0% of women used curative dental care, 22.9% of men and 32.5% of women used preventive dental care in the past year. No measures of social relationships were associated with curative dental care use among men and women, except the number of close ties among men. By contrast, all measures of social relationships were associated with preventive dental care use among men; the multivariate-adjusted prevalence ratios (95% confidence intervals) of the highest compared with the lowest level of social relationships were 1.58 (1.18-2.13) for membership of organizations, 1.58 (1.24-2.00) for the number of close ties, 1.41 (1.10-1.82) for informational support and 1.30 (1.01-1.68) for instrumental support. Among women, no measures of social relationships were associated with preventive dental care use. CONCLUSIONS Social relationships were associated with preventive dental care use among men but not among women, while these were not associated with curative dental care use.
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Affiliation(s)
- Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Graduate School of Medicine, Tohoku University, Sendai, Japan.,Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Hideki Hashimoto
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
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17
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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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