Barriers Affecting the Oral Health of People Diagnosed with Depression: A Systematic Review

Association of social frailty, sarcopenia, and oral frailty with depressive symptoms in Chinese older adults: a cross-sectional study

BACKGROUND

Depressive symptoms are a serious health issue that can cause profound, lifelong suffering for people who are affected by it. This study aimed to evaluate the effect of sarcopenia, oral frailty, and social frailty on depressive symptoms among Chinese participants aged ≥ 60 years old in China.

METHODS

This research utilized a cross-sectional design and used convenience sampling to select participants from Anhui Province, China. Demographic questionnaire, SARC-F (Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls), OFI-8 (Oral Frailty Index-8), the HALFT (Help, Participation, Loneliness, Financial, Talk) scale, and PHQ-9 (Patient Health Questionnaire-9) were used to conduct the survey. A chi-square test was performed to evaluate the differences between categorical variables, spearman correlation analysis was used to find the correlation between depressive symptoms and factors. Four regression models were set up to evaluate the effect of factors on depressive symptoms and select the appropriate adjustment variables.

RESULTS

Of 1453 participants, 33.5% had sarcopenia, 51.4% had oral frailty, 31.5% had pre-social frailty, 14.5% had social frailty, and 32.2% had depressive symptoms. Spearman correlation analysis indicated that depressive symptoms significantly correlated with sarcopenia (r = 0.415), oral frailty (r = 0.282), and social frailty (r = 0.410). In crude analysis, sarcopenia (OR = 0.179, 95%CI 0.141-0.227), oral frailty (OR = 3.946, 95%CI 3.101-5.021), pre-social frailty (OR = 4.449, 95%CI 3.401-5.818), and social frailty (OR = 12.552, 95%CI 8.833-17.837) were significantly associated with depressive symptoms in older adults. After adjusting for the covariates, sarcopenia (OR = 4.301, 95%CI 3.322-5.569), oral frailty (OR = 3.136, 95%CI 2.430-4.046), pre-social frailty (OR = 3.664, 95%CI 2.775-4.836) and social frailty (OR = 9.488, 95%CI 6.560-13.723) were significantly associated with depressive symptoms. (P <0.05).

CONCLUSION

This research indicated that sarcopenia, oral frailty, pre-social frailty, and social frailty, were significant and positively associated with depressive symptoms. These results provide clinicians with a reference for identifying high-risk older adults and give public health policymakers a scientific approach to taking targeted interventions. Future research should further explore the two-way relationship between these factors and depressive symptoms and assess the effectiveness of different interventions. This will help to improve the quality of life and mental health.

Brushing Away the Blues: Self-Reported Oral Hygiene Practices Are Associated With Mild Depressive Symptoms in Airline Pilots

Introduction Airline pilots are susceptible to mental health issues, with depression prevalence ranging from 1.9% to 12.6%. Recent research in the general population indicates a potential link between depression and oral health. In this cross-sectional study, we sought to investigate the association between self-reported oral hygiene practices and depressive symptoms among airline pilots. Methods One hundred actively working male airline pilots of Caucasian descent voluntarily enrolled in the study during routine occupational health visits. Depressive symptoms were assessed using the Beck Depression Inventory II (BDI-II). Self-reported oral hygiene practices, including toothbrushing frequency and mouthwash usage, were examined. Univariable and multivariable logistic regression analyses were performed to investigate associations between depressive symptoms and oral hygiene practices. Results Twelve pilots (12%) demonstrated mild depressive symptomatology (BDI-II scores 14-19). Pilots with mild depression reported significantly lower rates of brushing teeth twice or more per day (33.3% vs. 80.7%) and higher rates of rarely brushing (16.7% vs. 1.1%) compared to those with minimal depressive symptoms (p < 0.001). Nonuse of mouthwash was more prevalent among pilots with mild depression (66.6% vs. 23.9%, p = 0.008). Multivariable logistic regression analysis revealed that pilots who rarely brushed their teeth (adjusted odds ratio (OR) = 14.6; 95% confidence interval (CI) = 1.3-197.9; p < 0.05) or did not use mouthwash (adjusted OR = 5.7; 95% CI = 1.4-25.2; p < 0.05) had significantly higher odds of mild depressive symptoms. Conclusions Self-reported oral hygiene habits may serve as a proxy indicator for mild depressive symptoms among airline pilots. Incorporating oral health assessments into routine aeromedical examinations could provide a practical method of identifying pilots at risk for depression, supporting timely interventions and enhancing flight safety.

Oral health-related quality of life and depressive symptoms in adults: longitudinal associations of the English Longitudinal Study of Ageing (ELSA)

BACKGROUND

Little is known about the relationship between oral health status and depressive symptoms in adults in England. The aim of this study was to examine the longitudinal association between oral health parameters and depressive symptoms in adults in England.

METHODS

Data were obtained from the English Longitudinal Study of Aging (ELSA), which included information on self-rated oral health, oral impairment in daily life (Oral Impacts on Daily Performances, OIDP), and depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D) in 6790 adults aged ≥ 50 years. Wave 3 data were used as baseline, while Waves 5 and 7 were used for follow-up assessments. Logistic regression was used to determine whether depressive symptoms at baseline anticipated self-rated oral health and OIDP and whether oral health status (at baseline) was associated with the development of depressive symptoms at follow-up assessment.

RESULTS

Participants with poor self-rated oral health were at higher risk of developing depressive symptoms, even after adjusting for behavioral, clinical, and sociodemographic characteristics (OR = 1.69, 95% CI 1.38-2.07). Similarly, having oral impacts on daily performances were associated with the development of depressive symptoms: The OR for developing depressive symptoms at Wave 5 or 7 was 2.19 (95% CI 1.62-2.96) after adjustment for all covariates. Participants with depressive symptoms at baseline were more likely to report poor self-rated oral health (OR = 1.93, 95% CI 1.52-2.44) or one or more oral impacts (OR = 1.86, 95% CI 1.45-2.40) at follow-up than those without depressive symptoms at baseline, even after adjusting for confounders.

CONCLUSIONS

In the present study, a bidirectional association was found between depressive symptoms and poor oral health in older adults. Maintaining good oral health in older adults may be a protective factor against depressive symptoms. Therefore, more attention should be paid to promoting oral health awareness in older adults, including encouraging regular dental checkups, proper toothbrushing and flossing techniques, and healthy lifestyles.