Thorstensson Helene, Johansson Boo
Department of Periodontology, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
Community Dent Oral Epidemiol. 2009 Aug;37(4):325-32. doi: 10.1111/j.1600-0528.2009.00467.x.
Oral health is an integral part of general health; oral health contributes to and is influenced by a nexus of inputs from biological, psychological, and social functioning. Little is known about the relationship between markers of oral health and subsequent survival in late life.
The aim of this study was to examine the relative importance of oral health indicators in the context of demographic and psychosocial variables on subsequent survival during an 8-year period in a population-based sample of the oldest-old.
The study sample comprised 357 individuals with a median age of 86 years who were selected from participants in the comprehensive longitudinal Origins of Variance in the Old-Old: Octogenarian Twins (OCTO-Twin) study, which examined monozygotic and dizygotic twins aged 80 years and older on five occasions at 2-year intervals. The OCTO-Twin study includes a broad spectrum of biobehavioural measures of health and functional capacity, personality, well-being, and interpersonal functioning. Oral health variables were number of teeth, per cent decayed and filled surfaces (DFS%), and periodontal disease experience. A longevity quotient (LQ), the ratio between years actually lived and those statistically expected, was determined. The survival categories were shorter than expected, as expected, or longer-than-expected. Multivariate analyses and the Kaplan-Meier method were used in the survival analyses.
No associations between LQ and number of teeth, edentulousness, and periodontal disease experience were found. But survival of men with severe periodontal disease experience was shorter than expected. DFS% was significantly associated with survival. Individuals with a low number of decayed and filled surfaces (DFS) had a shorter-than-expected survival time compared with those with high DFS scores. The overall predictor of survival was cognitive status, independent of age and gender when dental variables were analysed in the context of psychosocial factors. In addition, number of teeth, smoking, and better financial status in childhood and during working life were also significant predictors.
Oral health was significantly associated with subsequent survival in a sample of oldest-old individuals, although psychosocial factors were stronger predictors.
口腔健康是整体健康的一个组成部分；口腔健康受到生物、心理和社会功能等一系列因素的影响，并对其产生作用。关于口腔健康指标与晚年后续生存之间的关系，我们所知甚少。
本研究旨在探讨在以高龄老人为基础的样本中，在人口统计学和社会心理变量背景下，口腔健康指标对8年期间后续生存的相对重要性。
研究样本包括357名年龄中位数为86岁的个体，这些个体选自全面纵向开展的高龄老人方差起源：八旬双胞胎（OCTO-Twin）研究的参与者，该研究对80岁及以上的同卵和异卵双胞胎每隔两年进行5次检查。OCTO-Twin研究包括广泛的生物行为健康和功能能力、个性、幸福感及人际功能测量。口腔健康变量包括牙齿数量、龋补牙面百分比（DFS%）和牙周疾病经历。确定了长寿商数（LQ），即实际存活年数与统计预期年数之比。生存类别分为短于预期、符合预期或长于预期。生存分析采用多变量分析和Kaplan-Meier方法。
未发现LQ与牙齿数量、无牙情况及牙周疾病经历之间存在关联。但患有严重牙周疾病经历的男性存活时间短于预期。DFS%与生存显著相关。与DFS分数高的个体相比，龋补牙面数量少（DFS）的个体生存时间短于预期。在社会心理因素背景下分析牙齿变量时，生存的总体预测因素是认知状态，与年龄和性别无关。此外，牙齿数量、吸烟以及童年和工作期间较好的经济状况也是显著的预测因素。
在高龄老人样本中，口腔健康与后续生存显著相关，尽管社会心理因素是更强的预测因素。
