Quine S, Morrell S
School of Public Health, Faculty of Medicine, University of Sydney, NSW, Australia.
Community Dent Health. 2009 Sep;26(3):177-82.
The purpose of this analysis was to explore whether, and if so to what extent, there is an association between self-reported oral and mental health problems, and if this association exists after controlling for self-rated physical health and age.
A large cross-sectional population-based telephone health survey with participants selected using random stratified sampling. The response rate was 71%. Survey weights were used for estimating proportions and for all statistical inferences.
Participants (n=8,881) were community-dwelling older people (65+ years) living independently in New South Wales, Australia.
The following measures were used in the analysis: physical health (1 item); oral health (5 items), mental health (2 items). Trends in prevalences across groups were analysed using the Cochrane-Armitage trend test. Logistic regression modelling was conducted to account for the main confounders of age and self-rated physical health, and attributable fractions calculated.
Both measures of mental health, feeling hopeless and feeling depressed, were significantly and positively associated with increased reporting of oral health concerns in both males and females. Logistic regression modelling showed that most of the oral health items remained strongly associated with mental health after controlling for self-rated physical health and age. The attributable fractions demonstrated that a proportion of the mental health problems identified in older people would be reduced if oral health concerns were adequately addressed.
The findings highlight the association between oral and mental health, and provide evidence to support the expansion of publicly funded dental health services.
本分析旨在探讨自我报告的口腔健康问题与心理健康问题之间是否存在关联,若存在关联,其程度如何,以及在控制自我评定的身体健康状况和年龄后这种关联是否依然存在。
一项基于人群的大型横断面电话健康调查,采用随机分层抽样选取参与者。应答率为71%。调查权重用于估计比例和所有统计推断。
参与者(n = 8881)为居住在澳大利亚新南威尔士州、独立生活的社区老年人(65岁及以上)。
分析中使用了以下测量指标:身体健康(1项);口腔健康(5项);心理健康(2项)。采用Cochrane-Armitage趋势检验分析各组患病率的趋势。进行逻辑回归建模以考虑年龄和自我评定的身体健康状况等主要混杂因素,并计算归因分数。
心理健康的两项指标,即感到绝望和感到沮丧,在男性和女性中均与口腔健康问题报告增加显著正相关。逻辑回归建模显示,在控制自我评定的身体健康状况和年龄后,大多数口腔健康项目与心理健康仍密切相关。归因分数表明,如果口腔健康问题得到充分解决,老年人中所发现的一部分心理健康问题将会减少。
研究结果突出了口腔健康与心理健康之间的关联,并为支持扩大公共资助的牙科保健服务提供了证据。