Laudisio Alice, Gemma Antonella, Fontana Davide O, Rivera Chiara, Bandinelli Stefania, Ferrucci Luigi, Incalzi Raffaele Antonelli
Unit of Geriatrics, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
UOS Accesso e Presa in Carico Assistenziale, Azienda Sanitaria Locale Roma E, Rome, Italy.
J Am Geriatr Soc. 2016 Dec;64(12):2503-2510. doi: 10.1111/jgs.14331. Epub 2016 Nov 27.
To evaluate the association, if any, between masticatory dysfunction (MD) and mortality in older adults.
The Invecchiare in Chianti (InCHIANTI) Study, a cohort study with 9-year follow-up.
Tuscany, Italy.
Individuals aged 65 and older (N = 1,155).
MD was self-reported; Cox regression was used to assess the association between self-reported MD and 9-year all-cause mortality. This association was also evaluated after stratifying according to use of dentures. Analyses were adjusted for potential confounders, including demographic characteristics, lifestyle habits, comorbidities, nutrient intake, medications, and objective parameters.
Four hundred five (35%) participants reported MD. Over the 9-year follow-up, 475 (41%) subjects died. According to Cox regression analysis, self-reported MD was associated with higher mortality (relative risk (RR) = 1.23, 95% confidence interval (CI) = 1.02-1.48), after adjusting for potential confounders. In participants with self-reported MD, uncorrected edentulism was the condition associated with the greatest risk of mortality (RR = 2.10, 95% CI = 1.07-4.14); use of dentures seemed to blunt this association (RR = 1.12, 95% CI = 0.87-1.44).
Self-reported MD, chiefly when due to uncorrected edentulism, is associated with 9-year all-cause mortality in community-dwelling elderly adults. Further studies are needed to evaluate whether the timely correction of MD using adequate dentures can increase the survival of older adults.
评估老年人咀嚼功能障碍(MD)与死亡率之间是否存在关联(若有)。
基安蒂地区老龄化研究(InCHIANTI研究),一项为期9年随访的队列研究。
意大利托斯卡纳。
65岁及以上个体(N = 1155)。
咀嚼功能障碍通过自我报告;采用Cox回归评估自我报告的咀嚼功能障碍与9年全因死亡率之间的关联。在根据假牙使用情况进行分层后,也对这种关联进行了评估。分析对潜在混杂因素进行了校正,包括人口统计学特征、生活方式习惯、合并症、营养摄入、药物治疗和客观参数。
405名(35%)参与者报告有咀嚼功能障碍。在9年随访期间,475名(41%)受试者死亡。根据Cox回归分析,在对潜在混杂因素进行校正后,自我报告的咀嚼功能障碍与较高的死亡率相关(相对风险(RR)= 1.23,95%置信区间(CI)= 1.02 - 1.48)。在自我报告有咀嚼功能障碍的参与者中,未矫正的无牙状态是与最高死亡风险相关的情况(RR = 2.10,95% CI = 1.07 - 4.14);使用假牙似乎减弱了这种关联(RR = 1.12,95% CI = 0.87 - 1.44)。
自我报告的咀嚼功能障碍,主要是由于未矫正的无牙状态,与社区居住的老年人9年全因死亡率相关。需要进一步研究来评估使用合适的假牙及时矫正咀嚼功能障碍是否能提高老年人的生存率。