Kamdem Benedikta, Seematter-Bagnoud Laurence, Botrugno Fabiana, Santos-Eggimann Brigitte
Health Services Unit, Institute of Social and Preventive Medicine (IUMSP), Route de la Corniche 10, 1010, Lausanne, CH, Switzerland.
BMC Geriatr. 2017 Aug 1;17(1):174. doi: 10.1186/s12877-017-0568-3.
Oral health and frailty might be linked through several pathways, but previous studies are scarce. This study examined the association between oral health and components of Fried's frailty phenotype.
This cross-sectional analysis was based on a sample of 992 community-dwelling persons aged 73 to 77 years observed in the 2011 follow-up of the Lausanne 65+ cohort (Lc65+) study. Data were collected through annual mailed questionnaires, interview and physical examination. Oral health was assessed according to self-reported oral pain and masticatory ability. Frailty was defined as meeting at least one criterion of the Fried's phenotype.
Oral pain was reported by 14.8% and chewing problems by 9.7%. Impaired masticatory ability (IMA) was more frequent in subjects with missing teeth or removable dentures (13.5%) than among those with full dentition or fixed dental prostheses (3.2%). In logistic regression analyses adjusting for demographics, alcohol consumption, smoking, comorbidity and financial difficulties, persons with oral pain and those with chewing problems had significantly higher odds of being frail (adjusted OR = 1.72; 95% CI 1.17-2.53 and adjOR1.70; 1.07-2.72, respectively). Lack of endurance was associated with both oral pain (adjOR = 3.61; 1.92-6.76) and impaired masticatory ability (adjOR = 2.20; 1.03-4.72). The latter was additionally linked to low physical activity (adjOR = 2.35; 1.29-4.28) and low gait speed (adjOR = 3.12; 1.41-6.90), whereas oral pain was associated with weight loss (adjOR = 1.80; 1.09-2.96) and low handgrip strength (adjOR = 1.80; 1.17-2.77).
Self-reported oral pain and chewing impairment had a significant relation with frailty and its components, not only through a nutritional pathway of involuntary weight loss. Longitudinal analyses are needed to examine whether a poor oral condition might be a risk factor for the onset of frailty.
口腔健康与身体虚弱可能通过多种途径相关联,但以往的研究较少。本研究调查了口腔健康与弗里德虚弱表型各组成部分之间的关联。
本横断面分析基于在洛桑65 +队列(Lc65 +)研究的2011年随访中观察到的992名年龄在73至77岁之间的社区居住者样本。数据通过年度邮寄问卷、访谈和体格检查收集。根据自我报告的口腔疼痛和咀嚼能力评估口腔健康。身体虚弱定义为符合弗里德表型的至少一项标准。
报告有口腔疼痛的占14.8%,有咀嚼问题的占9.7%。牙齿缺失或佩戴可摘假牙的受试者中咀嚼能力受损(IMA)的发生率(13.5%)高于全口牙列或固定义齿的受试者(3.2%)。在对人口统计学、饮酒、吸烟、合并症和经济困难进行调整的逻辑回归分析中,有口腔疼痛的人和有咀嚼问题的人身体虚弱的几率显著更高(调整后的比值比分别为1.72;95%置信区间1.17 - 2.53和调整后的比值比1.70;1.07 - 2.72)。耐力不足与口腔疼痛(调整后的比值比 = 3.61;1.92 - 6.76)和咀嚼能力受损(调整后的比值比 = 2.20;1.03 - 4.72)均相关。后者还与低体力活动(调整后的比值比 = 2.35;1.29 - 4.28)和低步态速度(调整后的比值比 = 3.12;1.41 - 6.90)有关,而口腔疼痛与体重减轻(调整后的比值比 = 1.80;1.09 - 2.96)和低握力(调整后的比值比 = 1.80;1.17 - 2.77)有关。
自我报告的口腔疼痛和咀嚼障碍与身体虚弱及其组成部分有显著关系,不仅通过非自愿体重减轻的营养途径。需要进行纵向分析以检查口腔状况不佳是否可能是身体虚弱发生的危险因素。