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在养老院居民中,口腔健康受损是否与更高的死亡率风险相关?一项对照临床研究。

Is compromised oral health associated with a greater risk of mortality among nursing home residents? A controlled clinical study.

机构信息

Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

Institute of Gerontology, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Germany.

出版信息

Aging Clin Exp Res. 2018 Jun;30(6):581-588. doi: 10.1007/s40520-017-0811-y. Epub 2017 Aug 30.

DOI:10.1007/s40520-017-0811-y
PMID:28856592
Abstract

AIM

The objective of this controlled clinical study was to evaluate the association between oral health and 1-year mortality among nursing home residents with or without oral health intervention.

METHODS

This research was part of a multidisciplinary intervention study (EVI-P) performed in 14 nursing homes in Germany. Two-hundred and nineteen nursing home residents were included in the study and assigned to an intervention group, for which dental health education was offered and ultrasonic baths were used for denture cleaning (n = 144), or to a control group (n = 75). Before the intervention, each participant was examined, and dental status, plaque control record (PCR), Denture Hygiene Index, and results from the Revised Oral Assessment Guide were recorded. Amount of care needed and dementia were also assessed, by use of the Barthel Index and the Mini Mental State Examination, respectively. Participant mortality was determined after 12 months, and bivariate analysis and logistic regression models were used to evaluate possible factors affecting mortality.

RESULTS

Bivariate analysis detected a direct association between greater mortality and being in the control group (p = .038). Participants with higher PCR were also more likely to die during the study period (p = .049). For dentate participants, the protective effect of being in the intervention group was confirmed by multivariate analysis in which covariates such as age and gender were considered.

CONCLUSION

Oral hygiene and oral health seem to affect the risk of mortality of nursing home residents. Dental intervention programs seem to reduce the risk of 1-year mortality among nursing home residents having remaining natural teeth. Further studies, with larger sample sizes and evaluation of the causes of death, are necessary to investigate the reasons for these associations.

摘要

目的

本对照临床研究旨在评估有或无口腔健康干预的养老院居民的口腔健康与 1 年死亡率之间的关联。

方法

本研究是在德国 14 家养老院进行的多学科干预研究(EVI-P)的一部分。共有 219 名养老院居民参与了该研究,并被分配到干预组(n=144),为其提供口腔健康教育,并使用超声波浴清洁义齿;或对照组(n=75)。在干预前,对每位参与者进行检查,并记录其口腔状况、菌斑控制记录(PCR)、义齿卫生指数和修订口腔评估指南的结果。还使用巴氏量表和简易精神状态检查分别评估所需护理量和痴呆症。12 个月后确定参与者的死亡率,并使用双变量分析和逻辑回归模型评估可能影响死亡率的因素。

结果

双变量分析发现,死亡率与对照组之间存在直接关联(p=0.038)。PCR 较高的参与者在研究期间死亡的可能性也更高(p=0.049)。对于有牙齿的参与者,在考虑年龄和性别等协变量的多变量分析中,证实了干预组的保护作用。

结论

口腔卫生和口腔健康似乎会影响养老院居民的死亡风险。牙科干预计划似乎可以降低有自然牙的养老院居民 1 年死亡率的风险。需要进一步研究,样本量更大,并评估死亡原因,以调查这些关联的原因。

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