Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, United Kingdom.
Department of Primary Care and Population Health, University College London, London, United Kingdom.
J Am Med Dir Assoc. 2019 Dec;20(12):1654.e1-1654.e9. doi: 10.1016/j.jamda.2019.06.010. Epub 2019 Aug 10.
Studies examining the associations between oral health and disability have limited oral health measures. We investigated the association of a range of objectively and subjectively assessed oral health markers with disability and physical function in older age.
DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analyses were based on the British Regional Heart Study (BRHS) comprising men aged 71 to 92 years (n = 2147) from 24 British towns, and the Health, Aging, and Body Composition (HABC) Study comprising men and women aged 71 to 80 years (n = 3075) from the United States. Assessments included oral health (periodontal disease, tooth count, dry mouth, and self-rated oral health), disability, and physical function (grip strength, gait speed, and chair stand test).
In the BRHS, dry mouth, tooth loss, and cumulative oral health problems (≥3 problems) were associated with mobility limitations and problems with activities of daily living and instrumental activities of daily living; these remained significant after adjustment for confounding variables (for ≥3 dry mouth symptoms, odds ratio (OR) 2.68, 95% confidence interval (CI) 1.94-3.69; OR 1.76, 95% CI 1.15-2.69; OR 2.90, 95% CI 2.01, 4.18, respectively). Similar results were observed in the HABC Study. Dry mouth was associated with the slowest gait speed in the BRHS, and the weakest grip strength in the HABC Study (OR 1.75, 95% CI 1.22, 2.50; OR 2.43, 95% CI 1.47-4.01, respectively).
Markers of poor oral health, particularly dry mouth, poor self-rated oral health, and the presence of more than 1 oral health problem, were associated with disability and poor physical function in older populations. Prospective investigations of these associations and underlying pathways are needed.
研究口腔健康与残疾之间关系的研究对口腔健康测量的方法有限。我们调查了一系列客观和主观评估的口腔健康指标与老年人残疾和身体功能的关系。
设计、地点和参与者:横断面分析基于英国区域心脏研究(BRHS),该研究包括来自 24 个英国城镇的 71 至 92 岁男性(n=2147 人),以及健康、衰老和身体成分(HABC)研究,该研究包括来自美国的 71 至 80 岁男性和女性(n=3075 人)。评估包括口腔健康(牙周病、牙齿数量、口干和自我评估的口腔健康)、残疾和身体功能(握力、步行速度和椅子站立测试)。
在 BRHS 中,口干、牙齿缺失和累积口腔健康问题(≥3 个问题)与活动受限以及日常生活活动和工具性日常生活活动的问题有关;在调整混杂变量后,这些仍然具有统计学意义(对于≥3 个口干症状,比值比(OR)2.68,95%置信区间(CI)1.94-3.69;OR 1.76,95% CI 1.15-2.69;OR 2.90,95% CI 2.01,4.18)。在 HABC 研究中也观察到了类似的结果。BRHS 中口干与最慢的步行速度有关,而 HABC 研究中与握力最弱有关(OR 1.75,95% CI 1.22,2.50;OR 2.43,95% CI 1.47-4.01)。
口腔健康不良的标志物,特别是口干、自我评估的口腔健康较差和存在超过 1 个口腔健康问题,与老年人的残疾和身体功能较差有关。需要对这些关联和潜在途径进行前瞻性研究。