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定期看牙医可预防严重的功能障碍:基于社区的前瞻性研究。

Regular dental visits may prevent severe functional disability: A community-based prospective study.

机构信息

Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Nara, Japan.

Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Nara, Japan.

出版信息

Arch Gerontol Geriatr. 2020 May-Jun;88:104019. doi: 10.1016/j.archger.2020.104019. Epub 2020 Jan 30.

Abstract

BACKGROUND

Previous studies have shown that regular dental visits can affect the relationship of tooth loss with mortality and functional disability. However, the independent association between regular dental visits and incident functional disability is unclear.

METHODS

Our study participants were community-dwelling individuals aged ≥65 years, without disability at baseline. The outcome was the level of incident functional disability, as defined in a new certification of the public long-term care insurance. We defined no disability as no certification at follow-up, mild disability as support levels 1-2 and care level 1 (i.e., independent in basic ADL, but requiring some help in daily activities), and severe disability as care levels 2-5 (i.e., dependent in basic ADL). The exposure variable, based on the questionnaire, was regular dental visits at baseline. Covariates included gender, age, socio-economic status, health status, lifestyle habits, physical and mental functioning, and oral health variables. Using multinomial logistic regression, we calculated adjusted odds ratio (aOR) and 95 % confidence interval (CI) for mild disability and severe disability, with no disability as a reference category.

RESULTS

Among 8,877 participants, the 33-month cumulative incidence of mild and severe disability was 6.0 % and 1.8 %, respectively. After controlling for all covariates, regular dental visits at baseline were significantly associated with a lower risk of incident severe disability (aOR 0.65; 95 % CI, 0.46-0.91) but not the incidence of mild disability (aOR 0.96; 95 % CI, 0.79-1.17).

CONCLUSIONS

Encouraging dental visits may contribute to prevention of severe functional disability and extension of healthy life expectancy among community-dwelling older adults.

摘要

背景

先前的研究表明,定期看牙医可以影响牙齿缺失与死亡率和功能障碍的关系。然而,定期看牙医与新发功能障碍之间的独立关联尚不清楚。

方法

我们的研究对象为年龄≥65 岁、基线时无残疾的社区居住者。结局为新发功能障碍的水平,根据公共长期护理保险的新认证来定义。我们将无残疾定义为随访时无认证,轻度残疾定义为支持水平 1-2 和护理水平 1(即基本日常生活活动自理,但日常活动需要一些帮助),严重残疾定义为护理水平 2-5(即基本日常生活活动依赖)。基于问卷的暴露变量为基线时定期看牙医。协变量包括性别、年龄、社会经济状况、健康状况、生活方式习惯、身体和精神功能以及口腔健康变量。使用多项逻辑回归,我们计算了调整后的优势比(aOR)和 95%置信区间(CI),以无残疾为参考类别,用于轻度残疾和严重残疾。

结果

在 8877 名参与者中,33 个月时轻度和重度残疾的累积发生率分别为 6.0%和 1.8%。在控制所有协变量后,基线时定期看牙医与新发严重残疾的风险降低显著相关(aOR 0.65;95%CI,0.46-0.91),但与新发轻度残疾无关(aOR 0.96;95%CI,0.79-1.17)。

结论

鼓励看牙医可能有助于预防社区居住的老年人严重功能障碍和延长健康预期寿命。

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