Iwasaki Masanori, Yoshihara Akihiro
Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Geriatr Gerontol Int. 2021 Jan;21(1):48-53. doi: 10.1111/ggi.14099. Epub 2020 Nov 24.
The effect of dentition status on higher-level functional capacity patterns over time remains unclear. We aimed to identify distinct higher-level functional capacity trajectories in individuals aged 70-80 years, and examine whether dentition status at 70 years predicted the trajectory.
The study included 551 community-dwelling adults aged 70 years at baseline. Higher-level functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) up to the age of 80 years. A higher TMIG-IC score indicated a higher level of competence. Group-based trajectory modeling was used to identify distinct TMIG-IC trajectories. The number of teeth, use of dentures, sex and education were added as baseline group membership predictors. Dental visits, health behaviors, body mass index and comorbidities during observation were added as time-varying covariates.
Three TMIG-IC trajectories were identified: "high/stable" (65.3%), "middle/decline" (24.5%) and "low/decline" (10.2%). A lower number of teeth and non-denture use were associated with increased odds of a low/decline trajectory relative to a high/stable trajectory (odds ratio 1.09, 95% confidence interval 1.04-1.14 [per one decrease] and odds ratio 3.96, 95% confidence interval 1.54-10.16, respectively).
Older adults with fewer teeth and those without dentures at the age of 70 years were more likely to follow a trajectory toward functional decline with low baseline TMIG-IC scores, which further declines by the age of 80 years. These findings suggest that preserving natural teeth later in life, as well as using dentures, could contribute toward maintaining a higher-level functional competence. Geriatr Gerontol Int 2021; 21: 48-53.
牙列状况对长期较高水平功能能力模式的影响尚不清楚。我们旨在确定70至80岁个体不同的较高水平功能能力轨迹,并研究70岁时的牙列状况是否能预测该轨迹。
该研究纳入了551名基线时年龄为70岁的社区居住成年人。使用东京都老人综合研究所能力指数(TMIG-IC)测量直至80岁时的较高水平功能能力。TMIG-IC得分越高表明能力水平越高。采用基于组的轨迹模型来确定不同的TMIG-IC轨迹。将牙齿数量、假牙使用情况、性别和教育程度作为基线组成员预测因素。将观察期间的牙科就诊、健康行为、体重指数和合并症作为随时间变化的协变量。
确定了三条TMIG-IC轨迹:“高/稳定”(65.3%)、“中/下降”(24.5%)和“低/下降”(10.2%)。与“高/稳定”轨迹相比,牙齿数量较少和不使用假牙与“低/下降”轨迹的几率增加相关(优势比分别为1.09,95%置信区间1.04-1.14[每减少一颗]和优势比3.96,95%置信区间1.54-10.16)。
70岁时牙齿较少和未佩戴假牙的老年人更有可能遵循功能下降的轨迹,基线TMIG-IC得分较低,到80岁时进一步下降。这些发现表明,在晚年保留天然牙齿以及使用假牙有助于维持较高水平的功能能力。《老年医学与老年病学国际杂志》2021年;21:48-53。