Department of Dental Specialties, Mayo Clinic, Rochester, MN, USA.
Apple Tree Dental, Rochester, MN, USA.
Gerodontology. 2021 Dec;38(4):338-350. doi: 10.1111/ger.12577. Epub 2021 Jul 30.
This systematic review updates the evidence for association between oral health characteristics and frailty status, identifying gaps in translational dental research and application of frailty assessment into clinical practice.
Clinicians have little guidance on stage-appropriate dental treatment for medically complex older adults. Oral health characteristics have been associated with frailty status, determined through validated assessment tools representing a concise measure of health. Translation of frailty assessment into dental practice has not been the focus of previous reviews.
Utilising the PRISMA framework for systematic reviews, a comprehensive database search identified articles describing the association of interest. Those included were cross-sectional or longitudinal, in English, included participants aged 50 years or older, used validated frailty assessments and measured clinically relevant oral health outcomes. From 835 screened articles, 26 full-text articles were eligible for quality appraisal and synthesis.
Frailty prevalence ranged from 8.5% to 66.0%. Most studies utilised the Fried frailty criteria. Qualitative synthesis of 17 cross-sectional and nine longitudinal studies demonstrated significant covariate-adjusted association between frailty status and number of teeth, chewing ability, prosthetic characteristics, dental caries, periodontitis, dental utilisation and oral health-related quality of life factors. Variability in findings reflected study sample diversity based on country of study origin, age at recruitment, sample size, frailty assessment type, use of clinical versus self-reported outcome measures and differences in statistical analysis.
Despite robust evidence of association with oral health characteristics, frailty assessment has yet to be sufficiently applied to translational dental research and clinical practice.
本系统评价更新了口腔健康特征与虚弱状态之间关联的证据，确定了转化牙科研究和将虚弱评估应用于临床实践方面的差距。
临床医生对治疗复杂的老年患者的口腔健康问题几乎没有指导。口腔健康特征与虚弱状态有关，这是通过经过验证的评估工具来确定的，这些工具代表了一种简明的健康衡量标准。以前的综述并未将虚弱评估转化为牙科实践作为重点。
利用 PRISMA 系统评价框架，对全面的数据库搜索进行了检索，以确定描述相关性的文章。这些文章包括横断面或纵向研究，以英语发表，纳入年龄在 50 岁或以上的参与者，使用经过验证的虚弱评估，并测量了临床上相关的口腔健康结果。从 835 篇筛选出的文章中，有 26 篇全文符合质量评估和综合的标准。
虚弱的患病率范围为 8.5%至 66.0%。大多数研究都使用了弗莱德虚弱标准。17 项横断面研究和 9 项纵向研究的定性综合表明，虚弱状态与牙齿数量、咀嚼能力、义齿特征、龋齿、牙周炎、牙科利用和口腔健康相关生活质量因素之间存在显著的协变量调整关联。研究结果的变异性反映了研究样本的多样性，这些多样性基于研究来源国、招募时的年龄、样本量、虚弱评估类型、使用临床还是自我报告的结果测量以及统计分析的差异。
尽管有大量证据表明口腔健康特征与虚弱状态有关，但虚弱评估尚未充分应用于转化牙科研究和临床实践。
