Department of Oral Health Sciences, Gerodontology, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University, Gent, Belgium.
UCL Research Department of Epidemiology and Public Health, University College London, London, UK.
Gerodontology. 2023 Sep;40(3):363-371. doi: 10.1111/ger.12664. Epub 2022 Nov 6.
The aim of this study was to assess the association between different levels of frailty and dental attendance among home-dwelling older adults, in Belgium.
While many determinants of dental attendance among older adults have been identified, no study has focused on the role of frailty.
This was a cross-sectional study on a random sample of home-dwelling adults aged 60 and over from two Belgian cities. Data were collected with a structured questionnaire through a participatory peer-research method. Time since the last dental attendance was the dependent variable. The independent variable was frailty, assessed with the Comprehensive Frailty Assessment Instrument, including physical, psychological, social, and environmental subdomains. Covariates were age, gender, having a partner, educational level, and household income, as well as self-perceived oral health. Data analysis included descriptive, bivariate (Chi-Square, ANOVA, and Kruskal-Wallis), and binomial logistic regression analyses.
The sample consisted of 1329 older adults with a mean age of 72.5 years (SD 8.9, range 60-103). In the low frailty group, 73% attended the dentist in the previous 12 months, while it was 62% and 54% in the medium and high frailty groups, respectively. In the fully adjusted model, the initial gradient in the relationship between overall frailty and dental attendance remained; those in the medium and the high frailty groups were respectively 1.46 (95% CI: 1.09, 1.95) and 1.67 (95% CI: 1.15, 2.43) times more likely to report no dental attendance in the previous year than the low frailty group. Similar associations could be seen in the physical and environmental frailty subdomains.
Frailty is consistently associated with less favourable dental attendance, independent from age, gender, socioeconomic factors, family composition, and self-perceived oral health. Once frailty has been detected, good interprofessional communication and care are needed to avoid the drop-out of older adults from the oral healthcare system.
本研究旨在评估比利时居家老年人不同虚弱程度与看牙就诊之间的关联。
尽管已经确定了许多影响老年人看牙就诊的因素，但尚无研究关注虚弱程度的作用。
这是一项在比利时两个城市进行的居家成年人（年龄 60 岁及以上）随机样本的横断面研究。数据通过参与式同伴研究方法使用结构化问卷收集。上一次看牙就诊时间是因变量。虚弱程度是用包含身体、心理、社会和环境等子领域的综合虚弱评估工具来评估的自变量。协变量包括年龄、性别、是否有伴侣、教育程度和家庭收入以及自我感知的口腔健康状况。数据分析包括描述性、双变量（卡方检验、方差分析和克鲁斯卡尔-沃利斯检验）和二项逻辑回归分析。
样本包括 1329 名年龄在 72.5 岁（标准差 8.9，范围 60-103 岁）的老年人。在低虚弱组中，73%的人在过去 12 个月内看过牙医，而在中、高虚弱组中，这一比例分别为 62%和 54%。在完全调整的模型中，整体虚弱程度与看牙就诊之间的初始梯度仍然存在；中、高虚弱组分别有 1.46 倍（95%置信区间：1.09，1.95）和 1.67 倍（95%置信区间：1.15，2.43）更有可能报告在过去一年中没有看牙医，而低虚弱组则报告没有看牙医。在身体和环境虚弱子领域也可以看到类似的关联。
虚弱程度与看牙就诊情况较差相关，与年龄、性别、社会经济因素、家庭构成和自我感知的口腔健康状况无关。一旦发现虚弱，就需要良好的跨专业沟通和护理，以避免老年人从口腔保健系统中流失。
