Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK; Division of Sport and Exercise Science, School of Health and Life Sciences, University of the West of Scotland, Blantyre, UK.
Department of Primary Care and Population Health, UCL, London, UK.
J Am Med Dir Assoc. 2023 Apr;24(4):468-474.e3. doi: 10.1016/j.jamda.2022.11.022. Epub 2022 Dec 28.
To investigate the prospective associations between oral health and progression of physical frailty in older adults.
Prospective analysis.
Data are from the British Regional Heart Study (BRHS) comprising 2137 men aged 71 to 92 years from 24 British towns and the Health, Aging, and Body Composition (HABC) Study of 3075 men and women aged 70 to 79 years.
Oral health markers included denture use, tooth count, periodontal disease, self-rated oral health, dry mouth, and perceived difficulty eating. Physical frailty progression after ∼8 years follow-up was determined based on 2 scoring tools: the Fried frailty phenotype (for physical frailty) and the Gill index (for severe frailty). Logistic regression models were conducted to examine the associations between oral health markers and progression to frailty and severe frailty, adjusted for sociodemographic, behavioral, and health-related factors.
After full adjustment, progression to frailty was associated with dentition [per each additional tooth, odds ratio (OR) 0.97; 95% CI: 0.95-1.00], <21 teeth with (OR 1.74; 95% CI: 1.02-2.96) or without denture use (OR 2.45; 95% CI 1.15-5.21), and symptoms of dry mouth (OR ≥1.8; 95% CI ≥ 1.06-3.10) in the BRHS cohort. In the HABC Study, progression to frailty was associated with dry mouth (OR 2.62; 95% CI 1.05-6.55), self-reported difficulty eating (OR 2.12; 95% CI 1.28-3.50) and ≥2 cumulative oral health problems (OR 2.29; 95% CI 1.17-4.50). Progression to severe frailty was associated with edentulism (OR 4.44; 95% CI 1.39-14.15) and <21 teeth without dentures after full adjustment.
These findings indicate that oral health problems, particularly tooth loss and dry mouth, in older adults are associated with progression to frailty in later life. Additional research is needed to determine if interventions aimed at maintaining (or improving) oral health can contribute to reducing the risk, and worsening, of physical frailty in older adults.
探讨老年人的口腔健康与身体虚弱进展之间的前瞻性关联。
前瞻性分析。
数据来自英国区域心脏研究（BRHS），该研究包括来自 24 个英国城镇的 2137 名 71 至 92 岁的男性，以及健康、衰老和身体成分（HABC）研究中的 3075 名 70 至 79 岁的男性和女性。
口腔健康标志物包括使用义齿、牙齿计数、牙周病、自我评估的口腔健康、口干和进食困难。根据两种评分工具确定大约 8 年后的身体虚弱进展情况：Fried 虚弱表型（用于身体虚弱）和 Gill 指数（用于严重虚弱）。进行逻辑回归模型以检查口腔健康标志物与虚弱和严重虚弱进展之间的关联，调整了社会人口统计学、行为和健康相关因素。
在充分调整后，与牙齿缺失有关的虚弱进展[每增加一颗牙齿，比值比（OR）0.97；95%可信区间：0.95-1.00]，BRHS 队列中无牙或戴义齿的牙齿数量<21（OR 1.74；95%可信区间：1.02-2.96），以及口干症状（OR≥1.8；95%可信区间≥1.06-3.10）。在 HABC 研究中，与虚弱进展相关的是口干（OR 2.62；95%可信区间 1.05-6.55）、自我报告的进食困难（OR 2.12；95%可信区间 1.28-3.50）和≥2 项累积口腔健康问题（OR 2.29；95%可信区间 1.17-4.50）。严重虚弱进展与无牙（OR 4.44；95%可信区间 1.39-14.15）和充分调整后无义齿的<21 颗牙齿有关。
这些发现表明，老年人的口腔健康问题，特别是牙齿缺失和口干，与晚年的虚弱进展有关。需要进一步研究以确定旨在维持（或改善）口腔健康的干预措施是否可以降低老年人身体虚弱的风险和恶化。
