主观口腔脆弱与老年后期不良健康结局或医疗和牙科支出之间的关系：一项为期 6 年的纵向研究。
The relationship between subjective oral frailty and adverse health outcomes or medical and dental expenditures in the latter-stage older adult: A 6-year longitudinal study.
机构信息
Department of Hygiene and Oral Health Science, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
Faculty of Health and Welfare, Tokushima Bunri University, Tokushima, Japan.
出版信息
Clin Exp Dent Res. 2023 Apr;9(2):349-357. doi: 10.1002/cre2.717. Epub 2023 Feb 5.
OBJECTIVES
The study aimed to investigate the relationship between subjective oral frailty and adverse health outcomes or medical and dental expenditures in the latter-stage older adult through a 6-year longitudinal study.
METHODS
The participants enrolled in the cross-sectional study were 3564 Tokushima City residents aged 75, 80, 85, and 90 years old who received oral health examinations and who responded to a questionnaire on oral conditions and health behavior at baseline. The data for the occurrence of disability or mortality, and the monthly medical expenditures, dental expenditures, and total medical expenditure of each participant were obtained from the National Health Insurance Database.
RESULTS
The total medical expenditure showed significant differences in participants who had difficulties in eating tough foods, difficulties in swallowing tea or soup, and dry mouth when compared to that of healthy participants, in addition to the current medical treatment against the general disease. The 6-year longitudinal study revealed that participants with subjective oral frailty symptoms, including difficulties in eating tough foods and difficulties in swallowing tea or soup at baseline, had significantly higher medical, dental, and total expenditures among 538 participants without certified nursing care. In addition, those with subjective oral frailty or with less than 19 teeth present were shown to have a higher possibility for the occurrence of disability or mortality by the cox proportional hazard analysis. Furthermore, it was found that medical and total expenditures in older adults with adverse health outcomes were higher than that of healthy participants.
CONCLUSION
These results suggest that subjective oral frailty in the latter-stage older adult is related to subsequent adverse health outcomes and an increase in medical and dental expenditures.
目的
本研究通过一项为期 6 年的纵向研究，旨在探讨高龄后期老年人主观口腔脆弱与不良健康结局或医疗和牙科支出之间的关系。
方法
本横断面研究的参与者为 3564 名年龄在 75、80、85 和 90 岁的德岛市居民，他们接受了口腔健康检查，并在基线时回答了关于口腔状况和健康行为的问卷。每个参与者的残疾或死亡发生情况的数据，以及每月的医疗支出、牙科支出和总医疗支出均从国家健康保险数据库中获得。
结果
与健康参与者相比，在总医疗支出方面，在进食硬质食物、吞咽茶或汤以及口干方面有困难的参与者存在显著差异，此外，还包括针对一般疾病的当前医疗治疗。6 年的纵向研究表明，在没有认证护理的 538 名参与者中，基线时有主观口腔脆弱症状（包括进食硬质食物和吞咽茶或汤困难）的参与者，其医疗、牙科和总支出显著更高。此外，通过 Cox 比例风险分析发现，有主观口腔脆弱或牙齿少于 19 颗的参与者发生残疾或死亡的可能性更高。此外，还发现有不良健康结局的老年患者的医疗和总支出高于健康参与者。
结论
这些结果表明，高龄后期老年人的主观口腔脆弱与随后的不良健康结局以及医疗和牙科支出的增加有关。
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