Yamamoto T, Mochida Y, Irie K, Altanbagana N U, Fuchida S, Aida J, Takeuchi K, Fujita M, Kondo K
Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, Yokosuka, Kanagawa, Japan.
Department of Education Planning, Kanagawa Dental University, Yokosuka, Kanagawa, Japan.
JDR Clin Trans Res. 2024 Oct;9(4):368-377. doi: 10.1177/23800844241238648. Epub 2024 Apr 23.
Oral frailty leads to poor nutritional status, which, in turn, leads to frailty. This cross-sectional study aimed to determine regional differences in the prevalence of oral frailty and to identify factors associated with oral frailty using 3-level multilevel models.
This study comprised 165,164 participants aged ≥65 y without long-term care requirements in the Japan Gerontological Evaluation Study. The dependent variable was oral frailty, which was calculated based on age, number of teeth, difficulty in eating tough foods, and choking. The individual-level independent variables included sociodemographics, present illness, social participation, frequency of meeting friends, and social capital. The local district-level independent variable was social capital ( = 1,008) derived from exploratory factor analyses. The municipality-level independent variable was population density ( = 62). Three-level multilevel Poisson regression analysis was performed to calculate the prevalence ratios (PRs).
The prevalence of oral frailty in municipalities ranged from 39.9% to 77.6%. Regarding district-level factors, higher civic participation was significantly associated with a lower probability of oral frailty. At the municipality level, the PR of the rural-agricultural area was 1.17 (95% confidence interval, 1.11-1.23) (reference: metropolitan).
These results highlight the usefulness of oral frailty prevention measures in encouraging social participation in rural areas.
The results of the present study showed regional differences in oral frailty. In particular, rural-agricultural areas show higher prevalence rates of oral frailty than those in metropolitan cities. Promoting measures of social participation among older adults may help prevent oral frailty in rural areas.
口腔功能衰弱会导致营养状况不佳，进而引发身体衰弱。这项横断面研究旨在确定口腔功能衰弱患病率的地区差异，并使用三级多水平模型确定与口腔功能衰弱相关的因素。
本研究纳入了日本老年学评估研究中165164名年龄≥65岁且无长期护理需求的参与者。因变量为口腔功能衰弱，根据年龄、牙齿数量、食用硬质食物困难程度和呛噎情况计算得出。个体水平的自变量包括社会人口统计学特征、现患疾病、社会参与、与朋友见面的频率和社会资本。地区层面的自变量是通过探索性因素分析得出的社会资本（n = 1008）。市层面的自变量是人口密度（n = 62）。进行三级多水平泊松回归分析以计算患病率比（PRs）。
各市口腔功能衰弱的患病率在39.9%至77.6%之间。关于地区层面的因素，较高的公民参与度与较低的口腔功能衰弱概率显著相关。在市层面，农村农业地区的PR为1.17（95%置信区间，1.11 - 1.23）（参照：大都市）。
这些结果凸显了口腔功能衰弱预防措施在鼓励农村地区社会参与方面的作用。
本研究结果显示了口腔功能衰弱存在地区差异。特别是，农村农业地区的口腔功能衰弱患病率高于大都市。促进老年人社会参与的措施可能有助于预防农村地区的口腔功能衰弱。
