Health Management and Policy, San Diego State University School of Public Health, San Diego, CA, United States.
Department of Biostatistics and Health Data Science, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Front Public Health. 2024 Aug 9;12:1428699. doi: 10.3389/fpubh.2024.1428699. eCollection 2024.
To examine the association of older adults' loneliness, life satisfaction, and other psychological stressors and resources with oral health status.
This study merged 2018 data from the Health and Retirement Study (HRS) CORE survey with the HRS-Dental Module, and Psychosocial and Lifestyle Questionnaire-Panel A "Leave Behind" surveys (HRS-LB)( = 418). Dental Module outcomes of interest were self-rated oral health status (SROH), and oral health-related quality of life (OHQOL). Older adults reported on loneliness, life satisfaction, perceived age, social status, control, mastery, and chronic stressors. Three distinct profiles based on the distribution of loneliness and life satisfaction were previously identified in the combined HRS and HRS-LB study population ( = 4,703) using latent class analysis (LCA). Class A:"Not Lonely/Satisfied" adults had the fewest psychosocial risk factors and most resources; Class C:"Lonely/Unsatisfied" adults exhibited the opposite profile (most risk factors, fewest resources); Class B:"Lonely/Satisfied" adults exhibited loneliness with favorable life satisfaction. Regression models examined associations between LCA classes and fair/poor SROH and the OHQOL scale score and individual items, after adjusting for socio-demographics.
About 13% of older adults experienced loneliness, and about 16% reported low life satisfaction. About one-quarter (28%) of older adults reported fair/poor SROH, and they experienced more psychosocial risk factors than their counterparts with better oral health status. Nearly half the older adults were categorized in Class A:"Not Lonely/Satisfied" ( = 201), and about one-quarter each in Class B:"Lonely/Satisfied" ( = 103) and Class C:"Lonely/Unsatisfied" ( = 112). In fully adjusted models, Class B older adults had 1.81 (1.11-2.96) times greater odds of fair/poor SROH, and Class C had 4.64 (2.78-7.73) times greater odds of fair/poor SROH than Class A. Fully adjusted linear regression model results indicated a gradient by LCA class. OHQOL varied; Class A older adults had the best (lowest) OHQOL score (mean = 8.22, 4.37-12.10), Class B scored in the middle (mean = 12.00, 7.61-16.50), while Class C had the worst (highest) OHQOL score (mean = 16.20, 11.80-20.60).
Loneliness, as a defining characteristic distinguishing three latent classes of older adults, was associated with more risk factors and poorer oral health outcomes. Loneliness, life satisfaction, perceived age, social status, control, mastery, and chronic stressors vary widely for older adults and matter for oral health and OHQOL.
探讨老年人的孤独感、生活满意度以及其他心理压力源和资源与口腔健康状况之间的关系。
本研究合并了 2018 年健康与退休研究（HRS）核心调查与 HRS-牙科模块以及心理社会和生活方式问卷-面板 A“遗留”调查（HRS-LB）的数据（=418）。牙科模块中感兴趣的结果是自我评估的口腔健康状况（SROH）和口腔健康相关生活质量（OHQOL）。老年人报告了孤独感、生活满意度、感知年龄、社会地位、控制感、掌握感和慢性压力源。先前在合并的 HRS 和 HRS-LB 研究人群中（=4703），基于孤独感和生活满意度的分布情况，使用潜在类别分析（LCA）确定了三个不同的类别。A 类：“不孤独/满意”的成年人有最少的心理社会风险因素和最多的资源；C 类：“孤独/不满意”的成年人表现出相反的特征（最多的风险因素，最少的资源）；B 类：“孤独/满意”的成年人表现出孤独感，但生活满意度良好。调整社会人口统计学因素后，回归模型探讨了 LCA 类别与口腔健康状况一般/差的 SROH 和 OHQOL 量表评分以及个别项目之间的关联。
约 13%的老年人感到孤独，约 16%的老年人报告生活满意度低。约四分之一（28%）的老年人报告口腔健康状况一般/差，他们经历的心理社会风险因素比口腔健康状况较好的同龄人多。约四分之一的老年人属于 A 类：“不孤独/满意”（=201），约四分之一属于 B 类：“孤独/满意”（=103），约四分之一属于 C 类：“孤独/不满意”（=112）。在完全调整的模型中，B 类老年人 SROH 一般/差的可能性是 A 类的 1.81 倍（1.11-2.96），C 类老年人 SROH 一般/差的可能性是 A 类的 4.64 倍（2.78-7.73）。完全调整的线性回归模型结果表明，LCA 类别存在梯度。OHQOL 有所不同；A 类老年人的 OHQOL 评分最好（最低）（均值=8.22，4.37-12.10），B 类评分居中（均值=12.00，7.61-16.50），而 C 类评分最差（最高）（均值=16.20，11.80-20.60）。
孤独感作为区分老年人三个潜在类别的特征，与更多的风险因素和较差的口腔健康结果相关。孤独感、生活满意度、感知年龄、社会地位、控制感、掌握感和慢性压力源在老年人中差异很大，对口腔健康和 OHQOL 很重要。
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