Åstrøm Anne Nordrehaug, Mastrovito Berit, Sannevik Josefine, Lie Stein Atle, Johansson Anders, Johansson Ann-Katrin
Department of Clinical Dentistry-Community Dentistry, University of Bergen, Bergen, Norway.
Dental Commissioning Unit, Östergötland County Council, Linköping, Sweden.
Community Dent Oral Epidemiol. 2025 Apr;53(2):235-244. doi: 10.1111/cdoe.13029. Epub 2025 Feb 5.
Focusing on two birth cohorts of older adults, this study aimed to (1) describe the development of oral health-related quality of life (OHRQoL) across time from 2007 to 2022 and (2) assess sociodemographic inequalities in OHRQoL and whether these inequalities remain stable, widen or narrow during the follow-up period.
In 1992 and 2007 the 1942 and 1932 birth cohorts living in the Swedish counties of Örebro and Östergotland participated with 6346 (response 71.4%) and 3735 individuals (response 71.9%), respectively. Of the 6346 1942 birth cohort participants, 2479 (38.5% of baseline) completed postal follow-ups in 1997, 2002, 2007, 2012, 2017 and 2022. Of the 3735 1932 birth cohort participants, 751 (20% of baseline) participated also in 2012, 2017 and 2022. Oral impacts of daily performance (OIDP) and socio-demographic characteristics were assessed at each survey year. A cohort table depicted the prevalence rates of OIDP (OIDP > 0) across time, disentangling age, period and cohort effects. Logistic mixed models with interaction terms of each socio-demographic covariate and time were used to test differences in socio-demographic inequalities of oral impacts over time.
Between 2007 and 2022, OIDP > 0 varied from 22.7% to 28.7% in the 1932 birth cohort (age 75-90) and from 25.3% to 26.6% in the 1942 cohort (age 65-80). Mixed models revealed that cluster specific odds ratios (ORs) for OIDP > 0 varied from 0.2 to 2.5 with respect to avoidance of dental care due to cost and health perceptions in the 1942 cohort. Corresponding OR estimates in the 1932 cohort were 0.2 and 2.1. In both cohorts, inequality estimates according to country of birth and education were smaller in 2022 than in 2007. In the 1932 cohort, inequality according to sex was larger in 2022 than in 2007.
Higher prevalence of oral impacts with increasing age and overtime were observed for both cohorts. Narrowing and widening of oral health socio-demographic disparities occurred. Further examination of the interaction of socio-demographic factors with age or time may allow for targeted policy strategies aimed to alleviate oral health disparities in older ages.
本研究聚焦于两个老年成年人出生队列，旨在（1）描述2007年至2022年期间口腔健康相关生活质量（OHRQoL）随时间的发展情况，以及（2）评估OHRQoL中的社会人口不平等现象，以及这些不平等在随访期间是保持稳定、扩大还是缩小。
1992年和2007年，居住在瑞典厄勒布鲁县和东约特兰省的1942年和1932年出生队列分别有6346人（应答率71.4%）和3735人（应答率71.9%）参与。在6346名1942年出生队列参与者中，2479人（占基线的38.5%）在1997年、2002年、2007年、2012年、2017年和2022年完成了邮政随访。在3735名1932年出生队列参与者中，751人（占基线的20%）也参与了2012年、2017年和2022年的研究。在每个调查年份评估日常表现的口腔影响（OIDP）和社会人口特征。一个队列表描绘了随时间推移OIDP（OIDP>0）的患病率，区分了年龄、时期和队列效应。使用带有每个社会人口协变量与时间交互项的逻辑混合模型来测试口腔影响的社会人口不平等随时间的差异。
在2007年至2022年期间，1932年出生队列（75 - 90岁）中OIDP>0的比例从22.7%变化到28.7%，1942年队列（65 - 80岁）中该比例从25.3%变化到26.6%。混合模型显示，在1942年队列中，因费用和健康认知而避免牙科护理方面，OIDP>0的聚类特定优势比（OR）在0.2到2.5之间变化。1932年队列中的相应OR估计值为0.2和2.1。在两个队列中，根据出生国家和教育程度的不平等估计值在2022年都比2007年小。在1932年队列中，根据性别的不平等在2022年比2007年更大。
两个队列均观察到随着年龄增长和时间推移，口腔影响的患病率更高。口腔健康社会人口差异出现了缩小和扩大的情况。进一步研究社会人口因素与年龄或时间的相互作用，可能有助于制定有针对性的政策策略，以减轻老年人的口腔健康差异。
