Altanbagana Nandin Uchral, Irie Koichiro, Song Wenqun, Fuchida Shinya, Aida Jun, Yamamoto Tatsuo
Department of Preventive Dentistry and Dental Public Health, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan.
Department of Oral Health, Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Nagasaki, Japan.
Healthcare (Basel). 2025 Aug 5;13(15):1916. doi: 10.3390/healthcare13151916.
: Despite growing interest in oral frailty as a public health issue, no nationwide study has assessed regional differences in oral frailty awareness, and the factors associated with such differences remain unclear. This study investigated regional differences in oral frailty awareness among older adults in Japan and identified the associated individual- and municipal-level factors, focusing on local policy measures and community-based oral health programs. : A cross-sectional analysis was conducted using data from the 2022 wave of the Japan Gerontological Evaluation Study. The analytical sample comprised 20,330 community-dwelling adults aged ≥65 years from 66 municipalities. Awareness of oral frailty was assessed via self-administered questionnaires. Individual- and municipal-level variables were analyzed using multilevel Poisson regression models to calculate prevalence ratios (PRs). : Awareness of oral frailty varied widely across municipalities, ranging from 15.3% to 47.1%. Multilevel analysis showed that being male (PR: 1.10), having ≤9 years (PR: 1.10) or 10 to 12 years of education (PR: 1.04), having oral frailty (PR: 1.04), and lacking civic participation (PR: 1.06) were significantly associated with lack of awareness. No significant associations were found with municipal-level variables such as dental health ordinances, volunteer training programs, or population density. : The study found substantial regional variation in oral frailty awareness. However, this variation was explained primarily by individual-level characteristics. Public health strategies should focus on enhancing awareness among socially vulnerable groups-especially men, individuals with low educational attainment, and those not engaged in civic activities-through targeted interventions and community-based initiatives.
尽管作为一个公共卫生问题，口腔脆弱性越来越受到关注，但尚无全国性研究评估口腔脆弱性认知的地区差异，且造成这种差异的相关因素仍不明确。本研究调查了日本老年人对口腔脆弱性认知的地区差异，并确定了与之相关的个人层面和市一级层面的因素，重点关注地方政策措施和社区口腔健康项目。
使用来自日本老年学评估研究2022年调查的数据进行横断面分析。分析样本包括来自66个市的20330名年龄≥65岁的社区居住成年人。通过自填问卷评估口腔脆弱性认知情况。使用多水平泊松回归模型分析个人层面和市一级层面的变量，以计算患病率比（PRs）。
各市对口腔脆弱性的认知差异很大，范围从15.3%到47.1%。多水平分析表明，男性（PR：1.10）、受教育年限≤9年（PR：1.10）或10至12年（PR：1.04）、存在口腔脆弱性（PR：1.04）以及缺乏公民参与（PR：1.06）与认知不足显著相关。未发现与市一级变量如牙齿健康条例、志愿者培训项目或人口密度有显著关联。
该研究发现口腔脆弱性认知存在显著的地区差异。然而，这种差异主要由个人层面的特征所解释。公共卫生策略应通过有针对性的干预措施和社区倡议，专注于提高社会弱势群体——尤其是男性、低学历者以及未参与公民活动者——的认知。
