Dental Status is Associated With Incident Functional Disability in Community-Dwelling Older Japanese: A Prospective Cohort Study Using Propensity Score Matching
Dental Status is Associated With Incident Functional Disability in Community-Dwelling Older Japanese: A Prospective Cohort Study Using Propensity Score Matching
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DOI：
10.2188/jea.je20180203
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发表时间：
2020-02-01
影响因子：
4.7
通讯作者：
Hattori, Yoshinori
中科院分区：
文献类型：
--
作者：
Komiyama, Takamasa;Ohi, Takashi;Hattori, Yoshinori
背景资料：越来越多的流行病学研究表明，口腔健康不良与功能性残疾的发生率增加有关。然而，很少有研究对混杂偏倚进行了适当调整。在这项研究中，我们研究了牙齿状况是否与功能障碍的日本老年人使用13年的前瞻性队列研究后，消除了混杂因素与倾向评分matching.Methods：参与者是居住在日本70岁或以上的社区谁住在鹤谷区仙台（n = 838）。剩余牙齿的数量（超过20颗牙齿vs 0-19颗牙齿）被定义为暴露变量。结果是功能性残疾的发生率，定义为日本长期护理保险（LTCI）的首次认证。被用来确定倾向评分匹配的变量是年龄，性别，体重指数（BMI），病史（中风，高血压，心肌梗死，癌症和糖尿病），吸烟，饮酒，教育程度，抑郁症状，认知障碍，身体功能，社会支持，和婚姻状况。有0-19颗牙齿的参与者比有20颗或更多牙齿的参与者更容易发生功能性残疾（风险比1.33; 95%置信区间，1.01-1.75）。在这项针对日本社区老年人的前瞻性队列研究中，即使在进行倾向评分匹配后，牙齿少于20颗也被证实是功能障碍的独立风险因素。这项研究支持以前的出版物表明，口腔健康与功能障碍有关。
Background: A growing number of epidemiology studies have shown that poor oral health is associated with an increased incidence of functional disability. However, there are few studies in which the confounding bias is adjusted appropriately. In this study, we examined whether dental status is associated with functional disability in elderly Japanese using a 13-year prospective cohort study after elimination of confounding factors with propensity score matching.Methods: Participants were community-dwelling Japanese aged 70 years or older who lived in the Tsurugaya district of Sendai (n = 838). The number of remaining teeth (over 20 teeth vs 0-19 teeth) was defined as the exposure variable. The outcome was the incidence of functional disability, defined as the first certification of long-term care insurance (LTCI) in Japan. The variables that were used to determine propensity score matching were age, sex, body mass index (BMI), medical history (stroke, hypertension, myocardial infarction, cancer, and diabetes), smoking, alcohol consumption, educational attainment, depression symptoms, cognitive impairment, physical function, social support, and marital status.Results: As a result of the propensity score matching, 574 participants were selected. Participants with 0-19 teeth were more likely to develop functional disability than those with 20 or more teeth (hazard ratio 1.33; 95% confidence interval, 1.01-1.75).Conclusions: In this prospective cohort study targeting community-dwelling older adults in Japan, having less than 20 teeth was confirmed to be an independent risk factor for functional disability even after conducting propensity score matching. This study supports previous publications showing that oral health is associated with functional disability.