Oral Health, Disability and Physical Function: Results From Studies of Older People in the United Kingdom and United States of America
Oral Health, Disability and Physical Function: Results From Studies of Older People in the United Kingdom and United States of America
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DOI：
10.1016/j.jamda.2019.06.010
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发表时间：
2019-12-01
影响因子：
7.6
通讯作者：
Ramsay, Sheena E.
中科院分区：
文献类型：
--
作者：
Kotronia, Eftychia;Wannamethee, S. Goya;Ramsay, Sheena E.
目的：检查口腔健康和残疾之间关系的研究有有限的口腔健康措施。我们调查了一系列客观和主观评估的口腔健康指标与老年人残疾和身体功能的关系。设计、环境和参与者：横断面分析基于英国区域心脏研究（BRHS），其中包括来自24个英国城镇的71岁至92岁的男性（n = 2147），以及来自美国的71岁至80岁的男性和女性（n = 3075）的健康、衰老和身体组成（HABC）研究。评估包括口腔健康（牙周病、牙齿计数、口干和自评口腔健康）、残疾和身体功能（握力、步态速度和椅子站立测试）。结果：在BRHS中，口干、牙齿脱落和累积口腔健康问题（>= 3问题）与活动受限、日常生活活动和日常生活工具活动问题相关；在校正混杂变量后，这些结果仍然显著(对于>= 3的口干症状，优势比（OR） 2.68, 95%可信区间（CI） 1.94-3.69；或1.76,95% ci 1.15-2.69；OR 2.90, 95% CI 2.01, 4.18)。在HABC研究中也观察到类似的结果。口干与BRHS中最慢的步态速度和HABC研究中最弱的握力相关（OR分别为1.75,95% CI 1.22, 2.50； OR为2.43,95% CI 1.47-4.01）。结论和意义：口腔健康状况不佳的标志，特别是口干、自评口腔健康状况不佳以及存在一种以上的口腔健康问题，与老年人群的残疾和身体功能不佳有关。需要对这些关联和潜在途径进行前瞻性调查。(C) 2019 AMDA -急性和长期护理医学学会。
Objectives: Studies examining the associations between oral health and disability have limited oral health measures. We investigated the association of a range of objectively and subjectively assessed oral health markers with disability and physical function in older age.Design, Setting, and Participants: Cross-sectional analyses were based on the British Regional Heart Study (BRHS) comprising men aged 71 to 92 years (n = 2147) from 24 British towns, and the Health, Aging, and Body Composition (HABC) Study comprising men and women aged 71 to 80 years (n = 3075) from the United States. Assessments included oral health (periodontal disease, tooth count, dry mouth, and self-rated oral health), disability, and physical function (grip strength, gait speed, and chair stand test).Results: In the BRHS, dry mouth, tooth loss, and cumulative oral health problems (>= 3 problems) were associated with mobility limitations and problems with activities of daily living and instrumental activities of daily living; these remained significant after adjustment for confounding variables (for >= 3 dry mouth symptoms, odds ratio (OR) 2.68, 95% confidence interval (CI) 1.94-3.69; OR 1.76, 95% CI 1.15-2.69; OR 2.90, 95% CI 2.01, 4.18, respectively). Similar results were observed in the HABC Study. Dry mouth was associated with the slowest gait speed in the BRHS, and the weakest grip strength in the HABC Study (OR 1.75, 95% CI 1.22, 2.50; OR 2.43, 95% CI 1.47-4.01, respectively).Conclusions and Implications: Markers of poor oral health, particularly dry mouth, poor self-rated oral health, and the presence of more than 1 oral health problem, were associated with disability and poor physical function in older populations. Prospective investigations of these associations and underlying pathways are needed. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.