Impact of Dental Diseases on Quality-Adjusted Life Expectancy in US Adults
Impact of Dental Diseases on Quality-Adjusted Life Expectancy in US Adults
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DOI：
10.1177/0022034519833353
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发表时间：
2019-05-01
影响因子：
7.6
通讯作者：
Watt, R. G.
中科院分区：
文献类型：
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作者：
Matsuyama, Y.;Tsakos, G.;Watt, R. G.
将牙科疾病的负担与其他健康结果进行比较，为公共政策提供了有用的见解。我们的目的是估计质量调整预期寿命（QALE）的损失，由于牙科条件在美国成年人口。还审查了牙科条件造成的QALE损失的社会不平等。汇总并分析了国家健康和营养检查调查的3个横截面波（NHANES波2001年至2002年，2003年至2004年和2011年至2012年）的数据。研究参与者（n = 9，445）的平均年龄为48.4岁。负效用评分来自自评健康和身体不健康的天数，精神不健康的天数和活动受限的天数，采用先前发表的算法。通过按年龄组（20-39岁、40-59岁和≥ 60岁）分层的多元线性回归，对负效用评分与龋齿、缺牙和牙周炎数量之间的关系进行了研究，并对其他协变量（年龄、性别、波固定效应、教育程度、吸烟和糖尿病）进行了调整。使用寿命表估计20岁时由于牙齿状况导致的QALE损失。龋齿和缺失的牙齿，而不是牙周炎，与一个较大的负效用评分。老年人中龋齿的系数较大，而缺牙的系数较小。估计的QALE损失为0.43年（95%置信区间[CI]，0.28-0.59），由于总体发病率，达到QALE损失的5.3%（8.15年; 95% CI，8.03-8.27）。有明显的社会梯度QALE损失的牙齿条件在整个生命过程中，高中或更低的教育程度的人有0.32年以上的QALE损失的人相比，大学或以上的教育。这项研究表明，人们牙齿健康的改善可能会在人口健康和福祉方面产生实质性的收益。强调了更全面的公共卫生战略的必要性。
Comparing the burden of dental conditions to other health outcomes provides useful insight for public policy. We aimed to estimate quality-adjusted life expectancy (QALE) loss due to dental conditions in the US adult population. Social inequalities in QALE loss by dental conditions were also examined. Data from 3 cross-sectional waves of the National Health and Nutrition Examination Survey (NHANES waves 2001 to 2002, 2003 to 2004, and 2011 to 2012) were pooled and analyzed. The average age of study participants (n = 9,445) was 48.4 y. Disutility scores were derived from self-rated health and the numbers of physically unhealthy days, mentally unhealthy days, and days with activity limitation, employing a previously published algorithm. The associations between the disutility scores and the numbers of decayed teeth, missing teeth, and periodontitis were examined by multiple linear regression stratified by age groups (20-39, 40-59, and >= 60 y), adjusted for other covariates (age, sex, wave fixed effect, educational attainment, smoking, and diabetes). The QALE loss due to dental conditions at the age of 20 was estimated using life tables. Decayed and missing teeth, but not periodontitis, were associated with a larger disutility score. The coefficient for decayed teeth was larger among the older population, whereas that of missing teeth was smaller among them. The estimated QALE loss was 0.43 y (95% confidence interval [CI], 0.28-0.59), which reached 5.3% of QALE loss (8.15 y; 95% CI, 8.03-8.27) due to overall morbidity. There were clear social gradients in QALE loss by dental conditions across the life course, and people with high school or less education had 0.32 y larger QALE loss in total compared with people with college or more education. This study suggests that improvements in people's dental health may yield substantial gains in population health and well-being. The necessity of more comprehensive public health strategies is highlighted.