Relationship Between Oral Health and Fractures in Community-Dwelling Older Japanese Adults
Relationship Between Oral Health and Fractures in Community-Dwelling Older Japanese Adults
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DOI：
10.1016/j.jamda.2021.01.058
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发表时间：
2021-06-01
影响因子：
7.6
通讯作者：
Hattori, Yoshinori
中科院分区：
文献类型：
--
作者：
Ito, Wakana;Komiyama, Takamasa;Hattori, Yoshinori
目的：调查日本老年人口腔健康状况不良与跌倒相关骨折发生率之间的关系。设计：9年前瞻性队列研究。设置和参与者：参与者包括937名70岁或以上的日本社区老年人。他们都住在仙台市郊区的鹤谷区，并在一家公共设施接受了包括口腔检查在内的综合老年病评估。测量：暴露变量与口腔健康状况（后牙咬合支持，剩余牙齿数量和咬合力）有关。结果测量是跌倒相关骨折的发生率，这是由国民健康保险数据确定的。分析的协变量包括年龄、性别、病史、吸烟、饮酒、教育水平、抑郁症状、认知障碍、身体功能、体重指数和福尔斯史。通过使用考克斯比例风险模型计算95%置信区间（CI）下的风险比（HR），检查统计学关系。结果如下：在多变量分析中，跌倒相关骨折的HR在单侧后咬合支持（HR，2.72; 95%CI，1.13-6.55）和无后咬合支持（HR，2.58; 95%CI，1.29-5.15）的患者中显著高于双侧后咬合支持的患者。10- 1 -9颗牙和1-9颗牙的个体和无牙个体与> 20颗牙的个体相比，跌倒相关骨折的HR（95%CI）分别为1.77（0.813.89）、2.67（1.24-5.75）和2.31（1.01-5.28）。结论和影响：口腔健康状况不佳是日本社区老年人跌倒相关骨折发生率的危险因素。研究结果表明，应将注意力集中在口腔健康状况上，以进一步了解社区居住的老年人发生跌倒相关骨折的风险。(c)2021 AMDA -急性后和长期护理医学协会。
Objective: To investigate the relationship between poor oral health and the incidence of fall-related fractures in older Japanese individuals. Design: A 9-year prospective cohort study. Setting and Participants: Participants comprised 937 community-dwelling older Japanese adults aged 70 years or older. They all lived in the Tsurugaya district, a suburban area of Sendai city, and underwent comprehensive geriatric assessment, including an oral examination, in a public facility. Measurements: The exposure variables were related to oral health status (posterior occlusal support, number of remaining teeth, and occlusal force). The outcome measure was the incidence of fall-related fractures, which was determined by National Health Insurance data. Analyzed covariates included age, sex, medical history, smoking, alcohol drinking, educational level, depressive symptoms, cognitive impairment, physical function, body mass index, and history of falls. Statistical relationships were examined by calculating hazard ratios (HRs) at 95% confidence intervals (CIs) using the Cox proportional hazard model. Results: In the multivariate analysis, the HRs of fall-related fractures were significantly higher in those with unilateral posterior occlusal support (HR, 2.72; 95% CI, 1.13-6.55) and no posterior occlusal support (HR, 2.58; 95% CI, 1.29-5.15) than in those with bilateral posterior occlusal support. The HRs (95% CIs) of fall-related fractures in individuals with 10-19 and 1-9 teeth and edentulous individuals were 1.77 (0.813.89), 2.67 (1.24-5.75), and 2.31 (1.01-5.28), respectively, compared to those with > 20 teeth. Conclusions and Implications: Poor oral health status is a risk factor for the incidence of fall-related fractures in community-dwelling older Japanese individuals. The findings suggest that attention should be focused on oral health status to further understand the risk of fall-related fractures among community-dwelling older adults. (c) 2021 AMDA -The Society for Post-Acute and Long-Term Care Medicine.