The physiological influence of oral health on healthy ageing: a longitudinal analysis of two epidemiological cohort studies

口腔健康对健康老龄化的生理影响：两项流行病学队列研究的纵向分析

• 批准号: 2468634
• 金额: --
• 依托单位: Newcastle University
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2468634
• 关键词: physiological; influence; oral; health; healthy

In recent years there has been a dramatic increase in the proportion of older people (i.e., people aged 65 years and above) in the UK and other advanced countries. In the UK it is projected that by the year 2050 one in four people will be 65 years or above 65 years [1]. Advancement in medicine and knowledge in preventive care has led to prolonged life. However, aging is usually associated with chronic diseases and health conditions such as diabetes, chronic obstructive pulmonary disease, and dementia which can have a substantial impact on quality of life. The increasing aging population therefore has health and public health implications; it is a critical public health challenge to promote 'healthy aging'. Healthy aging refers to optimal physical and cognitive functioning, delayed onset of chronic diseases, and social wellbeing in older age [2]. Oral health is a critical component of overall health and therefore efforts to promote healthy ageing also need to recognise the burden of oral health in older people. Oral health conditions are the most widely prevalent health conditions, and their risks increase substantially with age, constituting a major burden of ill-health [3]. In a population-based study of older British men, 64% had few teeth (<21 teeth), 43% had active periodontal (gum) disease and over a third had dry mouth [4]. Replacement of teeth with dentures is also problematic in older people due to resorption of the alveolar bone and complications of denture stomatitis [5]. Oral diseases are also very costly, with an estimated global yearly direct cost of treatment (dental services) to be US$298 billion in 2010 [6]. and £3.4 billion/year in England[7].Several studies have reported that oral health problems are associated with a number of health outcomes in older populations - such as, disability and physical function [8], frailty [9], cardiovascular diseases [10], mortality (Friedman 2016) and metabolic syndrome [11] - as well as with markers of chronic conditions, such as inflammatory, hemostactic and cardiac biomarkers [12].Poor oral health has also been linked to diet and nutrition. Dry mouth and tooth loss influence chewing ability and food selection, leading to the avoidance of foods that are difficult to chew (fruit, vegetables, meat) resulting in poor diet and deficiencies in key nutrients [5]. However, replacement of teeth with dentures is also problematic in older people due to resorption of the alveolar bone and complications of denture stomatitis [5]. Some studies also report or suggest a two-way association between type 2 diabetes and poor oral health [13-15]. Despite the increasing risks and burden of oral health problems among older people, few studies have investigated the influence of oral health on health and wellbeing (chronic conditions and quality of life) longitudinally and as such the mechanisms through which oral health influence quality of life of older populations is not well established. [8] and [9] conducted a cross sectional analysis to determine the influence of poor oral health on key health measures. They found that poor oral health was associated with frailty [9], physical function and disability [8]. There is the need for a longitudinal analysis to help better understand the associations and the underlying pathways. This project will use large longitudinal datasets with a long follow up period to examine the physiological mechanisms underpinning the association between age related health conditions (includes chronic diseases, such as type 2 diabetes mellitus) and oral health markers, particularly dry mouth and denture wearing. A clear understanding of the underlying and mediating pathways will help to improve the health of aging population.

近年来，在英国和其他发达国家，老年人（即65岁及以上的人）的比例急剧增加。在英国，预计到2050年，四分之一的人将是65岁或65岁以上。医学和预防保健知识的进步延长了人的寿命。然而，衰老通常与慢性疾病和健康状况有关，如糖尿病、慢性阻塞性肺病和痴呆症，这些疾病和健康状况会对生活质量产生重大影响。因此，日益增加的老龄化人口对健康和公共卫生产生影响；促进“健康老龄化”是一项重大的公共卫生挑战。健康老龄化是指老年人的身体和认知功能达到最佳状态，慢性病的延迟发作，以及社会福利。口腔健康是整体健康的关键组成部分，因此促进健康老龄化的努力也需要认识到老年人口腔健康的负担。口腔健康状况是最普遍的健康状况，其风险随着年龄的增长而大幅增加，构成健康不良的主要负担。在一项针对英国老年男性的人群研究中，64%的人牙齿很少（<21颗牙齿），43%的人患有活动性牙周（牙龈）疾病，超过三分之一的人有口干。由于牙槽骨的吸收和假牙口炎的并发症，用假牙代替牙齿在老年人中也是有问题的。口腔疾病的代价也非常高昂，据估计，2010年全球每年治疗（牙科服务）的直接费用为2980亿美元。在英格兰每年有34亿英镑。几项研究报告称，口腔健康问题与老年人的许多健康结果有关，如残疾和身体功能[8]、虚弱[9]、心血管疾病[10]、死亡率[11]（Friedman 2016）和代谢综合征[11]，以及慢性疾病标志物，如炎症、止血和心脏生物标志物[12]。口腔健康状况不佳也与饮食和营养有关。口干和牙齿脱落影响咀嚼能力和食物选择，导致避免难以咀嚼的食物（水果、蔬菜、肉类），导致饮食不良和主要营养素缺乏。然而，由于牙槽骨的吸收和假牙口炎的并发症，用假牙代替牙齿在老年人中也是有问题的。一些研究也报道或提出2型糖尿病与口腔健康状况不佳之间存在双向关联[13-15]。尽管老年人口腔健康问题的风险和负担不断增加，但很少有研究从纵向上调查口腔健康对健康和福祉（慢性病和生活质量）的影响，因此口腔健康影响老年人生活质量的机制尚未得到很好的确定。[8]和[9]进行了横断面分析，以确定口腔健康状况不佳对关键健康措施的影响。他们发现，口腔健康状况不佳与身体虚弱、身体功能和残疾有关。有必要进行纵向分析，以帮助更好地了解这些联系和潜在的途径。该项目将使用大型纵向数据集，并进行长期随访，以检查与年龄相关的健康状况（包括慢性疾病，如2型糖尿病）与口腔健康指标（特别是口干和假牙佩戴）之间关联的生理机制。清楚了解其潜在和中介途径将有助于改善人口老龄化的健康状况。