Multilevel analyses of oral health conditions among older adults in the All of Us Research Program

“我们所有人研究计划”中老年人口腔健康状况的多层次分析

基本信息

批准号：
10658463
负责人：
Jane A Weintraub
金额：
$ 12.82万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-15 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10658463
关键词：
Adult Affect Age Aging All of Us Research Program American Area Behavioral Cardiovascular Diseases Chronic Clinical Code Cognition Communities Data Data Analyses Data Set Dental Dental Care Dental General Practice Dental Records Dental caries Diabetes Mellitus Digit structure Edentulous Mouth Elderly Electronic Health Record Enrollment Ethnic Origin Frequencies Funding Geographic Locations Geography Goals Health Health Status Health and Retirement Study Health behavior Healthcare Individual Life Life Style Link Longitudinal Studies Medicaid Medical Medicare Medicine Modeling National Institute of Dental and Craniofacial Research Oral Oral health Outcome Participant Patient Self-Report Periodontitis Population Primary Health Care Psychosocial Factor Quality of life Retirement Risk Role Sampling Source Strategic Planning Stroke Surveys Systematized Nomenclature of Medicine Systemic disease Tooth Loss Tooth structure Underrepresented Populations United States United States National Institutes of Health Variant base cohort contextual factors craniofacial data ecosystem data infrastructure demographics edentulism education research functional status health care settings health data health inequalities improved insight large datasets multilevel analysis negative affect oral condition parent grant psychosocial racial disparity social social health determinants sociodemographic factors socioeconomics volunteer

项目摘要

Abstract The U.S. population is rapidly aging. Americans are living longer, with more chronic conditions, and retaining more teeth. Because of the relationships between oral and systemic conditions, there is a need for dental care to become better integrated with primary care. Oral health inequalities in access to dental care are prevalent among older adults. Routine dental care is not included in Medicare and large state-level variations exist in dental Medicaid benefits. The oral health of older adults in the US is understudied due to few national large- scale studies with longitudinal components that include medical dental, individual and community level data. With this supplement, secondary data analysis from the national NIH All of US (AoU) Research Project will expand information about adults age 51+ available from the longitudinal, nationally representative US Health and Retirement Study (HRS) currently being analyzed (NIDCR R03 DE030161-02). Our R03 goals are to study longitudinal changes in the oral health of older adults in relationship to changes in cognition, retirement, medical, contextual, psychosocial, behavioral and dental utilization data. Both HRS and AoU datasets provide information to link oral health status to medical conditions, demographics, lifestyle, psychosocial factors, and overall health. The HRS and AoU both include self-report survey data. Additionally, the AoU includes clinically- determined information from participants' electronic health records (EHR) obtained in healthcare settings. AoU seeks to enroll diverse, traditionally under-represented groups. The AoU Controlled Tier level data includes 3- digit ZIP code that provides access to geographical contextual information to explore social determinants of health using multilevel analyses. Poor oral health, partial tooth loss, and edentulism among older adults negatively affect their quality of life and functional status. An AoU analytical Controlled Tier dataset will be constructed with 3 groups having different oral conditions based on EHR data for comparison: 1) completely edentulous, 2) partially edentulous, and 3) evidence of being dentate (e.g., dental caries, periodontitis). The specific aims are: AIM 1a) Tabulate the means (SD) and frequency distribution of socio-demographic factors in Controlled Tier AoU data and medical, cognition, and social/lifestyle risk indicators from survey and EHR data associated with these 3 dental status groups (above). Aim 1b) Develop multivariable models using these 3 dental status groups and dental utilization to determine their influence on self-rated health, cognition, and other medical conditions (e.g., diabetes, cardiovascular disease, stroke). Aim 1c) Develop multilevel models including contextual variables using zip code data to represent geographic regions where participants reside to examine individual and area variations in outcomes. AIM 2: Compare AoU findings with 2018 HRS data and assess population differences in self-rated health, cognition, and medical outcomes. HRS and AoU are both large-scale, landmark studies with different key features. By analyzing both datasets, we will be able to take advantage of the best features of each one to further our understanding of the oral health of older adults.

抽象的美国人口正在迅速衰老。美国人的寿命更长，病情更长，保留更多的牙齿。由于口腔和系统条件之间的关系，需要牙科护理与初级保健更好地融合在一起。牙科护理的口腔健康不平等现象很普遍在老年人中。医疗保险中不包括常规牙科护理，并且存在大型州级变化牙科医疗补助福利。由于很少的国家大型，美国老年人的口腔健康受到了研究。具有纵向组件的量表研究，包括医疗牙科，个人和社区水平数据。有了这种补充，我们所有人的国家NIH（aou）研究项目的次要数据分析将扩展有关51岁以上成人的信息，可从纵向，全国代表性的美国卫生当前正在分析的退休研究（HRS）（NIDCR R03 DE030161-02）。我们的R03目标是研究老年人口腔健康的纵向变化与认知，退休的变化有关医学，上下文，心理社会，行为和牙科利用数据。 HRS和AOU数据集都提供信息以将口腔健康状况与医疗状况，人口统计，生活方式，社会心理因素和整体健康。 HRS和AOU都包括自我报告调查数据。此外，AOU在临床上包括从医疗保健环境中获得的参与者电子健康记录（EHR）确定了信息。 aou 寻求招募多样化的，传统上代表性不足的群体。 AOU控制的层级数据包括3- 数字邮政编码，可访问地理上下文信息，以探索社会决定因素使用多层次分析的健康。老年人的口腔健康状况不佳，部分牙齿脱落和脱牙负面影响其生活质量和功能状况。 AOU分析控制层数据集将是由3组基于EHR数据的3组构建以进行比较：1）完全倾听，2）部分牙齿和3）牙齿牙齿的证据（例如龋齿，牙周炎）。这具体目的是：目标1A）将均值（SD）和社会人口统计学因素的频率分布制成在受控层中数据和医学，认知以及调查和EHR的社会/生活方式风险指标与这3个牙科状态组相关的数据（上图）。目标1b）使用这些开发多变量模型 3个牙科状态群体和牙科利用来确定其对自我评估健康，认知和其他医疗状况（例如糖尿病，心血管疾病，中风）。 AIM 1C）开发多级模型包括使用邮政编码数据的上下文变量来表示参与者居住在的地理区域检查结果的个人和区域变化。目标2：将AOU的发现与2018 HRS数据和评估人口自我评估的健康，认知和医疗结果的人群差异。 HRS和AOU都是具有不同关键特征的大规模，具有里程碑意义的研究。通过分析两个数据集，我们将能够接受每个人的最佳特征的优势，以进一步了解我们对老年人口腔健康的理解。