Understanding the contribution of poor oral health to sarcopenia in older age and underlying mechanisms using UK and US cohort studies

项目摘要 人口老龄化趋势在美国和英国等国家提出了公共卫生挑战。 因此，与年龄相关的健康状况，如肌肉减少症（肌肉质量损失）正在成为 越来越普遍。口腔健康问题也随着年龄的增长而急剧增加，特别是牙齿脱落， 牙周病、口干、假牙相关问题和咀嚼困难。口腔健康状况不佳 被认为是肌肉减少症的危险因素然而，在何种程度上和什么具体的口头 健康标志物导致肌肉减少症的风险增加还没有得到很好的证实。而且 口腔健康可能影响肌肉减少症的途径或机制知之甚少。 目前的研究大多来自横截面研究或肌肉减少症的有限措施 老年人的口腔健康。这些研究无法确定口腔健康的贡献 肌肉减少症的标志 为了解决这些科学证据的差距，我们的目标是利用来自两个独特的、特征鲜明的 在英国和美国进行的队列研究。我们的首要目标是调查口腔健康的贡献 肌肉减少症的发展，并了解这种关系的机制。 我们的研究目标是：1）确定口腔健康不良（牙周）的标志物在多大程度上 疾病，牙齿脱落，口干，义齿问题，咀嚼困难）与 肌肉减少症超过6年的随访; 2）确定饮食因素作为潜在机制的作用 口腔健康不良与肌肉减少症发病率之间的潜在联系;以及3）确定 炎症作为不良口腔健康与肌肉减少症发病率关联的介质。 这些将通过对两个大型基于人群的纵向研究的次级数据分析来实现。 在英国和美国的老年人的研究，这是非常适合这些调查。这些 研究提供了关于口腔健康、饮食因素、炎症以及随时间推移的肌肉减少症的详细数据。 英国区域心脏研究是英国唯一一项针对老年人的纵向研究。研究 包括来自英国24个城镇的参与者，2012年随访年龄为71-92岁， 98年。美国健康、衰老和身体成分研究提供了补充数据， 对来自孟菲斯和匹兹堡的71-80岁的老年人进行的基于人群的研究。 这些调查的基础上，新的概念假设和跨国比较，在英国和 美国的研究，将显着推进我们对口腔健康在一个重要的 老年病，如肌肉减少症。这项研究的目的是为以下方面提供科学依据： 更好地识别和管理老年人的口腔健康状况，并确定 减少肌肉减少症的干预措施。这些努力的最终目的是改善老年人的健康。

PROJECT SUMMARY Population trends in aging present public health challenges in countries such as the USA and UK. Consequently, age-related health conditions such as sarcopenia (loss of muscle mass) are becoming increasingly prevalent. Oral health problems also increase dramatically with age, particularly tooth loss, periodontal disease, dry mouth, denture-related problems and chewing difficulties. Poor oral health has been implicated as a risk factor for sarcopenia. However, the extent to which and what particular oral health markers contribute to an increased risk of sarcopenia is not well-established. Moreover, the pathways or mechanisms by which oral health might influence sarcopenia are poorly understood. Current research is mostly from studies that are cross-sectional or have limited measures of sarcopenia and oral health in older populations. Such studies are not able to establish the contribution of oral health markers to the development of sarcopenia. To address these scientific evidence gaps, we aim to utilise data from two unique well-characterised cohort studies in the UK and USA. Our overarching goal is to investigate the contribution of oral health to the development of sarcopenia, and to understand the mechanisms underlying this relationship. Our research objectives are to: 1) determine the extent to which markers of poor oral health (periodontal disease, tooth loss, dry mouth, denture problems, chewing difficulties) are associated with incidence of sarcopenia over a 6-year follow-up; 2) determine the role of dietary factors as potential mechanisms underlying the association of poor oral health with incidence of sarcopenia; and 3) determine the role of inflammation as mediators of the association of poor oral health with incidence of sarcopenia. These will be achieved through secondary data analyses of two large population-based longitudinal studies of older people in the UK and USA, which are uniquely-placed for these investigations. These studies have detailed data on oral health, dietary factors, inflammation, as well as sarcopenia over time. The British Regional Heart Study is the only such longitudinal study of older people in the UK. The study comprises participants from 24 towns across Britain, followed-up at age 71-92 years in 2012 and at 77- 98 years. The US Health, Aging and Body Composition Study offers complementary data in a population-based study of older people from Memphis and Pittsburgh followed-up from age 71-80 years. These investigations based, on novel conceptual hypotheses and cross-country comparisons in UK and US studies, will significantly advance our understanding of the role that oral health plays in an important geriatric condition such as sarcopenia. The goal of this research is to provide the scientific basis for better identification and management of oral health conditions in older people, and to identify targets for interventions to reduce sarcopenia. These efforts are ultimately aimed at better health of older people.