Social Support, Depression, and Oral Health in Later Life

描述(由申请人提供)：口腔健康是美国老年人健康和幸福的重要组成部分，但往往被忽视。与年轻人相比，老年人口腔疾病的发病率和流行率都有所增加。一些研究表明，社会、心理和行为因素与口腔健康有关；然而，这些证据主要是基于横截面和非代表性样本，对关键协变量的复杂影响几乎没有控制。此外，人们对口腔健康与社会、心理和行为因素之间的相互关系知之甚少。为了响应RFA-DE-08-009，我们建议开发口腔健康的动态模型，以全面检查口腔健康的心理社会和健康行为决定因素。本研究有以下具体目的：1)描述老年人口腔健康的发展轨迹；2)检验口腔健康变化和社会支持之间的相互联系；3)评估口腔健康变化和抑郁症状之间的相互联系；4)评估不同社会经济阶层老年人口腔健康、抑郁症状和社会支持之间的关系的差异。这项拟议的研究在几个方面具有创新性：采用最先进的方法对口腔健康进行纵向和多层次的分析；检查社会支持、抑郁和口腔健康之间的相互联系；使用多个成熟的纵向数据集，包括具有国家和地区代表性的样本，以比较和确认各种数据集之间的相互联系，并确定口腔健康的预测因素；以及使用Medicare索赔数据来获得诊断的医疗条件和保健使用。我们的目标是从社会和行为的角度更好地理解口腔健康的决定因素。反过来，我们的研究可能会提出有效和创新的做法来防止口腔健康恶化的策略。由于将使用二手数据，拟议的研究是实现我们目标的一种非常具有成本效益的方式。项目简介：美国老年人的数量和比例不断增长，这使得老年口腔健康成为本研究将解决的日益重要的公共卫生问题。这项研究将有助于制定有效的预防和干预策略。

DESCRIPTION (provided by applicant): Oral health is a critical but often overlooked component of health and well-being in older Americans. Compared to younger individuals, elderly people have an increased incidence and prevalence of oral disease. Some research suggests that social, psychological, and behavioral factors are associated with oral health; however, this evidence is largely based on cross-sectional and non-representative samples with little control of the complex effects of key covariates. In addition, little is known about the inter-relationship between oral health and social, psychological and behavioral factors. In response to RFA-DE-08-009, we propose to develop dynamic models of oral health to comprehensively examine psychosocial and health behavioral determinants of oral health. This study has the following Specific Aims: 1) depict the trajectories of oral health among older individuals; 2) examine the reciprocal linkages between the changes in oral health and those in social support; 3) assess the reciprocal linkages between the changes in oral health and depressive symptoms; and 4) evaluate variations in the associations among oral health, depressive symptoms, and social support in older individuals across socioeconomic strata. This proposed research is innovative in several respects: state-of-the-art approach to undertake longitudinal and multi-level analysis of oral health; examination of the reciprocal linkage among social support, depression and oral health; use of multiple well-established longitudinal datasets, including nationally and regionally representative samples, to compare and confirm the reciprocal linkages across various datasets and to identify predictors of oral health; and use of Medicare claims data to obtain diagnosed medical conditions and health care use. We aim to better understand determinants of oral health from social and behavioral perspectives. And, in turn, our study may suggest strategies for effective and innovative practices to prevent oral health deterioration. As secondary data will be used, the proposed study is a very cost-effective way to accomplish our objectives. Project Narrative: The growing number and proportion of the older adults in the U.S. makes geriatric oral health an increasingly important public health issue that this study will address. This study will lead to the development of effective prevention and intervention strategies.