scholarly journals Social Isolation and Accelerated Tooth Loss Among Chinese Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 31-31
Author(s):  
Xiang Qi ◽  
Yaolin Pei ◽  
Katherine Wang ◽  
Shuyu Han ◽  
Bei Wu

Abstract Social isolation and loneliness in older adults are major global public health concerns. Tooth loss is also a common problem in this population. This study examined the effects of social isolation and loneliness on the number of remaining teeth and the rate of tooth loss among Chinese older adults. We included 4,268 older adults age 65+ from three waves of the Chinese Longitudinal Healthy Longevity Survey (2011/2012, 2014, 2018). Linear mixed-effect models showed higher levels of social isolation were associated with fewer remaining teeth (β = -1.59, P < 0.05) and accelerated tooth loss (β=-0.10, P<0.05) controlled for socio-demographic, lifestyle, oral hygiene behavior, and health status. Loneliness was neither associated with the number of remaining teeth (β=0.64, P>0.05) nor with the rate of tooth loss (β=-0.09, P>0.05) before and after controlling for covariates. These findings expand our knowledge regarding the correlation between social connection and tooth loss in non-Western populations.

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 31-31
Author(s):  
Weiyu Mao ◽  
Yaolin Pei ◽  
Huabin Luo

Abstract Oral health is a global public health concern. The four papers in this symposium capture various understudied risk and protective factors in oral health and dental care among older adults in China. The first paper examined the relationship between social isolation, loneliness, and tooth loss among Chinese older adults, using the Chinese Longitudinal Healthy Longevity Survey. The findings suggest that higher levels of social isolation, rather than loneliness, were associated with fewer remaining teeth and accelerated tooth loss over time. The second paper investigated urban-rural disparities in dental care utilization among Chinese adults aged 18 to 65 years old, using the 2019 New Era and Living Conditions in Megacities Survey. The findings demonstrate urban residents were more likely to visit dentists than rural residents. Besides socioeconomic status, health attitudes/behaviors, and oral health needs, health insurance coverage was considered an important enabling factor to promote dental care use in this population. The third paper examined the relationship between denture use and cognitive decline among Chinese older adults, using data from the Chinese Longitudinal Healthy Longevity Survey. The findings indicate that denture use is protective against cognitive decline over time in later life. The fourth paper examined the prevalence of self-reported orofacial pain symptoms and their correlates at the last year of life among Chinese older adults. Low socioeconomic status, smoking, chronic conditions, oral hygiene practice, and natural teeth condition were associated with such symptoms. This symposium offers valuable insights to improve oral health and dental care in older adults in China.


Author(s):  
Hai-Lian Yang ◽  
Fu-Rong Li ◽  
Pei-Liang Chen ◽  
Xin Cheng ◽  
Chen Mao ◽  
...  

Abstract Background Evidence regarding the associations of tooth loss and denture use with incident cognitive impairment is inconclusive in older adults, and few prospective studies have examined the potential interaction between tooth loss and denture use in these specific populations. Methods Data were assessed from 17 079 cognitively normal older adults aged ≥65 years, participating in the Chinese Longitudinal Healthy Longevity Survey. The outcome of interest was cognitive impairment (assessed by the Chinese version of Mini-Mental State Examination). The number of natural teeth and status of denture use were collected by a structural questionnaire. Results A total of 6456 cases of cognitive impairment were recorded during 88 627 person-years of follow-up. We found that compared with participants with 20+ teeth, those with 10–19, 1–9, and 0 teeth had increased risks of incident cognitive impairment (p-trend < .001). Participants without dentures also had a higher risk of incident cognitive impairment, compared with those who wore dentures. Effect modification by denture use was observed (p-interaction = .010). Specifically, among those without dentures, the adjusted hazard ratio (95% confidence interval) for participants with 10–19, 1–9, and 0 teeth were 1.19 (1.08, 1.30), 1.28 (1.17, 1.39), and 1.28 (1.16, 1.41), respectively, as compared to those with 20+ teeth. In contrary, among denture users, detrimental effect was only observed among those with 0 teeth (hazard ratio 1.14, 95% confidence interval: 1.16, 1.41). Conclusions In Chinese older adults, maintaining 20+ teeth is important for cognitive health; denture use would attenuate the detrimental effects of tooth loss, especially for partial tooth loss, on cognitive impairment.


2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.


Author(s):  
M. Anum Syed ◽  
Lynn McDonald ◽  
Corinne Smirle ◽  
Karen Lau ◽  
Raza M. Mirza ◽  
...  

RÉSUMÉLes adultes chinois plus âgés peuvent être exposés à un risque accru d’isolement social et de solitude; pourtant, une telle compréhension des défis auxquels ils peuvent faire face pour la participation sociale dans leurs quartiers et communautés est fragmentée. Un examen de la portée a été entrepris pour décrire les connaissances actuelles sur l’isolement social et la solitude chez les aînés chinois vivant en milieu urbain dans les sociétés occidentales afin d’éclairer les recherches, les pratiques et les politiques futures au Canada. Dix-neuf articles répondent aux critères d’inclusion. Le système des communautés conçues pour les adultes vieillisantes de l’Organisation mondiale de la Santé a contextualisé les résultats de l’étude. Les études ont identifié des questions liées (1) à la participation sociale; (2) au soutien communautaire et aux services de santé; (3) au logement; (4) à la communauté et à l’information; (5) au respect et à l’inclusion sociale; (6) aux espaces extérieurs et aux édifices publics; (7) à la participation civique et à l’emploi; et (8) au transport. L’isolement social et la solitude sont des préoccupations croissantes au sein de cette population au Canada, et des recherches supplémentaires sont nécessaires pour en déterminer la portée et les interventions efficaces.


2020 ◽  
Vol 99 (9) ◽  
pp. 1047-1053 ◽  
Author(s):  
J.T. Marchesan ◽  
K.M. Byrd ◽  
K. Moss ◽  
J.S. Preisser ◽  
T. Morelli ◽  
...  

The effect of preventive oral habits is largely unexplored in older individuals. The purpose of this study was to evaluate the associations between home use of flossing and prevalence of periodontal disease and caries in older adults. Five-year incident tooth loss was also evaluated. Data on 686 individuals ≥65 y-old from the Piedmont 65+ Dental Study were examined including: 1) interproximal clinical attachment level (iCAL), 2) interproximal probing depth (iPD), 3) numbers of caries, and 4) missing teeth. Flossing behavior was evaluated according to the Periodontal Profile Class (PPC) system. Five-year follow-up data ( n = 375) was evaluated for incident tooth loss. Dichotomous and categorical variables were analyzed using Pearson chi-square tests as well as covariate-adjusted Cochran-Mantel-Haenszel tests. Multiple linear regression compared clinical parameters based on flossing behavior. Elderly flossers had lower (mean, SE) %iCAL≥3 mm (38.2, 2.38 vs. 48.8, 1.56) and %iPD≥4 mm (8.70, 1.41 vs. 14.4, 0.93) compared to nonflossers ( P ≤ 0.005). Flossers showed less coronal caries compared to nonflossers ( P = 0.02). Baseline number of missing teeth (mean, SE) was 11.5 (0.35) in nonflossers compared to 8.6 (0.53) in flossers ( P < 0.0001). Regular dental visitors had lower oral disease levels compared to episodic dental users. The majority of flossers classified into PPC-Stage I (health) whereas nonflossers classified as PPC-Stages V, VI, and VII (disease). At the 5-y follow-up visit, the average tooth loss for flossers was ~1 tooth compared to ~4 teeth lost for nonflossers ( P < 0.0001). Among all teeth, molars showed the highest benefit (>40%) for flossing behavior ( P = 0.0005). In conclusion, the extent of oral disease for older individuals was significantly less in flossers than in nonflossers. Flossers showed less periodontal disease, fewer dental caries, and loss of fewer teeth over a 5-y period. These findings further support flossing as an important oral hygiene behavior to prevent oral disease progression in older adults.


Neurology ◽  
2017 ◽  
Vol 89 (13) ◽  
pp. 1391-1399 ◽  
Author(s):  
Zuzana Nedelska ◽  
Scott A. Przybelski ◽  
Timothy G. Lesnick ◽  
Christopher G. Schwarz ◽  
Val J. Lowe ◽  
...  

Objective:To assess whether noninvasive proton magnetic resonance spectroscopy (1H-MRS) tissue metabolite measurements at baseline can predict an increase in the rate of β-amyloid (Aβ) accumulation on serial PET in clinically normal (CN) older adults.Methods:Consecutive participants aged 60 years and older (n = 594) from the Mayo Clinic Study of Aging who were CN at baseline and who underwent 1H-MRS from the posterior cingulate voxel and longitudinal 11C-Pittsburgh compound B (PiB)–PET were included. The rate of Aβ accumulation by serial cortical PiB standardized uptake value ratios was estimated as a function of baseline 1H-MRS metabolite ratios and time using mixed-effect models adjusted for age, sex, and APOE ε4. Effect of APOE ε4 on the relationship between baseline MRS and an increased rate of Aβ accumulation was also assessed.Results:Among all participants, a higher myo-inositol (mI)/creatine (p = 0.011) and a lower N-acetylaspartate/mI (p = 0.006) at baseline were associated with an increased Aβ accumulation over time after adjusting for age, sex, and APOE ε4. APOE ε4 did not modify the association of baseline 1H-MRS metabolite ratios and rate of Aβ accumulation. However, APOE ε4 carriers accumulated Aβ faster than noncarriers regardless of the baseline Aβ load (p = 0.001).Conclusion:Among CN older adults, early metabolic alterations on 1H-MRS and APOE ε4 status are independently associated with an increased rate of Aβ accumulation. Our findings could have important implications for early diagnosis and identification of individuals for secondary prevention trials, because an increased rate of Aβ accumulation in CN older adults may confer a higher risk for cognitive decline and mild cognitive impairment.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 32-32
Author(s):  
Yaolin Pei ◽  
Xiang Qi ◽  
Xi Chen ◽  
Bei Wu

Abstract The aims of this study were to examine the prevalence of orofacial pain symptoms and its associated factors in Chinese older adults in the last year of life. We retrospectively followed 1,646 participants (60 years or older) in the last year of life to death from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The 6-month prevalence of toothache and jaw joint pain or facial pain for older adults in the last year of life to death were 14.1% and 4.5%, respectively. Older adults who had lower socioeconomic status, were smokers, and had any chronic disease tended to have orofacial pain symptoms. This study generated interesting but counterintutive findings that Chinese older adults who brusehed their teeth at least daily and those who had at least one natural teeth were more likely to have orofacial pain. It is important to include dental care as a part of end-of-life medical treatment.


2021 ◽  
Vol 8 ◽  
Author(s):  
Xurui Jin ◽  
Shangzhi Xiong ◽  
Changzheng Yuan ◽  
Enying Gong ◽  
Xian Zhang ◽  
...  

Introduction: The interactions between apolipoprotein E (APOE) genotype and diet pattern changes were found significant in several trials, implying that APOE gene may modify the effect of animal protein-rich food on health outcomes. We aim to study the interaction of APOE genotype with the effect of meat, fish and egg intake on mortality.Methods: This population-based study enrolled 8,506 older adults (mean age: 81.7 years, 52.3% female) from the Chinese Longitudinal Healthy Longevity Study. The intake frequency of meat, fish and egg was assessed by 3-point questions at baseline. Cox regression was conducted to calculate the hazard ratios for all-cause mortality of intake levels of meat, fish and egg. The analyses were stratified by APOE genotype and sex. The analyses were performed in 2020.Results: In the multivariable-adjusted models, meat and fish intake was associated with all-cause mortality (high vs. low intake: meat: HR: 1.14, 95% CI: 1.01, 1.28; fish: HR: 0.83, 95% CI: 0.73, 0.95). APOE genotype have significant interactions with meat and fish intake (Ps &lt; 0.05). Compared with low fish intake, high fish intake was associated with lower risk of mortality (HR: 0.74, 95% CI: 0.56–0.98) only among the APOE ε4 carriers. High meat intake was significantly associated with higher risks of mortality (HR: 1.13, 95% CI: 1.04–1.25) only among the APOE ε4 non-carriers. The interactive relationship was restricted among the male. No significant findings were observed between egg and mortality among carriers or non-carriers.Conclusions: Among Chinese older adults, the significance of associations of mortality with reported meat or fish intake depended on APOE-E4 carriage status. If validated by other studies, our findings provide evidence for gene-based “precision” lifestyle recommendations.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 173-174
Author(s):  
Fereshteh Mehrabi ◽  
François Béland

Abstract Social isolation and frailty are global public health issues that may lead to poor health outcomes. We tested the two following hypotheses: 1) changes in social isolation and frailty are associated with adverse health outcomes over two years, 2) the associations between social isolation and health vary across different levels of frailty. We estimated a series of latent growth models to test our hypotheses using data from the FRéLE longitudinal study among 1643 Canadian community-dwelling older adults aged 65 years and over. Missing data were handled by pattern mixture models with the assumption of missing not at random. We measured social isolation through social participation, social networks, and social support from different social ties. We assessed frailty using Fried’s criteria. Our results revealed that higher frailty at baseline was associated with a higher rate of comorbidity, depression, and cognitive decline over two years. Less social participation at baseline was associated with comorbidity, depression, and changes in cognitive decline. Less social support from friends, children, partner, and family at baseline was associated with comorbidity, cognitive decline, and changes in depression. Fewer contacts with grandchildren were related to cognitive decline over time. The associations of receiving less support from partner with depression and participating less in social activities with comorbidity, depression, and cognitive decline were higher among frail or prefrail than robust older adults over time. This longitudinal study suggests that intimate connectedness and social participation may ameliorate health status in frail older populations, highlighting the importance of age-friendly city policies.


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