scholarly journals Research Confirms Effectiveness of Oral Health Preventive Practices

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 251-251
Author(s):  
Michael Dodds
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Oral Health ◽  
Meta Analysis ◽  
Dental Services ◽  
Recent Systematic Review ◽  
Preventive Practices ◽  
Caries Increment ◽  
Dental Offices

Abstract Lack of insurance or funds for dental services, lack of access to dental offices, fear of dentists, and avoidance of dental offices during COVID can lead to oral health problems in older adults. Brushing, flossing, and drinking fluoridated water can protect teeth when dentists are unavailable. Limiting intake frequency of carbohydrates and chewing sugarfree gum after eating add protection. A recent systematic review and meta-analysis confirmed the effectiveness of sugarfree gum in reducing caries, in children and adults who chewed sugarfree gum compared with those who did not chew. Chewing sugarfree gum significantly reduced caries increment, with a prevented fraction of 28 percent, roughly equivalent to the prevented fractions for fluoride toothpastes and supplements. A follow-up systematic review provides further evidence that chewing sugarfree gum reduces the numbers of Streptococcus mutans in the oral cavity. Finally, chewing sugarfree gum could alleviate symptoms of xerostomia and may reduce caries.

scholarly journals Effectiveness of acute geriatric unit care on functional decline and process outcomes among older adults admitted to hospital with acute medical complaints: a protocol for a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e050524
Author(s):  
Íde O’Shaughnessy ◽  
Katie Robinson ◽  
Margaret O'Connor ◽  
Mairéad Conneely ◽  
Damien Ryan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Meta Analysis ◽  
Functional Decline ◽  
Index Admission ◽  
Research Centre ◽  
Cochrane Library ◽  
Process Outcomes

IntroductionOlder adults are clinically heterogeneous and are at increased risk of adverse outcomes during hospitalisation due to the presence of multiple comorbid conditions and reduced homoeostatic reserves. Acute geriatric units (AGUs) are units designed with their own physical location and structure, which provide care to older adults during the acute phase of illness and are underpinned by an interdisciplinary comprehensive geriatric assessment model of care. This review aims to update and synthesise the totality of evidence related to the effectiveness of AGU care on clinical and process outcomes among older adults admitted to hospital with acute medical complaints.DesignUpdated systematic review and meta-analysisMethods and analysisMEDLINE, Cumulative Index of Nursing and Allied Health Literature, Controlled Trials in the Cochrane Library and Embase electronic databases will be systematically searched from 2008 to February 2021. Trials with a randomised design that deliver an AGU intervention to older adults admitted to hospital for acute medical complaints will be included. The primary outcome measure will be functional decline at discharge from hospital and at follow-up. Secondary outcomes will include length of stay, cost of index admission, incidence of unscheduled hospital readmission, living at home (the inverse of death or institutionalisation combined; used to describe someone who is in their own home at follow‐up), mortality, cognitive function and patient satisfaction with index admission. Title and abstract screening of studies for full-text extraction will be conducted independently by two authors. The Cochrane risk of bias 2 tool will be used to assess the methodological quality of the included trials. The quality of evidence for outcomes reported will be assessed using the Grading of Recommendations Assessment, Development and Evaluations framework. A pooled meta-analysis will be conducted using Review Manager, depending on the uniformity of the data.Ethics and disseminationFormal ethical approval is not required as all data collected will be secondary data and will be analysed anonymously. The authors will present the findings of the review to a patient and public involvement stakeholder panel of older adults that has been established at the Ageing Research Centre in the University of Limerick. This will enable the views and opinions of older adults to be integrated into the discussion section of the paper.PROSPERO registration numberCRD42021237633.

scholarly journals Exercise-Based Interventions to Enhance Long-Term Sustainability of Physical Activity in Older Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

2019 ◽  
Vol 16 (14) ◽  
pp. 2527 ◽  
Author(s):  
Sansano-Nadal ◽  
Giné-Garriga ◽  
Brach ◽  
Wert ◽  
Jerez-Roig ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Active Control ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Community Dwelling ◽  
Exercise Interventions ◽  
Mean Differences

Exercise is a form of physical activity (PA). PA is an important marker of health and quality of life in older adults. The purpose of this study was to conduct a systematic review of the literature to assess the effect of exercise-based interventions on an at least six-month follow up PA measure, and to describe the specific strategies implemented during the intervention to strengthen the sustainability of PA in community-dwelling 65+ year-old adults. We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42017070892) of randomized clinical trials (RCT). We searched three electronic databases during January 2018 to identify RCT assessing any type of exercise-based intervention. Studies had to report a pre-, post-, and at least 6-month post-intervention follow-up. To be included, at least one PA outcome had to be assessed. The effect of exercise-based interventions was assessed compared to active (e.g., a low-intensity type of exercise, such as stretching or toning activities) and non-active (e.g., usual care) control interventions at several time points. Secondary analyses were conducted, restricted to studies that reported specific strategies to enhance the sustainability of PA. The intervention effect was measured on self-reported and objective measures of time spent in PA, by means of standardized mean differences. Standardized mean differences of PA level were pooled. Pooled estimates of effect were computed with the DerSimonian–Laird method, applying a random effects model. The risk of bias was also assessed. We included 12 studies, comparing 18 exercise intervention groups to four active and nine non-active control groups. Nine studies reported specific strategies to enhance the long-term sustainability of PA. The strategies were mostly related to the self-efficacy, self-control, and behavior capability principles based on the social cognitive theory. Exercise interventions compared to active control showed inconclusive and heterogeneous results. When compared to non-active control, exercise interventions improved PA time at the six-months follow up (standardized mean difference (SMD) 0.30; 95%CI 0.15 to 0.44; four studies; 724 participants; I2 0%), but not at the one- or two-years follow-ups. No data were available on the mid- and long-term effect of adding strategies to enhance the sustainability of PA. Exercise interventions have small clinical benefits on PA levels in community-dwelling older adults, with a decline in the observed improvement after six months of the intervention cessation.

scholarly journals Are digital technology interventions effective to reduce loneliness in older adults? A systematic review and meta-analysis

2020 ◽  
Author(s):  
Syed Ghulam Sarwar Shah ◽  
David Nogueras ◽  
Hugo Cornelis van Woerden ◽  
Vasiliki Kiparoglou
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Clinical Trials ◽  
English Language ◽  
Data Extraction ◽  
Meta Analysis ◽  
Future Research ◽  
Before And After ◽  
Quasi Experimental

Objective: To review the latest literature on the effectiveness of DTIs in reducing loneliness in (older) adults. Data Sources: Electronic searches in PubMed, Medline, CINAHL, EMBASE and Web of Science covering publication period from 1 January 2010 to 31 July 2019. Subjects: Adult men and women Design: Systematic review and meta-analysis Main Outcome Measure: Loneliness. Study Selection: Primary studies that used DTIs for tackling loneliness in adults (aged ≥18 years) with follow-up measurements at least three months or more and publication in the English language. Data Extraction and Synthesis: Two researchers independently screened articles and extracted data on several variables: participants, interventions, comparators and outcomes. Data was extracted on the primary outcome i.e. loneliness measured at the baseline and follow-up measurements at three, four, six and twelve months after the intervention. Results: Six studies were selected from 4939 articles screened. Selected studies included 5 clinical trials (4 RCTs and 1 quasi experimental study) and one before and after study, which enrolled 646 participants (men =154 (24%), women =427 (66%), no gender information =65 (10%) with average age between 73 and 78 years (SD 6-11). Five clinical trials were included in the meta-analysis and standardised mean differences (SMD) were calculated for each trial and pooled across studies using a random effects model. The overall effect estimates were not statistically significant in follow-up measurements at three months (SMD= 0.02, 95% CI= -0.36, 0.40; P=0.92), four months (SMDs= -1.11, 95% CI= -2.60, 0.38; P=0.14) and six months (SMD= -0.11, 95% CI= -0.54, 0.32; P=0.61). The quality of evidence was very low to moderate in these trials. Conclusions: There is insufficient evidence to make conclusions that DTIs are effective in reducing loneliness in older adults. Future research may consider RCTs with larger sample sizes and longer duration of interventions and follow-up.

Dietary Inflammatory Index and the Risk of Frailty Among Older Adults: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 016402752094817
Author(s):  
Sajjad Moradi ◽  
Amir Hadi ◽  
Hamed Mohammadi ◽  
Omid Asbaghi ◽  
Mehdi Zobeiri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Ratio Analysis ◽  
Dietary Inflammatory Index ◽  
Inflammatory Index ◽  
Prospective Cohort Studies ◽  
Low Bmi

A systematic review and meta-analysis was conducted to comprehensively examine the association between Dietary Inflammatory Index (DII®) score and risk of frailty. Frailty risk were available from five studies comprising 13,908 older adults. Furthermore, frailty related parameters were extacted from two studies with 7,539 individuals. A pooled adjusted odds ratio analysis indicated that there was an association between DII® score and frailty risk (OR = 1.24, 95%CI: 1.6–1.33, P < 0.001, I2 = 0.0%). The results of frailty related parameters demonstrated that DII® score was associated with weakness risk (OR = 1.12, 95%CI: 1.05–1.19, P = 0.014, I2 = 0.0%), but not other frailty-related parameters including exhaustion, low BMI or low physical activity. The results of this meta-analysis suggest that older adults who exhibit higher DII® scores have an increased frailty risk. Further prospective cohort studies with longer follow-up periods, are needed to support this possible association between DII® score and frailty risk.

scholarly journals The association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults: systematic review and meta-analysis

2019 ◽  
Vol 215 (2) ◽  
pp. 449-455 ◽  
Author(s):  
Jingkai Wei ◽  
Ruixue Hou ◽  
Xiaotao Zhang ◽  
Huiwen Xu ◽  
Liyang Xie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Cardiovascular Mortality ◽  
Meta Analysis ◽  
Late Life ◽  
Community Dwelling ◽  
Late Life Depression ◽  
Prospective Cohort Studies ◽  
Community Dwelling Older Adults

BackgroundLate-life depression has become an important public health problem. Available evidence suggests that late-life depression is associated with all-cause and cardiovascular mortality among older adults living in the community, although the associations have not been comprehensively reviewed and quantified.AimTo estimate the pooled association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults.MethodWe conducted a systematic review and meta-analysis of prospective cohort studies that examine the associations of late-life depression with all-cause and cardiovascular mortality in community settings.ResultsA total of 61 prospective cohort studies from 53 cohorts with 198 589 participants were included in the systematic review and meta-analysis. A total of 49 cohorts reported all-cause mortality and 15 cohorts reported cardiovascular mortality. Late-life depression was associated with increased risk of all-cause (risk ratio 1.34; 95% CI 1.27, 1.42) and cardiovascular mortality (risk ratio 1.31; 95% CI 1.20, 1.43). There was heterogeneity in results across studies and the magnitude of associations differed by age, gender, study location, follow-up duration and methods used to assess depression. The associations existed in different subgroups by age, gender, regions of studies, follow-up periods and assessment methods of late-life depression.ConclusionLate-life depression is associated with higher risk of both all-cause and cardiovascular mortality among community-dwelling elderly people. Future studies need to test the effectiveness of preventing depression among older adults as a way of reducing mortality in this population. Optimal treatment of late-life depression and its impact on mortality require further investigation.Declaration of interestNone.

scholarly journals The Effect of Silver Diamine Fluoride in Preventing Caries in the Primary Dentition: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 53 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Branca Heloisa Oliveira ◽  
Anjana Rajendra ◽  
Analia Veitz-Keenan ◽  
Richard Niederman
Keyword(s):  
Systematic Review ◽  
Primary Teeth ◽  
Data Extraction ◽  
Meta Analysis ◽  
Glass Ionomer Cement ◽  
Silver Diamine Fluoride ◽  
Caries Increment ◽  
The Difference ◽  
Caries Lesions

Objectives: To investigate whether silver diamine fluoride (SDF) is effective in preventing new caries lesions in primary teeth when compared to placebo or active treatments. Methods: Systematic review (CRD42016036963) of controlled clinical trials. Searches were performed in 9 electronic databases, 5 registers of ongoing trials, and reference lists of identified review articles. Two researchers carried out data extraction and quality appraisal independently. The primary outcome was the difference in caries increment (decayed, missing, and filled surfaces or teeth – dmfs or dmft) between SDF and control groups. These differences were pooled as weighted mean differences (WMD) and prevented fractions (PF). Results: Searches yielded 2,366 unique records; 6 reports of 4 trials that randomized 1,118 and analyzed 915 participants were included. Two trials compared SDF to no treatment, 1 compared SDF to placebo and sodium fluoride varnish (FV), and 1 compared SDF to high-viscosity glass ionomer cement (GIC). All studies had at least 1 domain with unclear or high risk of bias. After 24 months of follow-up, in comparison to placebo, no treatment, and FV, SDF applications significantly reduced the development of new dentin caries lesions (placebo or no treatment: WMD = –1.15, PF = 77.5%; FV: WMD = –0.43, PF = 54.0%). GIC was more effective than SDF after 12 months of follow-up but the difference between them was not statistically significant (WMD, dmft: 0.34, PF: –6.09%). Conclusion: When applied to caries lesions in primary teeth, SDF compared to no treatment, placebo or FV appears to effectively prevent dental caries in the entire dentition. However, trials specifically designed to assess this outcome are needed.

Tooth Loss and Nutritional Status in Older Adults: A Systematic Review and Meta-analysis

2020 ◽  
pp. 238008442098101
Author(s):  
R. Zelig ◽  
S. Goldstein ◽  
R. Touger-Decker ◽  
E. Firestone ◽  
A. Golden ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Health Status ◽  
Oral Health ◽  
Nutritional Status ◽  
Tooth Loss ◽  
Meta Analysis ◽  
Oral Health Status ◽  
Risk Of Bias ◽  
Inclusion Criteria

Background/Objective: Older adults are at risk for tooth loss and compromised nutritional status. Our objective was to conduct a systematic review and meta-analysis to answer the following question: Among adults aged ≥60 y living in developed countries, what are the associations between tooth loss and nutritional status as assessed by a validated nutrition screening or assessment tool? Methods: PRISMA guidelines were followed. PubMed, Scopus, CINAHL, Web of Science, and MEDLINE were searched for studies published in English between 2009 and 2019 that met inclusion criteria. Data extracted included study and participant characteristics, dentition, and nutritional status. Risk of bias was assessed with a modified Newcastle-Ottawa Scale. Random effects meta-analysis was used. Results: Of the 588 unduplicated articles identified, 78 were reviewed in full text, and 7 met inclusion criteria. Six studies were combined for a meta-analysis, which revealed that individuals who were completely edentulous or who lacked functional dentition had a 21% increased likelihood of being at risk of malnutrition or being malnourished, as compared with those who were dentulous or had functionally adequate dentition (risk ratio, 1.21; 95% CI, 1.11 to 1.32; I2 = 70%). Whether the article statistically adjusted for medical history explained most of the heterogeneity in the pooled effect. Conclusions and Implications: Findings suggest that older adults with tooth loss are at greater risk of malnutrition than those with functionally adequate dentition. Use of validated tools to assess risk of malnutrition in older adults with tooth loss is important to promote early intervention and referral to optimize nutrition and oral health status. Findings were limited by heterogeneity, risk of bias, and overall quality of the studies reviewed. Cohort studies that adjust for known confounders and use consistent approaches to assess tooth loss and nutritional status are needed. Knowledge Transfer Statement: The results of this study suggest that older adults with tooth loss are at greater risk of malnutrition than those with functionally adequate dentition. Screening of this population for malnutrition by health care professionals, including dentists and dietitians, may result in corresponding referrals to optimize nutrition and oral health status. Further research is needed with consistent approaches to assess tooth loss and nutritional status.

Does non-institutionalized elders have a better oral health status compared to institutionalized ones? A systematic review and meta-analysis

2020 ◽  
Vol 25 (6) ◽  
pp. 2177-2192 ◽  
Author(s):  
Ilky Pollansky Silva e Farias ◽  
Simone Alves de Sousa ◽  
Leopoldina de Fátima Dantas de Almeida ◽  
Bianca Marques Santiago ◽  
Antonio Carlos Pereira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Status ◽  
Oral Health ◽  
Dental Caries ◽  
Meta Analysis ◽  
Oral Health Status ◽  
Cochrane Library ◽  
Caries Experience ◽  
Institutionalized Elderly ◽  
Periodontal Status

Abstract This systematic review compared the oral health status between institutionalized and non-institutionalized elders. The following electronic databases were searched: PubMed (Medline), Scopus, Web of Science, Lilacs and Cochrane Library, in a comprehensive and unrestricted manner. Electronic searches retrieved 1687 articles, which were analyzed with regards to respective eligibility criteria. After reading titles and abstracts, five studies were included and analyzed with respect their methodological quality. Oral status of institutionalized and non-institutionalized elderly was compared through meta-analysis. Included articles involved a cross-sectional design, which investigated 1936 individuals aged 60 years and over, being 999 Institutionalized and 937 non-institutionalized elders. Studies have investigated the prevalence of edentulous individuals, the dental caries experience and the periodontal status. Meta-analysis revealed that institutionalized elderly have greater prevalence of edentulous (OR = 2.28, 95%CI = 1.68-3.07) and higher number of decayed teeth (MD = 0.88, 95%CI = 0.71-1.05) and missed teeth (MD = 4.58, 95%CI = 1.89-7.27). Poor periodontal status did not differ significantly between groups. Compared to non-institutionalized, institutionalized elders have worse dental caries experience.

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