Exploring associations between oral health and frailty in community-dwelling older people

Background: In frail older people with natural teeth factors like polypharmacy, reduced salivary flow, a decrease of oral self-care, general healthcare issues, and a decrease in dental care utilization contribute to an increased risk for oral complications. On the other hand, oral morbidity may have a negative impact on frailty. Objective: This study explored associations between oral health and two frailty measures in community-dwelling older people. Design: A cross-sectional study. Setting: The study was carried out in a Primary Healthcare Center (PHC) in The Netherlands. Participants: Of the 5,816 persons registered in the PHC, 1,814 persons were eligible for participation at the start of the study. Measurements: Two frailty measures were used: 1. Being at risk for frailty, using Electronical Medical Record (EMR) data, and: 2. Survey-based frailty using ‘The Groningen Frailty Indicator’ (GFI). For oral health measures, dental-record data (dental care utilization, dental status, and oral health information) and self-reported oral problems were recorded. Univariate regression analyses were applied to determine the association between oral health and frailty, followed by age- and sex-adjusted multivariate logistic regressions. Results: In total 1,202 community-dwelling older people were included in the study, 45% were male and the mean age was 73 years (SD=8). Of all participants, 53% was at risk for frailty (638/1,202), and 19% was frail based on the GFI (222/1,202). A dental emergency visit (Odds Ratio (OR)= 2.0, 95% Confidence Interval (CI)=1.33;3.02 and OR=1.58, 95% CI=1.00;2.49), experiencing oral problems (OR=2.07, 95% CI=1.52;2.81 and OR=2.87, 95% CI= 2.07;3.99), and making dietary adaptations (OR=2.66, 95% CI=1.31;5.41 and OR=5.49, 95% CI= 3.01;10.01) were associated with being at risk for frailty and survey-based frailty respectively. Conclusions: A dental emergency visit and self-reported oral health problems are associated with frailty irrespective of the approach to its measurement. Healthcare professionals should be aware of the associations of oral health and frailty in daily practice.

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EXPLORING ASSOCIATIONS BETWEEN FRAILTY AND ORAL HEALTH IN COMMUNITY-DWELLING OLDER PEOPLE

Innovation in Aging ◽

10.1093/geroni/igz038.179 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S46-S46

Author(s):

Babette Everaars ◽

Katarina Jerković - Ćosić ◽

Nienke Bleijenberg ◽

Niek J de Wit ◽

Geert j van der Heijden

Keyword(s):

Oral Health ◽

Older People ◽

Community Dwelling ◽

Cross Sectional ◽

Primary Care Data ◽

Record Data ◽

Community Dwelling Older People ◽

Logistic Regressions ◽

Dichotomous Outcomes ◽

Dental Emergency

Abstract This study explores associations between frailty and oral health in cross-sectional data of 1,202 community-dwelling older people. Two dichotomous outcomes were used: 1. Potential frailty, using routine primary care data; 2. Self-reported frailty, using a questionnaire. Oral health concerned dental record data and self-reported oral problems. Following exploration of univariate associations, age and sex adjusted multivariate logistic regressions were performed. For potential frailty and self-reported frailty associations were found with dental emergency visit (odds ratio (OR)= 2.0, 95% confidence Interval (CI)=1.33;3.02 respectively OR=1.58, 95% CI=1.00;2.49), experiencing oral problems (resp. OR=2.07, 95% CI=1.52;2.81 and OR=2.87, 95% CI= 2.07), making dietary adjustments (resp. OR=2.66, 95% CI= 1.31;5.41 and OR=5.49, 95% CI= 3.01;10.01). Additional associations were found for self-reported frailty with wearing dental prosthesis (OR=3.33, 95% CI=1.49;7.44) and missing periodontal information (OR=1.56, 95% CI=1.05;2.32). The cross-sectional data of this study show that in community dwelling older people oral health is associated with frailty.

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Social and Behavioral Factors, Oral Health, and Dental Care Utilization

Innovation in Aging ◽

10.1093/geroni/igaa057.2899 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 799-800

Author(s):

Bei Wu ◽

Stephen Shuman ◽

Elisa Ghezzi

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Oral Health ◽

Health Outcomes ◽

Dental Care ◽

Care Utilization ◽

Behavioral Factors ◽

Dental Care Utilization ◽

The Impact ◽

The U.S

Abstract Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the impact of early childhood disadvantages on oral health in later life among adults age 51 and above in the U.S. The second paper used large-scale epidemiological data that addressed the relationship between acculturation and subsequent oral health problems. It also tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The third paper demonstrated the importance of examining different pathways among foreign-born and native-born Chinese older adults with regard to offspring’s support on their oral health outcomes. While increasing evidence shows that cognitive function is associated with oral health, limited studies have been conducted to examine the impact of cognitive impairment, e.g., Alzheimer’s Disease (AD) and related dementias (RD), on dental care utilization and costs in older adults. The fourth paper aimed to address this knowledge gap. Results showed that AD and RD had different impacts on different types of dental care utilization and costs. The fifth paper further displayed that individuals with cognitive impairment face a significant challenge in handling dental-related medications. This symposium provides policy and clinical implications on improving oral health and dental care utilization among older adults in the U.S. Oral Health Interest Group Sponsored Symposium.

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Impact of Malnutrition on Low Muscle Mass in Community-Dwelling Older People in Singapore: Findings from the SHIELD study

Current Developments in Nutrition ◽

10.1093/cdn/nzaa040_080 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 80-80

Author(s):

Siew Ling Tey ◽

Samuel Teong Huang Chew ◽

Yatin Berde ◽

Geraldine Baggs ◽

Choon How How ◽

...

Keyword(s):

At Risk ◽

Nutritional Status ◽

Bone Mass ◽

Older People ◽

Muscle Mass ◽

Community Dwelling ◽

Risk Category ◽

Calf Circumference ◽

Factors Associated ◽

Community Dwelling Older People

Abstract Objectives Malnutrition contributes to loss of muscle mass. There is limited information on the prevalence of low muscle mass in community-dwelling older people who are (not) at risk of malnutrition. Factors associated with muscle mass are also not well characterized. This cross-sectional study aimed to determine the prevalence of low appendicular skeletal muscle mass index (ASMI; ASM/height2) in older people with normal nutritional status (Malnutrition Universal Screening Tool, MUST risk category = low) and those at risk of malnutrition (MUST risk category = medium or high), and to determine factors associated with ASMI. Methods Strengthening Health In ELDerly through nutrition (SHIELD) is a study involving 1211 (400 with normal nutritional status and 811 at risk of malnutrition) community-dwelling older people aged ≥65 years in Singapore. Low ASMI was determined by bioelectrical impedance analysis (Asian Working Group for Sarcopenia, 2014). Results One in five (20.6%) nourished participants had low ASMI vs. four in five (81.3%) participants at risk of malnutrition had low ASMI (P < 0.0001). Older people with low ASMI were more likely to be admitted to the hospital, had longer length of stay, 25-hydroxyvitamin D deficiency, and lower education level, compared to those with normal ASMI (all P ≤ 0.0472). In the multiple linear regression model, age (coefficient, b = −0.013 kg/m2; P < 0.001), gender (female: b = −0.963 kg/m2; P < 0.001), calf circumference (b = 0.042 kg/m2; P < 0.001), bone mass (b = 0.593 kg/m2; P < 0.001), BMI (b = 0.129 kg/m2; P < 0.001), and Physical Activity Scale for the Elderly (PASE) score (b = 0.001 kg/m2; P = 0.048) were associated with ASMI. Conclusions Community-dwelling older people at risk of malnutrition had four-fold greater risk of having low ASMI as compared to nourished counterparts. Increasing age was associated with lower ASMI, whereas calf circumference, bone mass, BMI, PASE score, and being male were positively associated with ASMI. These findings highlight the importance of screening for low muscle mass and maintaining muscle health as part of the overall malnutrition management in this population group. Funding Sources The Economic Development Board of Singapore, Abbott Nutrition, and Changi General Hospital funded this study.

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Cognitive Function and Dental Care Utilization Among Community-Dwelling Older Adults

American Journal of Public Health ◽

10.2105/ajph.2007.109934 ◽

2007 ◽

Vol 97 (12) ◽

pp. 2216-2221 ◽

Cited By ~ 36

Author(s):

Bei Wu ◽

Brenda L. Plassman ◽

Jersey Liang ◽

Liang Wei

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Dental Care ◽

Community Dwelling ◽

Care Utilization ◽

Dental Care Utilization ◽

Community Dwelling Older Adults

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Determinants for preventive oral health care need among community-dwelling older people: a population-based study

Special Care in Dentistry ◽

10.1111/scd.12021 ◽

2013 ◽

Vol 34 (1) ◽

pp. 19-26 ◽

Cited By ~ 9

Author(s):

Kaija Komulainen ◽

Pekka Ylöstalo ◽

Anna-Maija Syrjälä ◽

Piia Ruoppi ◽

Matti Knuuttila ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Older People ◽

Oral Health Care ◽

Population Based ◽

Community Dwelling ◽

Population Based Study ◽

Health Care Need ◽

Community Dwelling Older People

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Prevalence and Patterns of Dental Care Utilization among US-Born and Non–US Born Hispanics in the Hispanic Community Health Study/Study of Latinos

JDR Clinical & Translational Research ◽

10.1177/2380084420923338 ◽

2020 ◽

pp. 238008442092333

Author(s):

A.A. Akinkugbe ◽

S.E. Raskin ◽

E.E. Donahue ◽

M.E. Youngblood ◽

N.N. Laniado ◽

...

Keyword(s):

Oral Health ◽

Dental Care ◽

Odds Ratio ◽

Health Study ◽

Care Utilization ◽

Dental Visit ◽

Dental Care Utilization ◽

Perceived Need ◽

Hispanic Community ◽

Utilization Patterns

Objectives: Access to routine dental services is important to maintaining good oral health. The aims of this study were to describe the dental care utilization patterns of a diverse group of Hispanic/Latino men and women and assess differences in dental care utilization by perceived need for dental care and proxy measures of acculturation. Methods: Data from 13,792 participants of the Hispanic Community Health Study were analyzed with SAS 9.4. Time since last dental visit was dichotomized into <1 and ≥1 y. Acculturation measures included the language and social subscales of the Short Acculturation Scale for Hispanics, the Multiethnic Study of Atherosclerosis nativity subscore, and immigrant generation. Survey logistic regression adjusted for demographic (age and sex) and health-related variables, estimated associations among perceived need for dental care, acculturation measures, and dental care utilization. Results: About a quarter (23%) of the participants were born in the 50 US states, excluding territories, while 77% were non–US born. Overall, 74% perceived a need for dental care. Upon covariate adjustment, perceiving a need for dental care was associated with reduced odds of reporting a past-year dental visit (odds ratio, 0.32; 95% CI, 0.28 to 0.37), while there appeared to be no meaningful association between proxy measures of acculturation and past-year dental visit. Having health insurance was significantly associated with a past-year dental visit (odds ratio, 2.23; 95% CI, 1.99 to 2.49) for all groups combined and among the different Hispanic/Latino background groups. Conclusions: Acculturation affects general health and contributes to general health disparities; however, its role in dental care utilization remains questionable. Given that acculturation is a process that occurs over several years, longitudinal studies that evaluate oral health trajectories along the acculturation continuum are needed. Knowledge Transfer Statement: The results of this study are valuable for dental public health program planning and implementation for minority groups, as it describes the varying patterns of dental care utilization among US-born and non–US born Hispanics/Latinos and identifies factors that may partly explain dental care utilization patterns, such as acculturation.

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