Association between oral health markers and decline in muscle strength and physical performance in later life: longitudinal analyses of two prospective cohorts from the UK and the USA

Kimble, Rachel; McLellan, Gillian; Lennon, Lucy; Papacosta, AO; Weyant, Robert J.; Kapila, Yvonne L.; Mathers, John C.; Wannamathee, S Goya; Whincup, Peter H; Ramsay, Sheena E

doi:10.1016/s2666-7568(22)00222-7

Cited by 21 publications

(11 citation statements)

References 57 publications

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“…More specifically, compared with those with 20 teeth or more, the HRs (95% CIs) of fall-related fractures in individuals with 1–9 teeth and edentulous individuals were 2.67 (1.24 to 5.75) and 2.31 (1.01 to 5.28), respectively 9. Our study findings support the prior explanation that poor oral function is associated with increased malnutrition due to difficulty in eating31 and a decline in muscle strength and physical function, resulting in an increased risk of falls in both cross-sectional and prospective cohort studies 32 33…”

Section: Discussionsupporting

confidence: 83%

Temporal trends and the association between self-rated oral health and falls in community-dwelling older adults in South Korea: a secondary analysis of survey data

Seo,

Ahn,

Choi

2024

BMJ Open

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ObjectiveThis study aims to examine temporal trends and the association between falls and self-rated oral health (SROH) status in community-dwelling older Korean adults.DesignSecondary analysis of a serial cross-sectional study.MethodsWe analysed biennial data from 314 846 older adults in South Korea from 2011 to 2019 using data from the Korea Community Health Survey. Self-reported fall experience data came from the injury questionnaire question, ‘Have you fallen in the past year (slipping, tripping, stumbling and falling)?’. For SROH, the participants were asked, ‘How do you feel about your oral health, such as teeth and gums, in your own opinion?’. The association between SROH and falls was examined using a weighted multivariable logistic regression model adjusted for sociodemographic characteristics, health status and behaviours, and psychological factors.ResultsThose who reported poor SROH had a lower declining slope than the other groups, although all groups showed a significantly decreasing trend in both men and women from 2011 to 2019 (p for trend<0.001). Older adults who reported having poor SROH had a more significant history of fall accidents than the good SROH groups, controlling for potential confounding variables (adjusted OR 1.16 (95% CI 1.10 to 1.21) in men; adjusted OR 1.17 (95% CI 1.13 to 1.21) in women).ConclusionsOlder adults with poor SROH, especially women, had more fall accidents, making them a priority target for fall prevention strategies. This study suggests considering SROH status when identifying fall risk factors in community-dwelling older adults.

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Section: Discussionsupporting

confidence: 83%

Temporal trends and the association between self-rated oral health and falls in community-dwelling older adults in South Korea: a secondary analysis of survey data

Seo,

Ahn,

Choi

2024

BMJ Open

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“…In addition, based on a survey of community‐dwelling adults aged 65 years or older in China, we reported that poor dentition status (fewer than 20 remaining natural teeth) is associated with lower dietary diversity and worse nutritional status (Shen et al, 2023). Our previous work has been extended to Stage IV periodontitis subjects with functional impairment, supporting the hypothesis that loss of masticatory function impacts diet, nutrition and perhaps healthy ageing (Geissler & Bates, 1984; Kimble et al, 2022; Sheiham et al, 1999; Sheiham & Steele, 2001). In the present study, while causal path analysis could not establish causality, we presented data supporting the potential significance that loss of masticatory function consequent to periodontitis affects food choices and potentially nutrition and perhaps the ageing process.…”

Section: Discussionsupporting

confidence: 77%

The potential causal path between periodontitis stage diagnosis and vegetable consumption is mediated by loss of posterior functional tooth units and masticatory function

Wu,

Shen,

Zhang

et al. 2024

J Clinic Periodontology

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AimEmerging evidence points to a two‐way relationship between periodontitis and dietary choices and, thus, nutrition. This study aimed to assess the potential cause–effect relationship between the periodontitis stage, loss of functional tooth units (FTUs), masticatory function, and intake of different food groups using path analysis.Materials and MethodsA single calibrated examiner determined the periodontitis stage of a consecutive sample of 241 Chinese subjects reporting for tooth replacement. Their masticatory function was quantified by the mixing ability of a two‐colour chewing gum. Validated food frequency questionnaires were used to calculate the intake of 33 food group items by an experienced calibrated rater. After verification of assumptions, visual structural equation modeling was performed with Amos 23. The consistency of results and the potential modifying effect of age were assessed in 9043 subjects from the NHANES database.ResultsHighly significant models were constructed using periodontitis stage and age as exogenous factors. Periodontitis stage diagnosis significantly affected the number of posterior FTUs and oral health‐related quality of life (OHRQoL, path coefficient [PC] = –0.55 and −0.20, p < .05, respectively). In the model, FTUs also had an independent effect on OHRQoL (PC = 0.23, p < .05). FTUs determined the level of masticatory function (PC = –0.38, p < .05), which in turn affected vegetable intake but not fruit or meat intake (PC = –0.18, p < .0.5, PC = 0.06, NS and PC = 0.11, NS, respectively). The effect of age was significant for vegetable and meat intake and was also correlated with periodontitis stage diagnosis. Analysis of the NHANES database confirmed the negative impact of periodontitis on the number of occluding pairs and vegetable consumption for the 18–44, 45–60 and >60 age groups.ConclusionsPeriodontitis showed a potential cause–effect pathway affecting vegetable intake across cultures and age groups. The size of the effect is potentially of clinical and public health significance. Additional studies, including intervention trials, are required to test this potential mechanism linking oral health to nutrition.

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“…There is also the impact on dental treatment required. Barriers to optimal care include lack of specific training for dental professionals and aged care staff [ 19 , 20 , 21 ], overcoming patient fears related to past experiences of oral care [ 22 ], family attitudes to oral care [ 23 ] and lack of understanding of the importance of oral care and cost of and access to dental services [ 24 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…They concluded that there were strong longitudinal associations between oral health and frailty with oral health being a potential predictor of frailty and with nutrition as a potential mediator [ 21 ]. Similarly, Kimble and colleagues identified an association between the decline in muscle strength and oral health using data from two cohort studies [ 22 ]. Often at a point where things deteriorate, there are multiple co-morbidities and social issues to address, yet a lack of interdisciplinary primary care means this trend is often only noted at the stage when things start to go very wrong [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Rapid Oral Health Deterioration in Older People—A Narrative Review from a Socio-Economic Perspective

Slack‐Smith

Arena

See

2023

JCM

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Poor oral health is a common morbidity in old age with older adults less likely to attend dental care and more likely to have dental disease; this situation is exacerbated by older adults retaining more teeth often with complex restorations. Evidence suggests that some older adults experience rapid oral health deterioration (ROHD). While more clinical and population level evidence is needed, current evidence suggests upstream changes addressing disadvantage through the social determinants of health (SDH) may impact broader disorders such as ROHD, often occurring as older adults become dependent. The aim of this paper is to conduct a narrative review to explore the social determinants of ROHD in older adults. The social determinants of health are important in understanding oral health including ROHD. This includes the important influence of the economic determinants. We explored the SDH as relevant to oral health and ROHD including using a framework based on that of the Fisher-Owens conceptual model (for children) but adapted for older adults. Better understanding of these relationships is likely to assist in future prevention and care.

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Association between oral health markers and decline in muscle strength and physical performance in later life: longitudinal analyses of two prospective cohorts from the UK and the USA

Cited by 21 publications

References 57 publications

Temporal trends and the association between self-rated oral health and falls in community-dwelling older adults in South Korea: a secondary analysis of survey data

Temporal trends and the association between self-rated oral health and falls in community-dwelling older adults in South Korea: a secondary analysis of survey data

The potential causal path between periodontitis stage diagnosis and vegetable consumption is mediated by loss of posterior functional tooth units and masticatory function

Rapid Oral Health Deterioration in Older People—A Narrative Review from a Socio-Economic Perspective

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