Poor oral health and incidence of disability: results from studies of older people in the UK and USA

Abstract

Background To examine the association between oral health markers and disability 4 years later in two population-based studies of older people in the UK and USA. Methods Analyses were conducted in the British Regional Heart Study (BRHS) comprising older men (n = 2147) and the Health, Aging and Body Composition (HABC) Study comprising American older men and women (n = 3075). Data from a 4-year follow up period were used. Oral health measures included tooth loss, periodontal disease, dry mouth, and self-rated oral health. Mobility limitations and Activities of Daily Living (ADL) were markers of disability. Logistic regression was performed and analyses were adjusted for confounders (age, socioeconomic position, lifestyle factors, and chronic diseases). Results Over a 4-year follow-up, 15% of subjects in the BRHS and 19% in the HABC Study developed mobility limitations. In both studies, 12% of participants developed ADL problems. In the BRHS, tooth loss (complete and partial), periodontal disease, dry mouth and accumulation of oral health problems were associated with an increased risk of developing mobility limitations after adjustment for confounders (partial tooth loss, OR = 1.86, 95% CI 1.18-2.94, ≥3 dry mouth symptoms, OR = 1.97, 95%CI 1.25-3.09). Similar results were observed for the risk of developing ADL problems. In the HABC Study, complete tooth loss and accumulation of oral health problems were associated with greater risk of incident mobility limitations (OR = 1.77, 95%CI 1.13-2.76; OR = 1.18, 95% CI 1.02-1.37, respectively). Moreover, self-rated oral health was associated with increased risk of ADL problems, after adjustment for confounders. Conclusions Poor oral health was associated with increased risk of developing disability in community-dwelling older people. Screening tools of oral health may be helpful in identifying oral health problems, improving oral health status and promoting health and good quality of life. Key messages Poor oral health is associated with a higher risk of developing disability in later life. This highlights the importance of oral health on maintaining independence in older people.

Social participation, subjective well-being, and cognitive function as serial mediators between tooth loss and functional limitations in older Chinese adults.

“…Our findings could deepen the understanding of the role social and psychological factors played in the relationship between oral health and functional limitations and provide a reference for specific interventions to counter functional limitations. This study found that tooth loss had a significant positive association with functional limitations, consistent with Hypothesis 1 and previous studies that found significant associations between tooth loss and greater odds of mobility limitations or function impairment in older Notes: β, standardized coefficients; SE, the standard error of indirect effects estimated; LLCI, lower limit confidence interval; ULCI, upper limit confidence interval; IADL, instrumental activities of daily living; SWB, subjective well-being adults [4][5][6]19]. This related mechanism can be considered from the causes of tooth loss.…”

“…Many studies have confirmed that oral health is closely related to the risk of developing functional limitations [4]. Tooth loss, a key indicator of oral health, is no exception [5]. Studies have shown that tooth loss was linked to problems with instrumental activities of daily living (IADL), activities of daily living (ADL), and mobility [4][5][6].…”

“…Tooth loss, a key indicator of oral health, is no exception [5]. Studies have shown that tooth loss was linked to problems with instrumental activities of daily living (IADL), activities of daily living (ADL), and mobility [4][5][6]. Possible pathways underlying the associations between tooth loss and disability could include biological factors such as oral inflammation [7] and poor nutrition [8]; however, the role of psychological and social mechanisms remains unclear.…”