Incidence of attachment loss over 3 years in older adults--new and progressing lesions.

Abstract

Abstract Researchers attempting to identify and quantify risk factors have not paid adequate attention to whether or not they actually are identifying risk factors (exposures related to the onset of disease) and prognostic factors (characteristics related to the progression of established disease). The purpose of this paper is to present the incidence of attachment loss in people who have attachment loss in sites previously without disease and people who experience further progression of sites with disease, and to compare and contrast the characteristics of people with the two types of attachment loss. The subjects used for this study are a random sample of community‐dwelling older adults residing in five contiguous North Carolina counties who were followed for 3 yr. The subjects were categorized into four groups according to the type of clinical attachment loss (change of 3 or more mm) experienced, those who only had attachment loss in previously undiseased sites, those with progression of attachment loss in previously diseased sites, those who experienced both types of attachment loss, and those who had no new sites of attachment loss. A bivariate logistic model was developed to identify the characteristics associated with “new” disease onset as compared to “progression of disease”. Just over 40% of the people had no change in their baseline attachment level, 27.5% of the people experienced only new lesions. 11.1% of the people only experienced clinical attachment loss in sites that had clinical attachment loss at baseline, and 20.1% experienced both kinds of clinical attachment loss. Low income, taking medications associated with soft tissue reactions, smokeless tobacco users and those who experience a history of oral pain were at greater risk for new lesions. People at higher risk for disease progression were low income, taking medications that may result in soft tissue reactions, cigarette smokers, BANA positive, P. gingivalis positive, and had worsening financial problems. The model indicates that the characteristics are different enough that periodontitis may be like other diseases in which risk factors and prognostic factors are not the same.