Abstract
Preventing deterioration of oral health in older age can be crucial for survival. We aimed to examine associations of oral health problems with all-cause, cardiovascular disease (CVD), and respiratory mortality in older people. We used cohort data from the British Regional Health Study (BRHS) (N = 2147, 71–92 years), and the Health, Aging and Body Composition (HABC) Study (USA) (N = 3075, 71–80 years). Follow-up was 9 years (BRHS) and 15 years (HABC Study). Oral health comprised tooth loss, periodontal disease, dry mouth, and self-rated oral health. Cox regression was performed for all-cause mortality, competing risks for CVD mortality, and accelerated failure time models for respiratory mortality. In the BRHS, tooth loss was associated with all-cause mortality (hazard ratio (HR) = 1.59, 95% CI 1.09, 2.31). In the HABC Study, tooth loss, dry mouth, and having ≥ 3 oral problems were associated with all-cause mortality; periodontal disease was associated with increased CVD mortality (subdistribution hazard ratio (SHR) = 1.49, 95% CI 1.01, 2.20); tooth loss, and accumulation of oral problems were associated with high respiratory mortality (tooth loss, time ratio (TR) = 0.73, 95% CI 0.54, 0.98). Findings suggest that poor oral health is associated with mortality. Results highlight the importance of improving oral health to lengthen survival in older age.
Highlights
Preventing deterioration of oral health in older age can be crucial for survival
Having 2 oral health problems was associated with a 37% shorter survival when compared to no oral health problems after adjustment for confounders. In this prospective study of older population-based cohorts in the UK and USA, oral health problems were associated with greater risk of all-cause mortality after adjusting for chronic diseases, biological, and behavioral factors in both studies
Tooth loss, dry mouth and accumulation of oral health problems were associated with all-cause mortality
Summary
Preventing deterioration of oral health in older age can be crucial for survival. We aimed to examine associations of oral health problems with all-cause, cardiovascular disease (CVD), and respiratory mortality in older people. In the HABC Study, tooth loss, dry mouth, and having ≥ 3 oral problems were associated with all-cause mortality; periodontal disease was associated with increased CVD mortality (subdistribution hazard ratio (SHR) = 1.49, 95% CI 1.01, 2.20); tooth loss, and accumulation of oral problems were associated with high respiratory mortality (tooth loss, time ratio (TR) = 0.73, 95% CI 0.54, 0.98). Tooth loss and periodontal disease have been reported to be associated with increased risks of all-cause, CVD and respiratory mortality in communitydwelling middle-aged and older p eople[6,7,8,9,10,11,12,13]. Tooth loss and periodontal disease have been the most commonly investigated oral health measures, with fewer studies examining subjective (selfreported) measures such as dry mouth, and self-rated oral health.
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