Abstract
BackgroundOral health is an important component of general well-being for the elderly. Oral health-related problems include loss of teeth, nonfunctional removable dental prostheses, lesions of the oral mucosa, periodontitis, and root caries. They affect food selection, speaking ability, mastication, social relations, and quality of life. Frailty is a geriatric syndrome that confers vulnerability to negative health-related outcomes. The association between oral health and frailty has not been explored thoroughly. This study sought to identify associations between the presence of some oral health conditions, and frailty status among Mexican community-dwelling elderly.MethodsAnalysis of baseline data of the Mexican Study of Nutritional and Psychosocial Markers of Frailty, a cohort study carried out in a representative sample of people aged 70 and older residing in one district of Mexico City. Frailty was defined as the presence of three or more of the following five components: weight loss, exhaustion, slowness, weakness, and low physical activity. Oral health variables included self-perception of oral health compared with others of the same age; utilization of dental services during the last year, number of teeth, dental condition (edentate, partially edentate, or completely dentate), utilization and functionality of removable partial or complete dentures, severe periodontitis, self-reported chewing problems and xerostomia. Covariates included were gender, age, years of education, cognitive performance, smoking status, recent falls, hospitalization, number of drugs, and comorbidity. The association between frailty and dental variables was determined performing a multivariate logistic regression analysis. Final models were adjusted by socio-demographic and health factorsResultsOf the 838 participants examined, 699 had the information needed to establish the criteria for diagnosis of frailty. Those who had a higher probability of being frail included women (OR = 1.9), those who reported myocardial infarction (OR = 3.8), urinary incontinence (OR = 2.7), those who rated their oral health worse than others (OR = 3.2), and those who did not use dental services (OR = 2.1). For each additional year of age and each additional drug consumed, the probability of being frail increased 10% and 30%, respectively.ConclusionsUtilization of dental services and self-perception of oral health were associated with a higher probability of being frail.
Highlights
Oral health is an important component of general well-being for the elderly
The study sample is a subset of the participants of the Mexican Study of Nutritional and Psychosocial Markers of Frailty, a prospective cohort study aiming to evaluate the nutritional and psychosocial determinants of frailty among Mexican communitydwelling elderly, conducted by the Department of Geriatrics of the National Institute of Medical Sciences and Nutrition “Salvador Zubirán” (INCMNSZ) of Mexico in collaboration with the National Institute of Public Health (INSP), the Department of Dental Public Health, the Graduate Studies and Research Division of the Dental School at the National Autonomous University of Mexico (UNAM), the Department of Health of the Government of the Federal District of Mexico, and the National Institute of Geriatrics of the Mexican Ministry of Health
We observed, using a representative sample of people ≥70 years old who resided in one district of Mexico City, that the perception of having worse oral health than others of the same age and the failure to utilize dental services were associated with an increased probability of being frail
Summary
Oral health is an important component of general well-being for the elderly. Oral health-related problems include loss of teeth, nonfunctional removable dental prostheses, lesions of the oral mucosa, periodontitis, and root caries. The aging people experience a wide variety of oral health problems, such as loss of teeth, edentulism, periodontitis, coronal and root caries, oral mucosal lesions, utilization of nonfunctional dental prostheses (either partial or complete), xerostomia, and chewing problems, among others [4,5,6,7,8]. These problems begin earlier in life and can promote a decline in general health because reduced nutrient intake, pain, and low quality of life [4,9,10,11,12,13,14,15,16]. Frailty results from excessive demands imposed on a system with a diminished capacity [30,31]; its prevalence ranges from 3–30% in people ≥65 years old [26,30,32,33]
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