1
|
Khan S, Chen Y, Crocombe L, Ivey E, Owen AJ, McNeil JJ, Woods RL, Wolfe R, Freak-Poli R, Britt C, Gasevic D. Self-reported oral health status, edentulism and all-cause mortality risk in 12 809 Australian older adults: a prospective cohort study. Aust Dent J 2024; 69:82-92. [PMID: 37916480 DOI: 10.1111/adj.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To investigate the association between oral health status and all-cause mortality in older adults using prospective cohort study design. SETTING AND PARTICIPANTS In total, 12 809 adults aged ≥70 years (54.3% females) were participants of the ASPREE Longitudinal Study of Older Persons (ALSOP). METHODS Participants self-reported the presence of natural teeth and oral health status. The association of self-reported oral health, edentulism and the integrative measure of the two with all-cause mortality were explored using the Cox-regression models adjusted for age, gender, socio-economic status, health-related behaviours, weight status, aspirin and polypharmacy. Hazard ratios (HRs) and 95% confidence intervals (CIs) were reported. RESULTS In total, 22.2% of participants reported edentulism and 13.8% had fair/poor oral health. After adjustment for confounders, risk of all-cause mortality was higher among those with edentulism (vs. no edentulism) HR (95% CI) 1.43 (1.18, 1.73); and those with edentulism and reporting poor/fair oral health HR (95% CI) 1.69 (1.02, 2.82), or with no edentulism but reporting poor/fair oral health HR (95% CI) 1.46 (1.19-1.80) vs. no edentulism and reporting good/very good/excellent oral health. No association was observed between self-reported oral health alone and all-cause mortality. CONCLUSIONS The risk of all-cause mortality was 69% higher among older adults reporting both edentulism and poor/fair oral health compared with those with teeth and more favourable self-reported oral health. © 2023 Australian Dental Association.
Collapse
Affiliation(s)
- S Khan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, Victoria, Australia
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Y Chen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - L Crocombe
- University Department of Rural Health, La Trobe University, Bendigo, Victoria, Australia
| | - E Ivey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - A J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - J J McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - R L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - R Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - R Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - C Britt
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - D Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| |
Collapse
|
2
|
Lou J, Wang J, Fu Y, Huang D, Liu M, Zhao R, Deng J. Association between Oral Health and Depressive Symptoms in Chinese Older Adults: The Mediating Role of Dietary Diversity. Nutrients 2024; 16:1231. [PMID: 38674922 PMCID: PMC11054946 DOI: 10.3390/nu16081231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Diet is a modifiable factor in healthy population aging. Additionally, oral health and diet are important factors affecting depressive symptoms. To assess the mediating role of dietary diversity (DD) in oral health and depressive symptoms in older adults, we selected 8442 participants aged ≥ 65 years from the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS) for a cross-sectional study. Depressive symptoms were determined based on scores on the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Dietary diversity scores (DDS) were established based on the frequency of intake of food groups. Oral health was measured by denture use and toothbrushing frequency. Stepwise multiple linear regression and PROCESS macros were used for mediated effects analysis and testing. The sample had a positive detection rate of 44.1% for depressive symptoms, 40.8% for denture use, and 41.9% for once-a-day toothbrushing. Denture use (ρ = -0.077, p < 0.01) and toothbrushing frequency (ρ = -0.115, p < 0.01) were negative predictors of depressive symptoms in older adults. DD significantly mediated the association between denture use (indirect effect -0.047; 95%CI: -0.068-0.028; p < 0.001), toothbrushing frequency (indirect effect -0.041; 95%CI: -0.054-0.030; p < 0.001), and depressive symptoms. Denture use and toothbrushing frequency not only directly reduce the risk of depressive symptoms in older adults, but also indirectly affect depressive symptoms through DD.
Collapse
Affiliation(s)
- Jiaxu Lou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (J.L.); (Y.F.); (D.H.); (M.L.); (R.Z.); (J.D.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Jian Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (J.L.); (Y.F.); (D.H.); (M.L.); (R.Z.); (J.D.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Yingjie Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (J.L.); (Y.F.); (D.H.); (M.L.); (R.Z.); (J.D.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Derong Huang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (J.L.); (Y.F.); (D.H.); (M.L.); (R.Z.); (J.D.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Mei Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (J.L.); (Y.F.); (D.H.); (M.L.); (R.Z.); (J.D.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Ruonan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (J.L.); (Y.F.); (D.H.); (M.L.); (R.Z.); (J.D.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Jiahui Deng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (J.L.); (Y.F.); (D.H.); (M.L.); (R.Z.); (J.D.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| |
Collapse
|
3
|
Ye X, Hu M. Allostatic load and oral health later in life among middle-aged and older adults: An analysis of population-based panel data in China. J Oral Rehabil 2024; 51:313-320. [PMID: 37654157 DOI: 10.1111/joor.13586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/06/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Oral health is a major global public health problem, but its risk factors have not been fully identified. The limited evidence suggests that AL may affect oral health conditions, but most of these studies focus only on middle-aged western populations. OBJECTIVES To examine whether allostatic load is associated with oral health conditions later in life among middle-aged and older adults in China and there there is a correlation in both middle-aged and older people. MATERIALS AND METHODS Data were collected from the China Health and Retirement Longitudinal Study 2011-2018 (N = 10 890) and were analysed using logistic regressions for the overall sample and subsamples by age. RESULTS Results showed that higher inflammation load significantly increased the odds of edentulism (OR = 1.358, 95% CI = 1.020-1.809, p < .05). Higher metabolic load significantly increased the odds of denture use (OR = 1.375, 95% CI = 1.154-1.640, p < 0.001) and difficulty in chewing solid foods (OR = 1.100, 95% CI = 1.035-1.169, p < .01). These associations were manifested in older adults over 60 years of age, while in the middle-aged subsample, the associations were not significant. CONCLUSION The findings suggested that higher allostatic load was associated with poorer oral health conditions later in life. It is critical to lower allostatic load and improve oral health conditions, especially for older adults over 60 years of age. Prospective studies and intervention trials help to better understand whether allostatic load is causally linked to oral health.
Collapse
Affiliation(s)
- Xin Ye
- Institute for Global Public Policy, Fudan University, Shanghai, China
- LSE-Fudan Research Centre for Global Public Policy, Fudan University, Shanghai, China
| | - Mingzheng Hu
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| |
Collapse
|
4
|
Dai M, Song Q, Lin T, Huang X, Xie Y, Wang X, Zheng L, Yue J. Tooth loss, denture use, and all-cause and cause-specific mortality in older adults: a community cohort study. Front Public Health 2023; 11:1194054. [PMID: 37342280 PMCID: PMC10277727 DOI: 10.3389/fpubh.2023.1194054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/17/2023] [Indexed: 06/22/2023] Open
Abstract
Objectives The available evidence on the connections between tooth loss, denture use, and mortality from all causes or specific causes among older adults is inconclusive. Therefore, we aimed to investigate the association between tooth loss, denture use, and all-cause and cause-specific mortality in older adults. Methods A cohort of 5,403 participants aged 65 and older were recruited in the 2014 Chinese Longitudinal Healthy Longevity Survey wave and followed up in the 2018 wave. Cox proportional hazard models were used to examine the association between the number of natural teeth, denture use, and all-cause and cause-specific mortality. Results During a mean (SD) follow-up of 3.1 years (1.3), 2,126 deaths (39.3%) occurred. Individuals with 0 and 1-9 teeth had higher mortality due to all-cause, cardiovascular disease (CVD), cancer, and other causes (all p-trend <0.05) than those with 20+ teeth. At the same time, no association was found with respiratory disease mortality. Participants who used dentures had lower mortality due to all causes [hazard ratios (HR) 0.79, 95% confidence intervals (CI) 0.71-0.88], CVD (HR 0.80, 95% CI 0.64-1.00), respiratory disease (HR 0.66, 95% CI 0.48-0.92), and other causes (HR 0.77, 95% CI 0.68-0.88) than those without dentures. Joint analysis revealed that older adults with fewer natural teeth and no dentures had higher mortality. Additionally, interaction analyses showed that the effects of the number of natural teeth on all-cause mortality were more pronounced in older adults aged <80 years (p-value for interaction = 0.03). Conclusion Having fewer natural teeth, particularly less than 10 teeth, is linked to an increased risk of mortality from all causes, including CVD, cancer, and other causes, but not respiratory disease. The use of dentures would mitigate the adverse impact of tooth loss on all-cause and some cause-specific mortality.
Collapse
Affiliation(s)
- Miao Dai
- Department of Geriatrics, Jiujiang First People’s Hospital, Jiujiang, Jiangxi, China
| | - Quhong Song
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Taiping Lin
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaohong Huang
- Department of Geriatrics, Jiujiang First People’s Hospital, Jiujiang, Jiangxi, China
| | - Yufang Xie
- Department of Geriatrics, Jiujiang First People’s Hospital, Jiujiang, Jiangxi, China
| | - Xiang Wang
- Department of Cardiology, Jiujiang First People’s Hospital, Jiujiang, Jiangxi, China
| | - Liwei Zheng
- National Clinical Research Center for Oral Diseases, West China Hospital for Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
5
|
Niazi SA, Bakhsh A. Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review. Medicina (B Aires) 2022; 58:medicina58070931. [PMID: 35888650 PMCID: PMC9319780 DOI: 10.3390/medicina58070931] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 02/06/2023] Open
Abstract
The ‘Focal Infection Era in Dentistry’ in the late 19th and early 20th century resulted in widespread implementation of tooth extraction and limited the progress of endodontics. The theory proposed that bacteria and toxins entrapped in dentinal tubules could disseminate systemically to remote body parts, resulting in many types of degenerative systemic diseases. This theory was eventually refuted due to anecdotal evidence. However, lately there has been increased interest in investigating whether endodontic disease could have an impact on general health. There are reviews that have previously been carried out on this subject, but as new data have emerged since then, this review aims to appraise the available literature investigating the dynamic associations between apical periodontitis, endodontic treatment, and systemic health. The available evidence regarding focal infection theory, bacteraemia and inflammatory markers was appraised. The review also collated the available research arguing the associations of apical periodontitis with cardiovascular diseases, diabetes mellitus, adverse pregnancy outcome and autoimmune disorders, along with the effect of statins and immunomodulators on apical periodontitis prevalence and endodontic treatment prognosis. There is emerging evidence that bacteraemia and low-grade systemic inflammation associated with apical periodontitis may negatively impact systemic health, e.g., development of cardiovascular diseases, adverse pregnancy outcomes, and diabetic metabolic dyscontrol. However, there is limited information supporting the effect of diabetes mellitus or autoimmune disorders on the prevalence and prognosis post endodontic treatment. Furthermore, convincing evidence supports that successful root canal treatment has a beneficial impact on systemic health by reducing the inflammatory burden, thereby dismissing the misconceptions of focal infection theory. Although compelling evidence regarding the association between apical periodontitis and systemic health is present, further high-quality research is required to support and establish the benefits of endodontic treatment on systemic health.
Collapse
Affiliation(s)
- Sadia Ambreen Niazi
- Department of Endodontics, Centre of Oral Clinical & Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, Guy’s Dental Hospital, King’s College London, London SE1 9RT, UK
- Correspondence: ; Tel.: +44-(0)207188-7459
| | - Abdulaziz Bakhsh
- Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah 24381, Saudi Arabia;
| |
Collapse
|
6
|
Kotronia E, Brown H, Papacosta O, Lennon LT, Weyant RJ, Whincup PH, Wannamethee SG, Ramsay SE. Oral health problems and risk of incident disability in two studies of older adults in the United Kingdom and the United States. J Am Geriatr Soc 2022; 70:2080-2092. [PMID: 35437751 PMCID: PMC9283258 DOI: 10.1111/jgs.17792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 02/08/2022] [Accepted: 03/11/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Preventing oral health problems can be crucial for maintaining physical independence in older adults. We aimed to examine the associations of a range of oral health problems with incidence of disability in older adults. METHODS We used prospective 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). Oral health measures included tooth loss, periodontal disease, self-rated oral health, and self-reported dry mouth. Participants were followed for onset of disability over a follow-up period of 3 years. Onset of disability was assessed through new cases of mobility limitations, activities of daily living (ADL), and instrumental activities of daily living (IADL). Logistic regression was performed to calculate the odds of incident disability. RESULTS In the BRHS, tooth loss was associated with greater odds of mobility limitations and ADL difficulties. Periodontal disease was associated with greater incidence of mobility limitations. Self-report of ≥3 dry mouth symptoms was associated with increased odds of incident mobility limitations and ADL difficulties (OR = 2.08, 95% CI 1.27-3.42; OR = 1.73, 95% CI 1.03-2.90). Fair/poor self-rated oral health was associated with greater incidence of IADL difficulties. In the HABC study, complete tooth loss was associated with greater incidence of mobility limitations (OR = 1.86, 95% CI 1.13-3.06), and fair/poor self-rated oral health was associated with increased odds of incident ADL difficulties (OR = 1.42, 95% CI 1.04-1.94). CONCLUSIONS Oral health problems in older adults, particularly tooth loss, self-reported dry mouth and self-rated oral health were associated with greater incidence of disability. Poor oral health plays a potentially important role in the development of disability in older populations, which in turn is an essential part of quality of life and healthy aging.
Collapse
Affiliation(s)
- Eftychia Kotronia
- Population Health Sciences InstituteNewcastle UniversityNewcastle Upon TyneUK
| | - Heather Brown
- Population Health Sciences InstituteNewcastle UniversityNewcastle Upon TyneUK
| | - Olia Papacosta
- Department of Primary Care & Population HealthInstitute of Epidemiology and Health Care, University College LondonLondonUK
| | - Lucy T. Lennon
- Department of Primary Care & Population HealthInstitute of Epidemiology and Health Care, University College LondonLondonUK
| | - Robert J. Weyant
- Department of Dental Public Health, School of Dental MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Peter H. Whincup
- Population Health Research InstituteSt George's University of LondonLondonUK
| | - Sasiwarang Goya Wannamethee
- Department of Primary Care & Population HealthInstitute of Epidemiology and Health Care, University College LondonLondonUK
| | - Sheena E. Ramsay
- Population Health Sciences InstituteNewcastle UniversityNewcastle Upon TyneUK
| |
Collapse
|
7
|
Kimble R, McLellan G, Lennon LT, Papacosta AO, Mathers JC, Wannamethee SG, Whincup PH, Ramsay SE. Cohort Profile Update: The British Regional Heart Study 1978-2018: 40 years of follow-up of older British men. Int J Epidemiol 2022:6599229. [PMID: 35656703 PMCID: PMC10244063 DOI: 10.1093/ije/dyac122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/19/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Rachel Kimble
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Gillian McLellan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lucy T Lennon
- Department of Primary Care and Population Health, University College London, London, UK
| | - A Olia Papacosta
- Department of Primary Care and Population Health, University College London, London, UK
| | - John C Mathers
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - S Goya Wannamethee
- Department of Primary Care and Population Health, University College London, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London, UK
| | - Shenna E Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
8
|
Sriubas M, Bockute K, Palevicius P, Kaminskas M, Rinkevicius Z, Ragulskis M, Simonyte S, Ruzauskas M, Laukaitis G. Antibacterial Activity of Silver and Gold Particles Formed on Titania Thin Films. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:1190. [PMID: 35407308 PMCID: PMC9000426 DOI: 10.3390/nano12071190] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 02/07/2023]
Abstract
Metal-based nanoparticles with antimicrobial activity are gaining a lot of attention in recent years due to the increased antibiotics resistance. The development and the pathogenesis of oral diseases are usually associated with the formation of bacteria biofilms on the surfaces; therefore, it is crucial to investigate the materials and their properties that would reduce bacterial attachment and biofilm formation. This work provides a systematic investigation of the physical-chemical properties and the antibacterial activity of TiO2 thin films decorated by Ag and Au nanoparticles (NP) against Veillonella parvula and Neisseria sicca species associated with oral diseases. TiO2 thin films were formed using reactive magnetron sputtering by obtaining as-deposited amorphous and crystalline TiO2 thin films after annealing. Au and Ag NP were formed using a two-step process: magnetron sputtering of thin metal films and solid-state dewetting. The surface properties and crystallographic nature of TiO2/NP structures were investigated by SEM, XPS, XRD, and optical microscopy. It was found that the higher thickness of Au and Ag thin films results in the formation of the enlarged NPs and increased distance between them, influencing the antibacterial activity of the formed structures. TiO2 surface with AgNP exhibited higher antibacterial efficiency than Au nanostructured titania surfaces and effectively reduced the concentration of the bacteria. The process of the observation and identification of the presence of bacteria using the deep learning technique was realized.
Collapse
Affiliation(s)
- Mantas Sriubas
- Physics Department, Kaunas University of Technology, Studentu Str. 50, LT-51368 Kaunas, Lithuania; (M.S.); (M.K.); (G.L.)
| | - Kristina Bockute
- Physics Department, Kaunas University of Technology, Studentu Str. 50, LT-51368 Kaunas, Lithuania; (M.S.); (M.K.); (G.L.)
| | - Paulius Palevicius
- Department of Mathematical Modeling, Kaunas University of Technology, Studentu Str. 50, LT-51368 Kaunas, Lithuania; (P.P.); (M.R.)
| | - Marius Kaminskas
- Physics Department, Kaunas University of Technology, Studentu Str. 50, LT-51368 Kaunas, Lithuania; (M.S.); (M.K.); (G.L.)
| | - Zilvinas Rinkevicius
- Division of Theoretical Chemistry & Biology, KTH Royal Institute of Technology, School of Biotechnology, 109 61 Stockholm, Sweden;
| | - Minvydas Ragulskis
- Department of Mathematical Modeling, Kaunas University of Technology, Studentu Str. 50, LT-51368 Kaunas, Lithuania; (P.P.); (M.R.)
| | - Sandrita Simonyte
- Institute of Microbiology and Virology, Faculty of Veterinary Medicine, Veterinary Academy, Lithuanian University of Health Sciences, Tilzes Str. 18, LT-47181 Kaunas, Lithuania; (S.S.); (M.R.)
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu Ave. 15, LT-50162 Kaunas, Lithuania
| | - Modestas Ruzauskas
- Institute of Microbiology and Virology, Faculty of Veterinary Medicine, Veterinary Academy, Lithuanian University of Health Sciences, Tilzes Str. 18, LT-47181 Kaunas, Lithuania; (S.S.); (M.R.)
- Department of Anatomy and Physiology, Lithuanian University of Health Sciences, Tilzes Str. 18, LT-47181 Kaunas, Lithuania
| | - Giedrius Laukaitis
- Physics Department, Kaunas University of Technology, Studentu Str. 50, LT-51368 Kaunas, Lithuania; (M.S.); (M.K.); (G.L.)
| |
Collapse
|
9
|
Luo H, Wu B, Kamer AR, Adhikari S, Sloan F, Plassman BL, Tan C, Qi X, Schwartz MD. Oral Health, Diabetes, and Inflammation: Effects of Oral Hygiene Behaviour. Int Dent J 2021; 72:484-490. [PMID: 34857389 PMCID: PMC9259379 DOI: 10.1016/j.identj.2021.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/28/2021] [Accepted: 10/04/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction The aim of this research was to assess the association between inflammation and oral health and diabetes, as well as the mediating role of oral hygiene practice in this association. Methods Data were from the 2009–2010 National Health and Nutrition Examination Survey. The analytical sample consisted of 2,191 respondents aged 50 and older. Poor oral health was clinically defined by significant tooth loss (STL) and periodontal disease (PD). Diabetes mellitus (DM) was determined by glycemic levels. The outcome variable was serum C-reactive protein (CRP) level, dichotomised as ≥1 mg/dL (elevated CRP) vs <1 mg/dL (not elevated CRP). Two path models, one using STL and DM as the independent variable, the other using PD and DM as the independent variable, were estimated to assess the direct effects of having poor oral health and DM on elevated CRP and the mediating effects of dental flossing. Results In path model 1, individuals having both STL and DM (adjusted odds ratio [AOR], 1.92; 95% confidence interval [CI], 1.30–2.82) or having STL alone (AOR, 2.30; 95% CI, 1.68–3.15) were more likely to have elevated CRP than those with neither STL nor DM; dental flossing (AOR, 0.92, 95% CI, 0.88–0.96) was associated with lower risk of elevated CRP. In path model 2, no significant association was found between having both PD and DM and elevated CRP; dental flossing (AOR, 0.91; 95% CI:, 0.86–0.94) was associated with lower risk of elevated CRP. Conclusions Findings from this study highlight the importance of improving oral health and oral hygiene practice to mitigate inflammation. Further research is needed to assess the longer-term effects of reducing inflammation.
Collapse
Affiliation(s)
- Huabin Luo
- Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Angela R Kamer
- College of Dentistry, New York University, New York, New York, USA
| | | | - Frank Sloan
- Sanford School of Public Policy, Duke University, Durham, North Carolina, USA
| | | | - Chenxin Tan
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Xiang Qi
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Mark D Schwartz
- Grossman School of Medicine, New York University, New York, New York. USA
| |
Collapse
|
10
|
Kotronia E, Brown H, Papacosta AO, Lennon LT, Weyant RJ, Whincup PH, Wannamethee SG, Ramsay SE. Oral health and all-cause, cardiovascular disease, and respiratory mortality in older people in the UK and USA. Sci Rep 2021; 11:16452. [PMID: 34385519 PMCID: PMC8361186 DOI: 10.1038/s41598-021-95865-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/02/2021] [Indexed: 11/09/2022] Open
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.
Collapse
Affiliation(s)
- Eftychia Kotronia
- Population Health Sciences Institute, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Heather Brown
- Population Health Sciences Institute, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - A Olia Papacosta
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Lucy T Lennon
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Robert J Weyant
- Department of Dental Public Health, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, London, UK
| | - S Goya Wannamethee
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Sheena E Ramsay
- Population Health Sciences Institute, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| |
Collapse
|
11
|
Ni Lochlainn M, Cox NJ, Wilson T, Hayhoe RPG, Ramsay SE, Granic A, Isanejad M, Roberts HC, Wilson D, Welch C, Hurst C, Atkins JL, Mendonça N, Horner K, Tuttiett ER, Morgan Y, Heslop P, Williams EA, Steves CJ, Greig C, Draper J, Corish CA, Welch A, Witham MD, Sayer AA, Robinson S. Nutrition and Frailty: Opportunities for Prevention and Treatment. Nutrients 2021; 13:2349. [PMID: 34371858 PMCID: PMC8308545 DOI: 10.3390/nu13072349] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/28/2021] [Accepted: 07/07/2021] [Indexed: 02/07/2023] Open
Abstract
Frailty is a syndrome of growing importance given the global ageing population. While frailty is a multifactorial process, poor nutritional status is considered a key contributor to its pathophysiology. As nutrition is a modifiable risk factor for frailty, strategies to prevent and treat frailty should consider dietary change. Observational evidence linking nutrition with frailty appears most robust for dietary quality: for example, dietary patterns such as the Mediterranean diet appear to be protective. In addition, research on specific foods, such as a higher consumption of fruit and vegetables and lower consumption of ultra-processed foods are consistent, with healthier profiles linked to lower frailty risk. Few dietary intervention studies have been conducted to date, although a growing number of trials that combine supplementation with exercise training suggest a multi-domain approach may be more effective. This review is based on an interdisciplinary workshop, held in November 2020, and synthesises current understanding of dietary influences on frailty, focusing on opportunities for prevention and treatment. Longer term prospective studies and well-designed trials are needed to determine the causal effects of nutrition on frailty risk and progression and how dietary change can be used to prevent and/or treat frailty in the future.
Collapse
Affiliation(s)
- Mary Ni Lochlainn
- Department of Twin Research and Genetics, King’s College London, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK;
| | - Natalie J. Cox
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO17 1BJ, UK; (N.J.C.); (H.C.R.)
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Thomas Wilson
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth SY23 3DA, UK; (T.W.); (J.D.)
| | - Richard P. G. Hayhoe
- Department of Epidemiology & Public Health, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK; (R.P.G.H.); (A.W.)
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford CM1 1SQ, UK
| | - Sheena E. Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.E.R.); (N.M.)
| | - Antoneta Granic
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Masoud Isanejad
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK;
| | - Helen C. Roberts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO17 1BJ, UK; (N.J.C.); (H.C.R.)
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Daisy Wilson
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (D.W.); (C.W.)
| | - Carly Welch
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (D.W.); (C.W.)
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham B15 2TT, UK;
| | - Christopher Hurst
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Janice L. Atkins
- Epidemiology & Public Health Group, University of Exeter Medical School, Exeter EX1 2LU, UK;
| | - Nuno Mendonça
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.E.R.); (N.M.)
- EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, 1150-082 Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal
| | - Katy Horner
- School of Public Health, Physiotherapy and Sport Science and UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland; (K.H.); (C.A.C.)
| | - Esme R. Tuttiett
- The Medical Research Council Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing and The Department of Oncology and Metabolism, The University of Sheffield, Sheffield S10 2RX, UK; (E.R.T.); (E.A.W.)
| | - Yvie Morgan
- EDESIA PhD Programme, University of East Anglia Norwich Research Park, Norwich NR4 7TJ, UK;
| | - Phil Heslop
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
| | - Elizabeth A. Williams
- The Medical Research Council Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing and The Department of Oncology and Metabolism, The University of Sheffield, Sheffield S10 2RX, UK; (E.R.T.); (E.A.W.)
| | - Claire J. Steves
- Department of Twin Research and Genetics, King’s College London, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK;
| | - Carolyn Greig
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Birmingham B15 2TT, UK;
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham and NIHR Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham B15 2TT, UK
| | - John Draper
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth SY23 3DA, UK; (T.W.); (J.D.)
| | - Clare A. Corish
- School of Public Health, Physiotherapy and Sport Science and UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland; (K.H.); (C.A.C.)
| | - Ailsa Welch
- Department of Epidemiology & Public Health, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK; (R.P.G.H.); (A.W.)
| | - Miles D. Witham
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Avan A. Sayer
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Sian Robinson
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (A.G.); (C.H.); (P.H.); (M.D.W.); (A.A.S.)
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| |
Collapse
|
12
|
Mueller AL, McNamara MS, Sinclair DA. Why does COVID-19 disproportionately affect older people? Aging (Albany NY) 2020; 12:9959-9981. [PMID: 32470948 PMCID: PMC7288963 DOI: 10.18632/aging.103344] [Citation(s) in RCA: 553] [Impact Index Per Article: 138.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/18/2020] [Indexed: 12/12/2022]
Abstract
The severity and outcome of coronavirus disease 2019 (COVID-19) largely depends on a patient's age. Adults over 65 years of age represent 80% of hospitalizations and have a 23-fold greater risk of death than those under 65. In the clinic, COVID-19 patients most commonly present with fever, cough and dyspnea, and from there the disease can progress to acute respiratory distress syndrome, lung consolidation, cytokine release syndrome, endotheliitis, coagulopathy, multiple organ failure and death. Comorbidities such as cardiovascular disease, diabetes and obesity increase the chances of fatal disease, but they alone do not explain why age is an independent risk factor. Here, we present the molecular differences between young, middle-aged and older people that may explain why COVID-19 is a mild illness in some but life-threatening in others. We also discuss several biological age clocks that could be used in conjunction with genetic tests to identify both the mechanisms of the disease and individuals most at risk. Finally, based on these mechanisms, we discuss treatments that could increase the survival of older people, not simply by inhibiting the virus, but by restoring patients' ability to clear the infection and effectively regulate immune responses.
Collapse
Affiliation(s)
- Amber L. Mueller
- Glenn Center for Biology of Aging Research, Blavatnik Institute, Harvard Medical School, Boston, MA 20115, USA
| | - Maeve S. McNamara
- Glenn Center for Biology of Aging Research, Blavatnik Institute, Harvard Medical School, Boston, MA 20115, USA
| | - David A. Sinclair
- Glenn Center for Biology of Aging Research, Blavatnik Institute, Harvard Medical School, Boston, MA 20115, USA
| |
Collapse
|