邻里贫困与老年人口腔健康的变化:基于人口的纵向研究。

Journal of dental research Pub Date : 2024-04-01 Epub Date: 2024-02-27 DOI:10.1177/00220345231224337
S G Ganbavale, E Papachristou, J C Mathers, A O Papacosta, L T Lennon, P H Whincup, S G Wannamethee, S E Ramsay
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引用次数: 0

摘要

本研究的目的是探讨邻里层面的社会经济因素(客观的和感知的)在多大程度上与老年人长期的口腔健康状况不良有关,而与个人的社会经济地位无关。这项横断面和纵向观察研究的数据来自一个具有社会和地理代表性的队列,该队列中的男性在2010-12年间的年龄为71至92岁(n=1622),他们来自英国的全科诊所,该队列在2018-19年间接受了随访(年龄为78至98岁;n=667)。这两个时间段的牙科测量指标包括牙齿数量、牙周袋深度、口腔健康自评和口干。邻里贫困程度基于多重贫困指数(IMD)和衡量当地环境感知的累积指数。个人层面的社会经济地位基于从事时间最长的职业。在对相关的社会人口、行为和健康相关因素进行调整后,分别进行了多层次和多变量逻辑回归,以检验牙科指标与多重贫困指数(IMD)和感知邻里质量指数之间的关系。从横截面来看,牙齿脱落、牙周袋和口干的风险从IMD五分位数1到5(从最贫困到最贫困)依次增加;调整社会人口、行为和健康相关因素后,五分位数5的几率比(ORs)分别为2.22(95% 置信区间[CI],1.41-3.51)、2.82(95% CI,1.72-4.64)和1.51(95% CI,1.08-2.09)。与五分位数 1 相比,五分位数 5(问题最多)的感知邻里质量指数出现牙周袋深度增加和口干的风险明显更高。在 8 年的随访中,经过全面调整后,最贫困的 IMD 五分位数人群的牙质恶化(牙齿脱落)程度明显更高(五分位数 5 的 OR = 2.32;95% CI,1.09-4.89)。在感知邻里质量指数的五分位数中,牙质恶化和口干的程度明显更高。无论从横向还是纵向来看,邻里层面的因素都与老年人口腔健康状况不佳有关,尤其是与牙齿脱落和口干有关,与个人层面的社会经济地位无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neighborhood Deprivation and Changes in Oral Health in Older Age: A Longitudinal Population-Based Study.

The aim of this study was to examine the extent to which neighborhood-level socioeconomic factors (objective and perceived) are associated with poor oral health in older adults over time, independent of individual socioeconomic position. Data for this cross-sectional and longitudinal observation study came from a socially and geographically representative cohort of men aged 71 to 92 y in 2010-12 (n = 1,622), drawn from British general practices, which was followed up in 2018-19 (aged 78-98 y; N = 667). Dental measures at both times included number of teeth, periodontal pocket depth, self-rated oral health, and dry mouth. Neighborhood deprivation was based on Index of Multiple Deprivation (IMD) and a cumulative index measuring perceptions about local environment. Individual-level socioeconomic position was based on longest-held occupation. Multilevel and multivariate logistic regressions, adjusted for relevant sociodemographic, behavioral, and health-related factors, were performed to examine the relationships of dental measures with IMD and perceived neighborhood quality index, respectively. Cross-sectionally, risks of tooth loss, periodontal pockets, and dry mouth increased from IMD quintiles 1 to 5 (least to most deprived); odds ratios (ORs) for quintile 5 were 2.22 (95% confidence interval [CI], 1.41-3.51), 2.82 (95% CI, 1.72-4.64), and 1.51 (95% CI, 1.08-2.09), respectively, after adjusting for sociodemographic, behavioral, and health-related factors. Risks of increased pocket depth and dry mouth were significantly greater in quintile 5 (highest problems) of perceived neighborhood quality index compared to quintile 1. Over the 8-y follow-up, deterioration of dentition (tooth loss) was significantly higher in the most deprived IMD quintiles after full adjustment (OR for quintile 5 = 2.32; 95% CI, 1.09-4.89). Deterioration of dentition and dry mouth were significantly greater in quintile 5 of perceived neighborhood quality index. Neighborhood-level factors were associated with poor oral health in older age, both cross-sectionally and longitudinally, particularly with tooth loss, and dry mouth, independent of individual-level socioeconomic position.

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