牙齿缺失与功能限制的异质性关联

Y Matsuyama, J Aida, K Kondo, K Shiba
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引用次数: 0

摘要

牙齿脱落在老年人中很普遍,并与机能下降有关。目前还缺乏关于某些人对牙齿脱落影响的易感性的研究。本研究采用机器学习方法,旨在调查日本老年人牙齿脱落与高级功能能力之间关系的异质性。这是一项前瞻性队列研究,使用的是日本年龄≥65 岁成年人的数据(N = 16,553 人)。研究使用东京都老年学研究所能力指数(TMIG-IC)对老年人的高级功能能力(包括工具独立性、智力活动和社会角色)进行了评估。该指数从 0(最低功能)到 13(最高功能)不等。采用双稳健目标最大似然估计法来估算牙齿缺失(有牙齿)与社会角色之间的人群平均关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Heterogeneous Association of Tooth Loss with Functional Limitations.

Tooth loss is prevalent in older adults and associated with functional capacity decline. Studies on the susceptibility of some individuals to the effects of tooth loss are lacking. This study aimed to investigate the heterogeneity of the association between tooth loss and higher-level functional capacity in older Japanese individuals employing a machine learning approach. This is a prospective cohort study using the data of adults aged ≥65 y in Japan (N = 16,553). Higher-level functional capacity, comprising instrumental independence, intellectual activity, and social role, was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The scale ranged from 0 (lowest function) to 13 (highest function). Doubly robust targeted maximum likelihood estimation was used to estimate the population-average association between tooth loss (having <20 natural teeth) and TMIG-IC total score after 6 y. The heterogeneity of the association was evaluated by estimating conditional average treatment effects (CATEs) using the causal forest algorithm. The result showed that tooth loss was statistically significantly associated with lower TMIG-IC total scores (population-average effect: -0.14; 95% confidence interval, -0.18 to -0.09). The causal forest analysis revealed the heterogeneous associations between tooth loss and lower TMIG-IC total score after 6 y (median of estimated CATEs = -0.13; interquartile range = 0.12). The high-impact subgroup (i.e., individuals with estimated CATEs of the bottom 10%) were significantly more likely to be older and male, had a lower socioeconomic status, did not have a partner, and had poor health conditions compared with the low-impact subgroup (i.e., individuals with estimated CATEs of the top 10%). This study found that heterogeneity exists in the association between tooth loss and lower scores on functional capacity. Implementing tooth loss prevention policy and clinical measures, especially among vulnerable subpopulations significantly affected by tooth loss, may reduce its burden more effectively.

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