{"title":"老年人口腔虚弱的社会经济不平等：预防牙齿脱落作用的因果中介分析。","authors":"Mieko Fujita, Kenji Takeuchi, Yudai Tamada, Taro Kusama, Tatsuo Yamamoto, Katsunori Kondo, Ken Osaka","doi":"10.1111/joor.70042","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although social inequalities in oral health have been suggested, the link between socioeconomic status (SES) and oral frailty (OF) remains unclear. We aimed to investigate the inequalities in OF according to SES and the extent to which inequalities are mitigated by preventing tooth loss.</p><p><strong>Methods: </strong>We used cross-sectional data from 21 542 functionally independent participants aged ≥ 65 (48.5% men) from the Japan Gerontological Evaluation Study. The prevalence of OF, number of teeth, and educational attainment (EA) and equivalent income (EI) were used as outcome, mediator and explanatory variables, respectively. A Poisson regression model was used to examine the association between SES and OF. Causal mediation analysis was performed to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs) of the controlled direct effects (CDEs) of the number of teeth. The proportion eliminated (PE) of the ≥ 20 remaining teeth was calculated.</p><p><strong>Results: </strong>Overall 7984 participants had OF. The prevalence of OF was 1.45 times higher in participants with ≤ 9 years of EA and 1.38 times higher in participants with an EI of < $20.000. The estimated total effect (TE) of low EA or low EI on the prevalence of OF was mediated by the number of teeth (TE PR, 1.30 [95% CI, 1.25-1.35]; CDE PR, 1.22 [95% CI, 1.10-1.33]; PE, 28.2%) or (TE PR, 1.26 [95% CI, 1.22-1.31]; CDE PR, 1.23 [95% CI, 1.14-1.32]; PE, 12.9%).</p><p><strong>Conclusion: </strong>OF showed a clear social gradient based on SES. However, this association could be mediated by the remaining ≥ 20 teeth.</p>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":" ","pages":""},"PeriodicalIF":4.0000,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Socioeconomic Inequalities in Oral Frailty Among Older Adults: A Causal Mediation Analysis on the Role of Prevention From Tooth Loss.\",\"authors\":\"Mieko Fujita, Kenji Takeuchi, Yudai Tamada, Taro Kusama, Tatsuo Yamamoto, Katsunori Kondo, Ken Osaka\",\"doi\":\"10.1111/joor.70042\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although social inequalities in oral health have been suggested, the link between socioeconomic status (SES) and oral frailty (OF) remains unclear. We aimed to investigate the inequalities in OF according to SES and the extent to which inequalities are mitigated by preventing tooth loss.</p><p><strong>Methods: </strong>We used cross-sectional data from 21 542 functionally independent participants aged ≥ 65 (48.5% men) from the Japan Gerontological Evaluation Study. The prevalence of OF, number of teeth, and educational attainment (EA) and equivalent income (EI) were used as outcome, mediator and explanatory variables, respectively. A Poisson regression model was used to examine the association between SES and OF. Causal mediation analysis was performed to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs) of the controlled direct effects (CDEs) of the number of teeth. The proportion eliminated (PE) of the ≥ 20 remaining teeth was calculated.</p><p><strong>Results: </strong>Overall 7984 participants had OF. The prevalence of OF was 1.45 times higher in participants with ≤ 9 years of EA and 1.38 times higher in participants with an EI of < $20.000. The estimated total effect (TE) of low EA or low EI on the prevalence of OF was mediated by the number of teeth (TE PR, 1.30 [95% CI, 1.25-1.35]; CDE PR, 1.22 [95% CI, 1.10-1.33]; PE, 28.2%) or (TE PR, 1.26 [95% CI, 1.22-1.31]; CDE PR, 1.23 [95% CI, 1.14-1.32]; PE, 12.9%).</p><p><strong>Conclusion: </strong>OF showed a clear social gradient based on SES. However, this association could be mediated by the remaining ≥ 20 teeth.</p>\",\"PeriodicalId\":16605,\"journal\":{\"name\":\"Journal of oral rehabilitation\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-08-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of oral rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/joor.70042\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of oral rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/joor.70042","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Socioeconomic Inequalities in Oral Frailty Among Older Adults: A Causal Mediation Analysis on the Role of Prevention From Tooth Loss.
Background: Although social inequalities in oral health have been suggested, the link between socioeconomic status (SES) and oral frailty (OF) remains unclear. We aimed to investigate the inequalities in OF according to SES and the extent to which inequalities are mitigated by preventing tooth loss.
Methods: We used cross-sectional data from 21 542 functionally independent participants aged ≥ 65 (48.5% men) from the Japan Gerontological Evaluation Study. The prevalence of OF, number of teeth, and educational attainment (EA) and equivalent income (EI) were used as outcome, mediator and explanatory variables, respectively. A Poisson regression model was used to examine the association between SES and OF. Causal mediation analysis was performed to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs) of the controlled direct effects (CDEs) of the number of teeth. The proportion eliminated (PE) of the ≥ 20 remaining teeth was calculated.
Results: Overall 7984 participants had OF. The prevalence of OF was 1.45 times higher in participants with ≤ 9 years of EA and 1.38 times higher in participants with an EI of < $20.000. The estimated total effect (TE) of low EA or low EI on the prevalence of OF was mediated by the number of teeth (TE PR, 1.30 [95% CI, 1.25-1.35]; CDE PR, 1.22 [95% CI, 1.10-1.33]; PE, 28.2%) or (TE PR, 1.26 [95% CI, 1.22-1.31]; CDE PR, 1.23 [95% CI, 1.14-1.32]; PE, 12.9%).
Conclusion: OF showed a clear social gradient based on SES. However, this association could be mediated by the remaining ≥ 20 teeth.
期刊介绍：
Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function.
Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology.
The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
