J Chew, J Q Chia, K K Kyaw, J K Fu, J Ang, Y P Lim, K Y Ang, H N Tan, W S Lim
{"title":"住院老年人口腔健康与虚弱、营养不良风险和功能下降的关系:一项横断面研究","authors":"J Chew, J Q Chia, K K Kyaw, J K Fu, J Ang, Y P Lim, K Y Ang, H N Tan, W S Lim","doi":"10.14283/jfa.2023.33","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Poor oral health is known to be associated with adverse outcomes, but the frequency and impact of poor oral health on older adults in the acute inpatient setting has been less well studied.</p><p><strong>Objectives: </strong>We examined the association between oral health, frailty, nutrition and functional decline in hospitalized older adults.</p><p><strong>Design: </strong>Retrospective cross-sectional study.</p><p><strong>Setting and participants: </strong>We included data from 465 inpatients (mean age 79.2±8.3 years) admitted acutely to a tertiary hospital.</p><p><strong>Methods: </strong>We evaluated oral health using the Revised Oral Assessment Guide (ROAG), frailty using the Clinical Frailty Scale (CFS), malnutrition risk using the Nutritional Screening Tool (NST) and functional status using a modified Katz Activities of Daily Living (ADL) scale. We examined cross-sectional associations of oral health with frailty, malnutrition risk and functional decline on admission, followed by multivariate logistic regression models evaluating the association between poor oral health and the aforementioned outcomes.</p><p><strong>Results: </strong>343 (73.8%), 100 (21.5%) and 22 (4.7%) were classified as low, moderate and high risk on the ROAG, respectively. Poorer oral health was associated with greater severity of frailty, functional decline on admission and malnutrition risk. Abnormalities in ROAG domains of voice changes, swallowing difficulty, xerostomia, lips and tongue appearance were more frequently present at greater severity of frailty. Poor oral health was associated with frailty [odds ratio (OR): 1.76, 95% confidence interval (CI) 1.05-2.97; P=0.034]; malnutrition risk [OR: 2.76, 95% CI 1.46-5.19, P=0.002] and functional decline [OR: 1.62, 95% CI 1.01-2.59, P=0.046].</p><p><strong>Conclusions: </strong>Poor oral health is significantly associated with frailty, malnutrition risk and functional decline in older inpatients. Oral health evaluation, as part of a comprehensive geriatric assessment may be a target for interventions to improve outcomes. Further research including longitudinal outcomes and effectiveness of specific interventions targeted at oral health are warranted in older adults in the inpatient setting.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of Oral Health with Frailty, Malnutrition Risk and Functional Decline in Hospitalized Older Adults: A Cross-Sectional Study.\",\"authors\":\"J Chew, J Q Chia, K K Kyaw, J K Fu, J Ang, Y P Lim, K Y Ang, H N Tan, W S Lim\",\"doi\":\"10.14283/jfa.2023.33\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Poor oral health is known to be associated with adverse outcomes, but the frequency and impact of poor oral health on older adults in the acute inpatient setting has been less well studied.</p><p><strong>Objectives: </strong>We examined the association between oral health, frailty, nutrition and functional decline in hospitalized older adults.</p><p><strong>Design: </strong>Retrospective cross-sectional study.</p><p><strong>Setting and participants: </strong>We included data from 465 inpatients (mean age 79.2±8.3 years) admitted acutely to a tertiary hospital.</p><p><strong>Methods: </strong>We evaluated oral health using the Revised Oral Assessment Guide (ROAG), frailty using the Clinical Frailty Scale (CFS), malnutrition risk using the Nutritional Screening Tool (NST) and functional status using a modified Katz Activities of Daily Living (ADL) scale. 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Poor oral health was associated with frailty [odds ratio (OR): 1.76, 95% confidence interval (CI) 1.05-2.97; P=0.034]; malnutrition risk [OR: 2.76, 95% CI 1.46-5.19, P=0.002] and functional decline [OR: 1.62, 95% CI 1.01-2.59, P=0.046].</p><p><strong>Conclusions: </strong>Poor oral health is significantly associated with frailty, malnutrition risk and functional decline in older inpatients. Oral health evaluation, as part of a comprehensive geriatric assessment may be a target for interventions to improve outcomes. 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引用次数: 0
摘要
背景:众所周知，口腔健康状况不佳与不良结果有关，但口腔健康状况不佳对急性住院老年人的频率和影响的研究较少。目的:我们研究住院老年人口腔健康、虚弱、营养和功能下降之间的关系。设计:回顾性横断面研究。环境和参与者:我们纳入了465名三级医院急性住院患者(平均年龄79.2±8.3岁)的数据。方法:我们使用修订的口腔评估指南(ROAG)评估口腔健康，使用临床虚弱量表(CFS)评估衰弱，使用营养筛查工具(NST)评估营养不良风险，使用改良的Katz日常生活活动(ADL)量表评估功能状态。我们研究了口腔健康与入院时虚弱、营养不良风险和功能下降的横断面关联，随后采用多变量logistic回归模型评估口腔健康状况不佳与上述结果之间的关联。结果:ROAG低、中、高风险分别为343例(73.8%)、100例(21.5%)、22例(4.7%)。较差的口腔健康与更严重的虚弱、入院时功能下降和营养不良风险相关。声音变化、吞咽困难、口干、嘴唇和舌头外观的ROAG域异常在更严重的虚弱中更常见。口腔健康状况不佳与虚弱相关[优势比(OR): 1.76, 95%可信区间(CI) 1.05-2.97;P = 0.034);营养不良风险[OR: 2.76, 95% CI 1.46 ~ 5.19, P=0.002]和功能下降[OR: 1.62, 95% CI 1.01 ~ 2.59, P=0.046]。结论:口腔健康状况不佳与老年住院患者虚弱、营养不良风险和功能下降显著相关。口腔健康评估，作为全面的老年评估的一部分，可能是干预措施的目标，以改善结果。进一步的研究，包括纵向结果和针对口腔健康的特定干预措施的有效性，需要在住院的老年人中进行。
Association of Oral Health with Frailty, Malnutrition Risk and Functional Decline in Hospitalized Older Adults: A Cross-Sectional Study.
Background: Poor oral health is known to be associated with adverse outcomes, but the frequency and impact of poor oral health on older adults in the acute inpatient setting has been less well studied.
Objectives: We examined the association between oral health, frailty, nutrition and functional decline in hospitalized older adults.
Design: Retrospective cross-sectional study.
Setting and participants: We included data from 465 inpatients (mean age 79.2±8.3 years) admitted acutely to a tertiary hospital.
Methods: We evaluated oral health using the Revised Oral Assessment Guide (ROAG), frailty using the Clinical Frailty Scale (CFS), malnutrition risk using the Nutritional Screening Tool (NST) and functional status using a modified Katz Activities of Daily Living (ADL) scale. We examined cross-sectional associations of oral health with frailty, malnutrition risk and functional decline on admission, followed by multivariate logistic regression models evaluating the association between poor oral health and the aforementioned outcomes.
Results: 343 (73.8%), 100 (21.5%) and 22 (4.7%) were classified as low, moderate and high risk on the ROAG, respectively. Poorer oral health was associated with greater severity of frailty, functional decline on admission and malnutrition risk. Abnormalities in ROAG domains of voice changes, swallowing difficulty, xerostomia, lips and tongue appearance were more frequently present at greater severity of frailty. Poor oral health was associated with frailty [odds ratio (OR): 1.76, 95% confidence interval (CI) 1.05-2.97; P=0.034]; malnutrition risk [OR: 2.76, 95% CI 1.46-5.19, P=0.002] and functional decline [OR: 1.62, 95% CI 1.01-2.59, P=0.046].
Conclusions: Poor oral health is significantly associated with frailty, malnutrition risk and functional decline in older inpatients. Oral health evaluation, as part of a comprehensive geriatric assessment may be a target for interventions to improve outcomes. Further research including longitudinal outcomes and effectiveness of specific interventions targeted at oral health are warranted in older adults in the inpatient setting.
期刊介绍：
The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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