TY - JOUR
T1 - Relationship Between Oral Health and Fractures in Community-Dwelling Older Japanese Adults
AU - Ito, Wakana
AU - Komiyama, Takamasa
AU - Ohi, Takashi
AU - Hiratsuka, Takako
AU - Matsuyama, Sanae
AU - Sone, Toshimasa
AU - Tsuji, Ichiro
AU - Watanabe, Makoto
AU - Hattori, Yoshinori
N1 - Funding Information:
Funding Disclosure: This study was partly supported by a Health Labour Sciences Research Grant (H21-Choju-Ippan-001, H22-Junkankitou-Ippan-001) provided by the Ministry of Health, Labour and Welfare of Japan (Tokyo, Japan), and by JSPS KAKENHI grant numbers JP18K09904 and 19K19325 , a grant from the Futoku Foundation in 2020 for research projects. The sponsor had no role in the design, methods, subject recruitment, data collection, analysis, or preparation of this article.
Publisher Copyright:
© 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine
PY - 2021/6
Y1 - 2021/6
N2 - Objective: To investigate the relationship between poor oral health and the incidence of fall-related fractures in older Japanese individuals. Design: A 9-year prospective cohort study. Setting and Participants: Participants comprised 937 community-dwelling older Japanese adults aged 70 years or older. They all lived in the Tsurugaya district, a suburban area of Sendai city, and underwent comprehensive geriatric assessment, including an oral examination, in a public facility. Measurements: The exposure variables were related to oral health status (posterior occlusal support, number of remaining teeth, and occlusal force). The outcome measure was the incidence of fall-related fractures, which was determined by National Health Insurance data. Analyzed covariates included age, sex, medical history, smoking, alcohol drinking, educational level, depressive symptoms, cognitive impairment, physical function, body mass index, and history of falls. Statistical relationships were examined by calculating hazard ratios (HRs) at 95% confidence intervals (CIs) using the Cox proportional hazard model. Results: In the multivariate analysis, the HRs of fall-related fractures were significantly higher in those with unilateral posterior occlusal support (HR, 2.72; 95% CI, 1.13-6.55) and no posterior occlusal support (HR, 2.58; 95% CI, 1.29-5.15) than in those with bilateral posterior occlusal support. The HRs (95% CIs) of fall-related fractures in individuals with 10-19 and 1-9 teeth and edentulous individuals were 1.77 (0.81-3.89), 2.67 (1.24-5.75), and 2.31 (1.01-5.28), respectively, compared to those with ≥20 teeth. Conclusions and Implications: Poor oral health status is a risk factor for the incidence of fall-related fractures in community-dwelling older Japanese individuals. The findings suggest that attention should be focused on oral health status to further understand the risk of fall-related fractures among community-dwelling older adults.
AB - Objective: To investigate the relationship between poor oral health and the incidence of fall-related fractures in older Japanese individuals. Design: A 9-year prospective cohort study. Setting and Participants: Participants comprised 937 community-dwelling older Japanese adults aged 70 years or older. They all lived in the Tsurugaya district, a suburban area of Sendai city, and underwent comprehensive geriatric assessment, including an oral examination, in a public facility. Measurements: The exposure variables were related to oral health status (posterior occlusal support, number of remaining teeth, and occlusal force). The outcome measure was the incidence of fall-related fractures, which was determined by National Health Insurance data. Analyzed covariates included age, sex, medical history, smoking, alcohol drinking, educational level, depressive symptoms, cognitive impairment, physical function, body mass index, and history of falls. Statistical relationships were examined by calculating hazard ratios (HRs) at 95% confidence intervals (CIs) using the Cox proportional hazard model. Results: In the multivariate analysis, the HRs of fall-related fractures were significantly higher in those with unilateral posterior occlusal support (HR, 2.72; 95% CI, 1.13-6.55) and no posterior occlusal support (HR, 2.58; 95% CI, 1.29-5.15) than in those with bilateral posterior occlusal support. The HRs (95% CIs) of fall-related fractures in individuals with 10-19 and 1-9 teeth and edentulous individuals were 1.77 (0.81-3.89), 2.67 (1.24-5.75), and 2.31 (1.01-5.28), respectively, compared to those with ≥20 teeth. Conclusions and Implications: Poor oral health status is a risk factor for the incidence of fall-related fractures in community-dwelling older Japanese individuals. The findings suggest that attention should be focused on oral health status to further understand the risk of fall-related fractures among community-dwelling older adults.
KW - fall
KW - fracture
KW - occlusal support
KW - older adults
KW - Oral health
KW - tooth loss
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U2 - 10.1016/j.jamda.2021.01.058
DO - 10.1016/j.jamda.2021.01.058
M3 - Article
C2 - 33587891
AN - SCOPUS:85101395958
SN - 1525-8610
VL - 22
SP - 1184-1189.e1
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 6
ER -
