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Few teeth without dentures and absence of a regular dentist, not poor mastication and poor attitudes toward dental health, were associated with higher risk of dementia onset in the older Japanese cohort even after adjustment for available covariates.

Poor dental status was associated with a higher risk of onset of functional disability in older Japanese people. Sociodemographic, behavioral, and health status covariates explained the association between eating ability and onset of disability.

Cardiovascular diseases, cancer, and respiratory disease are major causes of death in developed countries. No study has simultaneously compared the contribution of oral health with these major causes of death. This study examined the association between oral health and cardiovascular diseases, cancer, and respiratory mortality among older Japanese. Self-administered questionnaires were mailed to participants in the Aichi Gerontological Evaluation Study (AGES) Project in 2003. Mortality data were analyzed for 4425 respondents. Three categories of oral health were used: 20 or more teeth, 19 or fewer teeth and eat everything, 19 or fewer teeth and eating difficulty. Sex, age, body mass index (BMI), self-rated health, present illness, exercise, smoking, alcohol, education, and income were used as covariates. During 4.28 years' follow-up, 410 people died, 159 from cancer, 108 of cardiovascular diseases, and 58 of respiratory disease. Multivariate adjusted Cox proportional hazard models showed that, compared with the respondents with 20 or more teeth, respondents with 19 or fewer teeth and with eating difficulty had a 1.83 and 1.85 times higher hazard ratio for cardiovascular disease mortality and respiratory disease mortality, respectively. There was no significant association with cancer mortality. Oral health predicted cardiovascular and respiratory disease mortality but not cancer mortality in older Japanese.

BackgroundBeing homebound is an important risk factor of functional disability in older people. There is a possibility of bidirectional relationship between homeboundness and dental health. This prospective cohort study examined the association of dental health, which includes social function, on homeboundness in the future.MethodsThe participants were ≥ 65 years, responded to two postal surveys conducted in 2006 and 2010, and were not homebound at baseline. Logistic regression analysis was used to estimate the odds ratios for homeboundness, defined as going out of one’s home less than once weekly. Self-reported baseline dental status was used as the main predictor. Age, sex, marital status, educational attainment, income, comorbidity, depression, walking time, living alone, and area of residence were used as covariates.ResultsAmong 4390 non-homebound respondents, 7.4 % were homebound four years later. The proportions of homebound respondents with < 20 teeth without dentures, < 20 teeth with dentures, and ≥ 20 teeth were 9.7, 8.8, and 4.4 %, respectively. The odds for being homebound in the 65–74-year age group, adjusted for covariates, was 1.78 (95 % CI: 1.01–3.13; p < 0.05) times higher for respondents with < 20 teeth and no dentures than that for respondents with ≥ 20 teeth. Among the participants in the ≥ 75-year age group, a significant association of homeboundness and dental health was not observed.ConclusionsAmong the young-old population, poor dental health predicted future onset of homeboundness, while depressive symptoms did not show any significant association.

The relationship of meal habits and alcohol/ cigarette consumption to circadian typology and sleep health in Japanese female students was studied from an epidemiological point of view. Questionnaires on Morningness-Eveningness by Torsvall and Åkerstedt (1980), sleep habits, regularity of meal intake and meal amount, and style of alcohol and cigarette consumption were administered to 800 students aged 18-29 years, attending university or training schools for nutrition specialists (Aichi Prefecture, 35°N). Points from ten questions were totaled to provide estimates of sleep habits given as the Unhealthy Sleep Index (UHSI). The average and standard deviation of Morningness-Eveningness scores were 16.07Ϯ3.53. Students who had breakfast at regular times showed significantly higher Morningness-Eveningness scores than those who ate at irregular times. Based on an integrated analysis (ANOVA) on the effect of regularity of breakfast intake on sleep health, regular breakfast intake may link to sleep health positively via the shifting to morning-type (i.e., the phase-advance of the circadian clock). However, a similar analysis promoted the hypothesis that alcohol consumption and cigarette smoking relate to sleep health negatively and directly, rather than via the shifting to evening-type (i.e., the phase-delaying of the circadian clock). In the case of young women, getting a good quality and quantity of sleep in normal life seems to be important for promoting their mental health, which may fluctuate throughout the menstruation cycle accompanied by mental symptoms as a part of premenstrual syndrome.

ObjectiveTo examine if self-reported number of teeth, denture use and chewing ability are associated with incident falls.DesignLongitudinal cohort study (the Aichi Gerontological Evaluation Study).Setting5 Japanese municipalities.Participants1763 community-dwelling individuals aged 65 years and older without experience of falls within the previous year at baseline.Main outcome measuresSelf-reported history of multiple falls during the past year at the follow-up survey about 3 years later. Baseline data on the number of teeth present and/or denture use and chewing ability were collected using self-administered questionnaires. Logistic regression analyses controlled for sex, age, functional disability during follow-up period, depression, self-rated health and educational attainment.Results86 (4.9%) subjects reported falls at the follow-up survey. Logistic regression models fully adjusted for all covariates showed that subjects having 19 or fewer teeth but not using dentures had a significantly increased risk for incident falls (OR 2.50, 95% CI 1.21 to 5.17, p=0.013) compared with those having 20 or more teeth. Among subjects with 19 or fewer teeth, their risk of falls was not significantly elevated so long as they wore dentures (OR 1.36, 95% CI 0.76 to 2.45, p=0.299). No significant association was observed between chewing ability and incident falls in the fully adjusted model.ConclusionsHaving 19 or fewer teeth but not using dentures was associated with higher risk for the incident falls in older Japanese even after adjustment for multiple covariates. Dental care to prevent tooth loss and denture treatment for older people might prevent falls, although the authors cannot exclude the possibility that the association is due to residual confounding.

BackgroundCommunity-level factors as well as individual-level factors affect individual health. To date, no studies have examined the association between community-level social gradient and edentulousness. The aim of this study was to investigate individual- and community-level social inequalities in edentulousness and to determine any explanatory factors in this association.MethodsWe analyzed the data from the Japan Gerontological Evaluation Study (JAGES). In 2010-2012, 112,123 subjects aged 65 or older responded to the questionnaire survey (response rate = 66.3%). Multilevel logistic regression analysis was applied to determine the association between community-level income and edentulousness after accounting for individual-level income and demographic covariates. Then, we estimated the probability of edentulousness by individual- and community-level incomes after adjusted for covariates.ResultsOf 79,563 valid participants, the prevalence of edentulousness among 39,550 men (49.7%) and 40,013 women (50.3%) were both 13.8%. Living in communities with higher mean incomes and having higher individual-level incomes were significantly associated with a lower risk of edentulousness (odds ratios [ORs] by 10,000 USD increments were 0.37 (95% confidence interval [CI] [0.22-0.63]) for community-level and 0.85 (95% CI [0.84-0.86]) for individual-level income). Individual- and community-level social factors, including density of dental clinics, partially explained the social gradients. However, in the fully adjusted model, both community- and individual-level social gradients of edentulousness remained significant (ORs = 0.43 (95% CI [0.27-0.67]) and 0.90 (95% CI [0.88-0.91]), respectively). One standard deviation changes in community- and individual-level incomes were associated with 0.78 and 0.84 times lower odds of edentulousness, respectively. In addition, compared to men, women living in communities with higher average incomes had a significantly lower risk of edentulousness (p-value for interaction < 0.001).ConclusionsIndividual- and community-level social inequalities in dental health were observed. Public health policies should account for social determinants of oral health when reducing oral health inequalities.