Aim Social isolation and oral health problems commonly exist in older populations and can influence each other. However, evidence on this bidirectional correlation is scarce. This systematic review aimed to provide a comprehensive overview of literature in which social isolation and oral health were associated with each other separately. Methods Electronic searches were performed through six databases. Original cross‐sectional and longitudinal prospective studies that evaluated the associations between social isolation and oral health as either exposure or outcome were included. Results In total, 282 articles were retrieved. Of these, 10 cross‐sectional studies and one longitudinal study were included in the analysis. The level of evidence reported was generally moderate to strong. Most studies found that both stronger objective and perceived social isolation were associated with worse oral health in both directions. The frequency of meeting friends had an inconsistent association with oral health. Conclusions The results of our systematic review showed a bidirectional association between social isolation and oral health in independent community‐dwelling older adults. Both objective and perceived social isolation are associated with oral health. As objective social isolation indicators, quality of social connectedness appears to play a more important role in the association with oral health.
Several preventive occupational therapy interventions have been reported as beneficial for communitydwelling older adults [1][2][3][4]; these are worth noting as the world's population ages rapidly. Occupational dysfunction (OD), which can be experienced despite the absence of an apparent medical diagnosis or disability [5], may be a new health indicator for community-dwelling older adults, who are the primary clients of preventive occupational therapy.OD was a concept proposed by Kielhofner [6, 7] in the Model of Human Occupation and is defined as a negative experience arising from the inability to engage in daily activities properly. OD may be the result of disturbing dynamic interaction among multiple factors that generate occupational engagement. Teraoka et al.[8] identified the four most common experiences in OD: occupational marginalization, imbalance, alienation, and deprivation. Occupational marginalization is defined as not having the opportunity to engage in desired daily activities, occupational imbalance describes a loss of balance in engagement in daily activities, occupational alienation occurs when individual needs relating to daily
Objective To examine the effect of different management methods on the effectiveness of care preventive programmes for community-dwelling older adults. Methods This study comprised two facilitator-led (FL) and one participant-led (PL) preventive care classes in Japan. All participants received the intervention for approximately 12 weeks. Functional assessments, occupational dysfunctions, and subjective health were measured before and after the interventions. A two-way mixed design analysis of covariance (ANCOVA) was adopted to examine the effect of the interventions, adjusted for previous experiences with preventive care services. The level of significance was set at P < 0.05. Results Fourteen participants in the PL group (76.64 ± 6.48 years, 92.9% women) and 29 participants in the FL group (76.55 ± 5.75 years, 75.9% women) were included in the statistical analysis. ANCOVA showed significant group × time interaction effects in the Five Times Sit-to-Stand Test (FTSST), the Timed Up & Go (TUG), occupational deprivation of the Classification and Assessment of Occupational Dysfunction Scale, and self-rated health. Simple main effect tests showed that the TUG decreased significantly in the PL group, while occupational deprivation and self-rated health scores improved significantly. In contrast, FTSST scores significantly improved in the FL group. Conclusion PL-type management may be more appropriate for preventing social isolation and withdrawal, while FL-type management may be more appropriate for preventing physical frailty. Selecting not only adequate programmes but also an appropriate management type that matches the service purpose can help provide more effective care preventive services.
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