Dentition status and 10‐year higher‐level functional capacity trajectories in older adults

Abstract

AimThe effect of dentition status on higher‐level functional capacity patterns over time remains unclear. We aimed to identify distinct higher‐level functional capacity trajectories in individuals aged 70–80 years, and examine whether dentition status at 70 years predicted the trajectory.MethodsThe study included 551 community‐dwelling adults aged 70 years at baseline. Higher‐level functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG‐IC) up to the age of 80 years. A higher TMIG‐IC score indicated a higher level of competence. Group‐based trajectory modeling was used to identify distinct TMIG‐IC trajectories. The number of teeth, use of dentures, sex and education were added as baseline group membership predictors. Dental visits, health behaviors, body mass index and comorbidities during observation were added as time‐varying covariates.ResultsThree TMIG‐IC trajectories were identified: “high/stable” (65.3%), “middle/decline” (24.5%) and “low/decline” (10.2%). A lower number of teeth and non‐denture use were associated with increased odds of a low/decline trajectory relative to a high/stable trajectory (odds ratio 1.09, 95% confidence interval 1.04–1.14 [per one decrease] and odds ratio 3.96, 95% confidence interval 1.54–10.16, respectively).ConclusionsOlder adults with fewer teeth and those without dentures at the age of 70 years were more likely to follow a trajectory toward functional decline with low baseline TMIG‐IC scores, which further declines by the age of 80 years. These findings suggest that preserving natural teeth later in life, as well as using dentures, could contribute toward maintaining a higher‐level functional competence. Geriatr Gerontol Int 2021; 21: 48–53.

Heterogeneous Association of Tooth Loss with Functional Limitations

“…The results regarding ATE of tooth loss on functional capacity align with previous studies. Edentulousness is associated with physical and cognitive decline over 10 y in older adults in England (Tsakos et al 2015) and predicted a faster decline in functional capacity (Iwasaki and Yoshihara 2021). Having ≥20 natural teeth was associated with a 0.156 higher TMIG-IC total score over 3 y compared to being edentulous (Sato et al 2016).…”

Aging trajectories of subscales in higher-level functional capacity among community-dwelling older Japanese adults: the Otassha study

“…The total score ranges from 0 to 13 points, with higher scores indicating higher-level functional capacity. Regarding subscale scores, IADL had a range of 0–5 points, IA and SR had a range of 0–4 points, and a less-than-perfect score indicated impairment in the functioning of each subscale [ 2 , 8 , 11 ].…”

“…The TMIG-IC was developed approximately 30 years ago, and high-quality longitudinal data have been used to determine its aging trajectory patterns [ 3 , 11 ]. Analyzing aging trajectory patterns can clarify what patterns exist in the decline of higher-level functional capacity in older adults and help determine the target proportion and timing of interventions for maintaining higher-level functional capacity [ 12 ].…”

“…Iwasaki and Yoshihara [ 11 ] identified three aging trajectory patterns, such as “high/stable,” “middle/decline,” and “low/decline” from the longitudinal data of the TMIG-IC collected from 1998 to 2008 in a cohort of community-dwelling older adults. They reported that poor dentition status is associated with a decline in higher-level functional capacity.…”