Does poor dental health predict becoming homebound among older Japanese?

Abstract

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.

Oral Health and Incident Depressive Symptoms: JAGES Project Longitudinal Study in Older Japanese

“…Problems with smiling, laughing and showing teeth without embarrassment may exacerbate social withdrawal, isolation and low self‐esteem. These pathways might explain the results of recent studies showing that few teeth and/or not using dentures predict future homeboundness and decline in higher‐level functional capacity in older people . Moreover, recent studies suggest that poor oral health increases the risk of progressing inflammatory diseases, which has been linked to depression …”

“…Number of teeth and oral health problems were evaluated based on a self‐administered questionnaire. Respondents were asked to indicate the number of teeth as 20 or more, 10–19, 1–9, or 0 . Oral health problems were asked using questions from the basic checklist for nursing care prevention developed by the Japanese Ministry of Health, Labor, and Welfare and those from a modified version of the Oral Impacts on Daily Performances .…”

“…Respondents were asked to indicate the number of teeth as 20 or more, 10-19, 1-9, or 0. 20 Oral health problems were asked using questions from the basic checklist for nursing care prevention developed by the Japanese Ministry of Health, Labor, and Welfare 25 and those from a modified version of the Oral Impacts on Daily Performances. 26 Three questions from the basic checklist were: "Have you experienced more difficulty chewing tough foods now than you did 6 months ago?"…”

“…Eating alone is reported as a risk of depression among older people . Other prospective cohort studies reported that poor oral health, proxied by having fewer teeth, predicts future homeboundness and decline in higher‐level functional capacity . Since social participation is a protective factor of depression, engaging in fewer social activities partially due to poor oral health is a possible cause of depression.…”

“…19 Other prospective cohort studies reported that poor oral health, proxied by having fewer teeth, predicts future homeboundness and decline in higher-level functional capacity. 20,21 Since social participation is a protective factor of depression, engaging in fewer social activities partially due to poor oral health is a possible cause of depression. However, few studies, including one qualitative study 22 exploring the range of reactions to and feelings about tooth loss, and one cohort study 23 examining the association between deterioration of oral health and depressive symptomatology, have addressed this issue.…”