Abstract
Objective
We examined the association between tooth loss, periodontal diseases, and frailty
among older American adults.
Designs, Settings, and Participants
Data from the National Health and Nutrition Examination Surveys (NHANES) 2011–2014
was used. We included 2368 community-dwelling adults aged 60 years and older. Frailty
was measured with the 49-item frailty index. Oral health indicators included number
of teeth and periodontal disease. A composite nutritional intake variable based on
13 micronutrients from the dietary assessment was created. Negative binomial regression
was used to test the association between oral health and frailty. The first model
was adjusted for age and gender, the second model was additionally adjusted for nutritional
intake, and the third model was additionally adjusted for other covariates.
Results
For each additional tooth, the rate ratio (RR) for frailty was 0.99 [95% confidence
interval (CI) 0.98–0.99] in the fully adjusted model. Similarly, participants with
moderate-severe periodontitis had 1.08 RR (95% CI 1.02–1.14) for frailty index compared
with participants with no periodontitis after adjusting for age, gender, and poor
nutritional intake. The association lost significance in the fully adjusted model.
Conclusions and Implications
Oral health is associated with the frailty index, and nutritional intake appears to
have a modest effect on the association. Periodontal disease has a weaker association
with frailty compared with number of teeth. The findings highlight the importance
of maintaining good oral health at older age and incorporating oral health indicators
in routine geriatric assessments. Future research should investigate the role of potential
mediating factors in this association.
Keywords
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Article info
Publication history
Published online: August 25, 2020
Footnotes
The authors declare no conflicts of interest.
This research did not receive any funding from agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
