Abstract
Objective
To investigate the relationship between poor oral health and the incidence of fall-related
fractures in older Japanese individuals.
Design
A 9-year prospective cohort study.
Setting and Participants
Participants comprised 937 community-dwelling older Japanese adults aged 70 years
or older. They all lived in the Tsurugaya district, a suburban area of Sendai city,
and underwent comprehensive geriatric assessment, including an oral examination, in
a public facility.
Measurements
The exposure variables were related to oral health status (posterior occlusal support,
number of remaining teeth, and occlusal force). The outcome measure was the incidence
of fall-related fractures, which was determined by National Health Insurance data.
Analyzed covariates included age, sex, medical history, smoking, alcohol drinking,
educational level, depressive symptoms, cognitive impairment, physical function, body
mass index, and history of falls. Statistical relationships were examined by calculating
hazard ratios (HRs) at 95% confidence intervals (CIs) using the Cox proportional hazard
model.
Results
In the multivariate analysis, the HRs of fall-related fractures were significantly
higher in those with unilateral posterior occlusal support (HR, 2.72; 95% CI, 1.13-6.55)
and no posterior occlusal support (HR, 2.58; 95% CI, 1.29-5.15) than in those with
bilateral posterior occlusal support. The HRs (95% CIs) of fall-related fractures
in individuals with 10-19 and 1-9 teeth and edentulous individuals were 1.77 (0.81-3.89),
2.67 (1.24-5.75), and 2.31 (1.01-5.28), respectively, compared to those with ≥20 teeth.
Conclusions and Implications
Poor oral health status is a risk factor for the incidence of fall-related fractures
in community-dwelling older Japanese individuals. The findings suggest that attention
should be focused on oral health status to further understand the risk of fall-related
fractures among community-dwelling older adults.
Keywords
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Article info
Publication history
Published online: February 12, 2021
Footnotes
Funding Disclosure: This study was partly supported by a Health Labour Sciences Research Grant (H21-Choju-Ippan-001, H22-Junkankitou-Ippan-001) provided by the Ministry of Health, Labour and Welfare of Japan (Tokyo, Japan), and by JSPS KAKENHI grant numbers JP18K09904 and 19K19325, a grant from the Futoku Foundation in 2020 for research projects. The sponsor had no role in the design, methods, subject recruitment, data collection, analysis, or preparation of this article.
The authors declare no conflicts of interest.
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© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
