Dental status and incident falls among older Japanese: a prospective cohort study
Identifieur interne : 002870 ( Pmc/Curation ); précédent : 002869; suivant : 002871Dental status and incident falls among older Japanese: a prospective cohort study
Auteurs : Tatsuo Yamamoto [Japon] ; Katsunori Kondo [Japon] ; Jimpei Misawa [Japon] ; Hiroshi Hirai [Japon] ; Miyo Nakade [Japon] ; Jun Aida [Japon] ; Naoki Kondo [Japon] ; Ichiro Kawachi [États-Unis] ; Yukio Hirata [Japon]Source :
- BMJ Open [ 2044-6055 ] ; 2012.
Abstract
To examine if self-reported number of teeth, denture use and chewing ability are associated with incident falls.
Longitudinal cohort study (the Aichi Gerontological Evaluation Study).
5 Japanese municipalities.
1763 community-dwelling individuals aged 65 years and older without experience of falls within the previous year at baseline.
Self-reported history of multiple falls during the past year at the follow-up survey about 3 years later. Baseline data on the number of teeth present and/or denture use and chewing ability were collected using self-administered questionnaires. Logistic regression analyses controlled for sex, age, functional disability during follow-up period, depression, self-rated health and educational attainment.
86 (4.9%) subjects reported falls at the follow-up survey. Logistic regression models fully adjusted for all covariates showed that subjects having 19 or fewer teeth but not using dentures had a significantly increased risk for incident falls (OR 2.50, 95% CI 1.21 to 5.17, p=0.013) compared with those having 20 or more teeth. Among subjects with 19 or fewer teeth, their risk of falls was not significantly elevated so long as they wore dentures (OR 1.36, 95% CI 0.76 to 2.45, p=0.299). No significant association was observed between chewing ability and incident falls in the fully adjusted model.
Having 19 or fewer teeth but not using dentures was associated with higher risk for the incident falls in older Japanese even after adjustment for multiple covariates. Dental care to prevent tooth loss and denture treatment for older people might prevent falls, although the authors cannot exclude the possibility that the association is due to residual confounding.
Url:
DOI: 10.1136/bmjopen-2012-001262
PubMed: 22855628
PubMed Central: 4400665
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<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p>To examine if self-reported number of teeth, denture use and chewing ability are
associated with incident falls.</p>
</sec>
<sec><title>Design</title>
<p>Longitudinal cohort study (the Aichi Gerontological Evaluation Study).</p>
</sec>
<sec><title>Setting</title>
<p>5 Japanese municipalities.</p>
</sec>
<sec><title>Participants</title>
<p>1763 community-dwelling individuals aged 65 years and older without
experience of falls within the previous year at baseline.</p>
</sec>
<sec><title>Main outcome measures</title>
<p>Self-reported history of multiple falls during the past year at the follow-up
survey about 3 years later. Baseline data on the number of teeth present
and/or denture use and chewing ability were collected using self-administered
questionnaires. Logistic regression analyses controlled for sex, age, functional
disability during follow-up period, depression, self-rated health and educational
attainment.</p>
</sec>
<sec><title>Results</title>
<p>86 (4.9%) subjects reported falls at the follow-up survey. Logistic regression
models fully adjusted for all covariates showed that subjects having 19 or fewer
teeth but not using dentures had a significantly increased risk for incident falls
(OR 2.50, 95% CI 1.21 to 5.17, p=0.013) compared with those having 20 or
more teeth. Among subjects with 19 or fewer teeth, their risk of falls was not
significantly elevated so long as they wore dentures (OR 1.36, 95% CI 0.76 to
2.45, p=0.299). No significant association was observed between chewing
ability and incident falls in the fully adjusted model.</p>
</sec>
<sec><title>Conclusions</title>
<p>Having 19 or fewer teeth but not using dentures was associated with higher risk
for the incident falls in older Japanese even after adjustment for multiple
covariates. Dental care to prevent tooth loss and denture treatment for older
people might prevent falls, although the authors cannot exclude the possibility
that the association is due to residual confounding.</p>
</sec>
</div>
</front>
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</author>
<author><name sortKey="Chan, Dh" uniqKey="Chan D">DH Chan</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Pitiphat, W" uniqKey="Pitiphat W">W Pitiphat</name>
</author>
<author><name sortKey="Garcia, Ri" uniqKey="Garcia R">RI Garcia</name>
</author>
<author><name sortKey="Douglass, Cw" uniqKey="Douglass C">CW Douglass</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Douglass, Cw" uniqKey="Douglass C">CW Douglass</name>
</author>
<author><name sortKey="Berlin, J" uniqKey="Berlin J">J Berlin</name>
</author>
<author><name sortKey="Tennstedt, S" uniqKey="Tennstedt S">S Tennstedt</name>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMJ Open</journal-id>
<journal-id journal-id-type="iso-abbrev">BMJ Open</journal-id>
<journal-id journal-id-type="publisher-id">bmjopen</journal-id>
<journal-id journal-id-type="hwp">bmjopen</journal-id>
<journal-title-group><journal-title>BMJ Open</journal-title>
</journal-title-group>
<issn pub-type="epub">2044-6055</issn>
<publisher><publisher-name>BMJ Group</publisher-name>
<publisher-loc>BMA House, Tavistock Square, London, WC1H 9JR</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">22855628</article-id>
<article-id pub-id-type="pmc">4400665</article-id>
<article-id pub-id-type="publisher-id">bmjopen-2012-001262</article-id>
<article-id pub-id-type="doi">10.1136/bmjopen-2012-001262</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Dentistry and Oral Medicine</subject>
<subj-group><subject>Research</subject>
</subj-group>
</subj-group>
<subj-group subj-group-type="hwp-journal-coll"><subject>1506</subject>
<subject>1686</subject>
<subject>1692</subject>
<subject>1698</subject>
</subj-group>
</article-categories>
<title-group><article-title>Dental status and incident falls among older Japanese: a prospective
cohort study</article-title>
<alt-title alt-title-type="short">Dental status and incident falls among older
Japanese</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Yamamoto</surname>
<given-names>Tatsuo</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kondo</surname>
<given-names>Katsunori</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Misawa</surname>
<given-names>Jimpei</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hirai</surname>
<given-names>Hiroshi</given-names>
</name>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nakade</surname>
<given-names>Miyo</given-names>
</name>
<xref ref-type="aff" rid="aff4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Aida</surname>
<given-names>Jun</given-names>
</name>
<xref ref-type="aff" rid="aff5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kondo</surname>
<given-names>Naoki</given-names>
</name>
<xref ref-type="aff" rid="aff6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kawachi</surname>
<given-names>Ichiro</given-names>
</name>
<xref ref-type="aff" rid="aff7">7</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Hirata</surname>
<given-names>Yukio</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
Division of Sociological Approach in Dentistry, Department of Dental Sociology, Kanagawa Dental College, Yokosuka-shi, Kanagawa, Japan</aff>
<aff id="aff2"><label>2</label>
Center for Well-being and Society, Nihon Fukushi University, Nagoya-shi, Aichi, Japan</aff>
<aff id="aff3"><label>3</label>
Department of Civil and Environmental Engineering, Faculty of Engineering, Iwate University, Morioka-shi, Iwate, Japan</aff>
<aff id="aff4"><label>4</label>
Department of Nutrition, Faculty of Health and Nutrition, Tokaigakuen University, Nagoya-shi, Aichi, Japan</aff>
<aff id="aff5"><label>5</label>
Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai-shi, Miyagi, Japan</aff>
<aff id="aff6"><label>6</label>
Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo-shi, Yamanashi, Japan</aff>
<aff id="aff7"><label>7</label>
Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, USA</aff>
<author-notes><corresp><label>Correspondence to</label>
Dr Yukio Hirata; <email>hiratay@kdcnet.ac.jp</email>
</corresp>
</author-notes>
<pub-date pub-type="collection"><year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>31</day>
<month>7</month>
<year>2012</year>
</pub-date>
<volume>2</volume>
<issue>4</issue>
<elocation-id>e001262</elocation-id>
<history><date date-type="received"><day>4</day>
<month>4</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>5</day>
<month>7</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to
use (where not already granted under a licence) please go to
http://group.bmj.com/group/rights-licensing/permissions</copyright-statement>
<copyright-year>2012</copyright-year>
<license license-type="open-access"><license-p>This is an open-access article distributed under the terms of the Creative Commons
Attribution Non-commercial License, which permits use, distribution, and
reproduction in any medium, provided the original work is properly cited, the use
is non commercial and is otherwise in compliance with the license. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/">http://creativecommons.org/licenses/by-nc/2.0/</ext-link>
and <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/legalcode">http://creativecommons.org/licenses/by-nc/2.0/legalcode</ext-link>
.</license-p>
</license>
</permissions>
<self-uri xlink:title="pdf" xlink:type="simple" xlink:href="bmjopen-2012-001262.pdf"></self-uri>
<abstract><sec><title>Objective</title>
<p>To examine if self-reported number of teeth, denture use and chewing ability are
associated with incident falls.</p>
</sec>
<sec><title>Design</title>
<p>Longitudinal cohort study (the Aichi Gerontological Evaluation Study).</p>
</sec>
<sec><title>Setting</title>
<p>5 Japanese municipalities.</p>
</sec>
<sec><title>Participants</title>
<p>1763 community-dwelling individuals aged 65 years and older without
experience of falls within the previous year at baseline.</p>
</sec>
<sec><title>Main outcome measures</title>
<p>Self-reported history of multiple falls during the past year at the follow-up
survey about 3 years later. Baseline data on the number of teeth present
and/or denture use and chewing ability were collected using self-administered
questionnaires. Logistic regression analyses controlled for sex, age, functional
disability during follow-up period, depression, self-rated health and educational
attainment.</p>
</sec>
<sec><title>Results</title>
<p>86 (4.9%) subjects reported falls at the follow-up survey. Logistic regression
models fully adjusted for all covariates showed that subjects having 19 or fewer
teeth but not using dentures had a significantly increased risk for incident falls
(OR 2.50, 95% CI 1.21 to 5.17, p=0.013) compared with those having 20 or
more teeth. Among subjects with 19 or fewer teeth, their risk of falls was not
significantly elevated so long as they wore dentures (OR 1.36, 95% CI 0.76 to
2.45, p=0.299). No significant association was observed between chewing
ability and incident falls in the fully adjusted model.</p>
</sec>
<sec><title>Conclusions</title>
<p>Having 19 or fewer teeth but not using dentures was associated with higher risk
for the incident falls in older Japanese even after adjustment for multiple
covariates. Dental care to prevent tooth loss and denture treatment for older
people might prevent falls, although the authors cannot exclude the possibility
that the association is due to residual confounding.</p>
</sec>
</abstract>
<abstract abstract-type="summary"><title>Article summary</title>
<sec><title>Article focus</title>
<list list-type="bullet"><list-item><p>An association has been reported between dental occlusion and physical function
including lower extremity dynamic strength and balance.</p>
</list-item>
<list-item><p>Whether number of teeth, denture use and chewing ability predict subsequent
incidence of falls is unknown.</p>
</list-item>
<list-item><p>The aim of this study was to examine if self-reported number of teeth, denture
use and chewing ability are associated with incident falls.</p>
</list-item>
</list>
</sec>
<sec><title>Key messages</title>
<list list-type="bullet"><list-item><p>Having 19 or fewer teeth but not using dentures was a strong independent
predictor of incident falls in a community-dwelling older population.</p>
</list-item>
<list-item><p>In addition to preventing tooth loss, denture treatment for older people might
prevent falls.</p>
</list-item>
</list>
</sec>
<sec><title>Strengths and limitations of this study</title>
<list list-type="bullet"><list-item><p>Strengths of this study include large sample size, population-based sampling
and control for many potential confounding factors.</p>
</list-item>
<list-item><p>The following limitations should be considered: the information on dental
status and falls was self-reported and misclassification of cases is possible.
Moreover, we cannot exclude the possibility that the association is due to
residual confounding.</p>
</list-item>
</list>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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