基于健康老龄化战略背景对口腔衰弱概念分析的研究

摘要

目的 应用Walker & Avant经典概念分析法界定口腔衰弱内涵。方法 系统检索中国知网、PubMed等中英文数据库,获取以“口腔衰弱”为主题的文献。检索时限为建库至2023年8月,语种限定为中/英文。两名研究者独立完成两轮筛选后,遵照经典概念分析步骤,从概念提出与发展、概念定义与属性等方面释义口腔衰弱内涵。结果 共纳入文献54篇,即中文12篇,英文42篇。口腔衰弱概念属性由增龄性口腔状况恶化,多维身心储备能力下降两方面组成;前因因素包括社会人口学、生理健康、心理健康与社会因素;生理层面为营养状况恶化及不良结局风险增加,心理层面为心理障碍发生风险增高,社会层面为社会交往能力下降,生理-心理-社会三层面构成其概念后果。结论 口腔衰弱不仅因增龄性衰老导致口腔功能持续减退,还受生物、心理、社会等因素协同作用诱发情绪障碍等不良健康结局。后续应基于国家卫健委健康老龄化战略背景行动专项内容,在已有基础上进一步完善口腔衰弱内涵,为早期识别高危人群及精准健康管理实证研究提供理论依据。

关键词

口腔衰弱 / 概念分析 / 老年人 / 健康老龄化

[1] Dent E, Martin FC, Bergman H, et al.Management of frailty: opportunities, challenges and future directions[J]. Lancet, 2019, 394(126): 1376-1386.
[2] Watanabe Y, Okada K, Kondo M, et al.Oral health for achieving longevity[J]. Geriatr Gerontol International, 2020, 20(6): 526-538.
[3] Tanaka T, Takahashi K, Hirano H, et al.Oral frailty as a risk factor for physical frailty and mortality in community-dwelling elderly[J]. Journals of Gerontology Series A-Biological Sciences and Medical Sciences, 2018, 73(12): 1661-1667.
[4] Lin YC, Huang SS, Yen CW, et al.Physical frailty and oral frailty associated with late-life depression in community-dwelling older adults[J]. Journal of Personalized Medicine, 2022,12(3): 459.
[5] Walker L, Avant K.Strategies for theory construction in nursing[M]. 5th ed. Upper Saddle River, NJ: Pearson-Prentice Hall, 2011: 157-159.
[6] Morley JE.Editorial: oral frailty[J]. Journal of Nutrition Health & Aging, 2020, 24(7): 683-684.
[7] Parisius KGH, Wartewig E, Schoonmade LJ, et al.Oral frailty dissected and conceptualized: A scoping review[J]. Arch Gerontol Geriatr, 2022,100:104653.
[8] Nishimoto M, Tanaka T, Hirano H, et al.Severe periodontitis increases the risk of oral frailty: a six-year follow-up study from kashiwa cohort study[J]. Geriatrics (Basel), 2023, 8(1): 25.
[9] Hirata A, Ishizaka M, Sawaya Y, et al.Relationship between the swallowing function, nutritional status, and sarcopenia in elderly outpatients[J]. Nihon Ronen Igakkai Zasshi, 2021, 58(1): 134-142.
[10] Hatanaka Y, Furuya J, Sato Y, et al.Associations between oral hypofunction tests, age, and sex[J]. International Journal of Environmental Research and Public Health, 2021, 18(19): 10256.
[11] Chuhuaicura P, Dias FJ, Arias A, et al.Mastication as a protective factor of the cognitive decline in adults: A qualitative systematic review[J]. International dental Journal, 2019, 69(5): 334-340.
[12] 范涛,曹乾,蒋露露,等. 老年人慢性病影响因素的健康生态学模型解释[J]. 中国全科医学,2012,15(1):33-36,40.
[13] Nakai S, Suzuki F, Okamoto S, et al.Association between bone mineral density and oral frailty on renal function: findings from the shika study[J]. Healthcare (Basel), 2023, 11(3): 314.
[14] Iwasaki M, Motokawa K, Watanabe Y, et al.Association between oral frailty and nutritional status among community-dwelling older adults: the takashimadaira study[J]. J Nutr Health Aging, 2020, 24(9): 1003-1010.
[15] Iwasaki M, Watanabe Y, Motokawa K, et al.Oral frailty and gait performance in community-dwelling older adults: findings from the Takashimadaira study[J]. J Prosthodont Res, 2021, 65(4): 467-473.
[16] Ishii M, Yamaguchi Y, Hamaya H, et al.Influence of oral health on frailty in patients with type 2 diabetes aged 75 years or older[J]. BMC Geriatr, 2022, 22(1): 145.
[17] Tanaka T, Hirano H, Ohara Y, et al.Oral Frailty Index-8 in the risk assessment of new-onset oral frailty and functional disability among community-dwelling older adults[J]. Arch Gerontol Geriatr, 2021, 94: 104340.
[18] Dibello V, Lozupone M, Manfredini D, et al.Oral frailty and neurodegeneration in Alzheimer's disease[J]. Neural Regen Res, 2021, 16(11): 2149-2153.
[19] Bush LA, Horenkamp N, Morley JE, et al.Dental: a rapid self-administered screening instrument to promote referrals for further evaluation in older adults[J]. Journal of the American Geriatrics Society, 1996,44(8): 979-981.
[20] Belafsky PC, Mouadeb DA, Rees CJ, et al.Validity and reliability of the eating assessment tool (EAT-10)[J]. Ann Otol Rhinol Laryngol, 2008, 117(12): 919-924.
[21] Kera T, Kawai H, Yoshida H, et al.Classification of frailty using the Kihon checklist: a cluster analysis of older adults in urban areas[J]. Geriatr Gerontol International, 2017, 17(1): 69-77.
[22] Choi JH, Kang JH, Koh SB, et al.Development of an oral and maxillofacial frailty index: a preliminary study[J]. Journal of Oral Rehabilitation, 2020, 47(2): 187-195.
[23] Hihara T, Goto T, Ichikawa T.Investigating eating behaviors and symptoms of oral frailty using questionnaires[J]. Dentistry Journal, 2019, 7(3): 66.

基金资助

河北省社会科学发展研究课题（20230205144）; 承德市社科联项目（20233281）; 河北省高等学校人文社会科学研究课题（SQ2023044）; 河北省卫健委课题（20240811,20241909）