成都市社区老年人口腔衰弱现状调查及影响因素分析^*

Status of oral frailty and its influencing factors among community-dwelling older adults in Chengdu

摘要

目的 调查成都市社区老年人口腔衰弱现状并分析其影响因素。方法 采用横断面研究设计, 通过分层、便利抽样的方法, 2022年11月—2023年3月选取成都市5个城市社区内470例老年人作为研究对象, 采用口腔衰弱-5对老年人口腔衰弱状况进行评估, 收集老年人一般资料、口腔保健行为、营养状况、焦虑、抑郁、握力、日常生活活动能力等资料。结果 254例(54.0%)社区老年人存在口腔衰弱, 口腔衰弱-5条目中舌唇运动功能异常占比最高, 多因素logistic回归分析显示, 年龄、牙签使用、握力、日常生活活动能力是城市社区老年人口腔衰弱的影响因素(P<0.05)。结论 成都市社区老年人口腔衰弱患病率高, 高龄、不使用牙签、握力下降及日常生活活动能力下降的老年人更容易发生口腔衰弱。社区医务工作者应关注老年人口腔衰弱问题, 并从老年人特征、口腔保健行为、身体状况等方面给予相关健康指导。

Abstract

Objective To investigate the status of oral frailty among the elderly in Chengdu community and analyze its influencing factors. Methods A cross-sectional study was conducted. A total of 470 elderly people from 5 communities in Chengdu were selected by stratified and convenient sampling from November 2022 to March 2023. The oral frailty of the elderly was evaluated by oral frailty-5. General data, oral health behavior, nutritional status, anxiety, depression, activities of daily living and handgrip strength were collected. Results There were 254 (54.0%) elderly people in the community with oral frailty, in which abnormal oral diadochokinesis accounted for the highest proportion. Multivariate logistic regression analysis showed that age, toothpick, activities of daily living and handgrip strength were the influencing factors of oral frailty in the elderly people. Conclusion The incidence of oral frailty was high, and the elderly people who did not use toothpick with decreased activities of daily living and handgrip strength were more prone to oral frailty. Community medical workers should pay attention to the oral frailty of the elderly, and give relevant health guidance from the characteristics of the elderly, oral health behavior and physical conditions.

关键词

口腔功能 / 口腔衰弱 / 影响因素

Key words

Oral function / Oral frailty / Influencing factors

参考文献

[1] 国家统计局. 王萍萍: 人口总量有所下降人口高质量发展取得成效[EB/OL]. (2024/1/18)[ 2024/2/9]. https://www.stats.gov.cn/xxgk/jd/sjjd2020/202401/t20240118_1946711.html.

[2] The National Bureau of Statistics of China. Wang Pingping : The total population has declined, and the high—quality development of the population has been effective[EB/OL]. (2024/1/18)[ 2024/2/9]. https://www.stats.gov.cn/xxgk/jd/sjjd2020/202401/t20240118_1946711.html.

[3] Luo Y, Guo C, Wang Y, et al. Trends and challenges for population health and migration—China, 2015—2050[J]. China CDC Wkly, 2020, 2(28): 520-524.

[4] Hakeem F F, Bernabé E, Sabbah W. Association between oral health and frailty: a systematic review of longitudinal studies[J]. Gerodontology, 2019, 36(3): 205-215.

[5] Tanaka T, Takahashi K, Hirano H, et al. Oral frailty as a risk factor for physical frailty and mortality in community—dwelling elderly[J]. J Gerontol A Biol Sci Med Sci, 2018, 73(12): 1661-1667.

[6] Watanabe Y, Okada K, Kondo M, et al. Oral health for achieving longevity[J]. Geriatr Gerontol Int, 2020, 20(6): 526-538.

[7] Hironaka S, Kugimiya Y, Watanabe Y, et al. Association between oral, social, and physical frailty in community—dwelling older adults[J]. Arch Gerontol Geriatr, 2020, 89: 104105.

[8] Kugimiya Y, Watanabe Y, Ueda T, et al. Rate of oral frailty and oral hypofunction in rural community—dwelling older Japanese individuals[J]. Gerodontology, 2020, 37(4): 342-352.

[9] 屠杭佳, 张书怡, 方雨慧, 等. 社区老年人口腔衰弱现状及影响因素分析[J]. 中华护理杂志, 2023, 58(11): 1351-1356.

[10] Tu H J, Zhang S Y, Fang Y H, et al. Current situation and influencing factors of oral frailty in the community elderly[J]. Chin J Nurs, 2023, 58(11): 1351-1356.

[11] 王琳, 鞠梅, 王婷, 等. 社区老年人口腔衰弱风险现状及影响因素分析[J]. 护理学杂志, 2023, 38(18): 112-116.

[12] Wang L, Ju M, Wang T, et al. Oral frailty risk and its influencing factors in community—dwelling elderly population[J]. J Nurs Sci, 2023, 38(18): 112-116.

[13] 唐吉, 唐小艳, 曾黎, 等. 贵州省农村地区老年人口腔衰弱的流行现况及影响因素分析[J]. 中国慢性病预防与控制, 2023, 31(5): 327-331.

[14] Tang J, Tang X Y, Zeng L, et al. Prevalence and influencing factors of oral frailty in the elderly of rural areas in Guizhou Province[J]. Chin J Prev Control Chronic Non—Commun Dis, 2023, 31(5): 327-331.

[15] Nomura Y, Ishii Y, Chiba Y, et al. Structure and validity of questionnaire for oral frail screening[J]. Healthcare (Basel), 2021, 9(1): 45.

[16] Tanaka T, Hirano H, Ikebe K, et al. Oral frailty five—item checklist to predict adverse health outcomes in community—dwelling older adults: a Kashiwa cohort study[J]. Geriatr Gerontol Int, 2023, 23(9): 651-659.

[17] Rubenstein L Z, Harker J O, Salvà A, et al. Screening for undernutrition in geriatric practice: developing the short—form mini—nutritional assessment (MNA—SF)[J]. J Gerontol A Biol Sci Med Sci, 2001, 56(6): M366-M372.

[18] 刘娟, 丁清清, 周白瑜, 等. 中国老年人肌少症诊疗专家共识(2021)[J]. 中华老年医学杂志, 2021, 40(8): 943-952.

[19] Liu J, Ding Q Q, Zhou B Y, et al. Chinese expert consensus on diagnosis and treatment for elderly with sarcopenia(2021)[J]. Chin J Geriatr, 2021, 40(8): 943-952.

[20] Miyahara S, Maeda K, Kawamura K, et al. Concordance in oral frailty five—item checklist and oral hypofunction: Examining their respective characteristics[J]. Arch Gerontol Geriatr, 2023, 118: 105305.

[21] 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.

[22] 蒋浩琛, 李珍. 从参保机制看日本医疗保险制度的经验与教训[J]. 社会保障研究, 2021(5): 103-111.

[23] Jiang H C, Li Z. Experience and lessons of Japanese health insurance system from the perspective of participation mechanism[J]. Soc Secur Stud, 2021(5): 103-111.

[24] 梁颖, 汝小美, 宋冰, 等. 日本预防保健体系对我国构建家庭保健体系的启示[J]. 中国计划生育学杂志, 2013, 21(3): 155-160.

[25] Liang Y, Ru X M, Song B, et al. Enlightenment of Japan's experiences in preventive health care to China on the establishment of the family—based health care system[J]. Chin J Fam Plan, 2013, 21(3): 155-160.

[26] Cheng M L, Wang C X, Wang X, et al. Dental expenditure, progressivity and horizontal inequality in Chinese adults: based on the 4th national oral health epidemiology survey[J]. BMC Oral Health, 2020, 20(1): 137.

[27] Zaitsu T, Saito T, Kawaguchi Y. The oral healthcare system in Japan[J]. Healthcare (Basel), 2018, 6(3): 79.

[28] 陈宗梅, 谭莹, 梁远俊, 等. 老年人口腔衰弱筛查量表的汉化及信效度检验[J]. 护理研究, 2023, 37(21): 3808-3812.

[29] Chen Z M, Tan Y, Liang Y J, et al. Chinesization of the oral frailty index—8 and its reliability and validity test[J]. Chin Nurs Res, 2023, 37(21): 3808-3812.

[30] Zhang Q, Kreulen C M, Witter D J, et al. Oral health status and prosthodontic conditions of Chinese adults: a systematic review[J]. Int J Prosthodont, 2007, 20(6): 567-572.

[31] Khalifa N, Allen P F, Abu—bakr N H, et al. Chewing ability and associated factors in a Sudanese population[J]. J Oral Sci, 2013, 55(4): 349-357.

[32] 许志刚, 刘晓蕾, 董碧蓉. 衰老的意义、特征及相关生物标记与评估模式[J]. 中国临床保健杂志, 2022, 25(4): 472-476.

[33] Xu Z G, Liu X L, Dong B R. Significance, characteristics and associated biomarkers and assessment patterns of aging[J]. Chin J Clin Healthcare, 2022, 25(4): 472-476.

[34] 常阳阳, 谢广平. 牙周病预防和控制的方法[J]. 中国社区医师, 2014, 30(21): 5—6, 8.

[35] Chang Y Y, Xie G P. Methods of periodontal disease prevention and control[J]. Chin Community Doct, 2014, 30(21): 5—6, 8.

[36] Ou X, Zeng L, Zeng Y, et al. Health behaviors and tooth retention among older adults in China: findings from the 4th Chinese national oral health survey[J]. BMC Oral Health, 2022, 22(1): 285.

[37] Li C, Yao N A. Socio—economic disparities in dental health and dental care utilisation among older Chinese[J]. Int Dent J, 2021, 71(1): 67-75.

[38] Arakawa—Kaneko I, Watarai Y, Schimmel M, et al. Relationship between tongue pressure and handgrip strength: a systematic review and meta—analysis[J]. J Oral Rehabil, 2022, 49(11): 1087-1105.

[39] Holm—Pedersen P, Schultz—Larsen K, Christiansen N, et al. Tooth loss and subsequent disability and mortality in old age[J]. J Am Geriatr Soc, 2008, 56(3): 429-435.

[40] Kim T N, Choi K M. Sarcopenia: definition, epidemiology, and pathophysiology[J]. J Bone Metab, 2013, 20(1): 1-10.

[41] Saintrain M V L, Saintrain S V, Sampaio E G M, et al. Older adults's dependence in activities of daily living: implications for oral health[J]. Public Health Nurs, 2018, 35(6): 473-481.

基金资助

^*四川省科技厅青年基金项目(2024NSFSC1607)