Subjective masticatory function and healthy life expectancy among older adults in Singapore: a multistate life table...

Masticatory function may influence physical capacity and independence in older age. This study estimated total life expectancy (LE) and healthy LE (defined as years free of self- or proxy-reported limitations in activities of daily living (ADL) or in physical function) by masticatory function status among older adults, aged 60 and above.

Using three waves of data (2009-2015) on 3381 participants of a nationally representative survey of older Singapore citizens and permanent residents, inverse probability weighted-multistate life table models estimated total and healthy LE, stratified by self- or proxy-reported masticatory function and dental prostheses use.

Impaired masticatory function was associated with shorter total and ADL-free LE, with greater reductions among dental prostheses users. At age 60, individuals without masticatory impairment lived 2.9 more ADL-free years than those with masticatory impairment (18.0 years [95 % CI 17.1-18.9] vs 15.1 years [95 % CI 13.9-16.3]); this gap narrowed to 1.7 years at age 80. Individuals with masticatory impairment spent 6-12 % higher proportion of remaining life with ADL limitations. Dental prostheses improved healthy LE overall but gains in ADL-free years were greater for individuals without masticatory impairment. For physical function-based healthy LE, masticatory impairment was associated with reductions of 0.9-2.2 years among non-users and 0.6-1.1 years among prostheses users.

Masticatory function is a determinant of healthy ageing. Dental prostheses provide partial compensation in healthy LE when masticatory function is impaired among older adults.

Geriatric care should integrate oral functional screening with objective assessments of mastication where feasible and prioritize function-oriented rehabilitation to extend healthy LE.