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在时间变化的混下,口腔健康不良和痴呆风险:基于边缘结构模型的队列研究
Taro Kusama1,2, Kenji Takeuchi1,2,3, Sakura Kiuchi1,4
1Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.
Journal of the American Geriatrics Society
|December 8, 2023
概括
口腔健康不佳,包括牙脱落和口腔干燥,与老年人患痴呆症的风险更高有关. 这种关联甚至在考虑到随着时间的推移而发生的认知变化时也存在.
科学领域:
- 老年学是指老年学的学科.
- 流行病学 流行病学
- 口腔健康科学 口腔健康科学
背景情况:
- 口腔健康和认知功能之间存在双向关系,在痴呆症发展中可能会因时间变化而产生混.
- 老年人中普遍存在牙脱落和口腔功能下降等口腔健康指标不佳.
- 认知障碍可以影响口腔健康行为,反之亦然,使病因学调查复杂化.
研究的目的:
- 研究口腔健康的各种指标与老年成人人口中随后发展的痴呆症之间的关联.
- 为应对由认知障碍引入的口腔健康-痴呆症关系时间变化的混的挑战.
- 提供旨在改善口腔健康的干预措施的证据,以潜在地减轻痴呆风险.
主要方法:
- 来自日本老年学评估研究的独立老年人 (≥65岁) 的九年随访队列研究.
- 暴露:自报口腔健康状况 (≤19颗牙,无牙,/吞困难,异口症) 评估于2010年和2013年.
- 结果:通过行政数据库识别的痴呆症发病率 (2013-2019);用边际结构模型 (MSM) 用稳定反向概率权重作为时间变化的混因子来处理认知障碍.
主要成果:
- 在37,556名参与者中,痴呆症发病率为每100人年2.2人.
- 发现痴呆症风险增加和: ≤19个剩余的牙 (HR=1.12),无牙 (HR=1.20),困难 (HR=1.11) 和异口牙 (HR=1.10) 之间存在显著的关联.
- 吞问题与痴呆发病没有显著的关联 (p>0.05).
结论:
- 在老年人中,证实了口腔健康指标差和痴呆症风险增加之间的显著关联.
- 即使考虑到认知功能的时间变化的混效应,这些发现仍然很强大.
- 保持良好的口腔健康可能是维护认知功能和降低老年人群痴呆风险的关键因素.
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