Association of changes in the number of teeth on psychological distress among community-dwelling older adults in Taiwan.

Yi-Chang Chou, Feng-Shiang Cheng, Shih-Han Weng, Hsiao-Yun Hu
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Abstract

Background: Aging populations worldwide face a substantial burden of psychological distress that affects their quality of life and overall health. Oral health is associated with psychological distress; however, the effect of changes in the number of teeth on psychological distress remains unknown. This study aimed to evaluate the association of changes in the number of teeth with the development of psychological distress among community-dwelling older adults in Taipei City.

Methods: From 2005 to 2013, 62,119 community-dwelling individuals aged 65 years and older participated in the physical examination program in Taipei. We collected data on the number of teeth during each examination. Psychological distress was defined as a score of ≥6 on the Brief Symptoms Rating Scale. A generalized estimating equation (GEE) model was used to examine the longitudinal relationship between changes in the number of teeth and the development of psychological distress.

Results: The participants lost an average of 6.6 teeth during the follow-up, with 9.9% of oral examination records showing the loss of ≥5 teeth compared with the previous examination. After GEE analysis with adjustment for multiple covariates, participants were at higher risk of developing psychological distress if they lost 1-4 teeth, 5-9 teeth, or ≥10 teeth compared to that at their previous oral examination. Subgroup analysis revealed that participants with ≥20 teeth at baseline and those who used dentures to compensate for the tooth loss had a lower risk of developing psychological distress than those who experienced tooth loss and did not use dentures.

Conclusion: A rapid decrease in the number of teeth is associated with an increased risk of psychological distress in older adults. Regular dental checkups, nutritional counseling, and the use of dentures are critical in mitigating the adverse psychological effects of the tooth loss.

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台湾社区老年人牙齿数目变化与心理困扰的关系。
背景:世界范围内的老龄人口面临着巨大的心理困扰负担,影响着他们的生活质量和整体健康。口腔健康与心理困扰有关;然而,牙齿数量的变化对心理困扰的影响尚不清楚。摘要本研究旨在探讨台北市社区老年人牙齿数目变化与心理困扰的关系。方法:2005 ~ 2013年,台北市62119名65岁及以上社区居民参加体检。我们在每次检查中收集牙齿数量的数据。心理困扰定义为在简短症状评定量表上得分≥6分。采用广义估计方程(GEE)模型对牙数变化与心理困扰发展之间的纵向关系进行了研究。结果:随访期间参与者平均脱落牙齿6.6颗,其中9.9%的口腔检查记录显示与前一次检查相比脱落牙齿≥5颗。在对多个协变量进行调整的GEE分析后,与之前的口腔检查相比,如果参与者失去1-4颗牙齿,5-9颗牙齿或≥10颗牙齿,则出现心理困扰的风险更高。亚组分析显示,基线时牙齿≥20颗以及使用假牙来弥补牙齿缺失的受试者发生心理困扰的风险低于牙齿缺失但不使用假牙的受试者。结论:牙齿数量的迅速减少与老年人心理困扰的风险增加有关。定期的牙齿检查,营养咨询和使用假牙对于减轻牙齿脱落的不良心理影响至关重要。
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