Association of 25-hydroxyvitamin D and physical activity with oral care needs among older U.S. adults.

Objectives: This study aimed to investigate the independent and combined association of serum 25-hydroxyvitamin D [25(OH)D] levels and physical activity on oral care needs in older United States (US) adults.

Methods: A cross-sectional study involving 6509 older adults aged 60 years and above data were included from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). The main data for our study came from Questionnaires Data and Laboratory Data. Oral care needs refer to the different levels of overall care recommendations given by trained interviewers after oral examination of interviewees in the NHANES. The weighted multivariate logistic regression model and restricted cubic spline (RCS) were used to explore the associations between 25(OH)D levels, physical activity, and oral care needs. Additional propensity score matching (PSM) was performed to test the stability and reliability of the results.

Results: The results showed that high serum 25(OH)D levels (OR = 0.99, 95% CI, 0.97-1.00, P = 0.04), and vigorous recreational activity (OR = 0.70, 95% CI, 0.53-0.93, P = 0.01) were independently associated significantly with lower risks of oral care needs. High levels of 25(OH)D combined with adequate physical activity might reduce oral care needs in older adults. The mediation effect analysis also showed a mediating effect of 25(OH)D in the association of vigorous recreational activity and oral care needs.

Conclusion: High serum 25(OH)D levels and vigorous recreational activity have been linked to a reduced risk of oral care need among older adults. 25(OH)D is a potential mediator of the reduced need for oral health care associated with vigorous recreational activity when combined effects are considered. Vitamin D supplementation and increased physical activity may be a potential cost-effective oral public health strategy for older adults.