Associations of poor oral health with frailty and physical functioning in the oldest old: results from two studies in England and Japan.

Very few studies have examined the relationship of oral health with physical functioning and frailty in the oldest old (> 85 years). We examined the association of poor oral health with markers of disability, physical function and frailty in studies of oldest old in England and Japan. The Newcastle 85+ Study in England (n = 853) and the Tokyo Oldest Old Survey on Total Health (TOOTH; n = 542) comprise random samples of people aged > 85 years. Oral health markers included tooth loss, dryness of mouth, difficulty swallowing and difficulty eating due to dental problems. Physical functioning was based on grip strength and gait speed; disability was assessed as mobility limitations. Frailty was ascertained using the Fried frailty phenotype. Cross-sectional analyses were undertaken using logistic regression. In the Newcastle 85+ Study, dry mouth symptoms, difficulty swallowing, difficulty eating, and tooth loss were associated with increased risks of mobility limitations after adjustment for sex, socioeconomic position, behavioural factors and co-morbidities [odds ratios (95%CIs) were 1.76 (1.26–2.46); 2.52 (1.56–4.08); 2.89 (1.52–5.50); 2.59 (1.44–4.65) respectively]. Similar results were observed for slow gait speed. Difficulty eating was associated with weak grip strength and frailty on full adjustment. In the TOOTH Study, difficulty eating was associated with increased risks of frailty, mobility limitations and slow gait speed; and complete tooth loss was associated with increased risk of frailty. Different markers of poor oral health are independently associated with worse physical functioning and frailty in the oldest old age groups. Research to understand the underlying pathways is needed. The online version contains supplementary material available at 10.1186/s12877-021-02081-5.

很少有研究探讨超高龄（>85岁）人群口腔健康与身体机能和衰弱之间的关系。我们在英国和日本针对超高龄人群的研究中，考察了口腔健康不佳与残疾、身体机能和衰弱指标之间的关联。 英国的纽卡斯尔85+研究（n = 853）和东京全面健康超高龄老人调查（TOOTH；n = 542）包含了年龄>85岁人群的随机样本。口腔健康指标包括牙齿缺失、口干、吞咽困难以及因牙齿问题导致的进食困难。身体机能基于握力和步速；残疾通过活动受限情况来评估。衰弱采用弗里德衰弱表型来确定。使用逻辑回归进行横断面分析。 在纽卡斯尔85+研究中，在对性别、社会经济地位、行为因素和共病进行调整后，口干症状、吞咽困难、进食困难和牙齿缺失与活动受限风险增加相关[比值比（95%置信区间）分别为1.76（1.26 - 2.46）；2.52（1.56 - 4.08）；2.89（1.52 - 5.50）；2.59（1.44 - 4.65）]。对于步速缓慢也观察到了类似结果。在充分调整后，进食困难与握力弱和衰弱相关。在TOOTH研究中，进食困难与衰弱、活动受限和步速缓慢的风险增加相关；完全牙齿缺失与衰弱风险增加相关。 不同的口腔健康不佳指标在超高龄人群中与较差的身体机能和衰弱独立相关。需要进行研究以了解潜在的途径。 网络版包含补充材料，可在10.1186/s12877 - 021 - 02081 - 5获取。