Age cohort changes in oral conditions and life transitions in the United States Health and Retirement Study

美国健康与退休研究中口腔状况和生活转变的年龄组变化

• 批准号: 10393524
• 负责人: Jane A Weintraub
• 金额: $ 16.24万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10393524
• 关键词: Address; Adult; Affect; Age; Aging; American; Area; Birth; Chronic; Climacteric; Cognition; Cognitive; Cohort Studies; Data; Data Analyses; Data Set; Dental; Dental Care; Dentistry; Dentition; Development; Edentulous Mouth; Elderly; Employment; Ethnic Origin; Etiology; Exposure to; Family Caregiver; Family member; Functional disorder; Gender; Generations; Goals; Health; Health Policy; Health Status; Health and Retirement Study; Healthcare; Impaired cognition; Incidence; Individual; Knowledge; Life; Life Experience; Link; Loneliness; Measures; Medicaid; Medical; Medicare; Mental Depression; National Institute of Dental and Craniofacial Research; Oral health; Outcome; Participant; Pattern; Personal Satisfaction; Persons; Population; Poverty; Predictive Factor; Preventive care; Psychosocial Assessment and Care; Psychosocial Factor; Questionnaires; Race; Regression Analysis; Research; Retirement; Sample Size; Sampling; Spouses; Statistical Models; Strategic Planning; Surveys; Telephone Interviews; Time; Tooth Loss; Tooth structure; United States; Validation; Visit; War; Weight; World War II; baby boomer; base; clinical practice; cognitive function; cognitive interview; cohort; disability; edentulism; experience; functional disability; health disparity; health related quality of life; human old age (65+); loss of function; low socioeconomic status; middle age; negative affect; nutrition; oral condition; population based; preventive intervention; programs; psychosocial; satisfaction; social factors; sociodemographics; stressor; trend

Abstract Longitudinal information of how changes in the lives of older adults (e.g., cognitive decline, retirement, medical conditions and disability) affect their oral health and dental utilization is sparse. Yet, longitudinal data are needed to assess causality. Baby Boomers and other generations have had different life circumstances that affect well- being and aging. To plan for their oral health needs and preventive care, statistical models should account for different birth cohorts. This secondary data analysis will use the comprehensive, longitudinal, nationally representative US Health and Retirement Study (HRS). HRS cohorts were 51+ year olds and their spouses who participated in the CORE biennial HRS waves from 2006-2018 (n≥15,960 per wave); Psychosocial subsample A (n=12,631 in any wave), and in the 2008 (n=1,300) and 2018 HRS dental modules (n=612 in both modules). Not all variables were collected biennially; 10-year and 12-year changes refer to 2008-2018 and 2006-2018. For population-based analysis, appropriate sampling weights will be applied in survey regression analysis to reflect the US population; appropriate covariates, potential confounders, and cohort/data subsets used. The specific aims are to: Aim 1) Determine 2018 oral health conditions and oral health disparities by traditional socio-demographic and less studied psychosocial and employment factors by HRS defined birth cohorts. Self-rated oral health, dentate status (with and without functional dentition, edentulous), and oral health- related quality of life will be assessed. Aim 2a) Compare 2008-2018 trends in dental utilization by birth cohort adjusting for oral health conditions; Aim 2b) Identify factors predictive of 10 or 12-year incidence of worsening oral health conditions (incident edentulism, incident tooth loss, worsening self-rated oral health). Aim 3) Evaluate within-subject changes and the bidirectional relationship with cognition (assessed via the Telephone Interviews for Cognitive Status(TICS) collected biennially) and adults' oral health status. Cognitive impairment is common in old age. It is important to understand the effects of decrements in oral health on cognition because of the large societal impact on the affected individuals, family members and caregivers. Prior studies have shown different relationships between oral health and cognition. Aim 3a. Determine if 2008 baseline oral health conditions are predictive of 10-year cognitive decline. Aim 3b. Determine if baseline cognitive status and 10/12-year cognitive decline are predictive of 10/12-year worsening oral health. Aim 4 focuses on the effects of longitudinal changes in psychosocial factors such as life satisfaction and loneliness measured in the HRS. Aim 4a) Compare patterns of dental utilization by psychosocial factors, birth cohorts and other factors. Aim 4b) Determine if baseline psychosocial factors and 12-year changes are predictive of incident edentulism and 2018 oral health outcomes. Aims 2b, 3b and 4b will use bootstrap cross-validation to assess prediction accuracy. Results will overcome gaps in knowledge about how different generations of older adults are faring over time and inform health policy decisions (i.e., inclusion of dental coverage in Medicare and adult Medicaid programs).

抽象的 纵向信息有关老年人生活如何变化的纵向信息（例如，认知能力下降，退休，医学 条件和残疾）影响他们的口腔健康，牙齿利用率很少。但是，需要纵向数据 评估因果关系。婴儿潮一代和其他几代人的生活环境不同 存在和衰老。为了计划其口腔健康需求和预防性护理，统计模型应考虑 不同的出生队列。该二次数据分析将使用全面的，纵向的，全国 代表美国健康和退休研究（HRS）。 HRS队列为51岁以上及其配偶 从2006 - 2018年开始参加核心双年展HRS波（每波n≥15,960）；社会心理 子样本A（在任何浪潮中n = 12,631），在2008年（n = 1,300）和2018小时牙科模块（n = 612 模块）。并非所有变量都是每两年一次的； 10年和12年的变更是指2008-2018，以及 2006- 2018年。对于基于人群的分析，适当的抽样权重将应用于调查回归中 分析以反映美国人口；适当的协变量，潜在的混杂因素和同类/数据子集 用过的。具体目的是：目标1）确定2018年口腔健康状况和口腔健康差异 HRS定义的出生 同伙。自我评估的口腔健康，牙齿状况（有和没有功能性牙齿，厌恶）和口腔健康 - 将评估相关的生活质量。 AIM 2A）比较2008-2018牙科利用率的趋势 调整口腔健康状况； AIM 2B）确定因素的因素预测10年或12年的忧虑发病率 口腔健康状况（事件编辑，事件也损失，担心自我评估的口腔健康）。目标3）评估 受试者内的变化和与认知的双向关系（通过电话访谈评估 每两年收集的认知状况（TICS）和成人的口腔健康状况。认知障碍很常见 在老年。重要的是要了解口腔健康减少对认知的影响，因为很大 社会对受影响的个人，家庭成员和照顾者的影响。先前的研究显示了不同的 口腔健康与认知之间的关系。目标3a。确定2008年基线口腔健康状况是否为 预测10年认知能力下降。目标3B。确定基线认知状况和10/12年认知能力是否 下降可以预测10/12年的口腔健康。 AIM 4专注于纵向变化的影响 在人力资源管理中测量的心理社会因素（例如生活满意度和孤独感）中。 AIM 4A）比较模式 通过社会心理因素，出生队列和其他因素的牙齿利用。目标4B）确定是否基线 社会心理因素和12年的变化可预测事件义务和2018年口腔健康结果。 AIMS 2B，3B和4B将使用自举交叉验证来评估预测准确性。结果将克服差距 在了解不同一代的老年人会随着时间的流逝以及为健康政策提供信息的知识 决定（即，在Medicare和成人医疗补助计划中包括牙科覆盖范围）。