中国老年人群牙齿缺失与全因死亡风险关联的前瞻性队列研究

 目的 探讨中国老年人群余留牙齿数量与全因死亡的关联。方法 基于2011－2018年中国老年健康影响因素跟踪调查(CLHLS)纵向随访资料,通过调查问卷获取调查对象的基线特征、既往病史、余留牙齿数量等信息,采用Katz量表和简易智能状态检查量表评估日常活动能力和认知功能。采用多因素Cox等比例风险模型评估余留牙齿数量与全因死亡的关联。结果 共纳入8658例老年人,男3895例(45.0%),女4763例(55.0%),平均年龄为(85.7±11.2)岁,经7年随访,死亡4488例(51.8%),牙齿余留数量与年龄增长呈负相关(P<0.05)。多因素Cox回归结果显示,在调整年龄、性别、身体质量指数(body mass index,BMI)、吸烟、饮酒、锻炼、高血压、呼吸道疾病、心血管疾病、日常活动能力失能、认知功能受损等因素后,余留牙齿数量每增加一个,全因死亡风险下降1%,与余留牙齿数量为0的老年人相比,≥20颗余留牙齿的老年人的全因死亡风险下降22%。结论 中国老年人群余留牙齿数量的减少可能增加全因死亡风险,应预防老年人群牙齿脱落。

Prospective cohort study on the relationship between tooth loss and all-cause death in the elderly of China

Objective To investigate the relationship between remaining tooth number and all-cause death in the elderly of China.Methods Based on Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2011 to 2018, the base line characteristics, the past medical history, and the number of remaining teeth of the respondents were obtained by the questionnaire. The activities of daily living and cognitive function were evaluated by Katz and MMSE scale, respectively. Multivariate Cox proportional hazards model was used to evaluate the association between the number of residual teeth and all-cause death.Results A total of 8658 participants were recruited in this study, with 3895 men (45.0%) and 4763 women (55.0%), and the average age was (85.7±11.2)years. After 7 years follow-up, 4488 participants died (51.8%) and the number of remaining teeth was negatively related with age (P<0.05). After adjusting for age, gender, BMI, smoking, drinking, exercise, hypertension, respiratory disease, cardiovascular disease, activities of daily living and cognitive function, multivariate Cox regression results showed that the risk of all-cause death decreased by 1% for each increase in the number of remaining teeth; compared with those with all teeth lost, the risk of all-cause death decreased by 22% in the elderly with ≥20 remaining teeth.Conclusions The decrease in the number of remaining teeth in the elderly population may increase the risk of all-cause death, and tooth loss in the elderly population should be prevented.