牙齿缺失和义齿使用对老年人认知功能障碍的影响  

Effects of tooth loss and denture use on cognitive impairment in the elderly

作　　者：张宇蝶 钱英[1] 虞晓芸 陈莹 王敏 ZHANG Yu-die;QIAN Ying;YU Xiao-yun;CHEN Ying;WANG Min(School of Nursing,Hangzhou Normal University,Hangzhou,Zhejiang 311121,China)

机构地区：[1]杭州师范大学护理学院,浙江杭州311121

出　　处：《现代预防医学》2024年第24期4548-4554,共7页Modern Preventive Medicine

摘　　要：目的探讨老年人牙齿缺失、义齿使用对认知功能障碍的影响,为有效预防认知功能减退提供思路。方法使用中国健康与养老追踪调查(CHARLS)2018年全国调查数据,选取≥60岁的老年人为研究对象,使用logistic回归探讨牙齿缺失、义齿使用对老年人认知功能障碍的影响,并对性别、社会参与进行亚组和交互作用分析。结果共纳入≥60岁老年人4372名,认知功能障碍检出率为16.22%(709/4372),年龄大、女性、居住在农村、受教育程度低、无配偶、有抑郁症状、无社会参与是认知功能障碍的风险因素。调整混杂因素后,非全牙缺失且无义齿(OR=1.382;95%CI:1.145~1.669),全牙缺失且无义齿(OR=2.074;95%CI:1.186~3.627)均会增加认知功能障碍的风险。亚组分析结果显示,男性人群中非全牙缺失且无义齿(OR=1.413;95%CI:1.077~1.853)、全牙缺失且无义齿(OR=2.600;95%CI:1.263~5.352)仍与认知功能障碍风险增加有关,而女性人群中仅有非全牙缺失且无义齿(OR=1.363;95%CI:1.046~1.776)与认知功能障碍的风险增加相关;无社会参与组中非全牙缺失且无义齿(OR=1.475;95%CI:1.123~1.937)、全牙缺失且无义齿(OR=2.720;95%CI:1.294~5.715)与认知功能障碍风险增加有关,而有社会参与组该变化无统计学意义。牙齿缺失、义齿使用与性别、社会参与各亚组间在认知功能障碍患病方面均无交互作用(P>0.05)。结论使用义齿可以减轻牙齿缺失对认知功能障碍的影响,尤其是部分牙齿缺失者。应鼓励老年人尽可能保留自然牙,及时修复缺失牙,减少认知功能减退的发生。尽管本研究并未发现牙齿缺失、义齿使用与社会参与的交互作用,但仍建议老年人积极参与社交活动。Objective To explore the effects of tooth loss and denture use on cognitive impairment in the elderly.Methods Based on the data of China Health and Retirement Longitudinal Study(CHARLS),over 60-year-old elderlies were selected as the research subjects.Logistic regression was conducted to explore the effects of tooth loss,denture use on cognitive impairment in elderly and subgroup analysis,and interaction analysis were performed for gender and social participation.Results A total of 4372 elderly people were enrolled,and the rate of cognitive impairment was 16.20%(709/4372).Older age,female,rural living,lower education,no spouse,with depressive symptoms,and without social-participation are risk factors for cognitive impairment.Group of non-total tooth loss without dentures(OR=1.382;95%CI:1.145-1.669)and group of total tooth loss without dentures(OR=2.074;95%CI:1.186-3.627)were associated with an increased risk of cognitive impairment.The results of subgroup analysis showed that the male population with non-total tooth loss and no dentures(OR=1.413;95%CI:1.077-1.853),with total tooth loss and no dentures(OR=2.600;95%CI:1.263-5.352)was still associated with an increased risk of cognitive impairment,while the female with non-total tooth loss and no dentures(OR=1.363;95%CI:1.046-1.776)was significantly associated with an increased risk of cognitive impairment.The non-social-participation-group with non-total tooth loss and no dentures(OR=1.475;95%CI:1.123-1.937),with total tooth loss and no dentures(OR=2.720;95%CI:1.294-5.715)were associated with an increased risk of cognitive impairment.There was no interaction between tooth loss,denture use,genderand social participation in the incidence of cognitive impairment(P>0.05).Conclusion The combination of tooth loss and denture use is an independent influence factor for cognitive impairment.The use of dentures can reduce the adverse effects of tooth loss on cognitive dysfunction,especially for those with partial tooth loss.The elderly should be encouraged to retain natural

关 键 词：认知功能 牙齿缺失 义齿 老年人 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R195.4[医药卫生—临床医学]