Abstract：
BACKGROUND: This study determined whether tooth loss was associated with the development of functional disability and estimated the population attributable fraction (PAF) of functional disability due to tooth loss, along with risk factors for functional disability such as physical function and cognitive impairment.
METHODS: The participants were 838 community-dwelling older adults aged ≥70 years living in the Tsurugaya district in Japan in 2003. The exposure variable was the number of remaining teeth (counted by trained dentists). Other variables were age, sex, depressive symptoms, cognitive impairment, educational attainment, physical function and social support. The Cox proportional hazards model was applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the incidence of functional disability for each risk factor, such as tooth loss. The functional disability PAF due to tooth loss was estimated, and risk factors for functional disability were identified.
RESULTS: In total, 619 (73.9%) participants developed functional disability during follow-up. A multivariable model showed that those with <20 teeth (HR, 1.28; 95% CI, 1.08-1.53) were more likely to develop functional disability than those with 20 teeth or more. PAF estimation for functional disability was shown to have decreasing values in the following order: age, female sex, tooth loss and reduced physical function.
CONCLUSIONS: Tooth loss was associated with the development of functional disability in community-dwelling older Japanese adults. While retaining teeth may be a potential strategy for avoiding functional disability, clinical studies on the effect of dental treatment on preventing functional disability are warranted.
METHODS: The participants were 838 community-dwelling older adults aged ≥70 years living in the Tsurugaya district in Japan in 2003. The exposure variable was the number of remaining teeth (counted by trained dentists). Other variables were age, sex, depressive symptoms, cognitive impairment, educational attainment, physical function and social support. The Cox proportional hazards model was applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the incidence of functional disability for each risk factor, such as tooth loss. The functional disability PAF due to tooth loss was estimated, and risk factors for functional disability were identified.
RESULTS: In total, 619 (73.9%) participants developed functional disability during follow-up. A multivariable model showed that those with <20 teeth (HR, 1.28; 95% CI, 1.08-1.53) were more likely to develop functional disability than those with 20 teeth or more. PAF estimation for functional disability was shown to have decreasing values in the following order: age, female sex, tooth loss and reduced physical function.
CONCLUSIONS: Tooth loss was associated with the development of functional disability in community-dwelling older Japanese adults. While retaining teeth may be a potential strategy for avoiding functional disability, clinical studies on the effect of dental treatment on preventing functional disability are warranted.
摘要：
背景：这项研究确定了牙齿脱落是否与功能性残疾的发展有关，并估计了由于牙齿脱落而导致的功能性残疾的人群归因分数（PAF），以及功能障碍的危险因素，如身体功能和认知障碍。
方法：参与者是2003年居住在日本Tsurugaya地区的838名70岁以上的社区老年人。暴露变量是剩余牙齿的数量(由受过训练的牙医计数)。其他变量是年龄，性别,抑郁症状,认知障碍，教育程度,身体机能和社会支持。Cox比例风险模型用于估计每个风险因素的功能性残疾发生率的风险比（HR）和95％置信区间（CI）。比如牙齿脱落。估计由于牙齿脱落导致的功能性残疾PAF，并确定了功能性残疾的危险因素.
结果：总计，619名(73.9%)参与者在随访期间出现功能性残疾。多变量模型显示，<20颗牙齿(HR，1.28；95％CI，1.08-1.53）比20颗或更多牙齿的人更容易发生功能障碍。功能性残疾的PAF估计显示按以下顺序递减：年龄，女性性别,牙齿脱落和身体机能下降。
结论：在居住在社区的日本老年人中，牙齿脱落与功能性残疾的发展有关。虽然保留牙齿可能是避免功能性残疾的潜在策略，有必要对牙科治疗对预防功能性残疾的作用进行临床研究.
方法：参与者是2003年居住在日本Tsurugaya地区的838名70岁以上的社区老年人。暴露变量是剩余牙齿的数量(由受过训练的牙医计数)。其他变量是年龄，性别,抑郁症状,认知障碍，教育程度,身体机能和社会支持。Cox比例风险模型用于估计每个风险因素的功能性残疾发生率的风险比（HR）和95％置信区间（CI）。比如牙齿脱落。估计由于牙齿脱落导致的功能性残疾PAF，并确定了功能性残疾的危险因素.
结果：总计，619名(73.9%)参与者在随访期间出现功能性残疾。多变量模型显示，<20颗牙齿(HR，1.28；95％CI，1.08-1.53）比20颗或更多牙齿的人更容易发生功能障碍。功能性残疾的PAF估计显示按以下顺序递减：年龄，女性性别,牙齿脱落和身体机能下降。
结论：在居住在社区的日本老年人中，牙齿脱落与功能性残疾的发展有关。虽然保留牙齿可能是避免功能性残疾的潜在策略，有必要对牙科治疗对预防功能性残疾的作用进行临床研究.
