Abstract：
OBJECTIVE: Depression is prevalent among older adults. Although the number of missing teeth is considered to be associated with depression, the relationship between masticatory function, which is usually indicated by functional tooth units (FTUs), and depression in older adults remains unclear.
METHODS: This study used data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. The number of FTUs was defined as pairs of opposing natural and artificial teeth. Depression was accessed using the Patient Health Questionnaire (PHQ-9), and participants who scored ≥10 on PHQ-9 were diagnosed with depression. Logistic regression analyses, propensity score matching (PSM) analyses and subgroup analyses were conducted to assess the association between FTU and depression.
RESULTS: The analysis included 5764 individuals over 60 years. An association between FTU and the risk of depression among older adults was detected (odds ratio [OR] = 0.951, 95% confidence interval [CI] 0.915-0.989), suggesting protective roles of more FTUs. Significant increase in the risk of depression in 0 ≤ FTUs ≤ 3 was observed compared with 10 ≤ FTUs ≤ 12 (OR = 1.819, 95% CI 1.157-2.858). However, no significant increase in the risk of depression in 4 ≤ FTUs ≤ 9 was found. After PSM, significant increase in the risk of depression in 0 ≤ FTUs ≤ 3 was still detected compared with 4 ≤ FTUs ≤ 12 (OR = 1.484, 95% CI 1.030-2.136). Subgroup analyses demonstrated consistent results in all subgroups, except for individuals aged 76-80 and drinking regularly.
CONCLUSIONS: The findings suggested the association between impaired masticatory function and the risk of depression among older adults. Longitudinal studies are needed to elucidate the role of masticatory function impairment in the development of depression further.
METHODS: This study used data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. The number of FTUs was defined as pairs of opposing natural and artificial teeth. Depression was accessed using the Patient Health Questionnaire (PHQ-9), and participants who scored ≥10 on PHQ-9 were diagnosed with depression. Logistic regression analyses, propensity score matching (PSM) analyses and subgroup analyses were conducted to assess the association between FTU and depression.
RESULTS: The analysis included 5764 individuals over 60 years. An association between FTU and the risk of depression among older adults was detected (odds ratio [OR] = 0.951, 95% confidence interval [CI] 0.915-0.989), suggesting protective roles of more FTUs. Significant increase in the risk of depression in 0 ≤ FTUs ≤ 3 was observed compared with 10 ≤ FTUs ≤ 12 (OR = 1.819, 95% CI 1.157-2.858). However, no significant increase in the risk of depression in 4 ≤ FTUs ≤ 9 was found. After PSM, significant increase in the risk of depression in 0 ≤ FTUs ≤ 3 was still detected compared with 4 ≤ FTUs ≤ 12 (OR = 1.484, 95% CI 1.030-2.136). Subgroup analyses demonstrated consistent results in all subgroups, except for individuals aged 76-80 and drinking regularly.
CONCLUSIONS: The findings suggested the association between impaired masticatory function and the risk of depression among older adults. Longitudinal studies are needed to elucidate the role of masticatory function impairment in the development of depression further.
摘要：
目的：抑郁症在老年人中普遍存在。尽管牙齿缺失的数量被认为与抑郁症有关，咀嚼功能之间的关系，通常由功能齿单元(FTU)指示，和老年人的抑郁症仍不清楚。
方法：本研究使用了2009-2018年国家健康与营养调查（NHANES）的数据。FTU的数量定义为一对相对的天然和人造牙齿。使用患者健康问卷（PHQ-9）访问抑郁症，PHQ-9评分≥10分的参与者被诊断为抑郁症.Logistic回归分析，我们进行了倾向评分匹配(PSM)分析和亚组分析,以评估FTU与抑郁之间的关联.
结果：分析包括5764名60岁以上的个体。检测到FTU与老年人抑郁症风险之间的关联（比值比[OR]=0.951，95％置信区间[CI]0.915-0.989），建议更多FTU的保护作用。与10≤FTUs≤12相比，0≤FTUs≤3的抑郁症风险显着增加（OR=1.819，95％CI1.157-2.858）。然而,未发现4≤FTUs≤9患者的抑郁风险显著增加.PSM之后,与4≤FTUs≤12相比,0≤FTUs≤3组的抑郁风险仍显著增加(OR=1.484,95%CI1.030-2.136).亚组分析显示所有亚组的结果一致，除了76-80岁和经常饮酒的人。
结论：研究结果表明，老年人咀嚼功能受损与抑郁风险之间存在关联。需要进行纵向研究以进一步阐明咀嚼功能损害在抑郁症发展中的作用。
方法：本研究使用了2009-2018年国家健康与营养调查（NHANES）的数据。FTU的数量定义为一对相对的天然和人造牙齿。使用患者健康问卷（PHQ-9）访问抑郁症，PHQ-9评分≥10分的参与者被诊断为抑郁症.Logistic回归分析，我们进行了倾向评分匹配(PSM)分析和亚组分析,以评估FTU与抑郁之间的关联.
结果：分析包括5764名60岁以上的个体。检测到FTU与老年人抑郁症风险之间的关联（比值比[OR]=0.951，95％置信区间[CI]0.915-0.989），建议更多FTU的保护作用。与10≤FTUs≤12相比，0≤FTUs≤3的抑郁症风险显着增加（OR=1.819，95％CI1.157-2.858）。然而,未发现4≤FTUs≤9患者的抑郁风险显著增加.PSM之后,与4≤FTUs≤12相比,0≤FTUs≤3组的抑郁风险仍显著增加(OR=1.484,95%CI1.030-2.136).亚组分析显示所有亚组的结果一致，除了76-80岁和经常饮酒的人。
结论：研究结果表明，老年人咀嚼功能受损与抑郁风险之间存在关联。需要进行纵向研究以进一步阐明咀嚼功能损害在抑郁症发展中的作用。
