Frailty as a Determinant of Dental Attendance Among Community-Dwelling Older Adults
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In this cross-sectional study designed to evaluate the association between different levels of frailty and dental attendance among home-dwelling adults aged 60 years and older, higher levels of overall frailty (the composite of physical, psychological, social, and environmental subdomains) were associated with a lower dental attendance in the previous year. Compared with adults in the low-frailty group, those in the medium- and high-frailty groups were 1.46 and 1.67 times, respectively, more likely to report no dental attendance in the prior year. In the fully adjusted regression model, the association between the physical and environmental subdomains remained.
- There is a clear and consistent association between overall frailty and dental attendance as well as between the physical and environmental aspects of frailty. Once frailty is detected, care is needed to avoid the dropout of older adults from the oral healthcare system and to allow for the early detection of oral health problems.
abstract
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Access this abstract nowOBJECTIVES
The aim of this study was to assess the association between different levels of frailty and dental attendance among home-dwelling older adults, in Belgium.
BACKGROUND
While many determinants of dental attendance among older adults have been identified, no study has focused on the role of frailty.
MATERIALS AND METHODS
This was a cross-sectional study on a random sample of home-dwelling adults aged 60 and over from two Belgian cities. Data were collected with a structured questionnaire through a participatory peer-research method. Time since the last dental attendance was the dependent variable. The independent variable was frailty, assessed with the Comprehensive Frailty Assessment Instrument, including physical, psychological, social, and environmental subdomains. Covariates were age, gender, having a partner, educational level, and household income, as well as self-perceived oral health. Data analysis included descriptive, bivariate (Chi-Square, ANOVA, and Kruskal-Wallis), and binomial logistic regression analyses.
RESULTS
The sample consisted of 1329 older adults with a mean age of 72.5 years (SD 8.9, range 60-103). In the low frailty group, 73% attended the dentist in the previous 12 months, while it was 62% and 54% in the medium and high frailty groups, respectively. In the fully adjusted model, the initial gradient in the relationship between overall frailty and dental attendance remained; those in the medium and the high frailty groups were respectively 1.46 (95% CI: 1.09, 1.95) and 1.67 (95% CI: 1.15, 2.43) times more likely to report no dental attendance in the previous year than the low frailty group. Similar associations could be seen in the physical and environmental frailty subdomains.
CONCLUSION
Frailty is consistently associated with less favourable dental attendance, independent from age, gender, socioeconomic factors, family composition, and self-perceived oral health. Once frailty has been detected, good interprofessional communication and care are needed to avoid the drop-out of older adults from the oral healthcare system.
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Additional Info
Frailty as a determinant of dental attendance among community-dwelling older adults
Gerodontology 2022 Nov 06;[EPub Ahead of Print], B Janssens, G Tsakos, L De Visschere, D Verté, N De WitteFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.