@article {13707, title = {Effect of retirement on self-rated oral health and dental services use: longitudinal fixed-effects instrumental variable study in 31 countries.}, journal = {Scandinavian Journal of Work, Environment \& Health}, year = {Forthcoming}, abstract = {

OBJECTIVE: This study examined the effect of retirement on self-rated oral health and dental services use.

METHODS: Covering 31 countries, we used harmonized panel data from the English Longitudinal Study on Aging (ELSA), Health and Retirement Study (HRS), and the Survey of Health, Aging and Retirement in Europe (SHARE). Data comprised 485 085 observations from 112 240 individuals aged >=50 years. Official and early retirement ages were leveraged as instruments in a fixed-effects instrumental variable approach.

RESULTS: We found that retirement exhibited a negative effect on self-rated oral health (β = -0.37; 95\% confidence interval (CI) -0.44- -0.30) and a positive effect on the propensity to seek dental care (β = 0.56; 95\% CI 0.53-0.60). Male retirees showed a stronger decrease in self-rated oral health and increase in dental services use than female retirees. Participants who previously worked in a physically demanding job showed a stronger effect on self-rated oral health. Conversely, participants without a physically demanding job in the past exhibited a stronger retirement effect on dental service use. Compared with other health system clusters, retirement effects on dental services use were stronger in three health system clusters: Belgium, Denmark, Finland, France, Ireland, Luxembourg, The Netherlands, and Sweden; Israel; and the United States.

CONCLUSIONS: Using a quasi-experimental design, we found that transition to retirement lowers self-rated oral health and increases the use of dental services. Retirement effects appeared heterogeneous across sexes, type of previous labor, and health systems.

}, keywords = {dental services, health systems, Oral Health, Retirement}, issn = {1795-990X}, doi = {10.5271/sjweh.4134}, author = {Baumeister, Sebastian-Edgar and Wesselmann, Hanna and Nascimento, Gustavo G and Listl, Stefan} } @article {12605, title = {Prediction Model Development and Validation of 12-Year Incident Edentulism of Older Adults in the United States.}, journal = {JDR Clinical \& Translational Research}, year = {Forthcoming}, abstract = {

INTRODUCTION: Edentulism affects health and quality of life.

OBJECTIVES: Identify factors that predict older adults becoming edentulous over 12 y in the US Health and Retirement Study (HRS) by developing and validating a prediction model.

METHODS: The HRS includes data on a representative sample of US adults aged >50 y. Selection criteria included participants in 2006 and 2018 who answered, "Have you lost all of your upper and lower natural permanent teeth?" Persons who answered "no" in 2006 and "yes" in 2018 experienced incident edentulism. Excluding 2006 edentulous, the data set ( = 4,288) was split into selection (70\%, = 3,002) and test data (30\%, = 1,286), and Monte Carlo cross-validation was applied to 500 random partitions of the selection data into training ( = 1,716) and validation ( = 1,286) data sets. Fitted logistic models from the training data sets were applied to the validation data sets to obtain area under the curve (AUC) for 32 candidate models. Six variables were included in all models (age, race/ethnicity, gender, education, smoking, last dental visit) while all combinations of 5 variables (income, alcohol use, self-rated health, loneliness, cognitive status) were considered for inclusion. The best parsimonious model based on highest mean AUC was fitted to the selection data set to obtain a final prediction equation. It was applied to the test data to estimate AUC and 95\% confidence interval using 1,000 bootstrap samples.

RESULTS: From 2006 to 2018, 9.7\% of older adults became edentulous. The 2006 mean (SD) age was 66.7 (8.7) for newly edentulous and 66.3 (8.4) for dentate ( = 0.31). The baseline 6-variable model mean AUC was 0.740. The 7-variable model with cognition had AUC = 0.749 and test data AUC = 0.748 (95\% confidence interval, 0.715-0.781), modestly improving prediction. Negligible improvement was gained from adding more variables.

CONCLUSION: Cognition information improved the 12-y prediction of becoming edentulous beyond the modifiable risk factors of smoking and dental care use, as well as nonmodifiable demographic factors.

KNOWLEDGE TRANSFER STATEMENT: This prediction modeling and validation study identifies cognition as well as modifiable (dental care use, smoking) and nonmodifiable factors (race, ethnicity, gender, age, education) associated with incident complete tooth loss in the United States. This information is useful for the public, dental care providers, and health policy makers in improving approaches to preventive care, oral and general health, and quality of life for older adults.

}, keywords = {Epidemiology, Geriatrics, Incidence, Oral Health, Tooth Loss}, issn = {2380-0852}, doi = {10.1177/23800844221112062}, author = {Preisser, J S and Moss, K and Finlayson, T L and Jones, J A and Weintraub, J A} } @article {CHEN2024100513, title = {The impact of retirement on health: Empirical evidence from the change in public pensionable age in Japan}, journal = {The Journal of the Economics of Ageing}, volume = {28}, year = {2024}, pages = {100513}, abstract = {The balance between maintaining and enhancing the health, quality of life, and healthy life expectancy of the elderly and their corresponding social costs, including medical and long-term care expenses, is an important policy issue in the context of Japan{\textquoteright}s super-aging society. In this paper, we employ individual panel data from the four waves of the Japanese Study of Aging and Retirement to examine how retirement from the labor market affects the health of elderly males. Numerous empirical studies have shown mixed results concerning the causal effect of retirement on health through diverse and complex mechanisms. However, we present several new insights by focusing on the policy change in 2000 of raising the pensionable age for the earnings-related public pension system which completely eliminates pension income after the statutory retirement age for particular cohorts. Our fixed-effects instrumental variable estimation shows that retirement significantly improves oral function and mental health, but it also makes male retirees more susceptible to lifestyle-related diseases. Supplemental results further suggest that a significant increase in dental care utilization would help improve post-retirement oral function.}, keywords = {Fixed-effects instrumental variable estimation, health, Japan, Oral Health, Pensionable age, Retirement}, issn = {2212-828X}, doi = {https://doi.org/10.1016/j.jeoa.2024.100513}, author = {Fengming Chen and Midori Wakabayashi and Michio Yuda} } @article {12977, title = {A Connection Between Diabetes, Oral Health and Dementia Highlights the Importance of Dental Care}, year = {2023}, publisher = {Oral Health Group}, keywords = {Dementia, Diabetes, Oral Health}, url = {https://www.oralhealthgroup.com/news/a-connection-between-diabetes-oral-health-and-dementia-highlights-the-importance-of-dental-care-1003972396/}, author = {Oral Heatlh} } @article {13372, title = {Oral health issues of early baby boomers.}, journal = {Spec Care Dentist}, volume = {43}, year = {2023}, pages = {313-319}, abstract = {

OBJECTIVES: The purpose of this article is to detail the oral health status of early baby boomers and how it is affected by the cultural influences after World War II.

METHODS: National data on clinically and self-assessed oral conditions from the 2021 NIDCR Oral Health in America Report, National Health and Nutrition Examination Survey (2011-2014), Center for Disease Control and Prevention, National Cancer Institute (2018), the Indian Health Service (2022), and the Health and Retirement Study (2018) were tabulated and compared (where available) to similar data for older and younger cohorts.

RESULTS: Data analyses show that there is more tooth retention overall. There are higher levels of tooth loss, unrestored caries, and periodontitis among Black, American Indian, Alaskan Native, and Hispanic baby boomers, and the poor. Smokers had higher rates of periodontitis.

CONCLUSION: A life course approach to oral health care is warranted. Only by regular access and preventive care throughout life can avoidable, unnecessary, overly complex, and invasive procedures be prevented.

}, keywords = {Dental Caries, Humans, Nutrition Surveys, Oral Health}, issn = {1754-4505}, doi = {10.1111/scd.12844}, author = {Jones, Judith A and Moss, Kevin and Weintraub, Jane A} } @article {13438, title = {Ten-year cross-sectional and longitudinal assessment and factors associated with unfavourable self-rated oral health in older adults in the United States.}, journal = {Gerodontology}, year = {2023}, abstract = {

OBJECTIVE: To investigate the association of demographic and socio-economic characteristics with self-reported oral health (SROH) among older adults who participated in the Health and Retirement Study (HRS) in 2008, 2018, or both, and to describe temporal changes.

METHODS: Data were from the University of Michigan{\textquoteright}s Health and Retirement Study (HRS), a nationally representative longitudinal survey of Americans aged 51 and older. Responses from participants who completed the Core HRS survey and Dental Module (DM) in 2008 (n = 1310), 2018 (n = 1330), and the "common group" at both timepoints (n = 559) were analysed. Using the common group, the outcome measure was 2018 self-rated oral health (Favourable vs Unfavourable). Potential explanatory variables included 2008 self-rated oral health (SROH), sociodemographic, and dental utilisation-related factors. Survey logistic regression analysis was used to identify factors that were associated with unfavourable 2018 SROH in 2018.

RESULTS: Unfavourable SROH prevalence was 28.5\% and 31.6\% in 2008 and 2018, respectively. Among the common, longitudinal group, the unfavourable prevalence remained the same, 26.1\% at both timepoints. A positive association was seen between 2018 unfavourable SROH and baseline variables of 2008 unfavourable SROH, male gender, less education, and lower levels of wealth.

CONCLUSIONS: Over a quarter of participants reported unfavourable SROH. There was little change in SROH during this period. Sociodemographic factors influence the SROH of the older population. Policies and programs to promote and protect the oral health of older adults should be designed and implemented to reduce social inequalities and improve the SROH of disadvantaged older adults.

}, keywords = {Older Adults, Oral Health, United States}, issn = {1741-2358}, doi = {10.1111/ger.12710}, author = {Tembhe, Amrita and Preisser, John S and Batorsky, Anna and Weintraub, Jane A} } @article {11710, title = {Dental Care Use, Edentulism, and Systemic Health among Older Adults.}, journal = {Journal of Dental Research}, volume = {100}, year = {2021}, pages = {1468-1474}, abstract = {

Past research suggests there are systematic associations between oral health and chronic illness among older adults. Although causality has not yet been credibly established, periodontitis has been found to be associated with higher risk of both heart disease and stroke. We advance this literature by estimating the direct association between dental care use and systemic health using multiple waves of the 1992 to 2016 Health and Retirement Study. Through the inclusion of individual fixed effects in our regression models, we account for unobservable time-invariant characteristics of individuals that might otherwise bias estimates of the association between dental care use and health. We find statistically significant negative associations between dental care use and the number of health conditions, self-reported overall health, the incidence of heart disease, and the incidence of stroke. In particular, the use of dental care within the past 2 y is associated with a 2.7\% reduction in the likelihood of being diagnosed with a heart condition and a reduction in the likelihood of a stroke diagnosis of between 5.3\% and 11.6\%. We also find large positive correlations between edentulism and the measures of chronic illness. Associations from models estimated separately for men and women are qualitatively similar to one another. These findings provide additional motivation for the consideration of a Medicare dental benefit.

}, keywords = {Cancer, Chronic conditions, Dental Care, Heart disease, Oral Health, Stroke}, issn = {1544-0591}, doi = {10.1177/00220345211019018}, author = {Meyerhoefer, C D and John V Pepper and Richard J. Manski and John F Moeller} } @article {12106, title = {Oral Conditions, Oral Health Related Quality of Life and Cognitive Function: Preliminary Results from the Health and Retirement Study}, journal = {Advances in Geriatric Medicine and Research}, volume = {3}, year = {2021}, pages = {e210020}, abstract = {Background: Growing evidence suggests that cognitive functioning is influenced by oral health status. This study examines the association between the status or condition of the mouth as measured by self-report (OH), oral health related quality of life (OHRQoL) and dental care utilization on cognitive function. Design: Population-based cross-sectional study. Setting: United States Health and Retirement Study (2018). Participants: Community-dwelling adults above 50 years of age (N = 1268; Mean age (SD) 67.14 {\textpm} 10.54 years). Measurements: Self-reported condition of mouth and teeth, number of teeth and denture use were used to determine the OH. OHRQoL was assessed as a composite score using self-reported pain or distress due to gums or teeth, difficulty to relax, avoiding eating certain foods, or socializing due to oral health issues. Validated cognitive score cut-offs were used: (i) (>=12) representing normal cognition (ii) (6{\textendash}11) {\textquotedblleft}cognitive impairment, not demented{\textquotedblright} (CIND), and (iii) (<6) dementia. Results: We found that participants with worse OHRQoL had 0.15 units lower global cognitive scores (β = -0.15, SE = 0.03, p = < 0.0001). Compared to those with dementia, participants in normal and CIND categories had greater odds of better OH (ORNormal = 1.76, (95\%CI: 1.09{\textendash}2.84); ORCIND = 2.86, (95\%CI: 1.60{\textendash}5.09)). Furthermore, participants in the CIND category had greater odds of using dentures compared to participants with dementia (ORCIND = 2.71, (95\%CI: 1.49{\textendash}4.93)). We did not find any statistically significant association between tooth loss or dental utilization and dementia. Conclusions: This study provides valuable preliminary insights into the potential association between OH and OHRQoL and cognitive function. If further validated, this method may allow dental and cognitive triage for follow-up assessments in community dwelling adults who may have limited access to care.}, keywords = {Cognition, Dementia, Oral Health, oral health related quality of life}, doi = {https://doi.org/10.20900/agmr20210020}, author = {Joshi, Prajakta and Kaufman, Laura B. and Cabral, Howard} } @article {12057, title = {Oral Health, Cognitive Function, and Mortality: Findings From National Surveys}, journal = {Innovation in Aging}, volume = {5}, year = {2021}, pages = {206}, abstract = {Poor oral health, diabetes mellitus (DM), and cognitive impairment are common problems in older adults. Using national surveys, this symposium aims to present new findings regarding the impact of the co-occurrence of DM and poor oral health on cognitive function, cognitive decline, and mortality. This symposium will also cover the topic of dental care use among adult populations in the U.S. Using data from the Health and Retirement Study (HRS) (2006- 2018), the first study shows that adults with both DM and edentulism had the worst cognitive function, followed by those with edentulism alone, and those with DM alone. Using the same HRS data, the second study found that co-occurrence of DM and edentulism had a higher risk of more rapid cognitive decline with advancing age than the presence of each condition alone. The third study used data from the 2006-2016 HRS linked with mortality files, and revealed that the risk of diabetes and edentulism on mortality may vary across racial/ethnic groups. Using the Behavioral Risk Factor Surveillance System survey (2002-2018), the fourth study examined disparities of dental service utilization among racial/ethnic groups (Whites, Hispanics, Blacks, Asians, American Indians or Alaska Natives, and Native Hawaiian or other Pacific Islanders). Age differences in dental services were also compared between older adults and other younger and middle-aged populations. This symposium highlights the role of oral health in improving cognitive health. Policies and programs are needed to increase dental care access, a critical way to help maintain good oral health.}, keywords = {cognitive function, Mortality, Oral Health}, doi = {https://doi.org/10.1093/geroni/igab046.790}, author = {Bei Wu and Keepper, Susie and Saunders, Michele} } @article {LEE2020100011, title = {The Association Between Oral Health and Food Avoidance Among Older Adults in the United States}, journal = {Public Health in Practice}, volume = {1}, year = {2020}, abstract = {Objectives This study examines the association between oral health and food avoidance among older adults in the United States. Study Design A population-based sample of 1,278 adults aged 51+ from the Health and Retirement Study was used. A logistic regression model was performed to evaluate various oral health conditions and food avoidance behavior among older adults. Results were quantified as odds ratios (OR). Results This study found a significant association between oral health and food avoidance in older adults. Individuals with teeth loss, poor self-rated oral health, and teeth or gum sensitivity experienced more food avoidance. Conclusions Geriatric health care professionals assessing older adults{\textquoteright} well-being can be informed by this study outcome to consider oral health as a potential risk factor for food avoidance. This study can inform policymakers to develop oral health promotion programs and goals for older adults, and also consider nutritional support for older adults with negative oral health conditions.}, keywords = {Gerontology, Oral Health, Public Health}, issn = {2666-5352}, doi = {10.1016/j.puhip.2020.100011}, author = {Yeonjung Jane Lee and Hyun-Kee [Harry] Lee} } @article {11334, title = {Early Life Conditions, Adulthood Experiences, and Edentulism at Older Ages}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {800}, abstract = {The role of childhood in shaping overall adult health has been well documented, especially for physical and mental health, but much less is known about the impact of early disadvantage on oral health in later life. Using data from the 2006 and 2012 Health and Retirement Study, we investigate the link between childhood financial and psychosocial adversity and edentulism over a six-year period among U.S. adults aged 51 and older. We find that those growing up with parents with fewer resources face higher risks of having lost all their tooth at baseline and during the follow-up. Adulthood socioeconomic status and health behaviors are strongly associated with the risk of edentulism, net of childhood conditions. However, the effect of low parental resources on the onset of edentulism persists when accounting for these life course factors. Part of a symposium sponsored by the Oral Health Interest Group.}, keywords = {adulthood experiences, early life conditions, edentulism, Oral Health}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa057.2900}, author = {Lee, Haena and Linda J. Waite} } @article {10919, title = {Education-Related Inequalities in Dental Services Use among Older Adults in 23 Countries}, journal = {Journal of Dental Research}, year = {2020}, abstract = {This study aimed to measure the magnitude of education-related inequalities in the use of dental services among older adults (aged 50?y or older) from a sizable multicountry sample of 23 upper-middle- and high-income countries. This study used cross-sectional data from nationally representative surveys of people aged 50 y and over. Countries included in the Health and Retirement Study surveys were the following: Brazil, China, South Korea, Mexico, United States, Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, France, Germany, Greece, Italy, Israel, Luxembourg, Poland, Portugal, Slovenia, Spain, Sweden, and Switzerland. The dependent variable was the use of dental services, based on the self-report of having had a dental visit within the previous year, except for the United States and South Korea, which used 2-y recall periods. Educational level was used as the measure of socioeconomic position and was standardized across countries. Multivariate logistic regression modeling was used to evaluate the factors associated with the use of dental services, and the magnitude of education inequalities in the use of dental services was assessed using the slope index of inequality (SII) to measure absolute inequalities and the relative index of inequality for relative inequalities. The pooled prevalence of the use of dental services was 31.7\% and ranged from 18.7\% in China to 81.2\% in Sweden. In the overall sample, the absolute difference in the prevalence of use between the lowest and highest educational groups was 20?percentage points. SII was significant for all countries except Portugal. Relative educational inequalities were significant for all countries and ranged from 3.2 in Poland to 1.2 in Sweden. There were significant education-related inequalities in the use of dental care by older adults in all countries. Monitoring these inequalities is critical to the planning and delivery of dental services.}, keywords = {Dental Care, Epidemiology, health care disparities, Health Services for the Aged, Oral Health, Socioeconomic factors}, isbn = {0022-0345}, doi = {10.1177/0022034520935854}, author = {Andrade, F. Bof de and Antunes, J.L.F. and Andrade, F.C.D. and Lima-Costa, M.F.F. and Macinko, J.} } @article {8377, title = {Disparity in dental attendance among older adult populations: a comparative analysis across selected European countries and the USA.}, journal = {Int Dent J}, volume = {66}, year = {2016}, month = {2016 Feb}, pages = {36-48}, publisher = {66}, abstract = {

BACKGROUND: The current study addresses the extent to which diversity in dental attendance across population subgroups exists within and between the USA and selected European countries.

METHOD: The analyses relied on 2006/2007 data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and 2004-2006 data from the Health and Retirement Study (HRS) in the USA for respondents>=51 years of age. Logistic regression models were estimated to identify impacts of dental-care coverage, and of oral and general health status, on dental-care use.

RESULTS: We were unable to discern significant differences in dental attendance across population subgroups in countries with and without social health insurance, between the USA and European countries, and between European countries classified according to social welfare regime. Patterns of diverse dental use were found, but they did not appear predominately in countries classified according to welfare state regime or according to the presence or absence of social health insurance.

CONCLUSIONS: The findings of this study suggest that income and education have a stronger, and more persistent, correlation with dental use than the correlation between dental insurance and dental use across European countries. We conclude that: (i) higher overall rates of coverage in most European countries, compared with relatively lower rates in the USA, contribute to this finding; and that (ii) policies targeted to improving the income of older persons and their awareness of the importance of oral health care in both Europe and the USA can contribute to improving the use of dental services.

}, keywords = {Aged, Aged, 80 and over, Demography, Dental Care, Europe, Female, Humans, Insurance Coverage, Interviews as Topic, Male, Middle Aged, Oral Health, Patient Acceptance of Health Care, United States}, issn = {0020-6539}, doi = {10.1111/idj.12190}, url = {http://onlinelibrary.wiley.com/doi/10.1111/idj.12190/epdf}, author = {Richard J. Manski and John F Moeller and Haiyan Chen and Widstrom, Eeva and Listl, Stefan} } @article {8340, title = {Trajectories of depressive symptoms and oral health outcomes in a community sample of older adults.}, journal = {Int J Geriatr Psychiatry}, volume = {31}, year = {2016}, note = {Export Date: 9 September 2015 Article in Press}, month = {2016 Jan}, pages = {83-91}, publisher = {31}, abstract = {

OBJECTIVE: Adverse outcomes associated with chronic depressive symptoms are of clinical importance. The objective was to identify subgroups of older adults based on their trajectories of depressive symptoms over a 10-year period and determine if these subgroups predicted oral health outcomes.

METHODS: The sample was 944 adults aged 65+ who participated in the oral health module of the the Health and Retirement Survey in 2008. Depressive symptoms were measured with a modified version of the Center for Epidemiologic Studies-Depression (CES-D) scale. Latent class trajectory analysis was used to identify distinct subgroups of elders based on their CES-D scores from 1998-2008. Group membership was used to predict self-rated oral health, overall mouth condition (problems with bleeding gums, gum sensitivity, and food avoidance), and edentulism in 2008.

RESULTS: Three distinct subgroups were identified using zero-inflated Poisson regression models: (i) minimal depressive symptoms over the study period (43\%), (ii) low but generally stable level of depressive symptoms (41\%), and (iii) moderate symptoms and higher CES-D scores than the other groups over the 10 years (16\%). Controlling for demographic and health variables and edentulism status, having a trajectory of moderate symptoms was associated with poorer mouth condition (p < 0.0001) and poorer self-rated oral health (p = 0.0003) compared with those with minimal symptoms. Having low levels of depressive symptoms was not significantly associated with these two outcomes. Group membership was not significantly associated with the probability of edentulism.

CONCLUSIONS: Chronic moderate depressive symptoms are associated with poorer oral health in older adults.

}, keywords = {Aged, Aged, 80 and over, Chronic disease, Depressive Disorder, Female, Humans, Longitudinal Studies, Male, Oral Health, Regression Analysis}, issn = {1099-1166}, doi = {10.1002/gps.4292}, author = {Celia F. Hybel and Joan M. Bennett and Lawrence R Landerman and Jersey Liang and Brenda L Plassman and Bei Wu} }