Sheena E Ramsay1,2, Efstathios Papachristou3, Richard G Watt4, Lucy T Lennon2, A Olia Papacosta2, Peter H Whincup5, S Goya Wannamethee2. 1. Institute of Health & Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, UK. 2. Institute of Epidemiology and Health Care, UCL, London, UK. 3. Psychology & Human Development, Institute of Education, UCL, London, UK. 4. Department of Epidemiology & Public Health UCL, London, UK. 5. Population Health Research Institute, St George's University of London, London, UK.
Abstract
Background: The influence of life-course socioeconomic disadvantage on oral health at older ages is not well-established. We examined the influence of socioeconomic factors in childhood, middle-age and older age on oral health at older ages, and tested conceptual life-course models (sensitive period, accumulation of risk, social mobility) to determine which best described observed associations. Methods: A representative cohort of British men aged 71-92 in 2010-12 included socioeconomic factors in childhood, middle-age and older age. Oral health assessment at 71-92 years (n = 1622) included tooth count, periodontal disease and self-rated oral health (excellent/good, fair/poor) (n = 2147). Life-course models (adjusted for age and town of residence) were compared with a saturated model using Likelihood-ratio tests. Results: Socioeconomic disadvantage in childhood, middle-age and older age was associated with complete tooth loss at 71-92 years-age and town adjusted odds ratios (95% CI) were 1.39 (1.02-1.90), 2.26 (1.70-3.01), 1.83 (1.35-2.49), respectively. Socioeconomic disadvantage in childhood and middle-age was associated with poor self-rated oral health; adjusted odds ratios (95% CI) were 1.48 (1.19-1.85) and 1.45 (1.18-1.78), respectively. A sensitive period for socioeconomic disadvantage in middle-age provided the best model fit for tooth loss, while accumulation of risk model was the strongest for poor self-rated oral health. None of the life-course models were significant for periodontal disease measures. Conclusion: Socioeconomic disadvantage in middle-age has a particularly strong influence on tooth loss in older age. Poor self-rated oral health in older age is influenced by socioeconomic disadvantage across the life-course. Addressing socioeconomic factors in middle and older ages are likely to be important for better oral health in later life.
Background: The influence of life-course socioeconomic disadvantage on oral health at older ages is not well-established. We examined the influence of socioeconomic factors in childhood, middle-age and older age on oral health at older ages, and tested conceptual life-course models (sensitive period, accumulation of risk, social mobility) to determine which best described observed associations. Methods: A representative cohort of British men aged 71-92 in 2010-12 included socioeconomic factors in childhood, middle-age and older age. Oral health assessment at 71-92 years (n = 1622) included tooth count, periodontal disease and self-rated oral health (excellent/good, fair/poor) (n = 2147). Life-course models (adjusted for age and town of residence) were compared with a saturated model using Likelihood-ratio tests. Results: Socioeconomic disadvantage in childhood, middle-age and older age was associated with complete tooth loss at 71-92 years-age and town adjusted odds ratios (95% CI) were 1.39 (1.02-1.90), 2.26 (1.70-3.01), 1.83 (1.35-2.49), respectively. Socioeconomic disadvantage in childhood and middle-age was associated with poor self-rated oral health; adjusted odds ratios (95% CI) were 1.48 (1.19-1.85) and 1.45 (1.18-1.78), respectively. A sensitive period for socioeconomic disadvantage in middle-age provided the best model fit for tooth loss, while accumulation of risk model was the strongest for poor self-rated oral health. None of the life-course models were significant for periodontal disease measures. Conclusion: Socioeconomic disadvantage in middle-age has a particularly strong influence on tooth loss in older age. Poor self-rated oral health in older age is influenced by socioeconomic disadvantage across the life-course. Addressing socioeconomic factors in middle and older ages are likely to be important for better oral health in later life.
Authors: S E Ramsay; P H Whincup; R G Watt; G Tsakos; A O Papacosta; L T Lennon; S G Wannamethee Journal: BMJ Open Date: 2015-12-29 Impact factor: 2.692
Authors: Lucy T Lennon; Sheena E Ramsay; Olia Papacosta; A Gerald Shaper; S Goya Wannamethee; Peter H Whincup Journal: Int J Epidemiol Date: 2015-06 Impact factor: 7.196
Authors: Aina Najwa Mohd Khairuddin; Eduardo Bernabé; Elsa Karina Delgado-Angulo Journal: Health Qual Life Outcomes Date: 2021-04-07 Impact factor: 3.186
Authors: Stefano Cianetti; Chiara Valenti; Massimiliano Orso; Giuseppe Lomurno; Michele Nardone; Anna Palma Lomurno; Stefano Pagano; Guido Lombardo Journal: Int J Environ Res Public Health Date: 2021-11-24 Impact factor: 3.390