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Oral Health, Disability and Physical Function: Results From Studies of Older People in the United Kingdom and United States of America

Lookup NU author(s): Eftychia KotroniaORCiD, Michael Visser, Professor Sheena Ramsay



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Objectives: Studies examining the associations between oral health and disability have limited oral health measures. We investigated the association of a range of objectively and subjectively assessed oral health markers with disability and physical function in older age. Design, setting and participants: Cross-sectional analyses were based on the British Regional Heart Study (BRHS) comprising men aged 71-92 (n=2147) from 24 British towns, and the Health, Aging and Body Composition (HABC) Study comprising men and women aged 71-80 (n=3075) from USA. Assessments included oral health (periodontal disease, tooth count, dry mouth, self-rated oral health), disability, and physical function (grip strength, gait speed, chair stand test). Results: In the BRHS, dry mouth, tooth loss, and cumulative oral health problems (≥3 problems) were associated with mobility limitations, problems with activities of daily living (ADL) and instrumental activities of daily living (IADL); these remained significant after adjustment for confounding variables (for ≥3 dry mouth symptoms, odds ratio (OR)=2.68, 95%CI=1.94-3.69; OR=1.76, 95%CI=1.15-2.69; OR=2.90, 95% CI: 2.01, 4.18, respectively). Similar results were observed in the HABC Study. Dry mouth was associated with the slowest gait speed in the BRHS, and the weakest grip strength in the HABC Study (OR=1.75, 95% CI: 1.22, 2.50; OR=2.43. 95%CI=1.47-4.01, respectively). Conclusions and Implications: Markers of poor oral health, particularly dry mouth, poor self-rated oral health and the presence of more than one oral health problems were associated with disability and poor physical function in older populations. Prospective investigations of these associations and underlying pathways are needed.

Publication metadata

Author(s): Kotronia E, Wannamethee SG, Papacosta AO, Whincup PH, Lennon LT, Visser M, Weyant RJ, Harris TB, Ramsay SE

Publication type: Article

Publication status: Published

Journal: Journal of the American Medical Directors Association

Year: 2019

Volume: 20

Issue: 12

Pages: 1654.e1–1654.e9

Print publication date: 01/12/2019

Online publication date: 10/08/2019

Acceptance date: 13/06/2019

Date deposited: 23/07/2019

ISSN (print): 1538-9375

ISSN (electronic): 1538-9375

Publisher: Elsevier


DOI: 10.1016/j.jamda.2019.06.010


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