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Oral health problems and risk of incident disability in two studies of older adults in the United Kingdom and the United States

Lookup NU author(s): Dr Eftychia Kotriona, Dr Heather Brown, Professor Sheena Ramsay



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2022 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society. Background: Preventing oral health problems can be crucial for maintaining physical independence in older adults. We aimed to examine the associations of a range of oral health problems with incidence of disability in older adults. Methods: We used prospective data from the British Regional Health Study (BRHS) (N = 2147, 71–92 years), and the Health, Aging and Body Composition (HABC) study (USA) (N = 3075, 71–80 years). Oral health measures included tooth loss, periodontal disease, self-rated oral health, and self-reported dry mouth. Participants were followed for onset of disability over a follow-up period of 3 years. Onset of disability was assessed through new cases of mobility limitations, activities of daily living (ADL), and instrumental activities of daily living (IADL). Logistic regression was performed to calculate the odds of incident disability. Results: In the BRHS, tooth loss was associated with greater odds of mobility limitations and ADL difficulties. Periodontal disease was associated with greater incidence of mobility limitations. Self-report of ≥3 dry mouth symptoms was associated with increased odds of incident mobility limitations and ADL difficulties (OR = 2.08, 95% CI 1.27–3.42; OR = 1.73, 95% CI 1.03–2.90). Fair/poor self-rated oral health was associated with greater incidence of IADL difficulties. In the HABC study, complete tooth loss was associated with greater incidence of mobility limitations (OR = 1.86, 95% CI 1.13–3.06), and fair/poor self-rated oral health was associated with increased odds of incident ADL difficulties (OR = 1.42, 95% CI 1.04–1.94). Conclusions: Oral health problems in older adults, particularly tooth loss, self-reported dry mouth and self-rated oral health were associated with greater incidence of disability. Poor oral health plays a potentially important role in the development of disability in older populations, which in turn is an essential part of quality of life and healthy aging.

Publication metadata

Author(s): Kotronia E, Brown H, Papacosta O, Lennon LT, Weyant RJ, Whincup PH, Wannamethee SG, Ramsay SE

Publication type: Article

Publication status: Published

Journal: Journal of the American Geriatrics Society

Year: 2022

Volume: 70

Issue: 7

Pages: 2080-2092

Print publication date: 13/07/2022

Online publication date: 19/04/2022

Acceptance date: 11/03/2022

Date deposited: 03/07/2023

ISSN (print): 0002-8614

ISSN (electronic): 1532-5415

Publisher: John Wiley and Sons Inc.


DOI: 10.1111/jgs.17792

PubMed id: 35437751


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Funder referenceFunder name
British Heart Foundation
National Institute of Dental and Craniofacial Research
National Institute on Aging
National Institute of Nursing Research
R03 DE028505-02
R592/0717Dunhill Medical Trust