Factors associated with perceived unmet dental care needs of older adults.

AIM: Although older adults have high dental care needs as a result of prevalent oral health problems, they have high unmet needs. The purpose of the present study was to examine factors associated with unmet dental care needs among older adults living in the community. METHODS: This study analyzed 1419 adults aged 65 years and older who participated in both the health interview survey and oral examination of the Fifth Korea National Health and Nutrition Examination Survey carried out in 2010. Predisposing (age, sex, education, marital status), enabling (place of residence, work status, income, health insurance) and need (self-rated oral health, difficulty chewing, toothache, number of teeth, dental caries, periodontal disease) factors associated with self-perceived unmet dental care needs were analyzed through multiple logistic regression analysis. RESULTS: Unmet dental care needs accounted for 27.9% in older adults. Age, income, difficulty chewing and the presence of permanent tooth caries were significantly associated with unmet dental care needs, adjusting for covariates. Compared with those aged 75 years and older, the 65-69 years age group showed 1.86-fold higher odds of unmet dental care needs. Lower household income was associated with a higher likelihood of not receiving dental care when required. Unmet dental care needs were significantly higher among those with chewing difficulty (OR 2.14, 95% CI 1.55, 2.95) and permanent tooth caries (OR 1.86, 95% CI 1.28-2.70). CONCLUSIONS: Unmet dental care needs are prevalent in older people who are socioeconomically disadvantaged and vulnerable in oral health. Geriatr Gerontol Int 2017; 17: 1936-1942.

Changes in physical activity and cognitive decline in older adults living in the community.

Accumulating evidence suggests that physical activity may be beneficial in preserving cognition in late life. This study examined the association between baseline and changes in physical activity and cognitive decline in community-dwelling older people. Data were from the Korean Longitudinal Study of Aging, with 2605 aged 65 years and older subjects interviewed in 2006 and followed up for 2 years. Cognitive decline was defined by calculating the Reliable Change Index using the Mini-Mental State Examination. Physical activity levels were categorized as sedentary, low, or high. Changes in physical activity were classified as inactive, decreaser, increaser, or active. Logistic regression analysis of baseline and changes in physical activity with cognitive decline was performed. Compared with the sedentary group at baseline, both the low and high activity groups were less likely to experience cognitive decline. The active (odds ratio [OR] = 0.40, 95 % confidence interval [CI] 0.23-0.68) and increaser (OR = 0.45, 95 % CI 0.27-0.74) group, compared with the inactive counterpart, demonstrated a significantly lower likelihood of cognitive decline. Older adults who remained active or increased activity over time had a reduced risk of cognitive decline. Engagement in physical activity in late life may have cognitive health benefits.

Frailty and body mass index as predictors of 3-year mortality in older adults living in the community.

BACKGROUND: Frailty and body mass index (BMI) are known to be predictive of late life mortality, but little is known about the combined effects of frailty and BMI on mortality. OBJECTIVE: This study investigated the influence of frailty status and BMI category on mortality in older adults. METHODS: Data were from the Living Profiles of Older People Survey, a national survey of community-dwelling older people in Korea, with a baseline study of 11,844 Koreans aged 65 years and older in 2008 and a 3-year follow-up for mortality. Frailty was categorized as not frail, prefrail, and frail, based on five indicators (weight loss, exhaustion, physical activity, walking speed, and grip strength). BMI (kg/m(2)) was classified as underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9), or obese (≥30.0). A Cox proportional model was used to analyze the association of the combined frailty and BMI categories with all-cause mortality, adjusting for sociodemographics and health-related factors. RESULTS: Adjusting for covariates, compared with the normal-weight nonfrail counterpart, the underweight or normal-weight prefrail/frail status demonstrated significantly increased rates of death. The obese frail respondents showed a significantly higher mortality risk (hazard ratio, 3.89; 95% confidence interval, 1.14-13.28). The overweight prefrail/frail group, however, exhibited no significant association with mortality. CONCLUSION: Among older people who were of normal weight or underweight, greater frailty was associated with poorer survival. Whereas being overweight tended to be neutral of the influence of frailty on mortality, the obese frail exhibited a significantly elevated rate of death.