Cone beam computed tomography analysis of the edentulous mandibular symphysis.

BACKGROUND/PURPOSE: Overdenture with single symphyseal implant is one of the useful clinical approach for elderly edentulous patients. We aimed to evaluate edentulous patients with regards to the relationship between dimensions, bone characteristics, cancellous densities, and cortical thickness of the mandibular symphyseal region using cone beam computed tomography (CBCT). MATERIAL AND METHODS: We analyzed 103 CBCT from pre-implant investigations. All included patients were healthy without any disorders affecting bone metabolism. We performed 13 measurements for each patient: 9 of height, width, and thickness (mm) and 4 of density (Hounsfield Units; HU). Fisher's exact test was applied to examine the association between two categorical variables, the Pearson correlation coefficient to measure the strength of linear relationship between two quantitative variables. We used the two-sample Student's t-test to compare mean symphysis height between men and women, the paired Student's t-test to compare mean lingual and buccal cortical thickness. For all tests, the threshold of significance was fixed at 5%. RESULTS: Men and women significantly differed with regards to mean total symphysis height (p = 0.004) and the distribution of Cawood and Howell classifications (p = 0.033). Symphysis height was negatively correlated with mean density of cancellous bone (r = -0.453, p < 0.001). Mean lingual cortical thickness significantly differed from mean vestibular thickness (p < 0.001, paired Student's t-test). CONCLUSION: Present findings supported that symphyseal measurements are parameters that reflect the symphysis bone characteristics, and can guide the choice of a suitable implant design.

Objective and perceived oral health status of elderly nursing home residents: a local survey in southern France.

OBJECTIVE: The aim of this study was to compare the perceived oral health of elderly persons and the clinical reality of their oral status. BACKGROUND: Persons aged over 60 have considerable need for oral health care; a need that increases over time. However, this population appears to be unaware of their state of oral health, and this may be a further obstacle to professional management. We thought it useful to examine the objective and the perceived oral health of these patients. Understanding what may influence their perception can help us to improve their management. METHODS: The data analyzed in this work are the findings of a field survey carried out in elderly nursing home residents. Their objective oral health was evaluated by using two variables: oral profile, determined by clinical examination, and the oral health index determined using the Oral Health Assessment Tool (OHAT). Perceived oral health was evaluated using the various categories and fields of the General Oral Health Assessment Index (GOHAI). RESULTS: Our clinical study showed a discrepancy between perceived oral health and the clinical reality: although a significant association can be demonstrated between the OHAT and the GOHAI, there are considerable variations. It also appeared that the number of teeth and total edentation considerably influence perceived oral health and that findings vary according to different situations. CONCLUSION: Numerous factors influence elderly persons' perception of their true oral health. In order to improve our elders' quality of life, the necessary measures must be taken for the follow-up and regular monitoring of their oral health. At the same time, all possible means should be used and awareness should be raised to improve the health behavior and perception of patients and their entourage.

Use of care and the oral health status of people aged 60 years and older in France: results from the National Health and Disability Survey.

OBJECTIVE: We aimed to analyze, from the data in a national survey, the use of oral care and the oral health status of patients living at home or in an institution. BACKGROUND: Patients aged 60 years and older have important oral health needs, but their oral management may differ according to their immediate environment. The fact of living at home or in an institution can influence the use of care and alter the patients' perception of their oral health status. METHODS: The data analyzed were taken from a survey on disability and health carried out in 2008-2009, which is representative of the population living in France. It consists of two sections, one centered on disability and health among home-dwellers and the other on patients living in an institution. In each of these two populations, we carried out descriptive analysis of three themes: use of care, forgoing of care, and oral health. RESULTS: Although visits to physicians and specialists were frequent, visits to dentists were lower in both populations. While a minority of patients forwent care, it was dental care that was mainly forgone by both home-dwellers and institutionalized patients. The cost factor remained the principal reason, but other factors such as fear or accessibility problems were cited. Use of a dental appliance was considerably more frequent among institutionalized patients than among home-dwellers, with just over half the institutionalized population wearing a dental appliance. Perceived state of oral health remained difficult to interpret. CONCLUSION: To improve access to oral care for the elderly, the patients, their entourage and health providers need increased awareness and information on the importance of good oral health. Better information must be associated with regular clinical examination.

Static or dynamic predictors of physical activity (PA)? A tracking study based on 12- and 38-month follow-ups in older adults.

Studies that investigated stability of PA in older populations are scarce. Moreover, no studies used dynamic indicators to predict PA trajectories. The purpose of the present study were to investigate PA stability overtime, and to examine if changes in self-reported physical function (dynamic indicator) are better predictors of trajectories of PA than baseline measures of physical function (static indicator). This is a prospective postal survey with two time-point follow-ups: 12 and 38 months. Participants were older adults aged ≥ 60 years, and members of the medical insurance scheme of the French national education system. They responded to a self-report questionnaire on PA and general health status at three different times: baseline, 12- and 38-month follow-ups (n=243 for the 12-month follow-up; n=164 for the 38-month follow-up). Overtime analyses of PA showed a moderate-to-good stability with regard to both duration and volume of PA; however, a decrease in stability for vigorous PA was found between 12- and 38-month follow-ups. Both baseline measure and changes in physical function predicted PA trajectories, but magnitudes of associations were stronger for the dynamic indicator. Moreover, change in physical function was the only predictor of both becoming active compared with Inactive (reduced probability) and becoming inactive compared to Active (increased probability). In conclusion, a dynamic indicator of physical function is a better predictor of PA variation than static indicators.

Are older adults who volunteer to participate in an exercise study fitter and healthier than nonvolunteers? The participation bias of the study population.

BACKGROUND: Participation bias in exercise studies is poorly understood among older adults. This study was aimed at looking into whether older persons who volunteer to participate in an exercise study differ from nonvolunteers. METHODS: A self-reported questionnaire on physical activity and general health was mailed out to 1000 persons, aged 60 or over, who were covered by the medical insurance of the French National Education System. Among them, 535 answered it and sent it back. Two hundred and thirty-three persons (age 69.7 ±7.6, 65.7% women) said they would volunteer to participate in an exercise study and 270 (age 71.7 ±8.8, 62.2% women) did not. RESULTS: Volunteers were younger and more educated than nonvolunteers, but they did not differ in sex. They had less physical function decline and higher volumes of physical activity than nonvolunteers. Compared with volunteers, nonvolunteers had a worse self-reported health and suffered more frequently from chronic pain. Multiple logistic regressions showed that good self-reported health, absence of chronic pain, and lower levels of physical function decline were associated with volunteering to participate in an exercise study. CONCLUSIONS: Volunteers were fitter and healthier than nonvolunteers. Therefore, caution must be taken when generalizing the results of exercise intervention studies.

Are Older Adults Who Volunteer to Participate in an Exercise Study Fitter and Healthier than Non-Volunteers? The participation bias of the study population.

BACKGROUND: Participation bias in exercise studies is poorly understood among older adults. This study was aimed at looking into whether older persons who volunteer to participate in an exercise study differ from non-volunteers. METHODS: A self-reported questionnaire on physical activity and general health was mailed out to 1000 persons, aged 60 or over, who were covered by the medical insurance of the French National Education System. Among them, 535 answered it and sent it back. Two hundred and thirty-three persons (age 69.7 ±7.6, 65.7% women) said they would volunteer to participate in an exercise study and 270 (age 71.7 ±8.8, 62.2% women) did not. RESULTS: Volunteers were younger and more educated than non-volunteers, but they did not differ in sex. They had less physical function decline and higher volumes of physical activity than non-volunteers. Compared to volunteers, non-volunteers had a worse self-reported health and suffered more frequently from chronic pain. Multiple logistic regressions showed that good self-reported health, absence of chronic pain, and lower levels of physical function decline were associated with volunteering to participate in an exercise study. CONCLUSIONS: Volunteers were fitter and healthier than non-volunteers. Therefore, caution must be taken when generalizing the results of exercise intervention studies.

Detecting and categorizing frailty status in older adults using a self-report screening instrument.

PURPOSE: The purpose of this study was to design and validate a self-reported assessment tool for the identification of frailty. MATERIALS AND METHODS: A thousand community-dwelling older adults (≥60 years), users of the medical insurance of the French national education system, received (Year 1) a postal questionnaire requesting information about health and socio-demographic characteristics. Among those who responded to the questionnaire (n=535), 398 individuals were classified as frail, pre-frail, or robust. One year later (Year 2), the same questionnaire was sent to this group and n=309 were returned. Frailty was operationalized using four criteria: low body mass index (BMI), low level of physical activity, and dissatisfaction with both muscle strength and endurance. RESULTS: Frailty constituted a single entity, different from physical limitation and co-morbidity. Compared with robust individuals, frail persons were older, had more chronic diseases, higher levels of disability and physical function decline. Pre-frail individuals had an intermediate distribution. Those people classified as either frail or pre-frail had higher frequency of hospitalization, and a higher probability of co-morbidity than robust. Frailty was also associated with higher mortality. CONCLUSIONS: Our screening tool for frailty was able to evidence important characteristics of this syndrome, i.e., it is a single entity with grades of severity which are associated with health problems. Detecting and categorizing frailty may lead to early therapeutic interventions to combat this condition.

Predictors of body satisfaction: differences between older men and women's perceptions of their body functioning and appearance.

OBJECTIVE: This article examines the predictors of body satisfaction among older men and women. METHOD: A self-reported questionnaire on body satisfaction (focused on body appearance and functioning), health, physical activity, and sociodemographic characteristics was completed by 384 older adults twice, at a year's interval. Women (n = 243) were on average 70.3 ± 7.9 years old, and men 70.9 ± 7.5 years old. RESULTS: Body mass index was found to be the strongest predictor of satisfaction with body appearance for both genders, along with body functioning in the case of men. Regarding satisfaction with body functioning, functional limitations were women's most important predictor of satisfaction, whereas for men body appearance was more important. DISCUSSION: Men seemed to link satisfaction with body appearance more closely to body functioning than did women. Gender differences suggest that interventions to improve body satisfaction must be gender specific, particularly those relating to body functioning.

Neural network involved in time perception: an fMRI study comparing long and short interval estimation.

In this study, long ( approximately 1,300 ms) and short duration ( approximately 450 ms) estimation trials in an event-related functional MRI (fMRI) study were contrasted in order to reveal the regions within a time estimation network yielding increased activation with the increase of the duration to be estimated. In accordance with numerous imaging studies, our results showed that the presupplementary motor area (preSMA), the anterior cingulate, the prefrontal and parietal cortices, and the basal ganglia were involved in the estimation trials whatever the duration to be estimated. Moreover, only a subset of the regions within this distributed cortical and subcortical network yielded increased activation with increasing time, namely, the preSMA, the anterior cingulate cortex, the right inferior frontal gyrus (homolog to Broca's area), the bilateral premotor cortex, and the right caudate nucleus. This suggests that these regions are directly involved in duration estimation. We propose that the caudate-preSMA circuit, the anterior cingulate, and the premotor-inferior frontal regions may support a clock mechanism, decision and response-related processes, and active maintenance of temporal information, respectively.