Petrauskiene, Egle;
(2024)
Oral Health and Frailty Among Older Adults: A Study of the Association, Directionality and Pathways.
Doctoral thesis (Ph.D), UCL (University College London).
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Egle Petrauskiene. PhD thesis. Oral Health and Frailty Among Older Adults. A Study of the Association, Directionality and Pathways.pdf - Other Download (3MB) | Preview |
Abstract
BACKGROUND: Poor oral health may be a risk factor for frailty. Literature suggests that this association may be bidirectional, but evidence on the directionality and mediating pathways is lacking. AIMS: This thesis aimed to assess the association between oral health and frailty in a nationally representative sample of older adults in England. Direction of this association and pathways via nutrition, inflammation and psychosocial factors were also examined. METHODS: Data from Wave 3 (2006/7) to Wave 9 (2018/19) of the English Longitudinal Study of Ageing were analysed. Oral health was assessed through edentulousness, self-rated oral health and oral impacts, while frailty was determined by the Rockwood Frailty Index. Mediators included fruits and vegetables consumption, blood C-reactive protein (CRP) levels, and loneliness. Regression modelling was used to examine cross-sectional and longitudinal associations between oral health and frailty. Structural Equation Modelling (SEM) assessed the direction and pathways of this association. RESULTS: Edentulousness among men but not women, poor self-rated oral health status, and experience of oral impacts (especially difficulties eating and speaking), were significantly associated with frailty development over a 13-year follow-up period. Associations between frailty and both self-rated oral health and oral impacts were bidirectional. Edentulism was also associated with higher probability of frailty, but the path in the opposite direction (frailty-edentulousness) was not significant. Loneliness mediated associations between all three oral health markers and frailty. Moreover, CRP mediated associations for both edentulousness and poor self-rated oral health, but not oral impacts, with frailty. Finally, no significant mediation via nutritional pathway was observed. CONCLUSIONS: Worse oral health is a long-term predictor of frailty in older adults, while frailty also contributed to worse oral health perceptions. Future research should assess the potential of public health policies that improve oral health throughout the life course in lowering the risk of frailty in older adults.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Oral Health and Frailty Among Older Adults: A Study of the Association, Directionality and Pathways |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2024. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10190576 |
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