The aims of this study were to assess the prevalence of periodontal conditions in the Uruguayan adult and elderly population and its association with socioeconomic and behavioral characteristics. Data from adults (35-44, n = 358) and elderly (65-74, n = 411) who participated in the first National Oral Health Survey, Uruguay, 2011, were used. The survey included a household questionnaire addressing socioeconomic characteristics, and tobacco use. Bleeding on probing (BOP), periodontal pockets (CPI) and clinical attachment loss (CAL) were measured by clinical examination. A multivariable analysis was carried out. Considering both age groups, the prevalence of mild/severe periodontal disease was 21.8% and 9.12% for severe periodontal disease. Adjusted analyses revealed an association between high education and all outcomes. Attendance at dental services was negatively associated with BOP and mild to severe periodontitis. Periodontal outcomes were higher in disadvantaged socioeconomic groups. Tobacco consumption has a strong association with periodontal disease in the elderly.
19 December 2022 in Acta Odontológica Latinoamericana
The fact that there are different epidemiological definitions of periodontitis and different evaluation protocols affects the estimate of periodontitis prevalence and of the influence of associated factors. The gold standard for periodontal examination is full-mouth record assessing CAL and PD. However, there are not always sufficient human and financial resources available to apply such assessment for epidemiological surveillance systems. Aim: This study was conducted to compare different protocols and definitions of periodontitis for assessing prevalence and the impact of related factors in adult patients who requested care at the School of Dentistry, UdelaR. Materials and Method: This was a cross-sectional study of 410 subjects with a high burden of disease in terms of NCDs and periodontitis. Clinical examination evaluated PD in all teeth and CAL in the CPI sextants (WHO 2013). Four periodontitis criteria were defined based on two examination protocols (WHO 2013 and WHO 1997) and two definitions of epidemiological case. Comparisons were made taking the 2013 WHO protocol as a reference. Results: Comparison of the two examination protocols showed that prevalence was underestimated when the WHO 1997 protocol was used to define moderate-severe and severe periodontitis, by 20% and 60%, respectively. Conclusions: When the severity of periodontitis was not considered, the WHO 2013 protocol did not provide more information on what factors increase the chance of periodontitis. However, when severity was considered, the associated factors were different. Consequently, in a small population, it would be worth using the WHO 2013 protocol, which is the closest to the full-mouth gold standard criterion. Keywords: cross-sectional studies - periodontal index - periodontitis - risk factors - non-communicable diseases
Objectives: To model trajectories of visuospatial reasoning measured using Kohs Block Design test under realistic missing data assumptions and evaluate their association with hazard of death. Methods: A joint longitudinal-survival model was used to estimate trajectories of visuospatial reasoning under a missing not at random assumption of participants from the Origins of Variance in the Old–Old: Octogenarian Twins study. Sensitivity analyses to missing data assumptions were conducted. Results: Visuospatial reasoning declined at constant rate. Baseline age, dementia status, education, and history of stroke were associated with visuospatial reasoning performance, but only dementia was associated with its rate of decline. Importantly, our results demonstrated an association between poorer visuospatial reasoning and increased hazard of death. Baseline age and sex were associated with risk of death. Discussion: We confirmed an association between visuospatial reasoning and death under plausible missing data assumptions.
23 February 2024 in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences
Most previous studies of frailty trajectories in older adults focus on the average trajectory and ignore death. Longitudinal quantile analysis of frailty trajectories permits the definition of reference curves, and the application of mortal cohort inference provides more realistic estimates than models that ignore death. Using data from individuals aged 65 or older (n = 25 446) from the Survey of Health, Ageing, and Retirement in Europe (SHARE) from 2004 to 2020, we derived repeated values of the Frailty Index (FI) based on the accumulation of health deficits. We applied weighted Generalized Estimating Equations to estimate the quantiles of the FI trajectory, adjusting for sample attrition due to death, sex, education, and cohort. The FI quantiles increased with age and progressed faster for those with the highest level of frailty ( = 0.0229, p < .001; = 0.0067, p < .001; H0: , p < .001). Education was consistently associated with a slower progression of the FI in all quantiles ( = −0.0001, p < .001; =−0.0004, p < .001; = −0.0003, p < .001) but sex differences varied across the quantiles. Women with the highest level of frailty showed a slower progression of the FI than men when considering death. Finally, no cohort effects were observed for the FI progression. Quantile FI trajectories varied by age, sex, education, and cohort. These differences could inform the practice of interventions aimed at older adults with the highest level of frailty.
Cross-sectional studies have shown improvements in cognition in later-born cohorts. However, it remains unclear whether these cohort effects extend beyond cognitive levels and are also detectable in the rate of age-related cognitive decline. Additionally, evidence is scarce on the presence and consistency of cohort effects throughout different segments of the distribution of cognitive trajectories. This study evaluates the existence and variability of cohort effects across the entire distribution of aging-related trajectories of verbal fluency. With this purpose, we develop sex and education-adjusted longitudinal norms of verbal fluency using data from 9 waves of the English Longitudinal Study of Aging (ELSA) by fitting quantile mixed models. The effect of age was modeled using splines to assess birth cohort effects, after grouping individuals in 5-year groups from 1920 to 1950 according to their age at study entry. To test for possible cohort effects across the 10th, 50th, and 90th quantiles, the coefficients associated with the splines were allowed to vary among cohorts. Our results suggest that, consistently across longitudinal quantiles, decline in verbal fluency across age is less pronounced for later-born individuals (p < .001), supporting the hypothesis of cohort effects. Additionally, we also found that quantiles of verbal fluency at any age are shifted upwards in later-born cohorts compared to those in earlier-born cohorts. These results enhance our understanding of cognitive decline in older adults by demonstrating that cohort effects on cognition are observable both cross-sectionally and longitudinally, affecting the entire range of verbal fluency trajectories.
1 January 2015 in Physical Therapy and Rehabilitation
Background: The migration of the Tibio-femoral Contact Point of the Femur with respect to the tibial plateau is altered by the rupture of the Anterior Cruciate Ligament and again changed after reconstructive