Psychosocial Profiles of Older Adults by Dentition Status and Dental Utilization History

Objective Psychosocial factors can affect health. Patterns of psychosocial stressors and resources among older adults were examined for oral health status.

Methods The Health and Retirement Study (HRS) is a representative sample of US adults >50 years. Participants completed the 2018 HRS CORE survey and Psychosocial and Lifestyle Questionnaire–Panel A “Leave Behind” survey (HRS-LB)(N=4703). All measures were self-reported, and stratified into outcome groups: 1) edentulous/dentate, 2) with/without a recent dental visit in the last two years. Psychosocial measures covered three domains: well-being, beliefs, and lifestyle. Specifically, we studied loneliness, life satisfaction, perceived age, social status, control, mastery, and chronic stressors. Latent class analysis (LCA) identified profiles of adults based on the distribution of psychological and social stressors and resources. Associations between latent classes and being edentulous and a recent dental visit were examined in logistic regression models.

Results About 30% reported no recent dental visit; 14% were edentulous. Three latent classes were identified; profiles had different distributions of psychosocial factors. Half were in Class A:“Satisfied/Connected” (n=2230), 27% in Class B:“Satisfied/Lonely” (n=1293), and 25% in Class C:“Unsatisfied/Lonely” (n=1180). “Satisfied/Connected” adults had the fewest psychosocial risk factors, most resources, were dentate, with a recent dental visit. “Unsatisfied/Lonely” adults exhibited the most psychosocial risk factors and fewest resources, more were edentulous and lacked a recent dental visit. “Satisfied/Lonely” adults exhibited characteristics between Classes A and C. In fully adjusted regression models, Class B adults had 1.29 (1.03-1.61) times greater odds than Class A to be edentulous, and 1.27 (1.07-1.50) times greater odds to not have a recent dental visit. Class C adults had 1.20 (0.96-1.51) times greater odds than Class A to be edentulous, and 1.33 (1.11-1.58) times greater odds to not have recent dental visit.

Conclusion Adverse psychosocial factors are associated with edentulism and lack routine dental visits.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The Health and Retirement Study data is sponsored by the National Institute on Aging (grand number U01AG009740) and is conducted by the University of Michigan. This analysis was conducted with financial support from the National Institute of Dental and Craniofacial Research, R03DE030161-01.

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Publicly available data used in this analysis are online at the Health and Retirement Study website: https://hrs.isr.umich.edu/data-products. The University of North Carolina at Chapel Hill Office of Human Research Ethics determined this secondary data analysis did not require approval.

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