Infrequent Denture Cleaning Increased the Risk of Pneumonia among Community-dwelling Older Adults: A Population-based Cross-sectional Study

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Abstract

Pneumonia is a leading cause of death among older adults. The effectiveness of oral care in preventing pneumonia in nursing homes and hospitals has been reported. However, in community-dwelling older adults, the role of denture cleaning in preventing pneumonia remains unknown. We aimed to investigate the association between infrequent denture cleaning and the risk of pneumonia in community-dwelling older adults. This cross-sectional study was based on the self-reported questionnaire targeting towards community-dwelling older adults aged ≥65 years. Responses of 71,227 removable full/partial denture users were included. The incidence of pneumonia within the last one-year and the frequency of denture cleaning (daily/non-daily) were treated as dependent and independent variables, respectively. The odds ratio (OR) and 95% confidence interval (CI) were calculated by the inverse probability weighting (IPW) method based on the logistic regression model. The mean age of the participants was 75.2 ± 6.5 years; 48.3% were male. Overall, 4.6% of the participants did not clean their dentures daily; 2.3% and 3.0% who did and did not clean their dentures daily, respectively, experienced pneumonia. After IPW, infrequent denture cleaning was significantly associated with pneumonia incidence (OR = 1.30, 95% CI = 1.01–1.68)). This study suggests that denture cleaning could prevent pneumonia among community-dwelling older adults.

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Aspiration Pneumonia

Dan L Longo, Lionel Mandell, Michael Niederman (2019)

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New perspectives on community-acquired pneumonia in 388 406 patients. Results from a nationwide mandatory performance measurement programme in healthcare quality

S Ewig, N Birkner, R Strauss … (2009)

Background: The database of the German programme for quality in healthcare including data of every hospitalised patient with community-acquired pneumonia (CAP) during a 2-year period (n = 388 406 patients in 2005 and 2006) was analysed. Methods: End points of the analysis were: (1) incidence; (2) outcome; (3) performance of the CRB-65 (C, mental confusion; R, respiratory rate ⩾30/min; B, systolic blood pressure <90 mm Hg or diastolic blood pressure ⩽60 mm Hg; 65, age ⩾65 years) score in predicting death; and (4) lack of ventilatory support as a possible indicator of treatment restrictions. The CRB-65 score was calculated, resulting in three risk classes (RCs). Results: The incidence of hospitalised CAP was 2.75 and 2.96 per 1000 inhabitants/year in 2005 and 2006, respectively, higher for males (3.21 vs 2.52), and strongly age related, with an incidence of 7.65 per 1000 inhabitants/year in patients aged ⩾60 years over 2 years. Mortality (13.72% and 14.44%) was higher than reported in previous studies. The CRB-65 RCs accurately predicted death in a three-class pattern (mortality 2.40% in CRB-65 RC 1, 13.43% in CRB-65 RC 2 and 34.39% in CRB-65 RC 3). The first days after admission were consistently associated with the highest risk of death throughout all risk classes. Only a minority of patients who died had received mechanical ventilation during hospitalisation (15.74%). Conclusions: Hospitalised CAP basically is a condition of the elderly associated with a higher mortality than previously reported. It bears a considerable risk of early mortality, even in low risk patients. CRB-65 is a simple and powerful tool for the assessment of CAP severity. Hospitalised CAP is a frequent terminal event in chronic debilitated patients, and a limitation of treatment escalation is frequently applied.

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The Burden of Community-Acquired Pneumonia in Seniors: Results of a Population-Based Study

Michael L. Jackson, Kathleen Neuzil, William W Thompson … (2004)

Abstract Background . Pneumonia is recognized as a leading cause of morbidity in seniors. However, the overall burden of this disease—and, in particular, the contribution of ambulatory cases to that burden—is not well defined. To estimate rates of community-acquired pneumonia and to identify risk factors for this disease, we conducted a large, population-based cohort study of persons aged ⩾65 years that included both hospitalizations and outpatient visits for pneumonia. Methods . The study population consisted of 46,237 seniors enrolled at Group Health Cooperative who were observed over a 3-year period. Pneumonia episodes presumptively identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes assigned to medical encounters were validated by medical record review. Characteristics of participants were defined by administrative data sources. Results . The overall rate of community-acquired pneumonia ranged from 18.2 cases per 1000 person-years among persons aged 65–69 years to 52.3 cases per 1000 person-years among those aged ⩾85 years. In this population, 59.3% of all pneumonia episodes were treated on an outpatient basis. In multivariate analysis, risk factors for community-acquired pneumonia included age, male sex, chronic obstructive pulmonary disease, asthma, diabetes mellitus, congestive heart failure, and smoking. Conclusions . On the basis of these data, we estimate that roughly 915,900 cases of community-acquired pneumonia occur annually among seniors in the United States and that ∼1 of every 20 persons aged ⩾85 years will have a new episode of community-acquired pneumonia each year.

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Author and article information

Contributors

Jun Aida:

ORCID: http://orcid.org/0000-0002-8405-9872

j-aida@umin.ac.jp

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 24 September 2019

Publication date PMC-release: 24 September 2019

Publication date Collection: 2019

Volume: 9

Electronic Location Identifier: 13734

Affiliations

[1 ]ISNI 0000 0001 2248 6943, GRID grid.69566.3a, Department of International and Community Oral Health, , Tohoku University Graduate School of Dentistry, ; Aoba-ku, Sendai, Miyagi Japan

[2 ]ISNI 0000 0001 2156 468X, GRID grid.462431.6, Department of Disaster Medicine and Dental Sociology, Graduate School of Dentistry, , Kanagawa Dental University, ; Yokosuka, Kanagawa Japan

[3 ]ISNI 0000 0004 0370 1101, GRID grid.136304.3, Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, , Chiba University, ; Chuo Ward, Chiba-shi, Chiba Japan

[4 ]Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatics and Gerontology, Obu city, Aichi Japan

Author information

Jun Aida http://orcid.org/0000-0002-8405-9872

Ken Osaka http://orcid.org/0000-0001-6885-9514

Article

Publisher ID: 50129

DOI: 10.1038/s41598-019-50129-9

PMC ID: 6760190

PubMed ID: 31551442

SO-VID: 462fecfd-ce0e-4c8d-84de-54b21c79afbd

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Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 10 July 2019

Date accepted : 6 September 2019

Funding

Funded by: MEXT(Ministry of Education, Culture, Sports, Science and Technology-Japan)-Supported Program for the Strategic Research Foundation at Private Universities (2009-2013), JSPS(Japan Society for the Promotion of Science) KAKENHI Grant Numbers (18390200, 22330172, 22390400, 23243070, 23590786, 23790710, 24390469, 24530698, 24683018, 25253052, 25870573, 25870881, 26285138, 26882010,15H01972, 18KK0057, 19H03860), Health Labor Sciences Research Grants (H22-Choju-Shitei-008, H24-Junkanki [Seishu]-Ippan-007, H24-Chikyukibo-Ippan-009, H24-Choju-Wakate-009, H25-Kenki-Wakate-015, H25-Choju-Ippan-003, H26-Irryo-Shitei-003 [Fukkou], H26-Choju-Ippan-006, H27-Ninchisyou-Ippan-001, H28-choju-Ippan-002, H28-Ninchisyou-Ippan-002, H30-Kenki-Ippan-006, H30-Junkankitou-Ippan-004), Japan Agency for Medical Research and development (AMED) (JP17dk0110017, JP18dk0110027, JP18ls0110002, JP18le0110009), the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology (24-17, 24-23, 29-42)

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Keywords: gerodontics,removable prosthodontics

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ScienceOpen disciplines: Uncategorized

Keywords: gerodontics, removable prosthodontics

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Infrequent Denture Cleaning Increased the Risk of Pneumonia among Community-dwelling Older Adults: A Population-based Cross-sectional Study

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Abstract

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Pneumonia, sex, and the environment

Most cited references 26

Aspiration Pneumonia

New perspectives on community-acquired pneumonia in 388 406 patients. Results from a nationwide mandatory performance measurement programme in healthcare quality

The Burden of Community-Acquired Pneumonia in Seniors: Results of a Population-Based Study

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