General health status and changes in chewing ability in older Canadians over seven years

Objectives: The purpose of this study was to describe the onset of and recovery from chewing problems in an older adult population over a seven-year period and to describe factors associated with these changes. Of particular interest was the relationship between general health and changes in oral functioning. Methods: The data came from a longitudinal study of community-dwelling individuals who were aged 50 years and older when first recruited. Data were collected at baseline (n=907) and at three (n=611) and seven-year (n=425) follow-ups. Oral function was assessed by means of a six-item index of chewing ability. Data were weighted to account for loss to follow-up using weights derived from the seven-year response proportions for dentate and edentulous subjects. Logistic regression analysis using backward stepwise selection was used to identify predictors of onset and recovery. Results: At baseline, 25 percent of subjects reported a problem chewing. This rose to 26 percent at three years and 34 percent at seven years. The seven-year incidence of chewing dysfunction was 19 percent. Of those with a chewing problem at baseline, 21 percent did not have a problem at seven years. A logistic regression model predicting the seven-year incidence of chewing problems indicated that subjects aged 65 years or older, the edentulous, those rating their oral health as poor, those without dental insurance and those without a regular source of dental care were more likely to be an incident case. In addition, a variable denoting the number of chronic medical conditions at baseline also entered the model. A logistic regression model predicting recovery indicated that older subjects, the edentulous, those from low-income households, and those with limitations in activities of daily living were less likely to recover over the observation period. Conclusion: The results of this study indicate a marked increase in the prevalence of chewing problems in this older adult population over the seven-year observation period. Poorer general health at baseline increased the probability of the onset of a chewing problem and decreased the probability of recovery.