The Longitudinal Relationship between Edentulism and the Progress of Multimorbidity.

ABSTRACT

OBJECTIVES: To examine the longitudinal relationship between edentulism, nutritional intake, and the progress of multimorbidity among older Americans. METHODS: We used data from the Health and Retirement Study (2006-2018), a longitudinal survey of older Americans that has collected data biennially since 1992. Edentulism was assessed in 2006 while nutritional intake was assessed in 2013. Multimorbidity was indicated by five self-reported chronic conditions diabetes, heart conditions, lung diseases, cancer, and stroke. Individuals with two or more conditions at baseline were excluded from the analysis. Nutritional intake was calculated by summing 10 nutrients (protein, vitamins C, D, B12 and E, calcium, zinc, polyunsaturated fatty acids, folate, and ß-carotene). Structural equation modelling (SEM) was used to examine the nutritional pathway between edentulism (2006) and the increase in multimorbidity from 2006 to 2018. RESULTS: The number of individuals included in the analysis was 3463. The incidence of multimorbidity between 2006 and 2018 was 24.07%, while the percentage of edentate participants in 2006 was 16.42%. The mean total nutrition in 2013 was 4.50 (4.43, 4.55). The SEM analysis showed that edentulism was negatively associated with nutritional intake {estimate -0.15 (95%CI -0.30, -0.01)}. A negative association was found between total nutrition and multimorbidity {estimate -0.008 (95%CI -0.01, -0.002)}. Age, wealth, and smoking were included in the analysis and had statistically significant associations with multimorbidity. CONCLUSION: The analysis demonstrated a longitudinal association between edentulism, nutritional intake, and the progress of multimorbidity.