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Background: The sustained growth of older people and the epidemiological shift from communicable to chronic health problems have attracted increased attention to geriatric wellbeing, including oral health. Aims: To evaluate the oral health of urban community-dwelling older people and identify their priority oral health needs. Methods: We recruited 352 adults aged ≥ 65 years in 2015 from social organizations and primary healthcare centres in Beirut and its suburbs. Older people underwent dental examination including the decayed, missing and filled teeth (DMFT) score, gingival health [plaque index (PI) and Periodontal Screening and Recording (PSR)], and dental functional units (FUs). Sociodemographic data were gathered through a structured questionnaire in a face-to-face interview. The participants were stratified into 3 age groups, and according to restoration with partial, complete and no dentures. Statistical analyses included the Mann–Whitney, Kruskal–Wallis and χ2 tests to explore the oral health status by sociodemographics. Results: Missing teeth contributed most to high DMFT score . Mean PI and root caries indices were high. Mean FU scores were low, but higher in women and in complete denture wearers. Lower numbers of remaining mandibular anterior and maxillary posterior teeth, higher DMFT scores, but better periodontal status (lower PSR scores) were found in the older age groups. The more educated participants exhibited the healthier scores. Conclusion: We observed poor oral health, particularly missing teeth and low FUs, in older people, warranting interventions to integrate oral health within the scope of geriatric general health.
Assuntos
Doenças não Transmissíveis , Saúde BucalRESUMO
ImportanceOlder Syrian refugees have a high burden of non-communicable diseases and economic vulnerability. ObjectiveThis study aimed to develop and internally validate a predictive model of the inability to manage non-communicable diseases (NCDs) in older Syrian refugees, and to describe barriers to adherence to NCD medication. DesignA nested cross-sectional study within a longitudinal study. SettingLebanon. PopulationSyrian refugees aged 50 years or older residing in Lebanon who self-reported having hypertension, diabetes, history of cardiovascular disease (CVD) or chronic respiratory disease (CRD). MethodsAll households with refugees aged 50 years or older who received humanitarian assistance from a non-governmental organization were invited to participate in a study examining the impact of COVID-19 on older Syrian refugees. Data were collected through telephone surveys between September 2020 and January 2021. The study outcome was self-reported inability to manage hypertension, diabetes, CVD or CRD. Predictors of inability to manage any NCD were assessed using a logistic regression models. The model was internally validated using bootstrapping techniques, which gave an estimate of optimism. The optimism-adjusted discrimination and calibration of the model were presented using C-statistic and calibration slope (C-slope), respectively. ResultsOut of 3,222 older Syrian refugees, 1,893 reported having at least one NCD including 43% who had hypertension, 24% diabetes, 24% history of CVD, and 11% CRD. There were 387 (20%) participants who were unable to manage at least one of their NCDs. Predictors for inability to manage NCDs were age, non-receipt of cash assistance, household water insecurity, household food insecurity, and having multiple chronic diseases. The models adjusted C-statistic was 0.65 (95%CI:0.62-0.67) and C-slope was 0.88 (95%CI:0.73-1.03). The prevalence of non-adherence to medication was 9% and the main reasons were unaffordability of medication (41%) and the belief that they no longer required the medication after feeling better (22%). ConclusionsThis study identified that the predictors of inability to manage NCDs among older Syrian refugees in Lebanon are mainly related to financial barriers, which aids the targeting of assistance and interventions. Context-appropriate assistance is required to overcome financial barriers and enable equitable access to medication and healthcare. Key pointsO_ST_ABSQuestionC_ST_ABSWhat are the predictors and barriers to managing NCDs as an older Syrian refugee in Lebanon? FindingsThis nested cross-sectional study assessed the predictors and barriers to managing any NCD, which included hypertension, diabetes, history of cardiovascular disease and chronic respiratory disease. Predictors included age, no cash assistance, household water insecurity, household food insecurity and having multiple chronic diseases. Primary reasons for not taking medications were unaffordability of the medication and belief medication was no longer required. MeaningContext-appropriate assistance is required to overcome financial barriers and enable equitable access to healthcare and medication required to manage NCDs.
