Insomnia, low sleep quality, and sleeping little are associated with frailty in Mexican women.

OBJECTIVE: To analyze the influence that sex has on the association between insomnia, sleep quality, sleep duration, and frailty in older adults. SUBJECTS & METHODS: Cross sectional study from the Cohort Obesity, Sarcopenia, and Frailty in Older Mexican Adults (COSFOMA). In total, 493 older adults aged 64-94 participated. Insomnia was evaluated with the Athens Insomnia Scale and sleep quality with the Pittsburgh Sleep Quality Index. Duration of sleep was classified as short (<5 h and 5-6 hours), recommended (7-8 hours), and long (≥ 9 h). Frailty was operationalized with the Fried phenotype. Furthermore, sociodemographic variables were collected, along with physical and mental health. Logistic regression models were stratified by sex to analyze the relationship between insomnia, sleep quality, sleep duration, and frailty. RESULTS: Participants included 299 (60.7 %) women and 194 (39.3 %) men. The average age was 70.1 ± 5.6 years. Frail older adults comprised 13.4 % of the sample (n = 66), while 62.5 %(n = 308) were pre-frail and 24.1 % were not frail (n = 119). In the statistical models adjusted for sociodemographic and health covariates, insomnia, low sleep quality, and sleeping less than five hours were shown to increase the odds of being frail in women, but not in men. CONCLUSION: In older adult women, the presence of insomnia, low sleep quality, and sleeping less than five hours could promote frailty. Therefore, treatment of sleep problems among women should be prioritized to avoid the onset of this condition.

The impact of poor oral health on the oral health-related quality of life (OHRQoL) in older adults: the oral health status through a latent class analysis.

BACKGROUND: Determine the impact of poor oral health on the oral health-related quality of life (OHRQoL) in community-dwelling older adults. METHODS: Cross-sectional study of community-dwelling older adults in Mexico City. Sociodemographic characteristics were obtained and assessed their OHRQoL according to the Geriatric/General Oral Health Assessment Index (GOHAI). Clinical evaluation of their oral health: painful chewing, use of dentures, dry mouth, xerostomia, plaque, calculus, coronal and root caries, tooth loss and gingival bleeding. Finally, we determined the oral health of participants through Latent Class Analysis (LCA), excluding totally edentulous. The strength of association was determined (Odds Ratio [OR] and 95% confidence interval [95% CI]) through logical regression between the oral health categories (latent classes) and OHRoL in older adults, adjusted with the other variables included in the study: age, sex, marital status, living arrangements (lives alone), educational level, paid work status, comorbidity, cognitive deterioration, depression and use of medical and dental services in the previous 12 months. RESULTS: The mean (SD) GOHAI score for the 228 older adults to 46.5 (8.7), number of classes to characterize oral health through LCA was three (entropy 0.805). The GOHAI mean for Class 3 (57.0%), acceptable oral health was 50.1 (7.1); totally edentulous (9.6%), 47.9 (8.4); for Class 2 (16.7%), regular oral health, 43.8 (9.3); and for Class 1 (16.7%), poor oral health, 42.2 (9.7). Significant differences were observed among means (p < .001). Using Class 3 an as a reference, the strength of association between the GOHAI scores and low OHRQoL (GOHAI 25th percentile = 24.0) was OR = 0.7, 95% CI = 0.2-3.3 for totally edentulous; OR = 3.0, 95% CI = 1.2-7.6 for Class 2 and OR = 5.0, 95% CI = 2.1-12.1 for Class 1. CONCLUSION: Poor oral health was associated with a negative impact on the OHRQoL of community-dwelling older adults. CLINICAL RELEVANCE: It is essential to design and implement oral health care policies specifically targeted at improving the quality of life in this older adult population.

[Quality of life related to oral health in older people. Evaluation instruments]. / Calidad de vida relacionada con la salud oral en adultos mayores. Instrumentos de evaluación.

Given that life expectancy has increased considerably due to medical and technological advances, in recent years researchers have decided to meet the specific needs of the elderly in order to provide them better health care, in view of the fact that the aging process generates physical, biological and social changes. On the basis of this knowledge it becomes evident the impact of general health and oral health quality of life, which usually has a negative impact. Consequently, the aim of this work is to provide researchers and clinicians a review of the instruments that have been used for evaluation of the quality of life related to oral health. These instruments are the Oral Health Impact Profile (OHIP), the Oral Impacts on Daily Performances (OIDP) and the General Oral Health Assessment Index (GOHAI). Supplementary to the explanation of these instruments, our aim is to describe their structure, assessment, validation and application in studies performed on elderly Mexicans. In addition to this, we review some of the reports that compare the usefulness of those instruments.

Dado que ha habido un aumento en la expectativa de vida gracias a los avances médicos y tecnológicos, desde hace ya algunos años los investigadores se han propuesto conocer las necesidades de los adultos mayores con el fin de ofrecerles una mejor atención en salud, puesto que el proceso de envejecimiento genera cambios físicos, biológicos y sociales. A partir de este conocimiento se hace evidente la repercusión del estado de salud general y oral en la calidad de vida, lo cual tiene un impacto que, por lo general, es negativo. Por lo tanto, el objetivo de este trabajo es brindar tanto a investigadores como a clínicos una revisión de los instrumentos que han sido más utilizados para la evaluación de la calidad de vida relacionada con la salud oral (el Oral Health Impact Profile [OHIP], el Oral Impacts on Daily Performances [OIDP] y el General Oral Health Assessment Index [GOHAI]), su estructura, evaluación, validación y aplicación en investigaciones llevadas a cabo en adultos mayores mexicanos. Asimismo, se revisan muchos de los reportes en los que se compara la utilidad de los instrumentos mencionados.