The aim of this study was to examine the extent to which neighborhood-level socioeconomic factors (objective and perceived) are associated with poor oral health in older adults over time, independent of individual socioeconomic position. Data for this cross-sectional and longitudinal observation study came from a socially and geographically representative cohort of men aged 71 to 92 y in 2010–12 ( n = 1,622), drawn from British general practices, which was followed up in 2018–19 (aged 78–98 y; N = 667). Dental measures at both times included number of teeth, periodontal pocket depth, self-rated oral health, and dry mouth. Neighborhood deprivation was based on Index of Multiple Deprivation (IMD) and a cumulative index measuring perceptions about local environment. Individual-level socioeconomic position was based on longest-held occupation. Multilevel and multivariate logistic regressions, adjusted for relevant sociodemographic, behavioral, and health-related factors, were performed to examine the relationships of dental measures with IMD and perceived neighborhood quality index, respectively. Cross-sectionally, risks of tooth loss, periodontal pockets, and dry mouth increased from IMD quintiles 1 to 5 (least to most deprived); odds ratios (ORs) for quintile 5 were 2.22 (95% confidence interval [CI], 1.41–3.51), 2.82 (95% CI, 1.72–4.64), and 1.51 (95% CI, 1.08–2.09), respectively, after adjusting for sociodemographic, behavioral, and health-related factors. Risks of increased pocket depth and dry mouth were significantly greater in quintile 5 (highest problems) of perceived neighborhood quality index compared to quintile 1. Over the 8-y follow-up, deterioration of dentition (tooth loss) was significantly higher in the most deprived IMD quintiles after full adjustment (OR for quintile 5 = 2.32; 95% CI, 1.09–4.89). Deterioration of dentition and dry mouth were significantly greater in quintile 5 of perceived neighborhood quality index. Neighborhood-level factors were associated with poor oral health in older age, both cross-sectionally and longitudinally, particularly with tooth loss, and dry mouth, independent of individual-level socioeconomic position.

中文翻译：

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社区剥夺和老年人口腔健康的变化：一项基于人口的纵向研究

本研究的目的是探讨随着时间的推移，社区层面的社会经济因素（客观的和感知的）与老年人口腔健康状况不佳之间的关联程度，而与个人的社会经济地位无关。这项横断面和纵向观察研究的数据来自 2010-12 年具有社会和地理代表性的 71 岁至 92 岁男性队列（n = 1,622），来自英国的一般实践，并于 2018-19 年进行了随访（ 78-98 岁；N = 667）。两次的牙科测量包括牙齿数量、牙周袋深度、口腔健康自评和口干。邻里剥夺基于多重剥夺指数（IMD）和衡量对当地环境看法的累积指数。个人层面的社会经济地位基于最长的职业。进行多层次和多变量逻辑回归，并根据相关的社会人口统计、行为和健康相关因素进行调整，以分别检查牙科测量与 IMD 和感知邻里质量指数的关系。从横截面来看，牙齿脱落、牙周袋和口干的风险从 IMD 五分位数 1 增加到 5（最不严重到最严重）；五分位数 5 的比值比 (OR) 分别为 2.22（95% 置信区间 [CI]，1.41–3.51）、2.82（95% CI，1.72–4.64）和 1.51（95% CI，1.08–2.09）。调整社会人口、行为和健康相关因素。与五分位数 1 相比，感知邻里质量指数五分位数 5（最高问题）的牙袋深度增加和口干的风险显着更高。在 8 年随访中，大多数人的牙列恶化（牙齿脱落）显着更高。完全调整后被剥夺的 IMD 五分位数（五分位数 5 的 OR = 2.32；95% CI，1.09–4.89）。在感知邻里质量指数的五分位数 5 中，牙列恶化和口干明显更严重。社区层面的因素与老年人口腔健康状况不佳有关，无论是横向还是纵向，尤其是牙齿脱落和口干，与个人层面的社会经济地位无关。