Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
Original Article
Frequency of Going Outdoors and Risk of Poor Oral Health Among Older Japanese Adults: A Longitudinal Cohort From the Japan Gerontological Evaluation Study
Keiko Ishimura, Ryoto Sakaniwa, Kokoro Shirai, Jun Aida, Kenji Takeuchi, Katsunori Kondo, Hiroyasu Iso
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Keywords: going outdoors, oral health, older adult, mediation effect, longitudinal study
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2024 Volume 34 Issue 2 Pages 63-69

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Abstract

Background: The association between the frequency of going outdoors and the risk of poor oral health has been reported in several studies; however, the findings have been inconclusive.

Methods: We conducted a 3-year longitudinal study of 19,972 Japanese adults aged ≥65 years who reported no poor oral condition at baseline in 2013. The respondents rated their frequency of going outdoors in three categories (≤1, 2–3, or ≥4 times/week), and the oral conditions reported in 2016 included tooth loss, chewing difficulty, swallowing difficulty, dry mouth, and composite outcomes. The associations between the frequency of going outdoors and the risk of poor oral health were examined as relative risk ratios (RRs) and 95% confidence intervals (CIs) using multivariable Poisson regression, while mediation analysis was performed to investigate indirect effects.

Results: During the follow-up, 32.5% of participants developed poor oral health. In the mediation analysis, indirect effects were observed through low instrumental activities of daily living, depressive symptoms, little social network diversity, and underweight. Compared to going outdoors ≥4 times/week, the multivariable RRs of composite poor oral health conditions were 1.12 (95% CI, 1.05–1.20) for 2–3 times/week and 1.22 (95% CI, 1.07–1.39) for ≤1 time/week (P-trend < 0.001). Similar associations were observed for tooth loss, chewing difficulty, and swallowing difficulty; the corresponding RRs were 1.07 (95% CI, 0.97–1.19) and 1.36 (95% CI, 1.13–1.64) (P-trend = 0.002), 1.18 (95% CI, 1.06–1.32) and 1.30 (95% CI, 1.05–1.60) (P-trend < 0.001), and 1.15 (95% CI, 1.01–1.31) and 1.38 (95% CI, 1.08–1.77) (P-trend = 0.002), respectively.

Conclusion: The frequency of going outdoors was inversely associated with the risk of poor oral health through several modifiable risk factors in the older population.

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© 2023 Keiko Ishimura et al.

This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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