Povezanost determinanti zdravlja i simptoma depresije sa nedostatkom zuba kod odraslog stanovništva Srbije: studija preseka

Dušan Čanković; Miloš Čanković; Snežana Ukropina; Vesna Mijatović Jovanović; Sonja Čanković

doi:10.2298/VSP171011182C

Dušan Čanković Institute of Public Health of Vojvodina, Novi Sad, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Miloš Čanković University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Snežana Ukropina Institute of Public Health of Vojvodina, Novi Sad, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Vesna Mijatović Jovanović Institute of Public Health of Vojvodina, Novi Sad, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Sonja Čanković Institute of Public Health of Vojvodina, Novi Sad, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia

DOI: https://doi.org/10.2298/VSP171011182C

Keywords: odrasle osobe, depresija, bezubost, faktori rizika, socijalno-ekonomski faktori, ankete i upitnici

Abstract

Apstrakt

Uvod/Cilj. Bolesti usta i zuba su glavni faktor rizika od gubitka zuba, ali i socijalni faktori i druge determinante zdravlja takođe mogu imati važnu ulogu. Cilj istraživanja je bio da se utvrdi da li potencijalni nezavisni faktori, kao što su sociodemografski faktori, stil života i depresivni poremećaji, mogu doprineti gubitku zuba odraslog stanovništva Srbije. Metode. Analizirani su podaci dobijeni u okviru Nacionalnog istraživanja zdravlja stanovništva Srbije koje je sprovedeno 2013. godine kao studija preseka na reprezentativnom uzorku odraslog stanovništva Srbije (bez podataka o stanovništvu Kosova i Metohije). Uzorak je izabran da obezbedi statistički pouzdane procene na nacionalnom nivou. Studija je obuhvatila 13 519 odraslih osoba starosti 20 godina i više. Prosečna starost ispitanika, uključujući 6 998 (51,7%) žena i 6 517 (48,2%) muškaraca bila je 49,9 godina. Kao zavisna varijabla analiziran je broj zuba koji su nedostajali ispitanicima, dok su nezavisne varijable bile: pol, starost, bračno stanje, obrazovanje, radni status, Indeks blagostanja, pušački status, indeks telesne mase (BMI), unos mleka i mlečnih proizvoda, voća (isključujući voćne sokove), povrća i salata (isključujući krompir) i depresija. Za utvrđivanje prisustva depresivne epizode korišćen je standardizovan Upitnik o zdravlju pacijenata – Patient Health Questionnaire (PHQ)-8. Gubitak prirodnih zuba definisan je kao bezubost (potpuna ili delimična). Za određivanje prediktora gubitka zuba korišćeni su modeli bivarijantne i multivarijantne logističke regresije za sve kategorije gubitka zuba. Rezultati. Nađena je statistički značajna razlika između kategorija bezubosti u odnosu na sve nezavisne promenljive izuzev unosa povrća i salata. Prevalencija totalne bezubosti bila je najveća kod žena, niskoobrazovanog i neaktivnog stanovništva, pothranjenih (BMI < 18,5 kg/m²) i ispitanika sa umereno teškim depresivnim epizodama (PHQ-8 skor od 15 do 19). Multivarijantnim modelom je utvrđeno da su demografski faktori (životno doba, život sa partnerom), socijalnoekonomski faktori (niže i srednje obrazovanje, Indeks blagostanja), pušenje, BMI, PHQ-8 skor i prisustvo depresivnih simptoma bili statistički značajno povezani sa delimičnim gubitkom zuba. Zaključak. Ova studija ukazuje na to da sociodemografski faktori, stil života i depresivni simptomi predstavljaju faktore koji mogu biti povezani sa gubitkom zuba. Studija ukazuje na neophodnost donošenja programa koji su usmereni na obrazovanje, prestanak pušenja cigareta, navike u ishrani, kao i redovne posete stomatologu.

References

REFERENCES

Thomson MW. Epidemiology of oral health conditions in older people. Gerodontology 2014; 31(Suppl 1): 9–16.

Beck JD, Youngblood M, Atkinson JC, Mauriello S, Kaste LM, Badner VM, et al. The prevalence of caries and tooth loss among participants in the Hispanic Community Health Study/Study of Latinos. J Am Dent Assoc 2014; 145(6): 531–40.

Copeland LB, Krall EA, Brown JL, Garcia RI, Streckfus CF. Pre-dictors of tooth loss in two US adult populations. J Public Health Dent 2004; 64(1): 31–7.

Burt BA, Ismail AI, Morrison EC, Beltran ED. Risk factors for tooth loss over a 28-year period. J Dent Res 1990; 69(5): 1126–30.

Marmot M, Wilkinson R. The social determinants of health. 2nd ed. Oxford, UK: Oxford University Press; 2006.

Pappa E, Kontodimopoulos N, Papadopoulos AA, Niakas D. As-sessing the socio-economic and demographic impact on health-related quality of life: evidence from Greece. Int J Pub-lic Health 2009; 54(4): 241–9.

Janković J, Simić S. The association of demographic and socioe-conomic determinants and self-perceived health. Srp Arh Ce-lok Lek 2012; 140(1–2): 77–83. (Serbian)

Klein BEK, Klein R, Knudtson MD. Life-style correlates of tooth loss in an adult Midwestern population. J Pub Health Dent 2004; 64(3): 145–50.

Okoro C, Strine T, Eke P, Dhingra S, Balluz L. The association between depression and anxiety and use of oral health services and tooth loss. Community Dent Oral Epidemiol 2012; 40(2): 134–44.

Tsakos G, Herrick K, Sheiham A, Watt RG. Edentulism and fruit and vegetable intake in low-income adults. J Dent Res 2010; 89(5): 462–7.

Alves LS, Susin C, Damé-Teixeira N, Maltz M. Overweight and obesity are not associated with dental caries among 12-year-old South Brazilian schoolchildren. Community Dent Oral Epidemiol 2013; 41(3): 224–31.

Hugo FN, Hilgert JB, de Sousa Mda L, Cury JA. Oral status and its association with general quality of life in older in-dependent-living south-Brazilians. Community Dent Oral Epidemiol 2009; 37(3): 231–40.

Grujic V. The prevalence of depression and health service re-sources in Vojvodina for the prevention and treatment of de-pression. Institut of Public Health of Vojvodina [cited 2016 Mar 15]. Preuzeto sa:

http://www.izjzv.org.rs/uploads/4a46a0895a9afe6d2e7ea5594413bc3c/2020_4_Prevalencija_depresije_i_resursi_zdrav_sluzbe_u_APV_V_Grujic.pdf

Finlayson TL, Williams DR, Siefert K, Jackson JS, Nowjack-Raymer R. Oral health disparities and psychosocial correlates of self-rated oral health in the National Survey of American Life. Am J Public Health 2010; 100(Suppl 1): S246–S55.

de Andrade FB, Lebrão ML, Santos JL, da Cruz Teixeira DS, de Oliveira Duarte YA. Relationship between oral health-related quality of life, oral health, socioeconomic, and general health factors in elderly Brazilians. J Am Geriatr Soc 2012; 60(9): 1755–60.

D'Mello DA. Are your patients depressed? Implications for dental practice. J Mich Dent Assoc 2003; 85(5): 26–32.

Ministry of Health of the Republic of Serbia. Health Survey of the Population of Serbia 2013: Final Report. 2013. [cited 2017 Jun 20]. Available from: http://www.batut.org.rs/ down-load/publikacije/2013SerbiaHealthSurvey.pdf

Cunha-Cruz J, Hujoel PP, Nadanovsky P. Secular trends in socio-economic disparities in edentulism: USA, 1972-2001. J Dent Res 2007; 86(2): 131–6.

Rutstein SO, Johnson K. The DHS Wealth Index: DHS Comparative Reports. No. 6. [cited 2016 Feb 28]. Available from: http://www.childinfo.org/files/DHS_Wealth_Index

_%28DHS_Comparative_Reports%29.pdf

World Health Organization. Global Database on Body Mass Index: BMI classification 2006. [cited 2016 Apr 10]. Available from: http://apps.who.int/bmi/index.jsp? intro Page=intro_3.html

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16(9): 606–13.

Kroenke K, Spitzer RL. The PHQ-9: a new depression and diag-nostic severity measure. Psychiatr Ann 2002; 32: 509–21.

World Health Organization. Oral health Fact sheet N˚318. 2012. April. [cited 2016 Mar 15]. Preuzeto sa: http://www.who.int/ mediacentre/factsheets/fs318/en/

Health Canada. Report on the findings of the oral health com-ponent of the Canadian Health Measures Survey 2007-2009. Ottawa, Ontario: Ministry of Health; 2010. [cited 2017 May 8]. Available from: http://publications.gc.ca/collections/ collection_2010/sc-hc/H34-221-2010-eng.pdf

Medina-Solís CE, Pérez-Núñez R, Maupomé G, Avila-Burgos L, Pontigo-Loyola AP, Patiño-Marín N, et al. National survey on edentulism and its geographic distribution, among Mexicans 18 years of age and older (with emphasis in WHO age groups). J Oral Rehabil 2008; 35(4): 237–44.

Ministry of Health of the Republic of Serbia. Health Survey of the Population of Serbia 2006: Final Report. 2006. [cited 2017 Jan 20]. Available from: http://www.batut. org.rs/download/publikacije/Finalni%20izvestaj%202006.pdf

Marcus M, Reifel NM, Nakazono TT. Clinical measures and treatment needs. Adv Dent Res 1997; 11(2): 263–71.

Locker D, Ford J, Leake JL. Incidence of and risk factors for tooth loss in a population of older Canadians. J Dent Res 1996; 75(2): 783–9.

Wennström A, Ahlqwist M, Stenman U, Björkelund C, Hakeberg M. Trends in toothloss in relation to socio-economic status among Swedish women, aged 38 and 50 years: Repeated cross-sectional surveys 1968-2004. BMC Oral Health 2013; 13: 63.

Hybels CF, Bennett JM, Landerman LR, Liang J, Plassman BL, Wu B. Trajectories of depressive symptoms and oral health outcomes in a community sample of older adults. Int J Geriatr Psychiatry 2016; 31(1): 83–91.

Kiecolt-Glaser JK, Glaser R. Depression and immune function: central pathways to morbidity and mortality. J Psychosom Res 2002; 53(4): 873–6.

Peeters FP, deVries MW, Vissink A. Risks for oral health with the use of antidepressants. Gen Hosp Psychiatry 1998; 20(3): 150–4.

OECD. Health at a Glance: Europe 2014. 2016. [cited 2016 Mar 15]. Available from: http://www.oecd.org/health/health-at-a-glance-europe-23056088.htm

US Public Health Service. Office of the Surgeon General. Oral health in America: A report of the Surgeon General. Rockville MD: US Public Health Service - US Department of Health and Human Services; 2000.