JMIR Publications

ABSTRACT

Background:

Edentulism impacts the physical health and quality of life of elderly individuals. The prevalence, influencing factors, and differences in terms of edentulism in the urban and rural areas of China have not been clarified.

Objective:

Objective:

To investigate the denture-wearing conditions and causes affecting elderly edentulous patients in urban and rural areas of China and analyse the differences.

Methods:

Method and participants: This cross-sectional study included the data of 5139 elderly edentulous individuals aged over 65 years. The data for this study was obtained from a survey conducted by the Chinese Longitudinal Healthy Longevity Survey project team in 2018 in 23 Chinese provinces. The participants were divided into urban and rural elderly groups based on their household registration. The factors influencing denture use among urban and rural elderly edentulous patients were explored using a binary logistic regression method. The factors for differences in denture wearing in urban and rural elderly edentulous patients were explored using the Fairlie decomposition method.

Results:

Results:

Among the 5139 participants, 67.05% (808/1205) participants from urban areas wore dentures, and 51.12% (2011/2600) participants from rural areas wore dentures. In urban areas, a higher level of education (1-6 years, odds ratio [OR]=2.093; ≥7 years, OR=2.187) and exercise (OR=2.840) were protective factors for denture use in edentulous elderly individuals, while a body mass index (BMI) of <18.5 kg/m2 (OR=0.558) and widowed marital status (OR=0.618) were risk factors for denture use in edentulous elderly individuals. In rural areas, a higher level of education (1-6 years, OR=1.742; ≥7 years, OR=1.498), living alone (OR=1.372), exercise (OR=1.612), high economic status (OR=1.234), residence in the eastern area (OR=2.045), presence of one or more chronic diseases (one chronic disease, OR=1.534; ≥2 chronic diseases, OR=1.500) were protective factors for denture use in edentulous elderly individuals, while age ≥80 years (OR=0.318), BMI <18.5 kg/m2 (OR=0.692), widowed marital status (OR=0.566), or other (OR=0.600) were risk factors for denture use in edentulous elderly individuals. The Fairlie decomposition model revealed that the number of chronic diseases (16.34%), education level (11.94%), region of residence (11.00%), annual income (10.55%), exercise (6.81%), and age (-0.92%) were the main factors responsible for differences between urban and rural edentulism. It could explain the difference in the denture-wearing rate of 58.48% between urban and rural edentulous elderly individuals.

Conclusions:

Conclusions:

In this cross-sectional study, individuals with a higher educational level and those who exercised were more willing to wear dentures, while BMI <18.5 kg/m2 decreased the willingness of older individuals to wear dentures in urban and rural areas. Controlling the number of chronic diseases, improving the education level and annual income, cultivating good exercise habits, and bridging the gap between the economic status of the east and west can narrow the differences in denture wearing among urban and rural elderly edentulous individuals.