Social participation and tooth loss, vision, and hearing impairments among older Brazilian adults

Background: Vision and hearing impairments can reduce participation in social activities. Given the prominent role of the mouth in face-to-face interactions, this study evaluated the associations of tooth loss, vision, and hearing impairments with social participation among older adults. Methods: This analysis included 1947 participants, aged 60+ years, who participated in three waves (2006, 2010, and 2015) of the Health, Wellbeing and Aging Study (SABE) in Brazil. Social participation was measured by the number of formal and informal social activities (requiring face-to-face interaction) participants were regularly involved in. Teeth were counted during clinical examinations and categorized as 0, 1–19, and 20+ teeth. Reports on vision and hearing impairments were classified into three categories (good, regular, and poor). The associations of each impairment with the 9-year change in the social participation score were tested in negative binomial mixed-effects models adjusting for time-variant and time-invariant covariates. Results: Each impairment was associated with the baseline social participation score and the annual rate of change in the social participation score. Participants with 1–19 (incidence rate ratio: 0.96, 95% CI: 0.91–1.01) and no teeth (0.92, 95% CI: 0.87–0.97), those with regular (0.98, 95% CI: 0.95–1.01) and poor vision (0.86, 95% CI: 0.81–0.90), and those with regular (0.94, 95% CI: 0.91–0.98) and poor hearing (0.91, 95% CI: 0.87–0.95) had lower baseline social participation scores than those with 20+ teeth, good vision, and good hearing, respectively. Furthermore, participants with 1–19 (0.996, 95% CI: 0.990–1.002) and no teeth (0.994, 95% CI: 0.987–0.999), those with regular (0.996, 95% CI: 0.992–0.999) and poor vision (0.997, 95% CI: 0.991–1.003), and those with regular (0.997, 95% CI: 0.992–1.001) and poor hearing (0.995, 95% CI: 0.990–0.999) had greater annual declines in the social participation score than those with 20+ teeth, good vision and good hearing, respectively. Conclusion: This 9-year longitudinal study shows that tooth loss, vision, and hearing impairments are associated with reduced social participation among older adults.