Abstract
In our previous study, we completed a retrospective dataset of Later-stage Elderly Dental Oral Health Examination（LEDO）of older residents in Shimane Prefecture along with medical and nursing care insurance information and clarified the relationship between functional disability or death and oral health indicators using survival analysis and population attributable fraction（PAF）values. This study aimed to examine gender differences in outcomes as there are differences between men and women in terms of oral health indicators, life expectancy, and lifestyle factors such as cooking.
The subjects of this analysis were individuals with functional disability data（9,175 men and 12,706 women）and death data（9,722 men and 13,025 women）. We conducted survival analysis using 13 oral health indicators as explanatory variables and adjusted for confounding factors using propensity scores created from age, BMI, and medical history for each gender. Subsequently, we calculated PAF to compare the impact of explanatory variables on outcomes between men and women.
For functional disability, the top three PAF values for men were：1）first quartile of objective masticatory ability（lowest）at 23.13 %, 2）having 20-27 teeth at 13.88 %, and 3）moderate periodontal condition at 13.22 %. For women, the top three PAF values were：1）first quartile of objective masticatory ability at 21.50 %, 2）second quartile of the same at 8.28 %, and 3）having 10-19 teeth at 7.20 %.
Similarly, for death, the top three PAF values for men were：1）first quartile of objective masticatory ability at 17.68 %, 2）having 10-19 teeth at 11.66 %, and 3）having 1-9 teeth at 9.43 %. For women, the top three PAF values were：1）first quartile of objective masticatory ability at 14.83 %, 2）poor oral hygiene at 5.84 %, and 3）second quartile of objective masticatory ability at 5.46 %.
Objective masticatory ability had the strongest impact on both genders for both functional disability and death, but other oral health indicators had a stronger impact on men.
