Avaliação multidimensional e interdisciplinar em idosos nãoinstitucionalizados de uma comunidade norte-mineira: relação entre sintomas depressivos, fatores sociodemográficos, condição de saúde sistêmica, polimorfismo na região promotora do gene transportador de serotonina (5HTTLPR) e saúde bucal

Abstract

This cross-sectional study was conducted to investigate the association of socio-demographic factors, systemic health condition, depressive symptoms and serotonin transporter-linked polymorphism region (5-HTTLPR) according to normative condition of oral health in elderly of a Brazilian community. The selected subjects were 200 older attended by two teams of the Family Health Strategy – FHE in Montes Claros city, Minas Gerais state, Brazil. Questionnaire was conducted in order to obtain socio-demographic data. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale. WHO and SB Brazil criteria for oral health clinical exams were used to evaluate normative condition of oral health (dental caries, periodontal disease, edentulism and oral mucosal lesion). Polymerase chain reaction-restriction fragment length polymorphism was used to evaluate the 5-HTTLPR alleles and genotype in all individuals. Bivariate analysis was performed by χ 2 test and the Fisher’s exact test. Besides, these associations were evaluated by Poisson regression model, adjusting for covariates. In relation to normative condition of oral health, it was found a high prevalence of dental caries (51.2%) and a low prevalence of periodontal disease (20.8%) among dentate subjects. Edentulism was verified in 58% of subjects and oral mucosal lesion was detected in 21.5% of them. The 5-HTTLPR gene polymorphisms were observed the frequencies of 56% L allele and 44% S. The frequencies of genotypic polymorphisms were 33.5% (LL), 45.0% (SL), and 21.5% (SS). The prevalence of the depressive symptoms identified by GDS-15 questionnaire was 21.5% (n=43). Multivariate analysis showed that older male exhibited more prevalence for dental caries (PR= 1.642; CI95%= 1.025-2.629) and older female exhibited more prevalence for edentulism (PR=1.774; CI95%= 1.346-2.338). Older aged over 65 years had significant association with occurrence of edentulism (PR= 1.476; CI95%= 1.066-2.045) and older 60-64 years had significant association with periodontal disease (PR= 2.778; CI95%= 1.142-6.760). Older with lower income had higher prevalence for dental caries (PR= 1.705; CI95%= 1.076-2.700). Older workers had higher prevalence of periodontal disease than old age pensioner subjects (PR= 2.715; CI95%= 1.121-6.573). Illiterate elderly were more likely to be edentulous than literate elderly (PR= 1.269; CI95%= 1.019-1.580). Still, 5-HTTLPR SS genotype variant was more prevalent in the periodontal disease (PR= 2.980; CI95%= 1.018-8.724) and edentulism (PR= 1.335; CI95%= 1.002-1.778). In conclusion, the findings of this study confirm previous observations of association between socio-demographic data and normative conditions of oral health of older people. Depressive symptoms were not associated with the normative conditions of oral health, however the 5-HTTLPR SS genotype variant was more prevalent in the periodontal disease and edentulism older groups.