Oral health-related quality of life in Colombian Older Adults

Abstract Despite its importance for health and wellbeing, oral health quality of life (OHQoL) has received little attention in lower-income countries, such as Colombia. This study describes the prevalence of older adults’ OHQoL and variability by socioeconomic status. We use data from the 2015 SABE-Colombia (N=18,700), a nationally representative survey of community-dwelling Colombians ages 60 and older. We used the Simple Count Geriatric Oral Health Assessment Index (SC-GOHAI), a self-reported measure of frequent oral health problems such as chewing, swallowing, and speaking designed to assess OHQoL. The scale ranges from 0-12; higher scores indicate worse OHQoL. About 69% of older Colombians reported at least one OHQoL problem. The most common issues were difficulty chewing hard food and speaking. High education and income were associated with better OHQoL and smoking were associated with worse OHQoL. Oral health may therefore reflect another dimension of social and health inequality for older Colombians.

Given the role of age as a risk factor in the covid pandemic, we examined the longitudinal cross-lagged relationship between subjective age and Covid-related worry, and possible moderators of this relationship. Data were obtained at two-time points (June and October 2020) by a phone/online survey, from N = 611 older participants (Mage = 69.92 years). Participants felt on average 10 and 8.5 years younger than their chronological ages at the two-time points, respectively. Younger subjective age at T1 increased the level of worry at T2 irrespective of age, perceived control and subjective health. Higher worry increased subjective age at T2, but only for those with worse subjective health. Our results show that subjective age and Covidrelated worry interact over time. This relation needs to be explored further in order to understand the relationship between subjective age and well-being especially, but not only in the pandemic context.

HEALTH AND AGING DISPARITIES AMONG LATIN AMERICAN OLDER ADULTS: FINDINGS FROM STUDIES IN BRAZIL, COLOMBIA, AND MEXICO Chair: Margarita Osuna
Aging in Latin America is occurring rapidly, in a context of high levels of poverty and inequality. This symposium is focused on population health and the heath-disparities found in some of Latin America's largest middle-income countries, Mexico, Brazil, and Colombia. This symposium contains presentations on different health-related issues affecting older adults, which can have further implications for wellbeing, health, and disease risk. The papers in this symposium examine a variety of health-related dimensions and disparities among older Latinos that include physiological functioning, cognition, and oral health. Using the Mexican Health and Aging Study (MHAS), Sheehan investigates the associations between personal and familial educational attainment on sleep quality. Also using MHAS, Milani. Using data from the Brazilian Longitudinal Study of Aging, Farina examines the relationship between race and cognition. Garcia uses data from the Colombian Survey of Health, Well-Being, and Aging to study the relationship between Motor Cognitive Risk Syndrome (MCRS) and cognition and frailty. Using the same dataset, Osuna examines variation in oral health in Colombian older adults and the impact this has on their wellbeing. Results indicate which population subgroups in Latin American have increased risk for poorer health and which dimensions of health have gender, race and socioeconomic disparities. The findings highlight the importance of understanding the conditions under which Latin American older adults are aging and the implications this can have in the future. Despite its importance for health and wellbeing, oral health quality of life (OHQoL) has received little attention in lower-income countries, such as Colombia. This study describes the prevalence of older adults' OHQoL and variability by socioeconomic status. We use data from the 2015 SABE-Colombia (N=18,700), a nationally representative survey of community-dwelling Colombians ages 60 and older. We used the Simple Count Geriatric Oral Health Assessment Index (SC-GOHAI), a self-reported measure of frequent oral health problems such as chewing, swallowing, and speaking designed to assess OHQoL. The scale ranges from 0-12; higher scores indicate worse OHQoL. About 69% of older Colombians reported at least one OHQoL problem. The most common issues were difficulty chewing hard food and speaking. High education and income were associated with better OHQoL and smoking were associated with worse OHQoL. Oral health may therefore reflect another dimension of social and health inequality for older Colombians.

THE INFLUENCE OF GENDERED SOCIAL POSITION ON COHORT DIFFERENCES IN SMOKING AMONG OLDER MEXICAN ADULTS
Sadaf Milani, 1 Jaqueline Avila, 2 and Rebeca Wong, 1 1. University of Texas Medical Branch,Galveston,Texas,United States,2. Brown University,United States Disparities throughout the life course, including social position, result in gendered pathways to health, which ultimately result in gender disparities in late life. Using data from the Mexican Health and Aging Study, we explore the concept of gendered social position over the life course (educational achievement, marital history, employment history) and its association with smoking status in old age (current, former, never). We compare two cohorts by gender, those aged 60 to 71 in 2001 (n=4,383) and 60-71 in 2012 (n=5,970), as these cohorts experienced vastly different life courses. Overall, current smoking decreased from 2001 to 2012, but men consistently report higher rates of current and past smoking, compared to women. This presentation will widen the lens of gender to consider the influence of social position established over the life course, on gender differences in smoking, a risk factor for poor health and function in old age.

THE LIFE COURSE ORIGINS OF THE RACE DISPARITY IN COGNITIVE FUNCTIONING IN BRAZIL Mateo Farina, University of Southern California, Los Angeles, California, United States
Background: Cognitive health is a major concern for understanding population health in Brazil. Race inequalities have been found for several health outcomes but less is known about older adult cognitive health. Health inequalities have been tied to several life course factors, but less is known about how the racial stratification in Brazil may contribute to race disparities in cognitive health. Method: Data come from the Brazilian Longitudinal Study of Aging. We used nested regression models to examine the life course origins of the race differences in cognitive functioning. Results: Whites had better cognitive functioning than non-Whites. Education reduced these differences by about half. Health behaviors and cardiometabolic conditions had little to no impact. Discussion: Race differences in cognitive functioning in Brazil are in large part attributable to educational opportunities. These finding point to the importance of cognitive development in childhood to understand racial disparities in later life cognitive health.

DOES FAMILIAL EDUCATIONAL ATTAINMENT PREDICT SLEEP QUALITY TRAJECTORIES FOR OLDER ADULTS IN MEXICO?
Connor Sheehan, 1 and Margarita Osuna, 2 1. ASU, Tempe, Arizona, United States, 2. USC, University of Southern California, California, United States Researchers have stressed the importance of sleep for healthy aging and longevity. However, there are few population-level studies of sleep quality focusing on older adults in Latin America and Mexico in particular. The objective of this study is to examine the associations between personal and familial educational attainment on sleep quality. We utilized data from the 2001-2015 Mexican Health and Aging Study (N=4,164; MHAS). Our sample consisted of older adults (aged 50+), married with children. We predicted longitudinal reports of restless sleep across four waves of MHAS using mixed-effects logistic regression. We found that lower levels of respondents' education, their spouses' education, and their children's' education were associated with lower levels of sleep quality. When the measures of education were included in the same model, one's own education and children's education remained significantly associated with quality sleep. Our results stress the importance of familial educational attainment for sleep in Mexico. Elkin Garcia-Cifuentes, Isabela Marquez, and Carlos Cano, Pontificia Universidad Javeriana, Pontificia Universidad Javeriana, Distrito Capital de Bogota, Colombia Cognitive decline and dementia have a significant impact older adult. Motor Cognitive Risk Syndrome (MCRS) is a pre-dementia stage where slow gait speed and subjective memory complaints are present. MCRS increases the risk of frailty, dementia, disability, falls and overall mortality. We used data from the SABE Colombia study (Health, Well-Being, and Aging) conducted in 2015 in adults aged 60 years and older. After adjusting for confounding variables MCRS was associated with MMSE (OR 0.90, CI 0.82-0.99), prefrail (OR 9.1, CI 3.26-25.47) and frail (OR 21.38,). This study found a prevalence of 5.45% of MCRS in Colombian older adults. We found an associations between cognitive performance (MMSE), frailty and MCRS. Our results increase the awareness of a pre-dementia stages different to Mild Cognitive Impairment (MCI), as these individuals are at greater risk than those with MCI to develop dementia. Data indicates that older persons will increase in numbers along with having an increase of life expectancy in the United States. Kaiser Permanente Los Angeles Medical Center's Utilization Department developed "65 & Thrive"an age-specialized initiative to provide holistic care that preserves independence, quality of life, prevents functional and cognitive decline, and promotes both patients and their families to continue thriving. The initiative's focus is guided by