Systemic and Oral Factors Relating to Stress in Later Life: A Study Using the Japanese National Statistics Database.

Background: The psychosomatic effects of stress are risk factors for a range of dental and systemic diseases. This study used the massive Japanese national statistics database to clarify the association of psychological stress with subjective symptoms and conditions requiring hospital visits. Methods: Anonymized data from 93,690 respondents of the 2019 Japanese survey were provided for this study. From these data, those of 29,777 respondents aged 40-89 years were classified into stress groups based on their responses to the Kessler Psychological Distress Scale (K6). The response rates for symptoms and diseases were compared and analyzed using contingency tables and binomial logistic regression. Results: The items with the largest odds ratios in the univariate analysis were depression/other mental disease (7.60), followed by irritability (6.86) and health perception QOL (6.31). Among those with subjective symptoms, the proportion in the high-stress group was higher (15.1%), with a univariate odds ratio of 3.17. The results of the binomial logistic regression analysis, with subjective QOL as the dependent variable, were as follows: The explanatory variables with the highest adjusted odds ratios were stress group classification (3.14), followed by feeling physically tired (2.44) and sleep satisfaction (2.22). The stress group was associated with subjective symptoms, such as irritability and depression/other mental diseases, as well as with social factors, such as household structure and work hours. These results suggest the existence of specific symptoms, diseases, and environmental factors associated with high stress. Conclusions: The results suggest that stress may have a substantial impact on quality of life in later life. Therefore, healthcare measures for older adults should focus on the symptoms and diseases that tend to be associated with stress to mitigate their effects.