Clinical features and subgroup patterns in elderly and super-elderly TMD patients

Abstract

This cross-sectional study compares TMD signs and symptoms in patients aged ≥ 65 (elderly) and ≥ 85 (super-elderly) with younger age groups. Additionally, this study sought to identify the key factors contributing to increased pain intensity in elderly and super-elderly patients with TMD. A total of 4,661 patients with TMD (mean age = 42.22 ± 20.08 years, 3069 women and 1592 men) were analyzed, categorized into six age groups, including those aged 65–74, 75–84, and 85 + years. The clinical characteristics, pain intensity (VAS), and TMD subgroup distribution were examined. Generalized linear models and 2D/3D visualizations were used to explore the correlations and multivariable relationships. Of the 4,661 patients aged 7–113 years, 16.8% were elderly and 1.1% were super-elderly. The female-to-male ratios in the elderly group were 1.93:1 and 1.78:1, with females being predominant across all age groups. Elderly groups, including those aged 65–74 (3.92 ± 2.49), 75–84 (3.94 ± 2.73), and 85 + years (3.92 ± 2.49), had significantly higher VAS scores compared to younger age groups (p < 0.001), indicating moderate pain levels. Maximum mouth opening values were significantly smaller in the 75–84 (38.81 ± 10.79 mm) and 85 + groups (38.08 ± 12.79 mm) compared to younger groups (p < 0.001). Arthralgia was one of the most prevalent TMD subgroups in both elderly (58.2%) and super-elderly (50.0%) patients. Degenerative joint disease was more prevalent in the super-elderly group (48.0%) than in the elderly group (37.9%) (P < 0.05). Chronic TMD was most prevalent in the 0–19 years group (50.3%), followed by the super-elderly group (44.0%) (p < 0.001). GLM analysis showed that TMJ pain (B = 1.324, p < 0.001), TMJ noise (B = 0.757, p < 0.001), and age (B = 0.014, p < 0.001) were significantly associated with higher VAS scores, whereas increases in CMO (B = -0.011, p < 0.001) were associated with lower VAS scores. In the super-elderly group, the VAS score was also significantly associated with degenerative joint disease. The 2D and 3D visualizations revealed a tangled web of relationships among these clinical and diagnostic variables, showing how intricately they are intertwined and how they influence each other in complex patterns. This study provides valuable insights into the clinical patterns of TMD in elderly and super-elderly patients, emphasizing the need for tailored TMD management as this population grows.