What pediatric nursing must prepare for now and in the future.

Worldwide, the proportion of older people in the population is growing []. In Sweden, it is estimated that by 2070, one in four individuals will be over the age of 64 years []. As people age, the prevalence of polypharmacy and multimorbidity increases []. These conditions pose significant health concerns, particularly among older people []. Today, more than 70% of the population aged 65 years and older are experiencing two or more chronic diseases, such as cardiovascular disease, cancer, diabetes, and stroke [, ]. These diseases are strongly associated with increased prevalence of polypharmacy and higher mortality risk, posing major challenges for society due to the burden of health costs []. Periodontitis is a global health problem affecting between 50 and 82% of the older population []. Periodontitis is the predominant cause of tooth loss among individuals aged 65 years and older, leading to masticatory impairments and reduced quality of life []. The association between periodontitis and various systemic conditions is well known [, ]. In recent years, some evidence also suggests that the risk of mortality may increase among individuals with systemic diseases such as cardiovascular diseases, diabetes mellitus, and respiratory diseases when periodontitis co-occurs [–]. Poor periodontal health has been shown to affect both functional ability and mortality among individuals 75 years and older []. Furthermore, studies suggest that poor self-rated oral health, resulting from conditions such as complete or partial absence of natural teeth, may be a predictor of mortality risk in individuals aged 60 years and above [, ]. In hospitalized older men with COVID-19, the presence of periodontitis was associated with 14.58 times higher odds of death compared to those without periodontitis []. Similarly, Zhang et al. [] reported that individuals 30 years and older with both depression and periodontitis had an increased risk of all-cause and cancer-related mortality. A meta-analysis by Romandini et al. [] further supports these findings, showing that periodontitis and edentulism are associated with an increased risk of all-cause mortality as well as mortality from cardiovascular diseases and cancer in individuals ≤ 65 years. These findings highlight the importance of addressing periodontitis as a public health concern in efforts to improve oral and general health in older populations. Previous studies have shown that the prevalence of periodontitis increases with age [–], which may affect life expectancy. Although the association between periodontitis and mortality has been investigated previously, few studies have combined comprehensive clinical and radiographic periodontal assessment with long-term mortality follow-up in a well-defined cohort of younger older age adults. The present study therefore aimed to examine the association between baseline moderate-to-severe periodontitis and all-cause mortality among individuals aged 60 and 66 years, followed over 23 years.