Oral health-related quality of life and associated factors in a care-dependent and a care-independent older population.

OBJECTIVES: To examine relationships between oral health (OH) factors and general health (GH) factors (including physical, mental, and social health domains), and oral health-related quality of life (OHRQoL) in a care-independent and a care-dependent older population.

METHODS: Care-independent participants (n=109) were recruited from the Nijmegen dental school; care-dependent participants (n=126) from residential aged care facilities. Data collected included: OHRQoL (Geriatric Oral Health Assessment Index (GOHAI)), age, gender, socioeconomic status, number of teeth and occluding pairs, presence of carious teeth, presence of removable dental prostheses, clinically assessed treatment need (CTN), self-reported GH, and, only for care-dependent participants: care-dependency level and health domain variables: physical, mental (SF-12: Physical and Mental Component Summary scores), and social (ENRICHD social support index). Multiple linear regression analyses were performed to assess the associations with GOHAI scores.

RESULTS: Mean GOHAI scores of care-independent (51.6±7.4) and care-dependent participants (52.1±6.7) did not differ significantly despite considerably worse OH status of the latter. Regression models revealed significant (p≤0.05) associations between GOHAI scores and age, prosthodontic status, and CTN in care-independent participants (R2 =0.19) and only with CTN in care-dependent participants. (R2 =0.09). Self-reported GH was not significantly associated with GOHAI; when substituted by the health domain variables, only social support was significantly associated with GOHAI scores.

CONCLUSIONS: GOHAI outcomes are associated with different variables in care-independent and care-dependent older subjects. In care-dependent subjects, GOHAI outcomes are more strongly related to social support than to OH factors or other GH factors.

CLINICAL SIGNIFICANCE: OHRQoL outcomes should not be compared across care-dependent and care-independent populations without careful interpretation of these outcomes against specific factors that distinguish such populations, like health factors and living environment.