Association between depressive symptoms and dental care-seeking behavior among elderly Brazilian people

Abstract Background Depressive symptoms are highly prevalent among the elderly population (10%). These symptoms frequently appear when there is a loss of quality of life associated with social exclusion and the appearance of severe diseases. Feelings of sadness, discouragement, despondency and deception, and events such as the loss of close friends and family can also be related to these symptoms. The consequences of depressive symptoms include negative oral health outcomes, such as a decrease in the frequency of toothbrushing, greater prevalence of caries and higher probability of the appearance of periodontitis. Aim This study aimed to evaluate the association between the presence of depressive symptoms and problem-oriented oral healthcare behavior, as well as the absence of healthcare-seeking behavior. Material and method 872 elderly people living in two health districts in Porto Alegre were evaluated. They provided information on socioeconomic variables at an interview, and responded to the Geriatric Depression Scale-15 and to a questionnaire assessing dental care-seeking behavior. In addition, an oral examination was performed. When analyzed using Poisson regression with robust variance, the variables of male sex, less schooling, lower income, reduced number of teeth, presence of root remnants and presence of depressive symptoms were found to be independently associated with the outcome. Result There was a significant difference regarding dental care-seeking behavior in relation to elderly people presenting depressive symptoms and those in low socioeconomic strata having poor oral status. Conclusion It was concluded that these factors need to be taken into consideration when evaluating dental care-seeking behavior.

摘要
研究背景：老年人群中抑郁症状的患病率极高，达10%。此类症状常因社会排斥、罹患重症导致生活质量下降而出现；悲伤、气馁、沮丧与愧疚等情绪，以及失去至亲好友等事件，也可能与该类症状相关。抑郁症状可带来不良口腔健康结局，例如刷牙频率降低、龋病患病率升高，以及罹患牙周炎的风险增加。
研究目的：本研究旨在评估抑郁症状存在与否与以问题为导向的口腔保健行为，以及未寻求口腔医疗行为之间的关联。
材料与方法：本研究纳入872名居住于阿雷格里港（Porto Alegre）两个卫生辖区的老年人开展评估。研究对象在访谈中提供社会经济相关变量信息，完成老年抑郁量表15项版（Geriatric Depression Scale-15）填写，并完成评估牙科就医行为的问卷调研；此外还接受了口腔检查。采用稳健方差泊松回归（Poisson regression with robust variance）进行分析后发现，男性、受教育程度较低、收入水平偏低、牙齿数量减少、存在牙根残片以及存在抑郁症状，均与研究结局存在独立关联。
研究结果：存在抑郁症状的老年人，以及社会经济地位较低且口腔健康状况不佳的老年人，其牙科就医行为存在显著差异。
研究结论：综上，在评估牙科就医行为时，需将上述因素纳入考量范畴。