Factors associated with oral health-related quality of life of institutionalized elders

Abstract This study aimed to evaluate the correlation between two Oral Health-Related Quality of Life (OHRQoL) questionnaires (the Oral Health Impact Profile (OHIP-14) and the Geriatric Oral Health Assessment Index (GOHAI)) and to investigate the factors associated with the OHRQoL of institutionalized elderly individuals. A cross-sectional multicenter study was performed with 344 institutionalized elderly individuals residing in two Brazilian cities. Six trained researchers interviewed the elderly individuals. Sociodemographic data were collected from medical records. Dental caries experience and the use of and need for dentures were recorded through oral examination performed by two trained examiners. A Likert scale (1–5 points) was used to assess general health and self-perceived oral health. The number of chewing cycles needed to chew a portion of peanuts was used to assess the swallowing threshold. The OHIP-14 and GOHAI were used to evaluate OHRQoL, and statistically significant correlations were assessed using Spearman’s correlation test (p < 0.05). Poisson regression (p < 0.05) was used to investigate the association of OHRQoL with independent variables. Scores on the OHIP-14 (7.57 ± 8.63) and GOHAI (32.46 ± 3.85) were strongly and inversely correlated (r2 = -0.671, p < 0.001), although these measures were associated with different factors. A higher OHIP-14 total score (worse OHRQoL) was associated with female gender, a greater number of healthy teeth, worse self-perceived general health and oral health, and a lower swallowing threshold (p < 0.05). A higher GOHAI total score (better OHRQoL) was associated with a greater number of filled teeth, better self-perceived oral health and a greater swallowing threshold (p < 0.05). In conclusion, worse OHRQoL among institutionalized elderly individuals is associated with worse self-perceived oral health and a greater swallowing threshold.

摘要 本研究旨在评估两款口腔健康相关生活质量（Oral Health-Related Quality of Life, OHRQoL）问卷——口腔健康影响量表（Oral Health Impact Profile, OHIP-14）与老年人口腔健康评估指数（Geriatric Oral Health Assessment Index, GOHAI）之间的相关性，并探究养老机构老年人的OHRQoL相关影响因素。本研究采用多中心横断面研究设计，纳入巴西两座城市的344名养老机构老年人，由6名经过规范化培训的研究人员对受试者开展访谈，从受试者的医疗记录中提取社会人口学相关数据；由2名经过规范化培训的口腔检查者通过口腔检查，记录受试者的龋病患病情况、义齿使用状况及义齿修复需求。采用1~5级李克特（Likert）量表评估受试者的总体健康状况与自我感知口腔健康水平，以咀嚼定量花生所需的咀嚼循环次数作为吞咽阈值的评估指标。采用OHIP-14与GOHAI评估受试者的OHRQoL水平，并通过斯皮尔曼（Spearman）相关性检验分析二者的统计学相关性（p < 0.05）；采用泊松回归（Poisson regression）分析OHRQoL与各自变量间的关联（p < 0.05）。研究结果显示，OHIP-14总分为7.57±8.63，GOHAI总分为32.46±3.85，二者呈显著负相关（r²=-0.671, p < 0.001），但二者的关联影响因素存在差异：OHIP-14总分越高（即OHRQoL水平越差）与女性性别、健康牙齿数量更多、自我感知总体健康与口腔健康状况更差以及更低的吞咽阈值显著相关（p < 0.05）；GOHAI总分越高（即OHRQoL水平越好）与补牙数量更多、自我感知口腔健康状况更佳以及更高的吞咽阈值显著相关（p < 0.05）。综上，养老机构老年人的OHRQoL水平越差，与自我感知口腔健康状况不佳及吞咽阈值降低显著相关。