Kim Hae-Young, Jang Moon-Sung, Chung Chong-Pyoung, Paik Dai-Il, Park Yong-Duk, Patton Lauren L, Ku Young
Department of Dental Hygiene, College of Medical Science, Konyang University, Korea.
Community Dent Oral Epidemiol. 2009 Oct;37(5):468-76. doi: 10.1111/j.1600-0528.2009.00489.x. Epub 2009 Jul 22.
The aim of this study was to assess the association of chewing ability to oral health-related quality of life (OHRQoL) measured by the Oral Health Impact Profile-14 (OHIP-14) controlling for clinical oral health status, self-reported health status, demographic factors, and socioeconomic conditions among community-dwelling and institutionalized Korean elders.
This cross-sectional study comprised a sample of 307 community-dwelling and 102 institutionalized people over the age of 60, using a cluster sampling procedure. A questionnaire was implemented and a clinical oral examination was completed for each subject. The outcome variable of interest was the OHIP-14 score, and its associations with chewing ability, objective oral health status, self-reported health status, demographic factors, and socioeconomic conditions were assessed. Because of highly-skewed distribution of the OHIP-14 scores, nonparametric analytic methods were used. The final model was developed using a multivariable two-level logistic regression model for a dichotomized OHIP-14 score to account for the cluster sampling method applied to this study.
The mean age of the participants was 75.4 years, with 67.7% being women. The median OHIP-14 score was 7. Negative oral health impacts were experienced fairly often or very often by a total of 36.4% of elderly. In the final model, elders who could chew none to three and four to six foods among seven indicator foods were 3.4 (P = 0.010) and 2.0 (P = 0.040) times more likely, respectively, to have worse OHRQoL compared with elders who could chew all seven food types. Also significant associations with worse OHRQoL were shown for being concerned about oral health [Odds Ratio (OR) = 4.9, P = 0.002], fair or better self-reported oral health (OR = 0.12, P = 0.002), very good/good self-reported general health (OR = 0.38, P = 0.008), being married (OR = 2.0, P = 0.054), and having a favourable economic status (OR = 0.43, P = 0.042).
This study showed highly significant association between chewing ability and OHRQoL measured by the OHIP-14 score after controlling for related factors. Amelioration of chewing ability might independently contribute to improving the OHRQoL of elders.
本研究旨在评估在控制临床口腔健康状况、自我报告的健康状况、人口统计学因素以及社会经济状况的情况下,咀嚼能力与通过口腔健康影响程度量表-14(OHIP-14)衡量的口腔健康相关生活质量(OHRQoL)之间的关联,研究对象为韩国社区居住和机构养老的老年人。
本横断面研究采用整群抽样方法,选取了307名社区居住的60岁以上老人和102名机构养老的60岁以上老人作为样本。对每位受试者进行问卷调查并完成临床口腔检查。感兴趣的结局变量为OHIP-14评分,并评估其与咀嚼能力、客观口腔健康状况、自我报告的健康状况、人口统计学因素以及社会经济状况之间的关联。由于OHIP-14评分呈高度偏态分布,因此使用非参数分析方法。最终模型采用多变量两级逻辑回归模型,对二分的OHIP-14评分进行分析,以考虑本研究采用的整群抽样方法。
参与者的平均年龄为75.4岁,女性占67.7%。OHIP-14评分的中位数为7。共有36.4%的老年人经常或非常频繁地经历负面口腔健康影响。在最终模型中,与能够咀嚼所有七种指示性食物的老年人相比,在七种指示性食物中只能咀嚼零至三种和四至六种食物的老年人,其OHRQoL较差的可能性分别高3.4倍(P = 0.010)和2.0倍(P = 0.040)。与较差的OHRQoL也存在显著关联的因素包括:关注口腔健康[优势比(OR)= 4.9,P = 0.002]、自我报告的口腔健康状况为中等或更好(OR = 0.12,P = 0.002)、自我报告的总体健康状况为非常好/良好(OR = 0.38,P = 0.008)、已婚(OR = 2.0,P = 0.054)以及经济状况良好(OR = 0.43,P = 0.042)。
本研究表明,在控制相关因素后,咀嚼能力与通过OHIP-14评分衡量的OHRQoL之间存在高度显著的关联。改善咀嚼能力可能会独立有助于提高老年人的OHRQoL。