Relationship between oral health conditions and quality of life in elderly with different fragility levels

Author(s)

Lilian Berta Rihs Perianes

• Document type: Doctoral Thesis
• Press: Piracicaba, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba
• Defense date: 2010-02-25

Examining board members

Maria da Luz Rosário de Sousa; Siilvia Cypriano; Juliana Balbinot Hilgert; Ronaldo Seichi Wada; Antonio Carlos Pereira

• Advisor: Maria da Luz Rosário de Sousa

Abstract

Given the scarcity of studies to assess the oral health conditions related to quality of life in elderly people with different frailty levels, the objectives of this study were: to evaluate the oral health conditions in a non-institutionalized elderly population with different frailty levels (Chapter 1), to present the xerostomy prevalence and its association with socio-demographic and clinical variables, as well as the self-perceived oral health (Chapter 2); to verify the self-perception on the oral health conditions in elderly people, compared with the frailty level (Chapter 3) and to verify oral health-related quality of life impact elderly people with different frailty levels (Chapter 4). This work is part of a thematic and multidisciplinary project: "Quality of life in frail elders: health indicators and subjective well-being". Non-institutionalized elderly aged 60 or more that presented different frailty levels were examined, being attended at the geriatric clinic of the State University of Campinas (UNICAMP). An oral examination following the recommendations from WHO (1997) was carried out, as well as an interview with questions relating to: self-perceived oral health, dry mouth sensation and GOHAI. The frailty condition evaluation was made after the application of 5 clinical criteria proposed by Fried et al. (2001). The frail elders were divided into two groups: pre-frail and frail. Data analysis was performed using SPSS 17. Chapter 1 shows that 61.2% (n=41) of those examined were edentulous; the mean of present teeth was 4.8 (SD=7.5) and DMFT of 28.8 (SD=5.1), and most of the index was composed of the lost component (94.4%). 50.7% (n=34) were considered pre-frail and 49.3% (n=33), frail. When dental variables were compared with the frailty condition, all were better in pre-frail individuals. In Chapter 2, it was found that older people considered as non-white were less likely to experience dry mouth (p=0.017/RP=0.68 [IC95%=0.49-0.93]). Among the frail elderly, who were illiterate had more dry mouth (p=0.03/RP=1.31 [IC95%=1.02-1.68]). In chapter 3, for the clinical variables in which the self-perception was compared between the different frailty levels, only for those who had need of any type of prosthesis it was observed that pre-frails rated their oral health in a negative way. In Chapter 4, in individuals who have obtained a negative self-perception of their oral health, only the mean present teeth was worse among frail individuals. It could be concluded that although this group of elderly people presented poor oral health conditions, with extensive tooth loss and high dry mouth prevalence, no relationship was found between the frailty and selfperceived oral health. It was considered that other systemic conditions of greater impact on the daily life of these elderly individuals had a greater weight than the oral self-perceived oral conditions, and to reverse this situation, it is necessary targeting dental programs specific for adults aimed at promoting health and control of dental caries and periodontal disease, thus avoiding the loss of teeth in the elderly, which in turn will improve their quality of life. (AU)