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ABSTRACT
Aim of the study To investigate the impact of oral health conditions and social factors on quality of life of older
people in Iasi. Material and methods Data were collected from 336 subjects aged 65 to 74 years,175 addresed
the dental office for treatment and 161 institutionalized in the Social Center St. Parascheva. Oral healthrelated quality of life was assessed with the Geriatric Oral Health Assessment Index questionnaire. Results The
risk for poor quality of life in terms of physical dimension was higher for females (OR=6.342) and for subjects
who needed removable dentures (OR=5.043). In terms of oral discomfort the risk was higher for
institutionalized (OR=6.329), and social limitation were correlated with female subjects (OR=3.899) and
institutionalized subjects (OR=2.852). Conclusions Institutionalization can be considered as a factor with
negative impacts on the quality of life of the elderly, affecting all the dimensions of the quality of life .
Keywords: elderly; GOHAI; social, clinical factors
people (3, 4,5).Unfortunately, the economicfinancial crisis from the recent years has
worsened many aspects of the social life and
the diminution of pensions, as an austerity
measure taken by Romania, has determined a
significant decrease of life quality for the
elderly people. On the other hand, in
Romania, the number of institutions
specialized to provided social and health
assistance is very low as compared to the
number of old persons needing help (6).
Though many institutions have medical
INTRODUCTION
Health is an essential dimension of human
communities quality of life, which means
more than only absence of disease. WHO
defines health as a complete physical,
mental and social well-being, and not merely
the absence of disease or infirmity (1).
Health is related to community welfare and
life standards, to what experts call a society
quality of life (2). Numerous studies have
documented poor oral and general health and
limited access to medical care among older
52
evaluation
used
the
World
Health
Organization criteria, based on clinical
considerations, without resorting to other type
of examinations (WHO, 1997). Clinical
examination were performed in the dental
office of Community Dentistry Clinic from
non-institutionalized subjects, and in the
medical office of St. Parascheva Center,
using mouth mirror, gloved hand and portable
lamp. Data were analyzed with the SPSS 17.0
system for Windows (SPSS Inc. Chicago, IL,
SUA).
RESULTS
The negative responses to the GOHAI-Ro
items from the participants and the most
serious problems (responses with often and
very often) were reported as it follows:
-108 (67.2%) institutionalized elderly
subjects and 114 (65.3%) independent elderly
reported hard foods limitations (GOHAI 1);
-103 (64.1%) institutionalized elderly
subjects
and
107
(61.3%)
noninstitutionalized patients reported chewing
problems for hard foods (question GOHAI 2);
-the same trend is observed for GOHAI 5: 77
(48%) subjects in group A and 87 (49.5%)
subjects in group B felt discomfort when
chewing any kind of food;
-psychological dimension - worried about
teeth, gums or dentures (GOHAI 9) is
reported by 48 ( 30.1%) institutionalized
people and 45 ( 25.5%) independent people;
-social dimension is less affected (GOHAI 6):
20 (16.7%) subjects from the St.
Parascheva Center and 30 (12.3%)
independent subjects limited contact with
people;
-only 15 (9.6%) subjects in group A and 27
(15.4%) in group B used medication for oral
pain often and very often (GOHAI 8).
Related to quality of life dimensions, the
most affected dimension was physical
dimension (GOHAI 1, 2, 3, 4), followed by
pain and discomfort (GOHAI 5, 8, 12); the
53
OR
Sig.
95% CI
Gender:
Female
Male
6.342
0.001*
3.075-13.079
Residence area:
Institutionalized
Non-institutionalized
2.185
0.026*
1.084-4.405
Education level
Primary and secondary school
University
0.034
0.231
0.551-2.114
Denture status:
Denture need
No denture need
5.043
0.001*
2.520-10.090
1.983
0.012*
2.154-3.422
Self
perception of general health:
Negative
Positive
*significance level at p<0.05
area-institutionalized
(OR=6.329)
and
education level-primary and secondary
school (OR=2.113); self perception of general
health have a low level of Odd ratio, only
1.782;
- clinical variables represented by the need
for removable denture have a OR = 3.278.
OR
Sig.
95% CI
Gender:
Female
Male
0.023
0.165
0.978-1.256
6.329
0.001*
7.427-35.899
54
2.113
0.031*
3.442-7.752
3.278
0.002*
1.567-6.856
1.782
0.043*
1.023-2.156
OR
Sig.
Gender:
Female
Male
3.899
0.001*
2.044-7.436
Residence area:
Institutionalized
Non-institutionalized
2.852
0.002*
1.350-6.025
Education level
Primary and secondary school
University
0.208
0.122
0.233-4.458
Denture status:
Denture need
No denture need
0.344
0.168
0.727-1.023
1.245
0.023*
1.033-2.316
Self
perception of general
health:
Negative
Positive
95% CI
DISCUSSIONS
After having applied the chi-square test,
we noticed significant statistic differences
(p<0.05) between the answers of the 2
categories of old people: if the independent
ones are unsatisfied with the aspect of their
teeth and gums (GOHAI 7) and use more
drugs for oral pains (GOHAI 8), the
institutionalized old people are more
concerned with the current situation of their
55
Acknowledgements
This study was supported by a grant of the University of Medicine and Pharmacy Gr. T.
Popa Iasi, Romania.
REFERENCES
1 WHO, World Health Organization. Basic Documents. 45th edition: World Health Organization
Supplement 2006. Available at http:// www.who.int/governance/eb/who_constitution/en.pdf.
2 Lupu I. Quality of life in health. Quality of life J 2006; 1-2: 73-91.
3 Petersen PE, YamamotoT. Improving the oral health of older people: the approach of the WHO
Global Oral Health Programme. Community Dent Oral Epidemiol 2005; 33: 81-92.
4 Mac Entee M I. Quality of life as an indicator of oral health in older people. J Am Dent Assoc 2007;
138: 47-52.
5 Pop CE. Health status of Romanian population in European context: a quality of life approach.
Quality of life J 2010; 3-4:272-305.
6 Muresan R. The third age between autonomy and vulnerability. [in Romanian] Cluj-Napoca:
Doctoral Thesis, 2012: 29-31.
7 Atchinson KA, Dolan TA. Development of the Geriatric Oral Health Assessment Index. J Dent Educ
1990; 54: 680-686.
8 Shaker D, Zouse SK. Translation and validation of the Arabic version of the Geriatric Oral Health
Assessment Index. J. Oral Sci 2008; 4: 453-459.
9 Hassel AJ, Rolko C, Koke U. A German version of the GOHAI. Community Dent Oral Epidemiol
2008; 36:34-42.
10 Locker D, Clarke M, Payne B. Self-perceived oral health status, psychological well-being, and life
satisfaction in an older adult population. J Dent Res 2000; 79: 970-975.
11 Mesas AE, de Andrade SM, Cabrera MA. Factors associated with negative self-perception of oral
health among elderly people in a Brazilian community. Gerodontology 2008; 25: 49-56.
12 Mcmillan A, Wong M, Lo E, Allen PF. The impact of oral disease among the institutionalized and
non-institutionalized elderly in Hong Kong. J of Rehabilitation 2003; 1: 46-54.
13 Ohman WN, Mutalib KA, Bakri R, Doss G, Jaafar N, Natifah C. et al. Validation of the Geriatric
Oral Health Assessment Index (GOHAI) in the Malay language. J Public Health Dent 2006; 66:199204.
14 John MT, Koepsell Th D, Hujoel P, LeResche L, Miglioretti DL, Micheelis W. Demographic factors,
denture status and oral health-related quality of life. Community Dent Oral Epidemiol 2004; 32:125
132.
15 McGrath C, Bedi R. Gender variations in the social impact of oral health. J Ir Dent Assoc 2000;
62:87-91.
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