Impact of Seniors Centers on oral health-related quality of life of older adults

Machado Luz, Fernanda W.; Silva, Alexandre Emídio Ribeiro; Perroni, Ana Paula; Goettems, Marília L.; Boscato, Noéli

doi:10.11606/s1518-8787.2020054001648

Brasil

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Original Article • Rev. Saúde Pública 54 • 2020 • https://doi.org/10.11606/s1518-8787.2020054001648 linkcopy

Impact of Seniors Centers on oral health-related quality of life of older adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE This study evaluated the oral health-related quality of life (OHRQoL) of older adults participating or not in Seniors Centers (SC).

METHODS Two independent samples were compared: older adults who participate in SC (n = 124) and older adults who visited Primary Healthcare Centers (PHC) and do not participate in SC (n = 164). The data collected consisted of sociodemographic (sex, age, educational level, marital status, family income) and psychosocial characteristics—Sense of Coherence (SOC), anxiety and depression using HADS, happiness—, and oral clinical evaluation—use and need of dental prosthesis and decayed (D), missing (M), or filled (F) teeth. The resulting OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14). The Mann-Whitney test was used to assess the associations between the independent variables and the OHIP-14. Poisson regression models were also used in the analyses (α=0.05).

RESULTS In the PHC, of the 270 individuals invited to participate in the study, 164 (60.7%) were interviewed and clinically examined; while in the SC, of the 166 individuals invited to participate in the study, 124 (74.7%) were interviewed and clinically examined. After adjustments for sociodemographic, psychosocial and clinical factors, we found that the impact on OHRQoL was 2.8 times higher (95%CI 2.0–4.2) for older adults who did not participate in SC.

CONCLUSION Older adults who participated in SC showed better perception on OHRQoL, independently of sociodemographic, psychosocial and clinical factors.

Aged; Self-Help Groups; Oral Health; Quality of Life

Variables	Primary Healthcare Centers (PHC)				Seniors Centers (SC)

	N	Mean	SD	P-value PHC	N	Mean	SD	P-value SC
Sociodemographic

Sex
Female	121	8.3	10.9	0.252	105	6.3	8.4	0.087
Male	43	8.8	9.4		19	5.1	9.7
Age
60-70	60	9.4	11.3	0.607	75	7.4	9.1	0.046
> 71	104	8.1	10.1		49	4.2	7.5
Educational Level
>8 years	150	8.6	10.7	0.653	75	5.9	7.9	0.841
≤ 8 years	14	6.5	7.7		49	6.5	9.7
Marital Status
Married/Stable Union	73	8.2	9.3	0.964	61	6.6	9.1	0.673
Single/Divorced/Widowed	89	8.9	11.9		63	5.7	8.2
Household Income
≤ 1.5 minimum wage	67	10.0	10.9	0.043	45	6.67	9.62	0.293
>1.5 minimum wage	93	7.3	10.1		62	4.49	6.73

Psychosocial

Sense of Coherence
High	67	6.3	6.7	0.232	61	3.2	4.7	<0.001
Low	62	10.9	13.5		63	9.0	10.5
Depression
Normal	64	6.6	7.7	0.006	98	5.4	7.3	<0.001
High/Low	76	13.5	14.7		12	15.1	13.0
Happiness
High	89	8.1	8.8	0.659	77	5.1	7.9	0.051
Low	53	9.2	12.9		47	7.9	9.6

Clinical

Use for Prosthesis
No	22	9.4	10.9	0.511	32	4.0	6.6	0.073
Yes	138	8.2	10.4		92	6.94	9.20
Need for Prosthesis
No	87	7.2	9.0	0.261	44	5.7	10.0	0.126
Yes	73	9.8	11.9		80	6.46	7.92
Number of Teeth
0–12	145	8.8	10.9	0.275	65	7.7	10.1	0.057
> 12	19	6.2	7.5		59	4.4	6.4

OHIP-14 Domains	Primary Healthcare Centers			Seniors Centers			P-value

	Never/ Hardly ever	Often/ Ocasionally/ Very often	Mean (SD) OHIP-14	Never/ Hardly ever	Often/ Ocasionally/ Very often	Mean (SD) OHIP-14

	n (%)	n (%)		n (%)	n (%)
FUNCTIONAL LIMITATION
1.Had difficulty to say a word due to problems with teeth, mouth or dentures	107 (73.30)	39 (26.7)	0.88 (1.39)	114 (91.94)	10 (8.06)	0.52 (1.09)	0.018
2.The taste of food has worsened due to problems with teeth, mouth or dentures	120 (83.33)	24 (16.67)	0.61 (1.22)	114 (91.94)	10 (8.06)	0.08 (0.27)	< 0.001
PHYSICAL PAIN
3.Has felt strong pain in the mouth	116 (80.0)	29 (20.0)	0.68 (1.23)	117 (94.35)	7 (5.65)	0.56 (0.23)	0.285
4.Has felt uncomfortable eating some kind of food due to problems with teeth, mouth or dentures	97 (66.44)	49 (33.56)	1.06 (1.47)	104 (83.87)	20 (16.13)	0.16 (0.36)	< 0.001
PSYCHOLOGICAL DISCOMFORT
5.Worried due to problems with teeth, mouth or dentures	89 (61.81)	55 (38.19)	1.21 (1.53)	103 (83.06)	21 (16.94)	0.16 (0.37)	< 0.001
6.Has felt stressed due to problems with teeth, mouth or dentures	111 (76.03)	35 (23.97)	0.79 (1.37)	108 (87.10)	16 (12.90)	0.12 (0.33)	< 0.001
PHYSICAL DISABILITY
7.Was impaired to eat due to problems with teeth, mouth or dentures	126 (86.90)	19 (13.10)	0.42 (1.01)	120 (96.77)	4 (3.23)	0.32 (0.17)	0.277
8.Has stopped eating meals due to problems with teeth, mouth or dentures	127 (86.99)	19 (13.01)	0.42 (0.96)	120 (96.77)	4 (3.23)	0.32 (0.17)	0.253
PSYCHOLOGICAL DISABILITY
9.Has had problems relaxing due to problems with teeth, mouth or dentures	129 (88.36)	17 (11.64)	0.42 (1.05)	121 (97.58)	3 (2.42)	0.24 (0.15)	0.060
10.Has felt ashamed due to problems with teeth, mouth or dentures	111 (76.55)	34 (23.45)	0.79 (1.34)	108 (87.10)	16 (12.90)	0.12 (0.33)	< 0.001
SOCIAL DISABILITY
11.Has had difficulties carrying out daily activities due to problems with teeth, mouth or dentures	128 (87.67)	18 (12.33)	0.40 (1.07)	123 (99.19)	1 (0.81)	0.008 (0.08)	< 0.001
12.Has been irritated with other people due to problems with teeth, mouth or dentures	138 (94.52)	8 (5.48)	0.20 (0.74)	121 (97.58)	3 (2.42)	0.24 (0.15)	0.555
HANDICAP
13.Has felt that life in general got worse due to problems with teeth, mouth or dentures	130 (89.04)	16 (10.96)	0.43 (1.06)	117 (94.35)	7 (5.65)	0.56 (0.23)	0.182
14.Has been unable to perform activities due to problems with teeth, mouth or dentures	140 (95.89)	6 (4.11)	0.17 (0.56)	122 (98.39)	2 (1.61)	0.16 (0.12)	0.846

Participation in SC	Unadjusted	Model 1	Model 2	Model 3

		Adjusted^**	Adjusted^**	Adjusted^**

	RR (95%CI)	RR (95%CI)	RR (95%CI)	RR (95%CI)
	p < 0.001	p < 0.001	p < 0.001	p < 0.001
Yes	1.0	1.0	1.0	1.0
No	2.4 (1.84–3.13)	2.8 (1.9–4.0)	2.9 (2.0–4.3)	2.8 (2.0–4.2)

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Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

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[TFN1] *Values different from 164 (Primary Healthcare Centers) and 124 (Seniors Centers) are due to missing responses; p < 0.05 indicates statistically significant differences; Mann Whitney test; Standard Deviation (SD).