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Dental Status, Quality of Life, and Mortality in an Older Community Population: A Multivariate Approach
Author(s) -
Appollonio Ildebrando,
Carabellese Corrado,
Frattola Alessandra,
Trabucchi Marco
Publication year - 1997
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1997.tb02930.x
Subject(s) - medicine , activities of daily living , socioeconomic status , logistic regression , quality of life (healthcare) , gerontology , multivariate analysis , mood , population , demography , univariate , multivariate statistics , univariate analysis , environmental health , physical therapy , clinical psychology , statistics , nursing , mathematics , sociology
OBJECTIVE : To evaluate the relationships between a functional measure of dental status (FDS), several variables belonging to a quality of life (QOL) profile, and mortality in an older community population. DESIGN : Cross‐sectional analysis for FDS and QOL; 10‐year prospective study for mortality. SETTING : The historical and central district of the city of Brescia, northern Italy PARTICIPANTS : The entire cohort of 70 to 75‐year‐old people living in the above‐mentioned district (n = 1303): 1201 subjects were eligible for interview at baseline; 11 refused the physical examination; 52 were lost to follow‐up; data are presented for the remaining sample of 1137 subjects. MEASUREMENTS : FDS examination was used to classify the subjects into three groups: naturally adequate (ADS) (25.2%), naturally inadequate (IDS) (14.3%) dental status, and denture wearers (DW) (60.4%). Various QOL domains were assessed: mood level, cognitive status, instrumental activities of daily living (IADL), social relationships, indexes of somatic health, and health behaviors. The demographic and socioeconomic parameters were used as covariates. RESULTS : Univariate analysis showed that both the ADS and the DW groups had a better QOL profile than the IDS group. Multiple logistic regression indicated that ADS and DW conditions were predicted independently by better educational and financial conditions, higher social relationships and a better IADL level in comparison with IDS. Moreover, compared with IDS, DS was a significant predictor of a better level at the SELF, IADL, and HCU scales whereas DW predicted only a better IADL level. Crude survival analysis showed that ADS was associated with a lower mortality risk compared with both DW and IDS, which did not differ from each other. FDS also remained a significant and independent predictor of mortality in a more general Cox's regression model. CONCLUSIONS : Within this cohort of 70 to 75‐year‐old urban residents, FDS is associated with several QOL domains and with long‐term survival. A hierarchy of reciprocal relationships exists among these parameters. The present study provides a basis for encouraging more extensive use of dentures. Longitudinal studies using oral health outcomes are warranted before clinical recommendations can be made. J Am Geriatr Soc 45:1315–1323, 1997 .