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Oral Health Status Is Associated with Common Medical Comorbidities in Older Hospital Inpatients
Author(s) -
Ní Chróinín Danielle,
Montalto Adrian,
Jahromi Shahrzad,
Ingham Nicholas,
Beveridge Alexander,
Foltyn Peter
Publication year - 2016
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/jgs.14247
Subject(s) - medicine , interquartile range , odds ratio , univariate analysis , dementia , confidence interval , comorbidity , polypharmacy , kidney disease , multivariate analysis , geriatrics , disease , psychiatry
Objectives To investigate oral health status and abnormalities in older adults admitted acutely to the hospital and explore the association with common medical comorbidities. Design Cross‐sectional study. Setting Hospital. Participants All individuals aged 70 and older (mean age 84.4, 61.4% female) admitted to a geriatric service over 3 months (N = 202). Measurements In‐person assessment using the Oral Health Assessment Tool ( OHAT ) (range 0–2, 2 = poorest) for lips, tongue, gums and soft tissue, saliva, teeth, dentures, oral cleanliness, and dental pain. Comorbidities and medications were also recorded. Results One hundred twenty‐eight (63%) participants had full or partial dentures, and 31 (15%) were edentulous. Median OHAT score was 6 (interquartile range 5–8). Of the eight domains, saliva scored worst, with 53% scoring 2. On univariate analysis, the highest (poorest) tertile of OHAT (score ≥8) was associated with dementia (odds ratio ( OR ) = 2.41, 95% confidence interval ( CI ) = 1.13–5.12, P = .02), moderate to severe renal impairment (estimated glomerular filtration rate <30 mL /min per 1.73 m 2 at discharge) ( OR = 5.52, 95% CI = 1.54–19.69, P = .009), recent anticholinergic medication burden ( P = .02), and low oral pH ( P = .05). On multivariate analysis adjusted for oral pH and anticholinergic medication burden, dementia ( OR = 2.29, P = .02) and moderate to severe renal impairment ( OR = 5.64, P = .01) were independently associated with the highest tertile of OHAT . Charlson Comorbidity Index (includes renal disease, dementia) was associated with OHAT on univariate analysis (Spearman rho = 0.19, P = .01) but not when adjusted for oral pH ( P = .10). Conclusion Poorer oral health was not uncommon and was associated with dementia and renal impairment even after adjustment for anticholinergic medication and oral pH . Oral health screening should be considered for vulnerable populations.