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Hägglund, P., Koistinen, S., Olai, L., Ståhlnacke, K., Wester, P. & Levring Jäghagen, E. (2019). Older people with swallowing dysfunction and poor oral health are at greater risk of early death. Community Dentistry and Oral Epidemiology, 47(6), 494-501
Open this publication in new window or tab >>Older people with swallowing dysfunction and poor oral health are at greater risk of early death
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2019 (English)In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 47, no 6, p. 494-501Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: We investigated the associations between swallowing dysfunction, poor oral health and mortality among older people in intermediate care in Sweden.

METHODS: This prospective cohort study investigated 391 older people in 36 intermediate care units (clusters). Swallowing function was assessed with the timed water swallow test (TWST), and oral health with the revised oral assessment guide (ROAG) at baseline. Data were collected on age, sex, education level, multimorbidity, cognitive impairment, care dependency and body mass index (BMI). Time to mortality was recorded during the following year. The mixed effects Cox regression model with cluster as a random factor was used to estimate hazards ratios (HR) with 95% confidence intervals (CI).

RESULTS: The median age of the participants was 84 years (interquartile range [IQR]: 11), and 53.3% were females. Mortality within one year was 25.1%. In the adjusted model, swallowing dysfunction and poor oral health were both independently associated with mortality (adjusted HR [aHR]: 1.67, 95% CI 1.02-2.75; P = .041 and aHR: 1.98, 95% CI 1.07-3.65; P = .029, respectively). Participants with combined swallowing dysfunction and poor oral health showed the highest mortality (35.0%) and 2.6 (95% CI 1.15-5.89; P = .022) times higher mortality risk than those with normal swallowing function and good oral health (13.0%).

CONCLUSIONS: Swallowing dysfunction and poor oral health were identified as independent risk factors for mortality in older people in intermediate care. Although further studies are required to verify these findings, they suggest that systematic assessment of swallowing function and oral health status should be performed for care considerations.

Keywords
mortality, nursing homes, oral care, oral hygiene, swallowing disorders
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30615 (URN)10.1111/cdoe.12491 (DOI)000482105300001 ()31407829 (PubMedID)
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-11-25Bibliographically approved
Koistinen, S., Olai, L., Ståhlnacke, K., Anna, F. & Ehrenberg, A. (2019). Oral health and oral care in short-term care: prevalence, related factors, and coherence between older peoples and professionals assessments. Scandinavian Journal of Caring Sciences, 33(3), 712-722
Open this publication in new window or tab >>Oral health and oral care in short-term care: prevalence, related factors, and coherence between older peoples and professionals assessments
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2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 3, p. 712-722Article in journal (Refereed) Published
Abstract [en]

Background: Oral health is important for well-being and overall health. Older peoples oral health is well described in the residential care context, but remains understudied in short-term care.

Objective: The aim of this study was to describe oral health, daily oral care and related factors among older people in short-term care and to compare self-perceived oral health with professional assessment.

Materials and methods: This cross-sectional study included 391 older people in 36 short-term units in 19 Swedish municipalities. Oral health was assessed professionally by clinical oral assessment and the Revised Oral Assessment Guide (ROAG). The older peoples’ perceptions of their own oral health were measured with a global question on self-perceived oral health. Self-care ability was assessed with Katz Index of Activities of Daily Living (Katz-ADL).

Results: Mean age was 82.9 years, 19% of participants were totally edentulous, and 43% had ≥20 teeth. Almost 60% had coating or food debris on their teeth, but only 19% received help with daily oral care. Those who were dependent on help with self-care had around a sixfold higher risk of having oral problems. There was a low level of agreement between the clinical assessment based on ROAG and self-perceived oral health.

Conclusion: Professionals’ assessments of oral health differed considerably from the older peoples own assessments. A higher risk of oral problems and more occurrence of coating or food debris or broken teeth were seen among those dependent on help with self-care (ADL). This study indicates that in order to improve older peoples oral health and oral care we need to provide person-centred oral care and to develop a close collaboration between nursing and dental staff.

Keywords
oral health, oral care, older people, short-term care, self-perceived, functional ability
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29647 (URN)10.1111/scs.12667 (DOI)000486090000021 ()30859599 (PubMedID)2-s2.0-85062833660 (Scopus ID)
Note

Open Access beslut 5/2019

Available from: 2019-03-12 Created: 2019-03-12 Last updated: 2019-10-07Bibliographically approved
Koistinen, S., Olai, L., Ståhlnacke, K., Fält, A. & Ehrenberg, A. (2019). Oral health-related quality of life and associated factors among older people in short-term care.. International Journal of Dental Hygiene
Open this publication in new window or tab >>Oral health-related quality of life and associated factors among older people in short-term care.
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2019 (English)In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: It is well known that oral health status is associated with oral health-related quality of life (OHRQoL) in the general population. The aim of this study was to describe and analyze OHRQoL among older people in short-term care and its associated factors.

MATERIALS AND METHODS: This cross-sectional study included 391 older people in 36 short-term care units. Data were collected via clinical oral assessments, questions about self-perceived oral and general health, Katz Index of Activities of Daily Living (Katz-ADL) and the Revised Oral Assessment Guide (ROAG). OHRQoL was measured using the Oral Health Impact Profile (OHIP-14). Multivariate logistic regression models were applied in the analysis.

RESULTS: Poor OHRQoL was reported by 34% of the older people. Associated factors were swallowing problems according to ROAG; quite poor/poor self-perceived physical, psychological, and oral health; and being a woman.

CONCLUSIONS: There is an association between OHRQoL and older people's self-perceived health according to the OHIP-14. This indicates the importance of early detection of oral health problems in frail older people and to assess both oral health and swallowing problems among older people in short-term care.

Keywords
Oral health-related quality of life, older people, oral health, self-perceived, short-term care
National Category
Clinical Medicine Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-31197 (URN)10.1111/idh.12424 (DOI)31782889 (PubMedID)
Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2019-12-09Bibliographically approved
Koistinen, S., Olai, L., Ståhlnacke, K., Fält, A. & Ehrenberg, A. (2018). Munhälsa hos äldre personer inom korttidsvård bedömd ur två perspektiv, självupplevd och professionell. In: : . Paper presented at Tandhygienistdagarna, 22-24 April 2018, Visby.
Open this publication in new window or tab >>Munhälsa hos äldre personer inom korttidsvård bedömd ur två perspektiv, självupplevd och professionell
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2018 (Swedish)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29211 (URN)
Conference
Tandhygienistdagarna, 22-24 April 2018, Visby
Available from: 2018-12-27 Created: 2018-12-27 Last updated: 2018-12-27Bibliographically approved
Koistinen, S., Olai, L., Ståhlnacke, K., Fält, A. & Ehrenberg, A. (2018). Munhälsa hos äldre personer inom korttidsvård, bedömd ur två perspektiv, självupplevd och professionell. In: : . Paper presented at Forskningens och utvecklingens dag, Örebro universitet.
Open this publication in new window or tab >>Munhälsa hos äldre personer inom korttidsvård, bedömd ur två perspektiv, självupplevd och professionell
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2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29209 (URN)
Conference
Forskningens och utvecklingens dag, Örebro universitet
Available from: 2018-12-27 Created: 2018-12-27 Last updated: 2018-12-27Bibliographically approved
Koistinen, S., Olai, L., Ståhlnacke, K., Fält, A. & Ehrenberg, A. (2018). Oral health among elderly people assessed from two perspectives: self-perceived and professional. In: : . Paper presented at 24th Nordic Congress of Gerontology, Oslo, 2-4 May 2018.
Open this publication in new window or tab >>Oral health among elderly people assessed from two perspectives: self-perceived and professional
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2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29210 (URN)
Conference
24th Nordic Congress of Gerontology, Oslo, 2-4 May 2018
Available from: 2018-12-27 Created: 2018-12-27 Last updated: 2018-12-27Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-0290-5586

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