Validation of the Geriatric Oral Health Assessment Index (GOHAI) in the Malay language

OBJECTIVE: To translate and validate the Geriatric Oral Health Assessment Index (GOHAI into the Malay language for use in Malaysia. METHODOLOGY: The 6-Likert scale GOHAI was translated into the Malay language and self-administered on 189 subjects aged 60+. All subjects underwent oral status assessment. The measure was assessed for construct and discriminant validity, for test-retest reliability and principal component factor. FINDINGS: Mean GOHAI score was 46.2 (SD 9.7, range 17-60). The Cronbach's alpha was 0.79. Mean GOHAI scores increased with more positive self-rated oral health and general health. The elderly with no perceived dental treatment need had higher mean GOHAI scores than those with perceived needs. There were slightly stronger inverse correlations between GOHAI scores and caries experience, number of teeth present, and number of pathologically mobile teeth. The measure demonstrated strong test-retest reliability. Eight of the 12 items had Spearman's r3 0.7. Only one principal factor was found at eigenvalue > 1. Using ANCOVA, self-rated perception of oral health and perceived need for dental treatment had the most significant impact on the GOHAI score. CONCLUSION: AND RECOMMENDATIONS: The Malay language version of the GOHAI demonstrated acceptable validity and reliability and will be an important instrument to measure oral health-related quality of life among Malay-speaking Malaysians. Use of the Malay language version GOHAI should also be pursued among diverse adult age groups.     

Validation of a Chinese version of the Oral Health Impact Profile (OHIP)

OBJECTIVES: To translate the original English version of Oral Health Impact Profile (OHIP) into a Chinese version, to validate the translated instrument for use among the elderly in Hong Kong and to derive a Chinese short-form OHIP. METHODS: The original English version of OHIP was translated into Chinese. Elderly persons aged 60-80 years were interviewed by two trained interviewers and examined clinically by one of two calibrated dentists. Information on subjects' demographic background and oral health conditions were collected. RESULTS: A total of 586 elderly persons were interviewed and clinically examined. Cronbach's alpha of the translated OHIP subscales ranged from 0.69 to 0.84 and the test-retest correlation coefficient ranged from 0.72 to 0.92. Construct validity of the translated Chinese version was supported by the finding that the OHIP-49 and subscale scores increased as the subject's perceived oral health status changed from healthy to unhealthy. Also, those who had a perceived dental treatment need had higher mean OHIP-49 and subscale scores compared to those who did not. The short-form OHIP derived in this study demonstrated comparable validity and reliability with the full version of OHIP. CONCLUSION: The translated Chinese version of OHIP demonstrated good validity and reliability. It is available for use by researchers in oral health-related quality of life studies in Chinese elderly populations. In situations where a Chinese short-form of OHIP is desirable, there are now two validated Chinese versions for researchers to choose.     

Linguistic adaptation and validation of the General Oral Health Assessment Index (GOHAI) in an elderly Japanese population

OBJECTIVES: This study sought to develop a Japanese version of the General Oral Health Assessment Index (GOHAI) and validate its use in an elderly Japanese population. METHODS: The GOHAI scale was translated in a standardized way consisting of forward translation, pilot study, and backward translation. Psychometric properties of the final version were assessed on 175 participants (mean age: 70.0 years, SD 6.4). RESULTS: The response rate was more than 98% for each item. The reliability in terms of a Cronbach's alpha value was 0.89. The mean GOHAI scores were significantly lower for participants with poor perceived oral health (P<0. 001) or poor perceived general health (P<0.01). Significant correlations were observed between the GOHAI scores and the general health or physical functioning scores of the Medical Outcome Study Short Form 36 (P<0.01). CONCLUSIONS: The present study showed that the Japanese version of the GOHAI was psychometrically valid in an elderly sample population.     

Validation of an oral health quality of life index (GOHAI) in France

Oral health has traditionally been defined in terms of disease. Today, health is seen in a wider context: taking into account its impact on everyday living. Several indices attempt to capture this dimension. The Geriatric Oral Health Assessment Index (GOHAI) has been adapted for general use and tested on adult samples, mainly in North America. Language, cultural norms and the health care system in France are different and this raises the need to validate the GOHAI in France before it receives widespread use. OBJECTIVES: The purpose of this study was to test the validity of a French version of the GOHAI. METHODS: The GOHAI is based on responses to a 12-item self-administered questionnaire. The items were translated into French, back-translated and compared with the original. After pilot testing and minor modifications, the French version was administered to a group of low-income persons benefiting from the national health insurance system (n = 260, 18-45 years). Measures for stability and internal consistency were calculated. Concurrent and discriminant validity were assessed. RESULTS: Cronbach's alpha (0.86) showed a high internal consistency and homogeneity between items. Item-scale correlations varied between 0.40 and 0.78. Repeat administration of the GOHAI to 32 participants gave weighted kappa coefficients from 0.51 to 0.87 and a Pearson's correlation coefficient of 0.87. Low GOHAI scores were associated with perceptions of poor oral and general health, low satisfaction with oral health and a perceived need for dental care. There were significant relationships between the GOHAI score and most objective measures of dental status except FT. Younger, well-educated and higher income respondents were more likely to have a high GOHAI score. CONCLUSION: The French version of the GOHAI exhibits satisfactory psychometric properties but two items (one about swallowing, the other with complex sentence structure) had poor stability.     

可摘局部义齿佩戴与口腔健康相关生活质量的关系

目的研究可摘局部义齿治疗前后老年修复患者的口腔健康相关生活质量,为可摘局部义齿治疗计划的制定提供参考。方法收集可摘局部义齿修复的老年牙列缺损患者154例,平均年龄为64.35岁,采用老年口腔健康评价指数(geriatric oral health assessment index,GOHAI)量表中文版进行问卷调查,对可摘局部义齿修复治疗前后的GOHAI得分进行统计学分析。结果可摘局部义齿修复后,患者GOHAI量表中生理功能(Z=-7.989)、心理功能维度(Z=-8.128)和总体得分(Z=-7.932)较治疗前明显升高,差异具有统计学意义(P<0.01)。结论可摘局部义齿修复通过改善患者的口腔生理功能和心理社会功能,可显著提高老年牙列缺损患者的口腔健康相关生活质量。     

A German version of the GOHAI

Abstract – Objectives: Translation, reliability analysis and validation of a German version of the Geriatric/General Oral Health Assessment Index (GOHAI) was the aim of this study. Methods: Translation was performed by a forward–backward process. Validity was assessed as convergent validity in comparison with another self‐perceived assessment of oral health (OHIP‐14) and as group validity (n = 218; mean age 73 years). Reliability was proved in terms of internal consistency, inter‐item and item‐scale correlations, and stability (test–retest procedure; n = 36; mean age 77 years). The responsiveness to change in oral health status was assessed by pre‐ and post‐treatment comparison (n = 21; mean age 63 years). Results: A German version of the GOHAI is presented. Convergent validity was sufficient (r = ?0.76 compared with OHIP‐14); group validity could be demonstrated for self‐perceived need for treatment, chewing problems, number of own teeth, caries lesions present and dental status. The internal consistency was high (Cronbach's alpha = 0.92) as were inter‐item and item‐scale correlations, for which good homogeneity of the index was apparent. The test–retest correlation for the summary score was r = 0.84, single item correlations ranged from r = 0.36 to r = 0.89. The GOHAI sum score increased significantly after patients received new dentures, indicating responsiveness of the GOHAI to clinical change in the expected direction. Conclusions: The German version of the GOHAI had sufficient reliability, validity and responsiveness to be used as measure of oral health‐related quality of life in cross‐sectional and longitudinal studies of the elderly.     

Determinants of change in oral health‐related quality of life over 7 years among older Japanese

Because there are more elderly people than ever before and because they are living for longer periods of time, it is essential to understand the determinants of healthy ageing. This study examined changes in oral health‐related quality of life (OHRQoL) among Japanese elderly over a 7‐year period. A sample of independently living individuals (aged 60+ years) underwent a questionnaire and dental examination at baseline and 7 years afterwards. The Geriatric Oral Health Assessment Index (GOHAI) was used to assess the impact of oral conditions. Occlusal force and salivary flow were also assessed. Of the 411 participants assessed at baseline, 130 (31·6%) accepted to participate after 7 years. There were no significant differences between those lost to follow‐up and those assessed at 7 years, except that a higher proportion of the latter rated their baseline general health as good. Among the latter, the overall mean GOHAI score did not change significantly (11·8 at baseline and 11·1 at follow‐up; P = 0·16). However, after controlling for age, gender and baseline GOHAI score, participants who had lost teeth or experienced a decline in occlusal force after 7 years had higher follow‐up GOHAI scores (indicating poorer OHRQoL). Unfavourable changes in clinical oral status over time are reflected in poorer self‐rated oral health.     

《口腔健康影响程度量表（OHIP—14中文版）》与《老年口腔健康评价指数（GOHAI中文版）》的比较研究

目的：了解《口腔健康影响程度量表（OHIP～14中文版）》与《老年口腔健康评价指数（GOHAI中文版）》各自特点及应用范围,指导口腔健康相关生存质量临床研究开展。方法：使用两种量表选取60岁以上、无认知障碍及视力疾患的老年人进行调查及口腔检查。通过对老年人口腔健康相关生存质量的测评,比较两份量表的维度、条目内部一致性及区分效度。结果：共250位老年人参与此次研究,收回有效量表221份,无效量表29份,数据缺失量表12份。比较两种量表平均得分GOHAI中文版比OHIP-14中文版高（P〈0．01）。两份量表都可由缺失牙数区分有牙颌人群的生存质量,同时能够区分出戴用活动义齿的人群与不戴用活动义齿的人群的生存质量,以及能通过自我评价口腔状况和满意程度方面来区分不同人群的生存质量。通过比较可认为这两份量表都具有一定的区分效度。结论：《老年口腔健康评价指数（GOHAI中文版）》和《口腔健康影响程度量表（OHIP-14中文版）》在信度、效度方面存在的差异并不明显,维度的分布方面则各有所侧重。     

A comparison of oral health in elderly populations seeking and not seeking dental care

The General Oral Health Assessment Index (GOHAI) has been recommended for use as an outcome measure In the evaluation of dental treatment. This study was designed to assess the ability of the GOHAI In the evaluation of differences in those actively seeking dental care compared with those not seeking care. GOHAI was self-administered to two samples of elderly Individuals, over 65 years of age, In the Columbus, OH, area. The first sample was ambulatory individuals living in a nursing home in Columbus, and the second sample consisted of patients accessing dental care at The Ohio State University (OSU) dental school clinics. Other variables used in this study were age, gender, self-rated oral and general health, and use of prostheses. Overall mean GOHAI score in the nursing home respondents was significantly higher (32.1 ± 3.0) when compared with that of dental patients (mean, 30.4 ± 3.9, p = 0.01). Mean GOHAI scores for all categories of variables used were consistently higher (better) in the nursing home respondents than for the dental patients. Results of this study show that self-assessed oral health measured by the GOHAI was higher for those individuals not seeking dental care than for those actively seeking dental care. The GOHAI is sensitive as an outcome measure in differentiating between Individuals actively seeking care and those not seeking care .     

The impact of providing dental services to frail older adults: Perceptions of elders in adult day health centers*

Very little is known about the oral health of, and access to, dental services among frail elders who live in the community and use an adult day health center (ADHC) for respite care. This pilot study evaluated the perceived oral health quality of life (OHQOL) of elders who used a mobile dental program in urban, suburban, and rural ADHC settings. Pre‐ and post‐treatment interviews were conducted to evaluate OHQOL using the Geriatric Oral Health Assessment Index (GOHAI). ADHC records were used to obtain demographic, medicai history and medication data. Following initial dental examinations and consent, dental treatment was provided at each ADHC. Of the 138 elders screened at three ADHCs, pre‐ and post‐treatment data were obtained on 76 subjects following their treatment (mean four months later). The groups members were mostly female (64.5%) and Caucasian (71.6%). Their mean age was 76.8 (+/‐ 9.8), with an average of 12.4 teeth (34.2% edentulous); 67.7% were on Medicaid. On average they had 5.5 chronic diseases, hypertension being the most common (67.1%); 44.8% had a neurological disorder or dementia. GOHAI scores were generally high both pre‐ and post‐treatment, reflecting high physical and psychosocial OHQOL and low leveis of worry. GOHAI scores were correlated with chronic diseases; the more chronic diseases an individual had, the lower his or her total score pre‐ and post‐treatment (r=‐.24, r=‐.26 respectively, p<.04). The more dental treatment needs an elder had, the lower his or her GOHAI (r=‐.23, p<.05). Elders with more teeth reported higher GOHAI pre‐ and post‐treatment (r=.36, r=.37 respectively, p<.002). Paired t‐tests comparing pre‐ and post‐treatment GOHAI scores revealed significant improvements in overall GOHAI (p<.001), and on two dimensions: physical (p<.005) and psychosocial (p<.002). The findings support the importance of providing on‐site access to dental services in order to maintain the general OHQOL of frail elders, more specifically in the areas of physical and psychosocial well‐being.     

上海市老年人牙缺失、义齿修复与口腔健康相关生命质量的现状研究

目的：以Eichner分类法代表牙缺失状况,研究上海市老年人牙缺失、修复情况及口腔健康相关生命质量的现状,同时探讨生命质量与牙缺失、义齿修复与否的相关性。方法：以65~74岁年龄组为研究对象,采用多阶段分层抽样方法抽取747名受试者纳入研究。使用第四次全国口腔流行病学调查的检查方法及问卷,收集受试者的缺牙状况、生命质量等数据。采用SPSS 19.0软件包进行非参数检验、二元logistic回归分析等。结果：79.1%的受试者存在牙缺失,35%的受试者未曾接受义齿修复。Eichner分组后,仅A1、A2和C3组受试者的老年口腔健康评价指数（general oral health assessment index,GOHAI）得分高于平均分,B组得分最低。GOHAI得分与受试者修复与否,全身健康状况及Eichner分组有显著相关性（P<0.05）。Eichner分组中,除C2组因样本量原因出现偏差外,其余Eichner组中,未修复受试者的GOHAI得分均低于已修复受试者。而在有缺牙未修复的人群中,81.2%的受试者认为自己牙没有问题或牙病不重。结论：上海市65~74岁老年人中牙缺失问题严重,但进行义齿修复的老人少。老年人的口腔健康相关生命质量与牙缺失状况、义齿修复与否及全身健康相关。应加强对缺牙老年人的口腔健康宣教,及时修复缺失牙,提高老年人的生命质量。     

口腔健康影响程度量表的验证研究

目的通过对口腔健康影响程度量表（OHIP-14中文版）的验证研究及其性质的考评，对该量表的信度、效度作出评价，探讨其在中国人群中进一步应用的可行性。方法按照国际生存质量评价（IQOLA）项目的标准程序，对OHIP-14进行翻译、回译、文化调适和改造，建立口腔健康影响程度量表。使用该量表和《口腔健康自我评价表》，对广东省部分地区年龄在18～65岁之间的居民应用多阶段简单随机抽样法，共抽取592个个体进行口腔健康相关生存质量调查，对调查结果进行统计学分析，考评量表的信度和效度。结果共有592位个体接受调查。回收有效问卷550份，其中数据缺失问卷38份。口腔健康影响程度量表内部一致性Cronbach’s α系数为0．93，条目与量表间的相关系数在0．53～0．71之间。因子分析提取的4个维度显示，口腔健康影响程度量表存在预想的连带关系和逻辑关系。量表得分与自我评价的口腔健康、自我感觉的治疗需要间呈显著正相关，相关系数分别为0．54、0．49（P〈0．0001）。结论口腔健康影响程度量表具有良好的信度、效度，其良好的心理测量学性质，为该量表在中国人群中的进一步推广应用提供了理论依据。     

老年患者口腔健康生命质量的相关因素分析

目的：初步研究老年口腔疾病患者的口腔健康生命质量及其影响因素。方法：选择在中山大学光华口腔医学院门诊就诊的250名55岁以上（含55岁）的老年人，应用老年口腔健康评价指数（geriatric oral healthassessment index，GOHAI）量表中文版、一般项目表及自我口腔健康评价表对其口腔健康生命质量进行调查，通过多元回归分析得出影响口腔健康生命质量的相关因素。结果：GOHAI中文版平均得分为12．26±7．67。多元回归方程为：GOHAI中文版得分=-6．477＋0．309×自我评价的口腔健康＋0．164×缺失牙数＋0．237×对口腔状况的满意度＋0．127×对生活的满意度，方程的决定系数为0．423。结论：自我评价的口腔健康、缺失牙数、对口腔状况的满意度及对生活的满意度是影响老年患者口腔健康生命质量的主要因素。     

儿童口腔健康影响程度量表的研制

目的评价儿童口腔健康影响程度量表（CPQ11- 14）中文版的信度和效度,探讨其在中国儿童中应用的可行性。方法对CPQ11- 14进行翻译、回译、文化调适和改造,建立儿童口腔健康影响程度量表中文版。使用该量表和口腔健康自我评价表对南宁市218名11～14岁中、小学生进行口腔健康检查和口腔健康相关生存质量调查,考评量表的信度和效度。结果口腔健康影响程度量表的重测信度系数为0.82（P<0.001）,内部一致性Cronbach′s α系数为0.79。通过因子分析提取的5个因子显示,口腔健康影响程度量表存在预想的连带关系和逻辑关系。量表得分与自我评价的口腔健康状态、自我感觉口腔健康对生活质量的影响间有明显相关性,其相关系数分别为- 0.33和0.50（P<0.000 5）。量表得分与龋失补牙指数呈明显正相关（P<0.001）,与中学组错畸形情况（美牙指数）也呈正相关（P<0.05）。结论本量表具有良好的信度和效度,为在中国进一步推广应用提供了理论依据。     

A Swedish version of the GOHAI index. Psychometric properties and validation

This study investigated a Swedish version of the 12 item General Oral Health Assessment Index (GOHAI). The aim was to validate the translated instrument, and to investigate factors that may influence the GOHAI score. Consecutive samples at eight dental clinics in G?teborg, Sweden were asked to answer the GOHAI, the short form of Oral Health Impact Profile (OHIP-14) and a questionnaire including socio-demographic, general health and oral health questions. 153 patients (50-89 yrs old) out of 237 (65%) returned the questionnaires. The most commonly reported problem (GOHAI) was 'worried or concerned' due to problems related to oral health (48%), followed by 'unhappy with the appearance of teeth, gums, or dentures' (36%) and 'teeth sensitive to hot, cold, or sweets' (33%). The Cronbach's Alpha (0.86) indicated a high degree of internal consistency and homogeneity between items. Item-scale correlations varied between 0.50 and 0.83. Strong relations were found between depressed GOHAI-scores and dental problems (mobile teeth, number of teeth, dentures). The correlation between the GOHAI score and the OHIP-14 was high (-0.83) indicating good construct validity. Also 'perceived general health' and 'satisfaction with life-situation' and dental status were significantly, but less strongly, correlated with the patient's GOHAI score. In a linear regression analysis, age,'perceived general health' and dental status (number of teeth in lower jaw and mobile teeth) were found to have a significant effect on the GOHAI score. Factor analysis of GOHAI indicated a two-factor solution and did not support the theoretical construction reported of the index. The test-re-test reliability was assessed in a separate sample (members of a physical handicap organization, n = 47) and the correlation coefficient for the GOHAI was 0.64. For individual items, the weighted kappa coefficient varied between 0.25 and 0.80. In conclusion, the Swedish version of the GOHAI showed acceptable reliability and validity.     

Tooth loss, denture wearing and oral health-related quality of life in elderly Chinese people

OBJECTIVES: To investigate the relationship between tooth loss, denture wearing and oral health-related quality of life (OHQoL) among community-dwelling elderly people in Hong Kong. METHODS: A questionnaire study of elderly people aged 60-80 years who were recruited at neighborhood social centres for the elderly. The Chinese version of the General Oral Health Assessment Index (GOHAI) was used and information about natural tooth number and denture wearing were obtained. RESULTS: 233 elderly subjects were recruited and interviewed. Around 20% of the partially dentate subjects had their last tooth loss within the previous year and a quarter within the last five years. Significantly fewer edentulous subjects had their last tooth loss within the previous year (3%) and within the last five years (12%, p < 0.001). Twenty two percent of the subjects had difficulty in accepting tooth loss. More edentulous subjects (69%) were satisfied with their dentures than partially dentate denture wearers (37%, p < 0.001). Edentulous elderly subjects had a higher mean GOHAI score (53.0) than partially dentate denture wearers (49.1, p < 0.001). Results from a multiple factor ANOVA revealed that elderly subjects who had loose teeth, difficulty in accepting tooth loss and were not satisfied with their removable dentures had a lower mean GOHAI score. CONCLUSIONS: In general, tooth loss and denture wearing did not have a major impact on OHQoL in elderly Chinese people. However, partially dentate denture wearers experienced a greater adverse impact on OHQoL than edentulous subjects most probably due to less satisfaction with their dentures and discomfort associated with loose teeth.     

Oral health-related quality of life and nutritional status

OBJECTIVES: This study examines whether oral health-related quality of life (OHRQoL) is associated with malnutrition risk in the elderly. METHODS: A cross-sectional study was designed using a representative sample of Spaniards over 65 years old. Data on sociodemographics and oral health status were gathered by interview and examination. Oral health-related quality of life was evaluated using the Geriatric Oral Health Assessment Index (GOHAI), and malnutrition risk using the Mini Nutritional Assessment (MNA). RESULTS: The final sample included 2,860 elderly, 41.7 percent males and 58.3 percent females, with a mean age of 73.7 +/- 6.8 years. Mean GOHAI score was 52.1 +/- 7.2, with 70.7 percent of the sample needing oral health care according to this index. The mean MNA score was 24.0 +/- 3.31; 3.5 percent of the elderly were malnourished, 31.5 percent were at risk of malnutrition, and 65.0 percent were considered adequately nourished. A strong association was found between mean GOHAI and MNA scores.     

Oral health-related quality of life of stroke survivors on discharge from hospital after rehabilitation

The study aimed to investigate oral health-related quality of life (OHR-QoL) of stroke survivors on hospital discharge after rehabilitation. It was a cross-sectional study involving 43 elderly survivors of mild to moderate stroke about to be discharged from hospital after rehabilitation and a comparison group of 43 community-dwelling elderly people. The Medical Outcomes Short Form 36 (SF-36) measure, the General Oral Health Assessment Index (GOHAI) and an oral health transition scale were administered prior to a dental examination. Median SF-36 subscale scores were significantly different between groups (P < 0.05). In physical function, role-physical, role-emotional and mental health domains, stroke survivors had significantly lower scores indicating poorer health. The median GOHAI score for the stroke group was 52 and 54 for the comparison group with no significant difference between groups although more stroke survivors had difficulty speaking compared with the comparison group. About 75% of stroke survivors considered their appearance to be worse, half of them felt that speech was worse and about a third had difficulty chewing hard food compared with the pre-stroke condition (P < 0.05). Most participants were partially dentate with no significant difference in DMFT scores or prosthetic status between groups (P > 0.05). Health-related quality of life in general was significantly poorer after stroke although patients were considered physically well enough to be discharged from hospital. There was some impairment of OHR-QoL. The nature of the stroke, the hospital environment including diet, coping strategies and elderly Chinese peoples' perception of health should be taken into account when interpreting measures of health status in stroke survivors.     

Validation of the Korean version of the oral health impact profile among the Korean elderly

OBJECTIVES: This study aimed to validate a Korean version of the oral health impact profile (OHIP) and to develop a short-form of OHIP for the Korean elderly. METHODS: The original English version of OHIP was translated into Korean using a forward-backward method. Internal consistency was measured by Cronbach's alpha among 1098 subjects aged 56 or more. Test-retest reliability was assessed by intraclass correlation coefficients (ICCs) with a 3-month interval among 155 subjects aged 57 or more. The validity of the Korean version of OHIP (OHIP-K) was assessed by comparing OHIP scores with the perceived dental treatment needs and by identifying associations between OHIP scores and the number of natural teeth among 128 subjects aged 54 or more. The short-form of OHIP for the Korean elderly (OHIP-14K) was developed using linear regression models and was also validated and compared with the short-form of OHIP by Slade (OHIP-14S). RESULTS: The Cronbach's alpha value for OHIP-K was 0.97. The ICC for OHIP-K was 0.64. Adults with perceived dental treatment needs had a higher OHIP score than adults without any such needs (P < 0.001). The number of natural teeth was negatively associated with the OHIP score (r = -0.44, P < 0.001). OHIP-14K and OHIP-14S shared seven identical items out of a total of 14 items. OHIP-14K results correlated with OHIP-K almost exactly (r(2) = 0.96), as did OHIP-14S (r(2) = 0.95). CONCLUSIONS: OHIP-K showed excellent reliability and validity. OHIP-14S may be a better choice for the evaluation of oral health-related quality of life among the Korean elderly for an international comparison.     

Comparison of the GOHAI and OHIP-14 as measures of the oral health-related quality of life of the elderly

OBJECTIVES: This paper compares the performance of the GOHAI and the OHIP-14 as measures of the oral health-related quality of life of the compromised elderly. METHODS: Data were obtained from a cross-sectional survey of 225 participants, most of whom lived in a large geriatric care centre. RESULTS: The mean age of subjects was 83 years and the majority had one or more chronic medical conditions and physical disabilities. Their main oral problems were high rates of tooth loss and xerostomia. Additive and simple count methods were used to derive GOHAI and OHIP-14 scores. Using the additive method, 8.4% had a GOHAI score of zero and 30.3% an OHIP-14 score of zero. Using the simple count method the percentage with a score of zero was 15.1% and 45.8%. Both measures discriminated between dentate subjects with and without one or more dentures, with and without a chewing problem and with and without dry mouth. Both also showed significant associations with self-rated oral health and satisfaction with oral health status. Associations tended to be stronger between GOHAI scores and these variables. The measures were equally good at predicting overall psychological well-being and life satisfaction. Although the GOHAI identified more oral functional and psychosocial impacts than the OHIP-14, neither was markedly superior to the other when used as discriminatory measures. However, the high prevalence of subjects with zero scores may compromise the ability of the OHIP-14 to detect within-subject change.