Burden of Oral Symptoms and Its Associations With Nutrition,Well-Being,and Survival Among Nursing Home Residents |
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| Affiliation: | 1. Department of General Practice, University of Helsinki, Helsinki, Finland;2. Social Services and Health Care Sector, Oral Health Care, City of Helsinki, Helsinki, Finland;3. Department of Social Services and Health Care, Developmental and Operational Support, City of Helsinki, Helsinki, Finland;4. Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland;1. Discipline of General Practice, School of Medicine, National University of Ireland Galway, Ireland;2. Health Protection Surveillance Centre (HPSC), Dublin, Ireland;3. Department of Clinical Microbiology, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland;4. Discipline of Bacteriology, School of Medicine, National University of Ireland Galway, Ireland;1. Signature HealthCARE, Louisville, KY;2. Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC;3. School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, NC;1. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC;2. Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC;3. Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC;1. Research Institute for Ageing, Waterloo, Ontario, Canada;2. School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada;3. Département de Médecine, Université de Montréal et Centre hospitalier de l''Université de Montréal, Montréal, Québec, Canada;4. Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada;5. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada;6. Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;7. Department of Medicine, McMaster University, Hamilton, Ontario, Canada;8. Department of Medicine, Western University, London, Ontario, Canada |
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| Abstract: | ObjectivesTo explore how oral problems, chewing problems, dry mouth, and swallowing difficulties cluster and whether their burden is associated with nutritional status, eating habits, gastrointestinal symptoms, psychological well-being, and mortality among institutionalized residents.DesignCross-sectional study with 1-year mortality.Setting and participants3123 residents living in assisted facilities and nursing homes in Helsinki, Finland.MeasuresTrained nurses assessed residents in all nursing homes and assisted living facilities in Helsinki in 2011. A personal interview, the Mini Nutritional Assessment (MNA), oral symptoms, questions about eating habits, and psychological well-being were used to assess each resident. We divided the subjects first according to the number of oral symptoms into 4 groups: no oral symptoms (G0), 1 oral symptom (G1), 2 oral symptoms (G2), and all 3 symptoms (G3); and second according to the symptoms: dry mouth, chewing problems, and swallowing difficulties. The diagnoses and medications were retrieved from medical records, and mortality data were obtained from central registers.ResultsIn all, 26% of the subjects had 1 oral problem (G1), 11% had 2 oral problems (G2), and 4% had all 3 oral problems (G3), whereas 60% (n = 1870) had no oral symptoms. Thus, the oral symptoms moderately overlapped. The burden of oral symptoms was linearly associated with malnutrition, higher numbers of comorbidities, dependency in physical functioning, gastrointestinal symptoms, and eating less and more often alone. The higher the burden of oral symptoms, the lower the self-rated health and psychological well-being. Mortality increased along with the higher oral symptoms burden. Among residents having 1 or more symptoms, 26% had chewing problems, 18% swallowing difficulties, and 15% dry mouth.Conclusions/ImplicationsThe burden of oral health problems was associated in a stepwise fashion with poor health and psychological well-being, malnutrition, and mortality. Clinicians should routinely assess older institutionalized residents' oral health status to improve residents’ well-being. |
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| Keywords: | Dry mouth chewing problems swallowing difficulty psychological well-being mortality oral health |
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