Dental status, quality of life, and mortality in an older community population: a multivariate approach.
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.


METHODS
Cross-sectional analysis for FDS and QOL; 10-year prospective study for mortality.


METHODS
The historical and central district of the city of Brescia, northern Italy.


METHODS
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.


METHODS
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.
Appollonio
I
I
Clinica Neurologica, Università di Milano, Ospedale San Gerardo, Monza, Italy.
Carabellese
C
C
Frattola
A
A
Trabucchi
M
M
D000368:Aged; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004522:Educational Status; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D009026:Mortality; D015999:Multivariate Analysis; D009909:Oral Health; D011788:Quality of Life; D012919:Social Behavior; D012959:Socioeconomic Factors; D016019:Survival Analysis