Discrimination of functional capacity for oral hygiene in elderly Spanish people by the Barthel General Index.
OBJECTIVE
To explore, among the institutionalized elderly in Spain, the association between functional dependence in manipulating aids used in oral self-care (oral hygiene dependence) and general functional capacities, as measured by the Index of Activities of Daily Oral Hygiene (ADOH) and the Barthel Index (BI), respectively.


METHODS
A cross-sectional study was performed in 2002 on 390 Spanish residents of a residential home for the elderly aged, 65-101 years. All study subjects underwent a oral examination and their ADOH and BI scores assessed. The association between the index scores was studied and the discriminant capacity of BI for oral hygiene dependence was calculated.


RESULTS
The mean number of decayed, missing, or filled permanent teeth (+/-SD) was 26.6 +/- 7.3. The mean BI score was 68.31 (95% CI 64.35-72.27), and 172 individuals (44.1%; 95% CI 39.2-49.0%) were independent in all BI-measured functions. The mean ADOH score was 2.43 (95% CI 2.11-2.75), and 238 individuals (61.0%; 95% CI 56.2-65.9%) were independent for oral hygiene, 39 (10.0%; 95% CI 7.2-13.4%) required assistance (assistive devices), and 113 (29.0%; 95% CI 24.5-33.5%) were completely dependent. The BI scores were significantly correlated with the ADOH scores (r = -0.80, P < 0.001). The BI showed a high discriminant capacity to identify the individuals who were dependent for oral hygiene in this population (area under the ROC curve +/- SE = 0.929 +/- 0.013). Using the optimal cut-off point according to the Youden Index (<61), the sensitivity was 0.87 +/- 0.03 and specificity 0.87 +/- 0.02.


CONCLUSIONS
There is a close association between BI and ADOH in this population, which could be useful to identify elderly individuals who are dependent for oral hygiene.
Ruiz-Medina
Pilar
P
Department of Dentistry, School of Dentistry, University of Granada, Granada, Spain.
Bravo
Manuel
M
Gil-Montoya
José Antonio
JA
Montero
Javier
J
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007326:Institutionalization; D008297:Male; D009735:Nursing Homes; D009910:Oral Hygiene; D013030:Spain / Q000453:epidemiology