title: The impact of providing dental services to frail older adults: perceptions of elders in adult day health centers.
abstract: 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, medical 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 group's 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 (67.19%); 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 levels 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.
authors.affiliation: School of Dentistry, University of Washington, USA.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Walker
authors.forename: H Asuman
authors.initials: HA
authors.lastname: Kiyak
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003631:Day Care, Medical; D016321:Dental Care for Aged / Q000523:psychology*; D005260:Female; D016330:Frail Elderly / Q000523:psychology; D015577:Geriatric Assessment; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008952:Mobile Health Units; D010865:Pilot Projects; D011788:Quality of Life; D011795:Surveys and Questionnaires