title: Social inequality in oral health-related quality-of-life, OHRQoL, at early older age: evidence from a prospective cohort study.
abstract: OBJECTIVE
  This study aimed to assess the long-term effect of socio-behavioral characteristics on oral impacts on daily performances (OIDP) at age 65 and the influence on OIDP at age 65 of changes in socio-behavioral characteristics between age 50 and 65.
  
  
  METHODS
  In 1992, all 50-year-olds in two counties of Sweden were invited to participate in a longitudinal survey. A total of 6346 responded and, of those, 4143 completed follow-ups at ages 55, 60 and 65 years.
  
  
  RESULTS
  At age 65, 26.9% had oral impacts. Subjects being immigrants, being unmarried, reporting economic barriers, bad general health, bad quality dental care, less than annual dental attendance, limited social network and smoking at age 50 experienced oral impacts at age 65 more frequently than their counterparts in the opposite groups. Compared to the stable advantaged groups, stable disadvantaged groups regarding marital status, health status, smoking and reported quality of care had increased ORs for oral impacts. Compared to the stable advantaged groups, those who experienced deterioration with respect to health status, dental attendance and quality of oral health care and those who quitted smoking had increased ORs for oral impacts.
  
  
  CONCLUSIONS
  Disadvantaged socio-behavioral condition at age 50 had a long lasting detrimental effect on OHRQoL at age 65. Deterioration in socio-behavioral circumstances was associated with increased oral impacts. Early protection against the effect of socio-behavioral adversity by imposing economic barriers, ensure provision of high quality care and by promotion of healthy lifestyles seems to have the potential to reduce oral impacts at older ages.
authors.affiliation: Institute of Clinical Dentistry-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway. anne.nordrehaug@cih.uib.no
authors.forename: Anne Nordrehaug
authors.initials: AN
authors.lastname: Astrøm
authors.forename: Gunnar
authors.initials: G
authors.lastname: Ekback
authors.forename: Sven
authors.initials: S
authors.lastname: Ordell
authors.forename: Lennart
authors.initials: L
authors.lastname: Unell
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003729:Dental Care / Q000592:standards / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006304:Health Status; D054625:Healthcare Disparities; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009909:Oral Health; D011446:Prospective Studies; D011787:Quality of Health Care; D011788:Quality of Life; D012907:Smoking; D016540:Smoking Cessation; D012923:Social Class; D012931:Social Environment; D012937:Social Mobility; D012944:Social Support; D012959:Socioeconomic Factors; D013548:Sweden; D035862:Vulnerable Populations