title: Self-reported oral health and oral health behaviors in older adults in the last year of life.
abstract: BACKGROUND
  The complex physiological, psychological, and functional changes at the end of life may dramatically affect oral health. However, evidence regarding oral health changes at the end of life is scarce. This study's objective was to examine self-rated oral health and oral health behaviors among community-dwelling elders in the last year of life.
  
  
  METHODS
  This study was a retrospective longitudinal study including 810 dentate community-dwelling older adults aged 65 and older. Based on death certificate data, the participants were retrospectively classified into two groups: died within 1 year after the last interview (end-of-life group) and survived more than 1 year after the last interview (comparison group). Participants were interviewed at baseline, 18, 36, 60, and 84 months regarding their sociodemographics, self-reported oral health, oral conditions, use of oral health services, and preventive behaviors. Generalized estimating equations were used to compare self-reported oral health and oral health behaviors between two groups.
  
  
  RESULTS
  After adjusting for sociodemographics, the end-of-life group was more likely to rate their oral health (odds ratio [OR] = 2.94, 95% confidence interval [CI]: 1.32, 6.54) and overall health (OR = 2.35, 95% CI: 1.12, 4.91) as bad than the comparison group. End-of-life participants were also more likely to dislike their mouth appearance (OR = 2.27, 95% CI: 1.07, 4.83) and rate their ability to taste (OR = 7.24, 95% CI: 2.64, 19.77) and smell (OR = 2.98, 95% CI: 1.09, 8.15) as bad. There was no difference in self-reported oral conditions, use of oral health services, and preventive behaviors.
  
  
  CONCLUSIONS
  Self-rated oral health significantly declines in the last year of life.
authors.affiliation: Department of Dental Ecology, University of North Carolina School of Dentistry, Campus Box 7450, Chapel Hill, NC 27599. xi_chen@dentistry.unc.edu.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.forename: Supawadee
authors.initials: S
authors.lastname: Naorungroj
authors.forename: Christian E
authors.initials: CE
authors.lastname: Douglas
authors.forename: James D
authors.initials: JD
authors.lastname: Beck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015438:Health Behavior; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009657:North Carolina; D009909:Oral Health; D009910:Oral Hygiene; D012189:Retrospective Studies; D057566:Self Report
keywords: End of life; Older adults; Oral health