title: Oral health care behavior and frailty-related factors in a care-dependent older population.
abstract: OBJECTIVE
  To assess, in older people with different levels of care-dependency 1) which frailty- and non-frailty related predisposing, enabling and need factors are associated with a) dental service use (DSU) frequency, b) changed DSU after the onset of care-dependency, c) brushing frequency, and d) changed brushing frequency since the onset of care-dependency; and 2) if unfavorable oral health care behavior is related to unfavorable oral health outcomes.
  
  
  METHODS
  Bivariate analyses and multivariable logistic regression analyses were performed to evaluate data from 126 Dutch care-dependent people aged≥65 on oral and general health, psychological and social issues.
  
  
  RESULTS
  Lower DSU frequency was mainly related to non-frailty-related predisposing factors, especially being edentate (OR=3.75; CI: 1.20-11.71; p=0.023) and lower socioeconomic status (OR=1.74; CI: 0.97-3.14; p=0.065); lower DSU frequency since the onset of care-dependency to frailty-related enabling and need factors, especially 'difficulty going to the dentist' (OR=4.98; CI:1.85-13.36; p=0.001) and clinically assessed treatment need (OR=3.23; CI:1.24-8.42; p=0.016); lower brushing and changed (reduced) brushing frequency to frailty-related enabling factors, and, in case of reduced frequency, significantly to 'not being capable of summoning the effort to brush' (OR=8.28; CI: 1.44-47.56; p=0.018) and high care-dependency level (OR=4.14; CI: 1.05-16.36; p=0.043). Elders with lower and especially those with reduced DSU and brushing frequencies since the onset of care-dependency, had generally worse oral health outcomes and related quality of life.
  
  
  CONCLUSIONS
  Oral health care behavior, especially lower brushing and DSU frequency since the onset of care-dependency, is related to specific frailty-related factors in a care-dependent older population.
  
  
  CONCLUSIONS
  Oral care-providers should be alert to the role of specific frailty-related factors, which are likely to reduce DSU and brushing frequency in the course of increasing frailty.
authors.affiliation: Department of Oral Function, College of Dental Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. Electronic address: dominique.niesten@radboudumc.nl.
authors.forename: Dominique
authors.initials: D
authors.lastname: Niesten
authors.affiliation: Department of Oral Function, College of Dental Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. Electronic address: dick.witter@radboudumc.nl.
authors.forename: Dick J
authors.initials: DJ
authors.lastname: Witter
authors.affiliation: Department of Cariology and Preventive Dentistry, College of Dental Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. Electronic address: ewald.bronkhorst@radboudumc.nl.
authors.forename: Ewald M
authors.initials: EM
authors.lastname: Bronkhorst
authors.affiliation: Department of Oral Function, College of Dental Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. Electronic address: nico.creugers@radboudumc.nl.
authors.forename: Nico H J
authors.initials: NHJ
authors.lastname: Creugers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D015984:Causality; D003729:Dental Care / Q000706:statistics & numerical data; D005260:Female; D016330:Frail Elderly; D015438:Health Behavior; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D009066:Mouth, Edentulous; D009909:Oral Health; D009910:Oral Hygiene; D011476:Prosthodontics; D011788:Quality of Life; D057566:Self Report; D012923:Social Class; D012944:Social Support; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000706:statistics & numerical data
keywords: Care-dependency; Dental service use; Frailty; Health care behavior; Older adults; Oral health care