kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2014.14.2.50 kjhp-14-50 Original Article The Effects of Oral Health on Activity of Daily Living, Depression and Quality of Life in Elderly Women LeeHung Sa 1 KimChunmi 1 LeeDohyun 2 Department of Nursing Science, College of Health Science, Sun Moon University, Asan, Korea School of Public Health, Indiana University Bloomington, Bloomington, IN, USA Corresponding author：Chunmi Kim, PhD Department of Nursing Science, College of Health Science, Sun Moon University, 221 beon-gil 70, Seonmun-ro, Tangjeong-myeon, Asan 336-708, Korea Tel: +82-41-530-2742, Fax: +82-41-530-2725 E-mail: spring4cmk@gmail.com 01 2014 20 01 2014 14 2 50 58 10052014 20062014 Copyright © 2014 The Korean Society of Health Promotion and Disease Prevention 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background

Although oral health in the elderly significantly affects their physical health and quality of life, there have only been limited studies on the relationship between oral health and quality of life. Thus, the purpose of this study was to examine the relationships between oral health, ADL, depression and quality of life in the elderly in Korea, and to provide data to assist the development of health promotion programs in this population.

 Methods

Study subjects included 201 community dwelling elders recruited during December 1 to 31, 2013. Data collected included socio-demographics, oral health (OHIP-14), activity of daily living (ADL), depression status (GDS-SF) and quality of life (QOL). For data analysis, ANOVA test, t‐test, Pearson correlation coefficient and multiple regression analysis were performed using the SPSS 20.0 and AMOS 20.0.

 Results

Average score of OHIP was 0.71, depression was 6.34 and QOL was 2.12. There were significant differences in OHIP according to education (F=7.49, P=0.001), economic status (F=4.08, P=0.018) and disease staus (F=3.08, P=0.048). Also there were statistically significant differences in the depression status according to education (F=7.49, P=0.001) and economic status (F=4.08, P=0.018), and in QOL according to education (F=7.01, P=0.001), economic status (F=4.87, P=0.009) and disease (F=11.04, P<0.001). ADL influenced OHIP and depression, OHIP influenced depression and depression influenced QOL.

 Conclusions

Oral health in the elderly should be considered in developing health programs for quality of life.

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Regression model of variables (Standardized regression weights)

Oral health impact profile according to general characteristics of study participantsa

Characteristics Total (n=201) OHIP t/F Pb
Age, y
 65–74 56 (27.9) 0.73±0.97 0.19 0.845
 75–84 145 (72.1) 0.70±0.67    
 Mean±SD 76.9±4.9      
Marital status        
 Married 62 (30.8) 0.58±0.76 –1.63 0.104
 Widow Educational level 139 (69.2) 0.77±0.76    
Educational level
 No education 74 (36.8) 0.97±0.80 (A) 7.49 0.001
 Elementary school 100 (49.8) 0.56±0.74 (B)   (A≠B=C)
 Middle school 27 (13.4) 0.52±0.50 (C)    
Economic status        
 Pauper Low 23 (11.4)73 (36.4) 0.97±0.08 (A)0.82±0.69 4.08 0.018(A≠B)
 Middle 105 (52.2) 0.57±0.70 (B)    
Living together        
 Alone 92 (45.8) 0.78±0.78 1.17 0.242
 Spouse or/and children 109 (64.2) 0.65±0.74    
Disease        
 No HT or DM 44 (21.9)107 (53.2) 0.55±0.50 (A)0.67±0.78 3.08 0.048(B≠A)
 HT and DM 50 (24.9) 0.92±0.84 (B)    
Total   0.71±0.76    

Abbreviations: OHIP, oral health impact profile; HT, hypertension; DM, Diabetes mellitus.

Values are presented as mean±SD or N (%) unless otherwise indicated.

Calculated by t-test or ANOVA test and Duncan test.

Differences in ADL, depression, and quality of life according to the characteristicsa

Characteristics ADL Dep. QOL
Mean±SD t/F Pb Mean±SD t/F Pb Mean±SD t/F Pb
Age, y                  
 65–74 0.03±0.18 –0.47 0.635 6.60±4.61 0.61 0.540 2.10±0.45 –0.37 0.711
 75–84 0.05±0.28     6.24±3.42     2.13±0.40    
Marital status                  
 Married 0.00±0.00 –2.73 0.007 5.85±4.04 –1.22 0.223 2.24±0.42 2.67 0.008
 Widow 0.07±0.31     6.56±3.65     2.07±0.41    
Education level No education Elementary school 0.10±0.39 (A)0.02±0.14 3.08 0.048(A≠B) 7.62±3.84 (A)6.02±3.49 (B) 10.51) <0.001(A≠B≠C) 2.08±0.46 (A)2.08±0.37 (B) 7.01 0.001(A=B≠C)
 Middle school 0.00±0.00 (B)     4.03±3.41 (C)     2.40±0.36 (C)    
Economic status                  
 Pauper Low Middle 0.26±0.61 (A) 0.05±0.22 (B) 0.00±0.00 (C) 10.42 <0.001 (A=B≠C) 7.82±3.39 (A) 7.54±4.00 (B) 5.08±3.33 (C) 11.50 <0.001(A=B≠C) 1.94±0.53 (A)2.06±0.422.20±0.37 (B) 4.87 0.009(A≠B)
Living together                  
 Alone 0.06±0.32 0.77 0.440 7.01±3.99 2.32 0.021 2.04±0.43 2.39 0.018
 Spouse or/and children 0.03±0.10     5.77±3.51     2.19±0.39    
Disease                  
 No HT or DM 0.00±0.000.03±0.19 2.80 0.063 5.59±3.606.19±3.83 2.65 0.073 2.36±0.30 (A)2.09±0.40 (B) 11.04 <0.001(A≠B=C)
 HT and DM 0.12±0.43     7.32±3.71     1.98±0.46 (C)    
Total 0.04±0.25     6.34±3.78     2.12±0.42    

Abbreviations: ADL, activity of daily living; Dep, depression; QOL, quality of life; HT, hypertension; DM, diabetes mellitus.

Values are presented as mean±SD unless otherwise indicated.

Calculated by t-test, ANOVA, Duncan test.

Correlations between general characteristics, activity of daily living, oral health impact profile, depression, and quality of lifea

Variables Age Age 1 Mar. Eco. Edu. Liv. Dis. OHIP ADL Dep. QOL
Mar. 0.337 1                
  <0.001                  
Eco. –0.240 –0.169 1              
0.001 0.017                
Edu. –0.106 0.134 –0.231 0.001 0.217 0.002 1            
Liv. –0.136 –0.505 0.386 –0.037 1          
0.053 0.000 0.000 0.599            
Dis. 0.053 0.212 –0.324 –0.267 –0.217 1        
0.458 0.003 0.000 <0.001 0.002          
OHIP 0.020 0.115 –0.197 –0.222 –0.083 0.408 1      
ADL 0.778–0.004 0.104 0.128 0.005–0.282 0.002–0.157 0.242–0.055 <0.001 0.280 0.414 1    
0.956 0.070 <0.001 0.026 0.440 <0.001 <0.001      
Dep. 0.022 0.086 –0.300 –0.316 –0.162 0.343 0.115 0.520 1  
0.760 0.223 0.000 <0.001 0.021 <0.001 0.105 <0.001    
QOL 0.038 –0.186 0.216 0.192 0.167 –0.286 –0.210 –0.414 –0.639 1
0.589 0.008 0.002 0.006 0.018 <0.001 0.003 <0.001 <0.001  

Abbreviations: Mar, marital status; Eco, economic status; Edu, educational level; Liv, living together; Dis, number of disease; OHIP, oral health impact profile; ADL, activity of daily living; Dep, depression; QOL, quality of life.

Assessed by Pearson's correlation coefficient.

Parameter statistics in hypothetical modela

Variable Categories Standard estimate SE CR P
Depression ADL (γ11) –0.120 0.958 –1.842 0.045
  OHIP (γ12) 0.570 0.023 8.719 <0.001
QOL Depression (β11) –0.651 0.145 –11.995 <0.001
ADL OHIP 0.402 0.209 5.311 <0.001

Abbreviations: SE, standard error; CR, critical ratio; ADL, activity of daily living; OHIP, oral health impact profile; QOL, quality of life.

Calculated by multiple regression analysis using AMOS.