The Effects of Oral Health on Activity of Daily Living, Depression and Quality of Life in Elderly Women

Hung Sa Lee; Chunmi Kim; Dohyun Lee

doi:10.15384/kjhp.2014.14.2.50

Korean J Health Promot > Volume 14(2); 2014 > Article

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Lee, Kim, and Lee: The Effects of Oral Health on Activity of Daily Living, Depression and Quality of Life in Elderly Women

Original Article

Korean Journal of Health Promotion 2014;14(2):50-58.

Published online: January 20, 2014

DOI: https://doi.org/10.15384/kjhp.2014.14.2.50

The Effects of Oral Health on Activity of Daily Living, Depression and Quality of Life in Elderly Women

¹Department of Nursing Science, College of Health Science, Sun Moon University, Asan, Korea

²School of Public Health, Indiana University Bloomington, Bloomington, IN, USA

Hung Sa Lee¹, Chunmi Kim^1,, Dohyun Lee²

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

Received May 10, 2014 Accepted June 20, 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.

Keywords: Oral health, Depression, Quality of life, Aged

Figure 1

Regression model of variables (Standardized regression weights)

Table 1.

Oral health impact profile according to general characteristics of study participants^a

Characteristics	Total (n=201)	OHIP	t/F	P^b
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.

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

^bCalculated by t-test or ANOVA test and Duncan test.

Table 2.

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

Characteristics	ADL			Dep.			QOL
Characteristics	Mean±SD	t/F	P^b	Mean±SD	t/F	P^b	Mean±SD	t/F	P^b
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±0.42 2.20±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±0.00 0.03±0.19	2.80	0.063	5.59±3.60 6.19±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.

^aValues are presented as mean±SD unless otherwise indicated.

^bCalculated by t-test, ANOVA, Duncan test.

Table 3.

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

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
Eco.	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
Liv.	0.053	0.000	0.000	0.599
Dis.	0.053	0.212	–0.324	–0.267	–0.217	1
Dis.	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
ADL	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
Dep.	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
QOL	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.

^aAssessed by Pearson's correlation coefficient.

Table 4.

Parameter statistics in hypothetical model^a

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.

^aCalculated by multiple regression analysis using AMOS.

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