DENTAL STATUS, QUALITY-OF-LIFE, AND MORTALITY IN AN OLDER COMMUNITY POPULATION - A MULTIVARIATE APPROACH

OBJECTIVE: To evaluate the relationships between a functional measure of dental status (FDS), several variables belonging to a quality of li fe (QOL) profile, and mortality in an older community population. DESI GN: Cross-sectional analysis for FDS and QOL; 10-year prospective stud y for mortality. SETTING: The historical and central district of the c ity of Brescia, northern Italy PARTICIPANTS: The entire cohort of 70 t o 75-year-old people living in the above-mentioned district (n = 1303) : 1201 subjects were eligible for interview at baseline; 11 refused th e physical examination; 52 were lost to follow-up; data are presented for the remaining sample of 1137 subjects. MEASUREMENTS: FDS examinati on was used to classify the subjects into three groups: naturally adeq uate (ADS) (25.2%), naturally inadequate (IDS) (14.3%) dental status, and denture wearers (DW) (60.4%). Various QOL domains were assessed: m ood level, cognitive status, instrumental activities of daily living ( IADL), social relationships, indexes of somatic health, and health beh aviors. The demographic and socioeconomic parameters were used as cova riates. RESULTS: Univariate analysis showed that both the ADS and the DW groups had a better QOL profile than the IDS group. Multiple logist ic regression indicated that ADS and DW conditions were predicted inde pendently by better educational and financial conditions, higher socia l relationships and a better IADL level in comparison with IDS. Moreov er, compared with IDS, DS was a significant predictor of a better leve l at the SELF, IADL, and HCU scales whereas DM predicted only a better IADL level. Crude survival analysis showed that ADS was associated wi th a lower mortality risk compared with both DW and IDS, which did not differ from each other. FDS also remained a significant and independe nt predictor of mortality in a more general Cox's regression model. CO NCLUSIONS: Within this cohort oi: 70 to 75-year-old urban residents, F DS is associated with several QOL domains and with long-term survival. A hierarchy of reciprocal relationships exists among these parameters . The present study provides a basis for encouraging more extensive us e of dentures. Longitudinal studies using oral health outcomes are war ranted before clinical recommendations can be made.