Cross-Country Validation of the Association Between Oral Health and General Health in Community-Dwelling Older Adults

Johanna de Almeida Mello, Trung Dung Tran, Stefanie Krausch-Hofmann, Brigette Meehan, Hein van Hout, Luke Turcotte, Henriette G. van der Roest, Vjenka Garms-Homolová, P. lmi Jónsson, Graziano Onder, Harriet Finne-Soveri, Jan de Lepeleire, Dominique Declerck, Emmanuel Lesaffre, Joke Duyck, Anja Declercq

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Objective: Oral health is known to be associated with general health, but longitudinal relationships between oral health and general health indicators have not yet been fully explored in international research. Setting and participants: The sample consisted of 3 longitudinal databases: a sample from Belgium from the Protocol 3 project (n = 8359), a combined sample from 6 European countries (n = 2501) from the IBenC study (Belgium, Finland, Iceland, Germany, Italy, and the Netherlands), and a sample from New Zealand (n = 15,012). All clients were 65 years or older and received long-term home care services. Methods: Bayesian models were used to analyze the associations between 3 oral health indicators (chewing difficulty, nonintact teeth, and dry mouth) and 4 aspects of general health (activities of daily living functioning, cognition, depression, and health instability). In addition, the models explored the associations between current oral health and general health status and future oral health and general health status. Results: Clients who had poorer oral health had a higher risk of suffering from poor general health. Especially chewing difficulty was associated with all general health indicators in all data sets (odds ratios > 1). Dry mouth and nonintact teeth showed significant associations with almost all general health indicators. Additionally, having poor oral health (respectively general health) was predictive of poor general health (respectively oral health) at future assessments (significant cross-lagged parameters). Conclusions/Implications: The results point out the need of the inclusion of oral health assessment and advice from dentists or oral health practitioners into the multidisciplinary conversation. In addition, identifying older people with oral health problems is essential in order to provide treatment and monitoring. Raising awareness for oral health is important, and policy makers should foster oral health promotion and care for older adults in order to keep them in good health.
Original languageEnglish
Pages (from-to)1137-1142.e2
JournalJournal of the American Medical Directors Association
Issue number9
Publication statusPublished - 1 Sept 2019


  • Bayesian modeling
  • Oral health
  • bivariate autoregressive models
  • cross-country validation
  • general health

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