This study aimed to examine the effects of the oral health impact profile (OHIP-14), physical functions (ADL, IADL), and mental functions (CES-D, MMSE-K) on the quality of life (WHOQOL-BREF) for the elderly in long-term care facilities. The research was conducted in 602 facility allowance beneficiaries authorized to be eligible for long-term care in long-term care facilities through personal interviews using a structured questionnaire from May 1 to June 30, 2013.
The main results of this study are as follows:
1. The quality of life was significantly lower among females than among males (p=0.001), in the group receiving government subsidies than in the group whose livelihood was maintained by themselves or by their children (p=0.000), in the group with a longer period of care (p=0.000), in the group with fewer visits of family (p=0.000), in the drinking group than in the non-drinking group (p=0.005), in the group with no regular exercise than in that with regular exercise (p=0.000), in the group with irregular meals than in that with regular meals (p=0.000), in the group with bad subjective oral health conditions than in that with good subjective oral health conditions (p=0.000), in the group with a smaller number of daily toothbrushing(p=0.000), in the group using up-and-down toothbrushing (p=0.003), and in the group with subjective dry mouth than in that with no subjective dry mouth (p=0.000).
2. The quality of life was significantly lower in the group with higher OHIP-14 than in that with lower OHIP-14, in the group with malfunction than in that with a normal range of ADL and IADL, and in the group with cognitive impairment than in that with normal CES-D and MMSE-K.
3. The quality of life was significantly positively correlated with OHIP-14 (r=0.425, p<0.01), activities of daily living (r=0.461, p<0.01), instrumental activities of daily living (r=0.460,p<0.01), and cognitive impairment (r=0.289, p<0.01) but was negatively correlated with depression (r=-0.751, p<0.01).
4. Hierarchical multiple regression analysis found that the quality of life was lower among females than among males, in the group receiving government subsidies than in the group whose livelihood was maintained by themselves or by their children, in the group with a longer period of care, in the drinking group than in the non-drinking group, in the group with no regular exercise than in that with regular exercise, in the group with irregular meals than in that with regular meals, in the group with bad subjective health conditions than in that with good subjective health conditions, in the group with a smaller number of daily toothbrushing, in the group with xerostomia than in that with no xerostomia, in the group with lower OHIP-14, in the group with lower ADL and IADL, and in the group with lower CES-D and MMSE-K and these factors accounted for 68.0%. In particular, the addition of health-related behavior characteristics and CES-D and MMSE-K has increased explanatory power by 20.8% and 21.7%, respectively, which implies that the quality of life is significantly correlated with health-related behavior characteristics and mental functions.
5. The covariance structure analysis found that the quality of life was more affected by CES-D and MMSE-K than by ADL and IADL or by OHIP-14; the higher ADL and IADL and OHIP-14 and the higher CES-D and MMSE-K, the higher quality of life. The higher OHIP-14 and ADL and IADL, the higher CES-D and MMSE-K.
These results imply that the quality of life is significantly correlated with OHIP-14, ADL and IADL, and CES-D and MMSE-K as well as with socio-demographic characteristics, health-related behavior characteristics, and oral health conditions for the elderly in long-term care facilities. In particular, the quality of life is more affected by health-related behavior characteristics and CES-D and MMSE-K than by other factors. It is therefore necessary to make efforts to prevent depression and cognitive impairment, including health-related behavior, with the objective of improving the quality of life for the elderly in long-term care facilities.