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Oral Health Status and Self-Reported Functional Dependence in Community-Dwelling Older Adults


Address correspondence to Yau-Hua Yu, School of Dentistry, National Yang Ming University, Taipei, Taiwan, No. 155, Sec. 2, Li-Nong St., Beitou District, Taipei City 112, Taiwan. E-mail:


OBJECTIVES: To assess the strength of association between graded groups of oral health status and self-reported functional dependence in community-dwelling older adults.

DESIGN: Population-based cross-sectional study.

SETTING: National Health and Nutritional Examination Survey (NHANES) 1999 to 2004.

PARTICIPANTS: Three thousand eight hundred fifty-six participants aged 60 and older (mean age 71.2) without missing values in the examined correlates.

MEASUREMENTS: Oral health status was evaluated according to edentulism, severity of periodontal disease, and recommendation of periodontal care and compared with that of healthy controls. Self-reported functional dependence was assessed according to 19 questions in five domains: activities of daily living (ADLs), instrumental activities of daily living (IADLs), leisure and social activities (LSAs), lower extremity mobility (LEM), and general physical activities (GPAs).

RESULTS: After controlling for demographic and dental variables, health-related behaviors, C-reactive protein, and comorbidities, edentulism was significantly associated with disability in IADLs (odds ratio (OR)=1.58), LSAs (OR=1.63), LEM (OR=1.31), and GPAs (OR=1.45) compared with healthy controls. Likewise, severe periodontitis was associated with disability in IADLs (OR=1.58), LSAs (OR=1.70), and LEM (OR=1.63). The trends toward disability in IADLs, LSAs, LEM, and GPAs were statistically significant across increasing severity of oral health problems.

CONCLUSION: Poor oral health, specifically edentulism and severe periodontitis, is associated with multiple domains of late-life disability, but a causal relationship cannot be established based on current study design.