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Older people with swallowing dysfunction and poor oral health are at greater risk of early death
Umea Univ, Fac Med, Dept Odontol, Oral & Maxillofacial Radiol, Umea, Sweden.ORCID iD: 0000-0002-2254-7862
Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.ORCID iD: 0000-0003-0290-5586
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.
Publ Dent Hlth Serv, Orebro, Sweden;Orebro Univ, Fac Hlth & Med, Orebro, Sweden.
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2019 (English)In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 47, no 6, p. 494-501Article in journal (Refereed) Published
Abstract [en]

Objectives We investigated the associations between swallowing dysfunction, poor oral health and mortality among older people in intermediate care in Sweden. Methods This prospective cohort study investigated 391 older people in 36 intermediate care units (clusters). Swallowing function was assessed with the timed water swallow test (TWST), and oral health with the revised oral assessment guide (ROAG) at baseline. Data were collected on age, sex, education level, multimorbidity, cognitive impairment, care dependency and body mass index (BMI). Time to mortality was recorded during the following year. The mixed effects Cox regression model with cluster as a random factor was used to estimate hazards ratios (HR) with 95% confidence intervals (CI). Results The median age of the participants was 84 years (interquartile range [IQR]: 11), and 53.3% were females. Mortality within one year was 25.1%. In the adjusted model, swallowing dysfunction and poor oral health were both independently associated with mortality (adjusted HR [aHR]: 1.67, 95% CI 1.02-2.75; P = .041 and aHR: 1.98, 95% CI 1.07-3.65; P = .029, respectively). Participants with combined swallowing dysfunction and poor oral health showed the highest mortality (35.0%) and 2.6 (95% CI 1.15-5.89; P = .022) times higher mortality risk than those with normal swallowing function and good oral health (13.0%). Conclusions Swallowing dysfunction and poor oral health were identified as independent risk factors for mortality in older people in intermediate care. Although further studies are required to verify these findings, they suggest that systematic assessment of swallowing function and oral health status should be performed for care considerations.

Place, publisher, year, edition, pages
WILEY , 2019. Vol. 47, no 6, p. 494-501
Keywords [en]
mortality, nursing homes, oral care, oral hygiene, swallowing disorders
National Category
Dentistry
Identifiers
URN: urn:nbn:se:uu:diva-398864DOI: 10.1111/cdoe.12491ISI: 000482105300001PubMedID: 31407829OAI: oai:DiVA.org:uu-398864DiVA, id: diva2:1377239
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-2127The Kamprad Family Foundation, 20132115The Kempe FoundationsAvailable from: 2019-12-11 Created: 2019-12-11 Last updated: 2019-12-11Bibliographically approved

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