Abstract
BackgroundAs the general population of Japan ages, the population of hospitalized psychiatric patients is also ageing. The purpose of this study was to investigate the associations of oral health-related quality of life (OHRQoL) with age and oral health, including oral and swallowing function, among psychiatric inpatients.MethodsThe subjects included 165 psychiatric inpatients in psychiatric hospitals in Japan. The General Oral Health Assessment Index (GOHAI) and the Eating Assessment Tool (EAT-10) were included in the questionnaire survey for the measurement of OHRQoL and the screening of dysphagia. A score ≥ 3 on the EAT-10 was defined as suspected dysphagia. Oral examinations and oral diadochokinesis (ODK) measurements for the tongue-lip motor function evaluation were conducted. The inpatients with acute psychiatric symptoms, moderate and severe dementia, and cognitive impairment that affected their ability to communicate and relate their feelings were excluded. A chi-squared test, the Mann–Whitney U test, and linear regression analysis were used for the analysis. The data were analysed at the 5% significance level.ResultsA total of 100 (64.5%) psychiatric inpatients (mean age, 67.3 [SD, 14.5] years, 49% males, and 51% females) participated in this study. The means ± SDs for the decayed missing filled teeth (DMFT) index and GOHAI score were 20.6 ± 6 and 49.7 ± 7.9, respectively. The GOHAI score in the older age group (≥ 65 years) was significantly lower than that in the younger age group (< 65 years). The mean ODK scores were less than 3 times/s for all syllables. The percentage of the participants with suspected dysphagia was 45.0%. Tooth loss and suspected dysphagia were significantly associated with low GOHAI scores. The EAT-10 score was significantly correlated with the GOHAI score only after adjusting for age and sex (β = − 0.725, 95% CI − 0.97, − 0.64).ConclusionsIn hospitalized psychiatric patients, impaired oral health in the older subjects was more pronounced compared with that among general adults. Tooth loss and swallowing function were associated with OHRQoL. Therefore, oral care for the recovery of occlusal and swallowing functions may be needed to improve OHRQoL among psychiatric patients.
Highlights
As the general population of Japan ages, the population of hospitalized psychiatric patients is ageing
Some previous studies reported that patients with schizophrenia and dementia had poor swallowing function and were at risk for aspiration pneumonia [16, 17]
The clinical assessment was recorded according to the WHO criteria [36]: severity of lifetime accumulated caries estimated with the decayed-missing-filled teeth (DMFT) index [number of decayed teeth (DT), missing teeth due to decay (MT), and filled teeth (FT)]
Summary
As the general population of Japan ages, the population of hospitalized psychiatric patients is ageing. The number of patients with psychiatric disorders is increasing worldwide. A survey conducted in Japan by the Ministry of Health, Labour and Welfare in 2017 estimated that 513 thousand patients (252 thousand inpatients and 261 thousand outpatients) were diagnosed with psychiatric and behavioural disorders [3]. Several original international studies [5,6,7,8,9,10,11,12,13,14] and one meta-analysis [15] reported that the oral health status of psychiatric patients was poor compared to that of the general population. Some previous studies reported that patients with schizophrenia and dementia had poor swallowing function and were at risk for aspiration pneumonia [16, 17]
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