Poor Oral Health Is a Factor that Attenuates the Effect of Rehabilitation in Older Male Patients with Fractures.

Abstract

Poor oral health can lead to poor general health. We hypothesized that poor oral health might be a factor that attenuates the effect of rehabilitation in older patients with fractures. This study aimed to evaluate the relationship between oral health in elderly patients with fractures and improvement in activities of daily living (ADL) through rehabilitation. In addition, we assessed factors associated with ADL improvement among older patients with fractures. This case-control study was conducted at a rehabilitation hospital among 178 men aged ≥65 years who underwent fracture rehabilitation. Patients were divided into two groups based on the oral health assessment tool (OHAT) score on admission (≥4 and <4). Analysis of comparison between the two groups and multivariate linear regression analyses were performed, with respect to functional independence measure (FIM) gain during rehabilitation. FIM gain was significantly lower in the group with OHAT score ≥4 (26.2±17.5) than that in group with OHAT score <4 (31.1±16.1, p=0.044). There were also significant differences between the two groups in body mass index values, Mini Nutritional Assessment Short Form (MNA-SF) scores, and fracture types. OHAT score on admission was significantly associated with FIM gain during hospitalization (coefficient: 6.350, 95% confidence interval: 1.043-11.658, p=0.019). FIM on admission, Mini-Mental State Examination score, and period of rehabilitation were significantly associated with FIM gain. We demonstrated that the group with poor oral health had lesser ADL improvement than the group with good oral health. In addition, oral health and period of rehabilitation were independent factors that significantly affected ADL improvements. Older patients with poor oral health should be encouraged to undergo further rehabilitation, and to not refrain from exercise because of old age and fractures.