Geriatric Oral Health Assessment Index Scores Research Articles

Oral Health‐Related Quality of Life and Nutritional Status

This study examines whether oral health-related quality of life (OHRQoL) is associated with malnutrition risk in the elderly. A cross-sectional study was designed using a representative sample of Spaniards over 65 years old. Data on sociodemographics and oral health status were gathered by interview and examination. Oral health-related quality of life was evaluated using the Geriatric Oral Health Assessment Index (GOHAI), and malnutrition risk using the Mini Nutritional Assessment (MNA). The final sample included 2,860 elderly, 41.7 percent males and 58.3 percent females, with a mean age of 73.7 +/- 6.8 years. Mean GOHAI score was 52.1 +/- 7.2, with 70.7 percent of the sample needing oral health care according to this index. The mean MNA score was 24.0 +/- 3.31; 3.5 percent of the elderly were malnourished, 31.5 percent were at risk of malnutrition, and 65.0 percent were considered adequately nourished. A strong association was found between mean GOHAI and MNA scores.

Translation and validation of the Arabic version of the Geriatric Oral Health Assessment Index (GOHAI)

Our aim was to translate the original English version of the Geriatric Oral Health Assessment Index (GOHAI) into Arabic and assess its validity and reliability for use among people in North Jordan. After translation into Arabic and back-translation to check the translation quality, a total of 288 participants completed the Arabic version of the GOHAI questionnaire. Individual GOHAI items were recoded and summed as originally recommended. The questionnaire sought information about socio-demographic characteristics and self-reported perception of general and oral health. Clinical examination included assessment of periodontal status, and number of decayed teeth, missing teeth, filled teeth and crowned teeth. Reliability, internal consistency, and concurrent, convergent and discriminant validity of GOHAI scores were examined. Mean GOHAI score was 40.9 (SD = 10.6, range: 12 to 60). Cronbach's alpha for the GOHAI score was 0.88, indicating a high degree of internal consistency and homogeneity between the GOHAI items. The test-retest correlation coefficient for add-GOHAI scores was 0.72, indicating good stability. Add-GOHAI scores increased with poorer perceived general and oral health. Convergent validity, construct validity and discriminant validity of the GOHAI were demonstrated. The Arabic translation of the GOHAI demonstrated acceptable validity and reliability when used for people in North Jordan. It could therefore be used as a valuable instrument for measuring oral health-related quality of life for people in this region.

The impact of providing dental services to frail older adults: Perceptions of elders in adult day health centers*

Very little is known about the oral health of, and access to, dental services among frail elders who live in the community and use an adult day health center (ADHC) for respite care. This pilot study evaluated the perceived oral health quality of life (OHQOL) of elders who used a mobile dental program in urban, suburban, and rural ADHC settings. Pre- and post-treatment interviews were conducted to evaluate OHQOL using the Geriatric Oral Health Assessment Index (GOHAI). ADHC records were used to obtain demographic, medical history and medication data. Following initial dental examinations and consent, dental treatment was provided at each ADHC. Of the 138 elders screened at three ADHCs, pre- and post-treatment data were obtained on 76 subjects following their treatment (mean four months later). The group's members were mostly female (64.5%) and Caucasian (71.6%). Their mean age was 76.8 (+/- 9.8), with an average of 12.4 teeth (34.2% edentulous); 67.7% were on Medicaid. On average they had 5.5 chronic diseases, hypertension being the most common (67.19%); 44.8% had a neurological disorder or dementia. GOHAI scores were generally high both pre- and post-treatment, reflecting high physical and psychosocial OHQOL and low levels of worry. GOHAI scores were correlated with chronic diseases; the more chronic diseases an individual had, the lower his or her total score pre- and post-treatment (r=-.24, r=-.26 respectively, p<.04). The more dental treatment needs an elder had, the lower his or her GOHAI (r=-.23, p<.05). Elders with more teeth reported higher GOHAI pre- and post-treatment (r=.36, r=.37 respectively, p<.002). Paired t-tests comparing pre- and post-treatment GOHAI scores revealed significant improvements in overall GOHAI (p<.001), and on two dimensions: physical (p<.005) and psychosocial (p<.002). The findings support the importance of providing on-site access to dental services in order to maintain the general OHQOL of frail elders, more specifically in the areas of physical and psychosocial well-being.

Validation of the Geriatric Oral Health Assessment Index (GOHAI) in the Malay Language

To translate and validate the Geriatric Oral Health Assessment Index (GOHAI into the Malay language for use in Malaysia. The 6-Likert scale GOHAI was translated into the Malay language and self-administered on 189 subjects aged 60+. All subjects underwent oral status assessment. The measure was assessed for construct and discriminant validity, for test-retest reliability and principal component factor. Mean GOHAI score was 46.2 (SD 9.7, range 17-60). The Cronbach's alpha was 0.79. Mean GOHAI scores increased with more positive self-rated oral health and general health. The elderly with no perceived dental treatment need had higher mean GOHAI scores than those with perceived needs. There were slightly stronger inverse correlations between GOHAI scores and caries experience, number of teeth present, and number of pathologically mobile teeth. The measure demonstrated strong test-retest reliability. Eight of the 12 items had Spearman's r3 0.7. Only one principal factor was found at eigenvalue > 1. Using ANCOVA, self-rated perception of oral health and perceived need for dental treatment had the most significant impact on the GOHAI score. The Malay language version of the GOHAI demonstrated acceptable validity and reliability and will be an important instrument to measure oral health-related quality of life among Malay-speaking Malaysians. Use of the Malay language version GOHAI should also be pursued among diverse adult age groups.

Validation of an oral health quality of life index (GOHAI) in France.

Oral health has traditionally been defined in terms of disease. Today, health is seen in a wider context: taking into account its impact on everyday living. Several indices attempt to capture this dimension. The Geriatric Oral Health Assessment Index (GOHAI) has been adapted for general use and tested on adult samples, mainly in North America. Language, cultural norms and the health care system in France are different and this raises the need to validate the GOHAI in France before it receives widespread use. The purpose of this study was to test the validity of a French version of the GOHAI. The GOHAI is based on responses to a 12-item self-administered questionnaire. The items were translated into French, back-translated and compared with the original. After pilot testing and minor modifications, the French version was administered to a group of low-income persons benefiting from the national health insurance system (n = 260, 18-45 years). Measures for stability and internal consistency were calculated. Concurrent and discriminant validity were assessed. Cronbach's alpha (0.86) showed a high internal consistency and homogeneity between items. Item-scale correlations varied between 0.40 and 0.78. Repeat administration of the GOHAI to 32 participants gave weighted kappa coefficients from 0.51 to 0.87 and a Pearson's correlation coefficient of 0.87. Low GOHAI scores were associated with perceptions of poor oral and general health, low satisfaction with oral health and a perceived need for dental care. There were significant relationships between the GOHAI score and most objective measures of dental status except FT. Younger, well-educated and higher income respondents were more likely to have a high GOHAI score. The French version of the GOHAI exhibits satisfactory psychometric properties but two items (one about swallowing, the other with complex sentence structure) had poor stability.

The sensitivity of the Geriatric Oral Health Assessment Index to dental care

The sensitivity of the Geriatric Oral Health Assessment Index (GOHAI) to dental treatment was evaluated using data from a community-based oral health promotion project. Ninety-six subjects completed baseline and twenty-four-month follow-up interviews that included the GOHAI as well as other self-reported measures of oral health. Subjects were predominantly white, female, not currently married, with less than a high school education, and had average age of seventy-six years at baseline. Through the health promotion project, participants were offered low cost diagnostic and preventive services on a sliding fee basis. At twenty-four months, subjects' records were abstracted regarding the receipt of dental hygiene, transportation, emergency, diagnostic, restorative, and prosthodontic services. Subjects were also asked about dental expenditures in the previous year and the type of dental care received, regardless of the source of care. The mean change in GOHAI scores from baseline to the twenty-four-month interview was 2.2 (std. dev. 6.6) and ranged from -15 to 30. Findings suggest that the GOHAI is sensitive to the provision of dental care, although additional research is needed to understand the impact of various dental services on the individual items of the GOHAI, as well as the overall index score. The potential applications of self-reported oral health outcome measures such as the GOHAI in dental education are discussed.

Development of the Geriatric Oral Health Assessment Index

The development of measures for assessing oral health status is essential to the evolution and maturation of a scientific knowledge base in geriatric dentistry. The literature suggests a high prevalence of dental diseases in older adults, yet valid and reliable instruments to assess the impact of oral diseases on older individuals or populations are lacking. This paper describes the rationale for and the development of the Geriatric Oral Health Assessment Index (GOHAI), a self-reported measure designed to assess the oral health problems of older adults. Following a review of the literature and consultation with health care providers and patients, a pilot instrument was developed. The GOHAI was initially tested on a convenience sample of 87 older adults. A revised instrument was then administered to a sample of 1755 Medicare recipients in Los Angeles County. The GOHAI demonstrated a high level of internal consistency and reliability as measured by a Cronbach's alpha of 0.79. Associations of the GOHAI with a single-item rating of dental health and with clinical and sociodemographic supported the construct validity of the index. Having fewer teeth, wearing a removable denture and perceiving the need for dental treatment were significantly related to a worse (lower) GOHAI score. Respondents who were white, well educated, and with a higher annual household income were more likely to have a high GOHAI score, indicating fewer dental problems. Additional applications of the GOHAI are necessary to further evaluate the instrument's validity and reliability, and to establish population norms of oral health in older adult populations as measured by the GOHAI.