Insights Into Associations Between Oral and General Health Outcomes of Nursing Home Residents Based on InterRAI Data: Cross-Sectional Study.

Abstract

Background: Oral health of nursing home residents is generally poor, largely due to age-related conditions that increase their vulnerability and make them more dependent on others for oral care. Poor oral health can significantly impact general health and well-being, highlighting the important role of caregivers in preventing, detecting, and addressing residents' oral health problems in time. The interRAI Suite of instruments, widely used for comprehensive health assessments, offers the opportunity for nondental caregivers to assess oral health as part of general health and well-being and facilitates the integration of oral health in general care planning.

Objective: Based on interRAI data, this study explored the associations between oral health and general health outcomes of nursing home residents in Flanders (Belgium) and the Netherlands.

Methods: This cross-sectional study included baseline interRAI assessments of 2362 Flemish and Dutch residents aged 65 years and older, collected by caregivers (eg, nurses, nurse aids) between October 2020 and February 2024. Validated outcome scales (eg, Activities of Daily Living Hierarchy Scale, Cognitive Performance Scale, and Depression Rating Scale), health conditions such as diabetes and low weight (BMI ≤19), and family support and participation in social activities, included in the interRAI instrument, provided information on residents' general health and well-being. Oral health was defined according to the 9 items of the optimized Oral Health Screener (OHS) for use in the interRAI instruments. Adjusted logistic regression models were used to explore the associations between oral and general health outcomes.

Results: Oral health problems were interconnected, with conditions in one oral structure impacting the health of others. When controlling for confounding variables, dependency on others for personal care and hygiene was significantly associated with poor oral hygiene (odds ratio [OR] 1.7, 95% CI 1.1-2.4), chewing difficulties (OR 2.2, 95% CI 1.3-3.5), compromised teeth (OR 1.7, 95% CI 1.1-2.5), and the need for dental referral (OR 1.8, 95% CI 1.4-2.3). Natural dentition and gender had a significant impact on oral health status. Low weight was associated with poor chewing function (OR 2.0, 95% CI 1.1-3.6) and dry mouth (OR 1.8, 95% CI 1.0-3.2), both associated with oral discomfort or pain (OR 6.8, 95% CI 3.3-14.0 and OR 3.5, 95% CI 1.8-6.9, respectively). Family support was identified as a facilitator in mitigating oral health problems.

Conclusions: The interRAI instrument, including the OHS, is a valuable tool for monitoring residents' health and identifying areas requiring additional support. The results demonstrated the importance of prioritizing oral health as an integral component of comprehensive care. Recognizing the interconnection between oral health and other health conditions, including indicators of well-being, can guide caregivers and other health care professionals in incorporating preventive and supportive oral care practices into daily care routines, contributing to improved resident health and well-being outcomes.