Multimorbidity and polypharmacy in older adults, and their impact on oral health-related quality of life

Document Type : Original Article

Authors

1 Student Research Committee, Babol University of Medical Sciences, Babol, Iran

2 Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

3 Oral Health Research Center, Babol University of Medical Sciences, Babol, Iran

Abstract

Background: The term oral health-related quality of life (OHRQOL) was used since the early 1980s. This research examines the relationship between multimorbidity, polypharmacy, and oral health-related quality of life (OHRQOL) among older adults.
Methods: This cross-sectional research was conducted among older adults ( ≥ 60) living in Amirkola, northern Iran. Demographic characteristics, the number of drugs consumed, and the presence of comorbid disorders were collected through direct interviews. Consuming five or more drugs was defined as polypharmacy, and the simultaneous presence of three or more chronic diseases was recorded as multimorbidity. Dental specialists examined the older adults, and the Geriatric Oral Health Assessment Index (GOHAI) was used to assess the OHRQOL.
Results: A total of 800 older adults, including 433 (54.1%) men and 367 (45.9%) women, with a mean age of 69.30 ± 7.03 years, were included. The mean number of comorbidities was 3.74 ± 2.27, and the mean number of consumed drugs was 3.74 ± 3.09. The average OHRQOL score was 51.36 ± 7.25. Multivariable regression analysis revealed that the effect of multimorbidity on OHRQOL was significant (adjusted OR = 1.803; 95% CI = 1.239-2.622; P = 0.002). However, polypharmacy had no such significant effect (Adjusted OR = 1.016; 0.697-1.482, P = 0.934).
Conclusion: Considering that 66.1% of older adults had multimorbidity, which significantly impacted oral health-related quality of life, health service providers must pay attention to maintaining and improving the oral health of older people.

Keywords

Main Subjects

References

1. Ferrillo M, Migliario M, Agostini F, Marotta N, Santilli G,
Boffano P, et al. Oral health-related quality of life in elderly: an
umbrella review of systematic reviews from a multidisciplinary
rehabilitation point-of-view. Clin Ter. 2024;175(1):73-82. doi:
10.7417/ct.2024.5036.
2. Dahmardeh A, Yazdani R, Pakdaman A, Shamshiri AR. Oral
health literacy and oral health behaviors of disadvantaged
women residing in the slum area of Zahedan, Iran: a crosssectional
study. J Oral Health Oral Epidemiol. 2024;13(3):127-
32. doi: 10.34172/johoe.2312.1604.
3. Tahani B, Baghban AA, Kazemian A. Determinants of oral
health status: an ecological study in Iran. BMC Oral Health.
2023;23(1):910. doi: 10.1186/s12903-023-03557-z.
4. Ravaghi V, Kazemian A. Rethinking dental care in Iran. J
Oral Health Oral Epidemiol. 2022;11(1):1-4. doi: 10.22122/
johoe.2022.197262.1462.
5. Shoaee S, Sharifi F, Ghavidel Parsa P, Sobhaninejad S, Heydari
MH, Sofi-Mahmudi A. Dental caries among the elderly in Iran:
a meta-analysis. Med J Islam Repub Iran. 2024;38:11. doi:
10.47176/mjiri.38.11.
6. Azami-Aghdash S, Pournaghi-Azar F, Moosavi A, Mohseni
M, Derakhshani N, Alaei Kalajahi R. Oral health and related
quality of life in older people: a systematic review and metaanalysis.
Iran J Public Health. 2021;50(4):689-700. doi:
10.18502/ijph.v50i4.5993.
7. Wong FM, Ng YT, Leung WK. Oral health and its associated
factors among older institutionalized residents-a systematic
review. Int J Environ Res Public Health. 2019;16(21):4132.
doi: 10.3390/ijerph16214132.
8. Deana NF, Pardo Y, Ferrer M, Espinoza-Espinoza G, Garin
O, Muñoz-Millán P, et al. Evaluating conceptual model
measurement and psychometric properties of oral healthrelated
quality of life instruments available for older adults: a
systematic review. Health Qual Life Outcomes. 2024;22(1):5.
doi: 10.1186/s12955-023-02218-7.
9. Navabi N, Hashemi NS, Hashemipour MA, Samierad S,
Salari H, Gandjalikhan-Nassab A. Quality of life associated
with oral health in smokers and non-smokers. J Oral Health
Oral Epidemiol. 2021;10(3):168-74. doi: 10.22122/johoe.
v10i3.1165.
10. Torres-Vanegas M, Cardona-Arango D. Oral healthrelated
quality of life in older adults in a health program in
Envigado, Colombia, 2018. Rev Fac Odontol Univ Antioq.
2020;32(1):36-47. doi: 10.17533/udea.rfo.v32n1a4.
11. Chen S, Wang S, Jia W, Han K, Song Y, Liu S, et al.
Spatiotemporal analysis of the prevalence and pattern of
multimorbidity in older Chinese adults. Front Med (Lausanne).
2021;8:806616. doi: 10.3389/fmed.2021.806616.
12. Gao S, Sun S, Sun T, Lu T, Ma Y, Che H, et al. Chronic diseases
spectrum and multimorbidity in elderly inpatients based on a
12-year epidemiological survey in China. BMC Public Health.
2024;24(1):509. doi: 10.1186/s12889-024-18006-x.
13. Marzban M, Jamshidi A, Khorrami Z, Hall M, Batty JA, Farhadi
A, et al. Determinants of multimorbidity in older adults in
Iran: a cross-sectional study using latent class analysis on
the Bushehr Elderly Health (BEH) program. BMC Geriatr.
2024;24(1):247. doi: 10.1186/s12877-024-04848-y.
14. The Academy of Medical Sciences. Multimorbidity: A Priority
for Global Health Research. 2018. Available from: https://
acmedsciacuk/file-download/82222577.
15. Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What
is polypharmacy? A systematic review of definitions. BMC
Geriatr. 2017;17(1):230. doi: 10.1186/s12877-017-0621-2.
16. Kurczewska-Michalak M, Lewek P, Jankowska-Polańska
B, Giardini A, Granata N, Maffoni M, et al. Polypharmacy
management in the older adults: a scoping review of available
interventions. Front Pharmacol. 2021;12:734045. doi:
10.3389/fphar.2021.734045.
17. Watt RG, Serban S. Multimorbidity: a challenge and opportunity
for the dental profession. Br Dent J. 2020;229(5):282-6. doi:
10.1038/s41415-020-2056-y.
18. Gill B, Harris A, Tredwin C, Gill P. Multimorbidity and oral
health: need for new models of care. Fam Med Community
Health. 2020;8(4):e000387. doi: 10.1136/fmch-2020-000387.
19. Ramírez L, Sánchez I, González-Serrano J, Muñoz M,
Martínez-Acitores ML, Garrido E, et al. Factors influencing
xerostomia and oral health-related quality of life in
polymedicated patients. Gerodontology. 2024;41(3):424-32.
doi: 10.1111/ger.12724.
20. Jamalinasab A, Tahani B, Maracy MR, Keshvari M. Oral health
and oral health-related quality of life among elderly people
in Iran. Iran J Nurs Midwifery Res. 2024;29(2):217-23. doi:
10.4103/ijnmr.ijnmr_16_23.
21. Bijani A, Ghadimi R, Mikaniki E, Kheirkhah F, Mozaffarpur
SA, Motallebnejad M, et al. Cohort profile update: the
Amirkola Health and Ageing Project (AHAP). Caspian J Intern
Med. 2017;8(3):205-12. doi: 10.22088/cjim.8.3.205.
22. Nikbin A, Bayani M, Jenabian N, Khafri S, Motallebnejad
M. Oral health-related quality of life in diabetic patients:
comparison of the Persian version of Geriatric Oral Health
Assessment Index and Oral Health Impact Profile: a descriptiveanalytic
study. J Diabetes Metab Disord. 2014;13(1):32. doi:
10.1186/2251-6581-13-32.
23. Mirhosseini N, Shoorgashti R, Lesan S. The evaluation of
clinical factors affecting oral health impacts on the quality of
life of Iranian elderly patients visiting dental clinics: a crosssectional
study. Spec Care Dentist. 2024;44(4):1219-27. doi:
10.1111/scd.12980.
24. Kanungo S, Ghosal S, Kerketta S, Sinha A, Mercer SW, Lee JT,
et al. Association of oral health with multimorbidity among
older adults: findings from the longitudinal ageing study in
India, wave-1, 2017-2019. Int J Environ Res Public Health.
2021;18(23):12853. doi: 10.3390/ijerph182312853.
25. Schmidt-Mende K, Arvinge C, Cioffi G, Gustafsson LL, Modig
K, Meyer AC. Profiling chronic diseases and hospitalizations
in older home care recipients: a nationwide cohort study in
Sweden. BMC Geriatr. 2024;24(1):312. doi: 10.1186/s12877-
024-04796-7.
26. Ramien AS, Azmi AA, Ravichandran S, Wai Li TT, Ravendran
S, Kyaw Soe HH, et al. Oral health-related quality of life
among non-institutionalized elderly in Malaysia: a teaching
hospital-based survey. Cureus. 2024;16(3):e56202. doi:
10.7759/cureus.56202.
27. Mohamad Fuad MA, Yacob H, Mohamed N, Wong NI.
Association of sociodemographic factors and self-perception
of health status on oral health-related quality of life among
the older persons in Malaysia. Geriatr Gerontol Int. 2020;20
Suppl 2:57-62. doi: 10.1111/ggi.13969.
28. Chahar P, Mohanty VR, Aswini YB. Oral health-related
quality of life among elderly patients visiting special clinics
in public hospitals in Delhi, India: a cross-sectional study.
Indian J Public Health. 2019;63(1):15-20. doi: 10.4103/ijph.
IJPH_316_17.
29. Ye L, Yang-Huang J, Franse CB, Rukavina T, Vasiljev V,
Mattace-Raso F, et al. Factors associated with polypharmacy
and the high risk of medication-related problems among
older community-dwelling adults in European countries:
a longitudinal study. BMC Geriatr. 2022;22(1):841. doi:
10.1186/s12877-022-03536-z.
30. Hassan BH, Abd El Moniem MM, Dawood SS, Alsultan AA,
Abdelhafez AI, Elsakhy NM. Dental anxiety and oral-healthrelated
quality of life among rural community-dwelling older
adults. Int J Environ Res Public Health. 2022;19(13):7643. doi:
10.3390/ijerph19137643.
31. Teng CJ, Lin SC, Chen JH, Chen Y, Kuo HC, Ho PS.
The association between denture self-satisfaction rates
and OHRQoL - a follow-up study. BMC Oral Health.
2020;20(1):140. doi: 10.1186/s12903-020-01119-1.
Journal of Oral Health and Oral Epidemiology
Volume 14, Issue 1
January 2025
Pages 1-7

Files

History

  • Receive Date: 04 February 2025
  • Revise Date: 17 May 2025
  • Accept Date: 24 May 2025

Share

How to cite

Statistics