Objective: To describe subjective oral health status and its association with overall health conditions and socioeconomic factors in the elderly (60 years and older) living in the capital cities with the oldest average populations in South America. Background: Oral diseases are a public health problem, frequently neglected in older adults. In recent years, the subjective assessment of psychological and social consequences of the problems related to oral health has been valued. One of the instruments used to estimate the Oral Health‐Quality of Life is the Geriatric Oral Health Assessment (GOHAI). Material and methods: Representative samples from SABE study (1999–2000) of Santiago (n = 1301), Buenos Aires (n = 1043), and Montevideo (n = 1450) aged 60 and over community‐dwelling people. We assessed OH‐QoL (GOHAI), self‐reported missing teeth, denture use, and self‐rated‐health, among other indicators. Logistic regression models(GOHAI < 58) for each city, adjusted by sex and age, were applied. Results: GOHAI average scores were higher in Montevideo (54.8 ± 6.1) than in Buenos Aires (53.1 ± 7.4) and Santiago (49.9 ± 8.6). A pronounced gradient of the oral condition and GOHAI scores were observed within the three‐cities. Denture use ‐less prevalent in Santiago and more common among women‐ is a protective factor against a poor OH‐QoL. Conclusion: Socioeconomic inequalities in oral health status and OH‐QoL are observed in the three cities. The increasing life expectancy emphasizes the need to integrate prevention and treatment efforts, as a way to improve OH‐QoL over the course of a lifetime.
To validate short-form-36 health survey (SF-36) with specific scoring algorithm obtained in a large sample of Chilean older people and to associate quality of life in this sample with social and health related factors. A cross-sectional study on 2,143 community-living subjects aged 60-92 years (33 % men and 67 % women) conducted in Santiago, Chile. Scores in 8 scales of SF-36-physical function (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE) and mental health (MH)-, were calculated. Factor analysis was used to extract two principal factors and logistic regression model was applied to estimate its association with socio-demographic and health variables. The internal consistency of scales was high (Cronbach's alpha 0.86-0.87). Factor analysis retained two factors: mental (MCS) and physical (PCS) components accounting for 65.3 % of total variance (55.3 and 10.0 % respectively). High correlations (0.61-0.94) between MCS and MH, V, RE and SF were obtained. PCS correlated highest (0.72-0.86) with RP, PF and BP. Self-perceived symptoms of depression (GDS-15 C5) was the main variable explaining low scores in both MCS and PCS (adjusted OR = 26.9; 95 % CI: 15.3-47.2; OR = 3.4; 95 % CI: 2.1-5.5, respectively). We have demonstrated the reliability and validity of SF-36 questionnaire to evaluate health related quality of life, reporting Chilean-Specific factor score coefficients for MCS and PCS based in national Chilean means and standard deviations for older people. After adjusting by age and gender, the main predictors of low health related QoL in Chilean older people were selfperceived symptoms of depression, the presence of two or more chronic diseases and illiteracy. Important gender inequalities were observed in all of these results, being consistently less favorable in women than in men.
This study corroborates the social stratification of functional status and mortality, suggesting that aging is not a leveler of inequalities. In Latin-American countries, policies should aim to reduce inequalities by attempting to limit exposure to risk factors and to compensate for deficiencies (especially among the poorest older people) in order to prevent the progression of functional impairment to disability.
BackgroundPrevious studies on the role of gender in the association between self-rated health and mortality have shown contrasting results. This study was aimed to determine the importance of gender in the association between self-rated health and mortality among older people in Santiago, Chile.MethodsA 10 year follow-up of 1066 people aged 60 or more, from the Chilean cohort of the Study of Health, Ageing and Well-Being. Self-rated health was assessed in face to face interviews through a single general question, along with socio-demographic and health status information. Cox proportional hazards and flexible parametric models for survival analyses were employed.ResultsBy the end of follow-up, 30.7% of women and 39.4% of men died. Adjusted hazard ratio of poor self-rated health, compared to good self-rated health, was 1.92(95% CI 1.29–2.86). In models stratified by gender, an increased risk of mortality was observed among women who rated their health as poor (HR = 2.21, 95% CI 1.43–3.40), but not among men (HR = 1.04, 95% CI 0.58–1.86). Age was associated with mortality in both groups; for men, functional limitation and underweight were also risk factors and obesity was a protective factor.ConclusionsCompared to older women who rated their health as good, older women who rated their health as poor had a 2 fold increased risk of mortality over the subsequent 10 years. These findings stress the importance of considering a gender perspective into health programmes, including those focused on older people, in order to address the different elements that increase, on the long run, the risk of dying among older women and men.
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