Background The impact of poor oral health on older adults’ quality of life is a public health problem. In this study, the mediating effects of dental status, occlusal condition, dysphagia, and masticatory performance on the association between xerostomia and oral health-related quality of life (OHRQoL) were assessed in the older adult population. Methods Stratified cluster sampling was used to recruit 1076 community-dwelling adults aged 65 years and older from Kaohsiung, Taiwan. Community care centers were randomly selected according to their geographic classifications (urban, rural, or mountainous areas). Assessments of dental status and occlusal condition were performed by dentists. Information on demographics, physical function, xerostomia, dysphagia and depression was collected through face-to-face interviews. Masticatory performance was evaluated using color-changeable chewing gum. OHRQoL was measured using the Geriatric Oral Health Assessment Index. Hierarchical regression models were used to assess the relationships between OHRQoL and physical function, dental status and oral function in older adults. Path analysis was used to estimate direct and indirect pathways between xerostomia and OHRQoL. Results Participants with xerostomia exhibited a 0.20 OHRQoL reduction (p < .001) compared with patients with no xerostomia, and the direct effect accounted for 83.3% of the total effect. Dysphagia and masticatory performance were found to exert significant mediating effects on the association between xerostomia and OHRQoL (βs = 0.20 and − 0.12, respectively; both p < .001; βs = 0.06 and − 0.09, respectively; both p < .05). Moreover, potential mediating effects of the number of functional teeth (βs = − 0.11 and − 0.43, respectively; both p < .001) and occlusal condition (βs = 0.09 and 0.13, respectively; both p < .05) on the relationship between xerostomia and masticatory performance were noted. Conclusions Dysphagia and masticatory performance may serve as pathways through which xerostomia affects quality of life. Early oral function intervention may be a valuable and actionable target for older adults to maintain quality of life. Our results further suggest that checkup and screening for oral dysfunction are essential to prevent or delay the onset of complications.

Background: The impact of poor oral health in older adults affecting their quality of life is a public health problem. This study assessed the mediating effects of dental status, occlusal condition, dysphagia and masticatory performance on the association between xerostomia and oral health-related quality of life (OHRQoL) in the older population. Methods: Stratified cluster sampling method was used to recuit 1100 community-dwelling adults aged 65 years and older from Kaohsiung, Taiwan. Community care centers were randomly selected based on their geographic classifications (urban, rural, and mountainous areas). Assessments of dental status and occlusal condition were performed by dentists. Information on demographics, physical function, xerostomia dysphagia and depression was collected using face-to-face interview. Masticatory performance was evaluated using color-changeable chewing gum. OHRQoL was measured using Geriatric Oral Health Assessment Index. Hierarchical regression models were utilized to assess the relationship between OHRQoL and physical function, dental status and oral function in older adults. Path analysis was used to estimate direct and indirect pathways between xerostomia and OHRQoL.Results: Participants with xerostomia had a 0.17 OHRQoL reduction (p< .001) comparing to the non-xerostomia, and the direct effect was accounted for 85.0% of the total effect. The dysphagia and the poor masticatory performance were found to have a significant mediating effect on the association between xerostomia and OHRQoL (βs = 0.17 and −0.09, respectively, both p< .001; βs = 0.05 and −0.08, respectively, both p< .001) moreover, potential mediating influences of the number of functional teeth (βs = −0.11 and −0.44, respectively, both p < .001) and poor occlusal condition (βs = 0.09 and 0.12, respectively, both p < .05) on the relationship between xerostomia and masticatory performance were obervered.Conclusions: Dysphagia and poor masticatory performance may serve as a pathway of which xerostomia affects quality of life. Providing early oral function intervention may be a valuable and actionable target for older adults to maintain their quality of life. Our results further suggest that checkup and screening for oral dysfunction is essential to prevent or delay the onset of complications.

Background: The adverse impact of poor oral conditions in older adults on their quality of life is a public health problem. This study assessed the mediating effects of dental status, occlusal condition, dysphagia and masticatory performance on the association between xerostomia and oral health-related quality of life (OHRQoL) in the older population. Methods: A total of 1100 representative community-dwelling adults aged 65 years and older were recruited from a large-scale survey conducted in Kaohsiung, Taiwan. Dental status and occlusal condition were performed by dentists. Information on demographics, physical function, xerostomia, and dysphagia was collected using face-to-face interview. Masticatory performance was evaluated using color-changeable chewing gum. OHRQoL was measured using Geriatric Oral Health Assessment Index. Results: Comparing with non-xerostomia, participants with xerostomia had a 0.20 decrease in the level of OHRQoL (p< .001), and the direct effect was accounted for 83.3% of the total effect. The dysphagia and the masticatory performance were found to have a significant mediating effect on the association between xerostomia and OHRQoL (βs = 0.20 and −0.13, respectively; βs = 0.05 and −0.08, respectively) and 10.8% of the effect was attributed to dysphagia mediation. Furthermore, the functional teeth and occlusal condition had a significant mediating effect on the association between xerostomia and masticatory performance , and the functional teeth was accounted for 43.6% of the effect. Conclusions: Xerostomia had the greatest effect on OHRQoL. The mediating role of dysphagia and masticatory performance on the association between xerostomia and OHRQoL was significant and deserves further attention. Older adults could improve their OHRQoL through a community-based oral function intervention. Our results further suggest that early screening for swallowing and masticatory function is essential to prevent or delay the onset of complications.

Background: The impact of poor oral health on older adults’ quality of life is a public health problem. In this study, the mediating effects of dental status, occlusal condition, dysphagia, and masticatory performance on the association between xerostomia and oral health-related quality of life (OHRQoL) were assessed in the older adult population. Methods: Stratified cluster sampling was used to recuit 1076 community-dwelling adults aged 65 years and older from Kaohsiung, Taiwan. Community care centers were randomly selected according to their geographic classifications (urban, rural, or mountainous areas). Assessments of dental status and occlusal condition were performed by dentists. Information on demographics, physical function, xerostomia, dysphagia and depression was collected through face-to-face interviews. Masticatory performance was evaluated using color-changeable chewing gum. OHRQoL was measured using the Geriatric Oral Health Assessment Index. Hierarchical regression models were used to assess the relationships between OHRQoL and physical function, dental status and oral function in older adults. Path analysis was used to estimate direct and indirect pathways between xerostomia and OHRQoL.Results: Participants with xerostomia exhibited a 0.20 OHRQoL reduction (p < .001) compared with patients with no xerostomia, and the direct effect accounted for 83.3% of the total effect. Dysphagia and masticatory performance were found to exert significant mediating effects on the association between xerostomia and OHRQoL (βs = 0.20 and −0.12, respectively; both p < .001; βs = 0.06 and −0.09, respectively; both p < .05). Moreover, potential mediating effects of the number of functional teeth (βs = −0.11 and −0.43, respectively; both p < .001) and occlusal condition (βs = 0.09 and 0.13, respectively; both p < .05) on the relationship between xerostomia and masticatory performance were noted.Conclusions: Dysphagia and masticatory performance may serve as pathways through which xerostomia affects quality of life. Early oral function intervention may be a valuable and actionable target for older adults to maintain quality of life. Our results further suggest that checkup and screening for oral dysfunction are essential to prevent or delay the onset of complications.