Search

In later life, optimistic health appraisals promote well-being and survival, whereas pessimistic appraisals can be harmful. This study contrasted subjective health (SH) appraisals with objective health (OH) to identify realists, whose ratings were congruent (SH = OH), distinguishing them from health pessimists (SH OH) and health optimists (SH OH) with incongruent ratings. Health congruence and functional well-being of 757 older adults were assessed via two interviews conducted 5 years apart. We examined consistency in health congruence, and among those with persistent OH, we examined 5-year functional well-being changes that corresponded with SH shifts and determined whether SH shifts predicted 30-month survival. Most realists remained realists; health optimists and pessimists tended to become realists. Increased health optimism corresponded with enhanced functioning; increased pessimism corresponded with decreased functioning. Among realists, increasingly positive SH predicted survival. Findings have implications for quality and length of life among older adults with chronic health conditions.

–Objectives: This paper compares the performance of the GOHAI and the OHIP-14 as measures of the oral health-related quality of life of the compromised elderly. Methods: Data were obtained from a cross-sectional survey of 225 participants, most of whom lived in a large geriatric care centre. Results: The mean age of subjects was 83 years and the majority had one or more chronic medical conditions and physical disabilities. Their main oral problems were high rates of tooth loss and xerostomia. Additive and simple count methods were used to derive GOHAI and OHIP-14 scores. Using the additive method, 8.4% had a GOHAI score of zero and 30.3% an OHIP-14 score of zero. Using the simple count method the percentage with a score of zero was 15.1% and 45.8%. Both measures discriminated between dentate subjects with and without one or more dentures, with and without a chewing problem and with and without dry mouth. Both also showed significant associations with self-rated oral health and satisfaction with oral health status. Associations tended to be stronger between GOHAI scores and these variables. The measures were equally good at predicting overall psychological well-being and life satisfaction. Although the GOHAI identified more oral functional and psychosocial impacts than the OHIP-14, neither was markedly superior to the other when used as discriminatory measures. However, the high prevalence of subjects with zero scores may compromise the ability of the OHIP-14 to detect within-subject change.

Defining oral self-care as activities undertaken by individuals to maintain or promote dental health, this paper examines the distribution of oral self-cure behaviours in a sample of dentate adults, age 50 and over, living in Ontario, Canada (n= 713). Results are presented separately for two older cohorts, respondents ages 50–64 and those 65 and older, and for females and males. Six oral self-care behaviours were examined: toothbrushing, flossing, use of an interdental device, extra fluoride use, frequency of between meal snacks and ingestion of cariogenic foods. High males of self-care occurred only for tooth brushing. Age groups differed significantly for use of interdental devices, consumption of cariogenic foods and snacking between meals while gender differences were found for tooth brushing, flossing and consuming sweet foods. The need to target older adults and especially older males for oral hygiene information and instruction in order to counteract possible misleading beliefs learned before the advent of current Dental hygiene practices is apparent from these data.