Review Article

Oral Health and Related Quality of Life in Older People: A Sys-tematic Review and Meta-Analysis


Background: Of the most important implications and complaints in the elderly group of the population, is oral and dental health problems. This study aimed to assess oral health- related quality of life in older people.

Methods: To data collection, databases were searched including PubMed, EMBASE, Scopus, SID, MagIran, Cochrane Central Register of Controlled Trials and scholar google The keywords were “older adults", “Geriatric” Elderly", "Older", “Aged”, "Ageing", "Oral health", "Oral hygiene" and "Quality of life", "QOL. For manual searching, several specialized journals of related scope as well as the finalized articles' reference list were searched. Studies from 1st Jan 2000 to 30th Jan 2017 were included. Studies were subjected to meta-analysis to calculate indexes, using CMA:2 (Comprehensive Meta-Analysis) software.

Results: Totally, 3707 articles were searched that 48 of them were subjected to the oral and dental health-related quality of life in 59 groups of the elderly population with the mean age of 73.57+6.62 in the 26 countries. The obtained percentage values of dental and oral health were 80.2% (0-60), 14.8% (0-12), 16.4% (0-70), 22% (0-14 or 0-59) and 19.2% (0-196) for GOHAI with the additive method, GOHAI with Simple Count Method, OHIP-14 with the additive method, OHIP-14 with Simple Count method and OHIP-49 with additive method indexes, respectively.

Conclusion: The elderly group of the population had no proper oral health-related quality of life. Regarding the importance and necessity of oral and dental health and its effect on general health care in the target group, it is recommended to improve dental hygiene in the mentioned group of population.

Lutz W, Sanderson W, Scherbov S (2008).The coming acceleration of global population ageing. Nature. 451(7179):716-9.
2. Kinsella KG, Phillips DR (2005). Global aging: The challenge of success. Population Bulletin, 60(1): 3-40.
3. Beard HPJR, Bloom DE (2015).Towards a comprehensive public health response to population ageing. Lancet, 385(9968):658-661.
4. Suzman R, Beard JR, Boerma T, et al (2015).Health in an ageing world—what do we know? Lancet, 385(9967):484-6.
5. Reider N, Gaul C (2016). Fall risk screening in the elderly: A comparison of the min-imal chair height standing ability test and 5-repetition sit-to-stand test. Arch Gerontol Geriat, 65:133-9.
6. Kabeshova A, Launay CP, Gromov VA, et al (2016). Falling in the elderly: Do statis-tical models matter for performance crite-ria of fall prediction? Results from two large population-based studies. Eur J In-tern Med, 27:48-56.
7. Swoboda J, Kiyak HA, Persson RE, et al (2006). Predictors of oral health quality of life in older adults. Spec Care Dentist, 26(4):137-44.
8. Da Mata C, Cronin M, O’Mahony D, et al (2015). Subjective impact of minimally in-vasive dentistry in the oral health of older patients. Clin Oral Investig, 19(3):681-7.
9. Karki A, Monaghan N, Morgan M (2015). Oral health status of older people living in care homes in Wales. Br Dent J, 219(7):331-4.
10. Baghaie H, Kisely S, Forbes M, et al (2017). A systematic review and meta‐analysis of the association between poor oral health and substance abuse. Addiction, 112(5):765-779.
11. Lacruz RS, Habelitz S, Wright JT, et al (2017). Dental enamel formation and im-plications for oral health and disease. Physiol Rev, 97(3):939-993.
12. Nazar H, Al-Mutawa S, Ariga J, et al (2014). Caries prevalence, oral hygiene, and oral health habits of Kuwaiti infants and tod-dlers. Med Princ Pract, 23(2):125-8.
13. Marino R, Albala C, Sanchez H, et al (2015). Prevalence of diseases and conditions which impact on oral health and oral health self-care among older chilean. J Aging Health, 27(1):3-16.
14. Kobayashi N, Soga Y, Maekawa K, et al (2017). Prevalence of oral health‐related conditions that could trigger accidents for patients with moderate‐to‐severe demen-tia. Gerodontology, 34(1):129-34.
15. Kwan SY, Petersen PE, Pine CM, et al (2005). Health-promoting schools: an opportunity for oral health promotion. Bull World Health Organ, 83(9):677-85.
16. Bozdemir E, Yilmaz H, Orhan H (2016). General health and oral health status in elderly dental patients in Isparta, Turkey. East Mediterr Health J, 22(8):579-585.
17. Freitas YN, Lima KC, Silva DAd (2016). Oral health status and functional capacity in the elderly: a longitudinal population-based study. Rev Bras Epidemiol, 9(3):670-674.
18. Joseph AG, Janakiram C, Mathew A (2016). Prosthetic Status, Needs and Oral Health Related Quality of Life (OHRQOL) in the Elderly Population of Aluva, India. J Clin Diagn Res, 10(11):ZC05-ZC09.
19. Costa MJF, Lins CAdA, Macedo LPVd, et al (2019). Clinical and self-perceived oral health assessment of elderly residents in urban, rural, and institutionalized communities. Clinics (Sao Paulo), 74: e972.
20. Paredes-Rodríguez V-M, Torrijos-Gómez G, González-Serrano J, et al (2016). Quality of life and oral health in elderly. J Clin Exp Dent, 8(5): e590–e596.
21. Jafari-Shobeiri M, Ghojazadeh M, Azami-Aghdash S, et al (2015).Prevalence and risk factors of gestational diabetes in Iran: a systematic review and meta-analysis. Iran J Public Health, 44(8):1036-44.
22. Camelo LdV, Giatti L, Barreto SM (2016).Health related quality of life among elderly living in region of high vulnerability for health in Belo Horizonte, Minas Gerais, Brazil. Rev Bras Epidemiol, 19(2):280-93.
23. Kaier K, Gutmann A, Baumbach H, et al (2016).Quality of life among elderly patients undergoing transcatheter or surgical aortic valve replacement–a model-based longitudinal data analysis. Health Qual Life Outcomes, 14:109.
24. Kleczyński P, Bagieński M, Dziewierz A, et al (2016).Twelve-month quality of life improvement and all-cause mortality in elderly patients undergoing transcatheter aortic valve replacement. Int J Artif Organs, 39(8):444-449.
25. Kaplan RM, Ries AL (2007).Quality of life: concept and definition. COPD, 4(3):263-71.
26. Sandau KE, Hoglund BA, Weaver CE, et al (2014).A conceptual definition of quality of life with a left ventricular assist device: results from a qualitative study. Heart Lung, 43(1):32-40.
27. Xavier FM, Ferraz M, Marc N, et al (2003).Elderly people s definition of quality of life. Braz J Psychiatry, 25(1):31-9.¬
28. Yaghoubi A, Tabrizi J-S, Mirinazhad M-M, et al (2012).Quality of life in cardiovascular patients in iran and factors affecting it: a systematic review. J Cardiovasc Thorac Res, 4(4):95-101.
29. Maleki MR, Derakhshani N, Azami-Aghdash S, et al (2020).Quality of Life of People with HIV/AIDS in Iran: A Systematic Review and Meta-Analysis. Iran J¬ Public Health, 49(8):1399-1410.
30. Azami-Aghdash S, Gharaee H, Aghaei MH, et al (2019).Cardiovascular diseases patient's Quality of Life in Tabriz-Iran: 2018. Journal of Community Health Research,8(4):245-252.
31. Azami-Aghdash S, Ghojazadeh M, Naghavi-Behzad M, et al (2019).A pilot study of fear of disease consequences and its relationship with quality of life, depression and anxiety in patients with multiple sclerosis. International Archives of Health Sciences, 6(3):132-135.
32. Alcarde ACB, Bittar TO, Fornazari DH, et al (2010).A cross-sectional study of oral health-related quality of life of Piracicaba's elderly population. Rev odonto ciênc, 25(2):126-31.
33. Atchison KA, Dolan TA (1990).Development of the geriatric oral health assessment index. J Dent Educ,¬ 54(11):680-7.
34. Cousson PY, Bessadet M, Nicolas E, et al (2012).Nutritional status, dietary intake and oral quality of life in elderly complete denture wearers. Gerodontology, 29(2):e685-92.
35. Kshetrimayum N, Reddy CV, Siddhana S, et al (2013).Oral health-related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore City, India. Gerodontology, 30(2):119-25.
36. Khan K, Kunz R, Kleijnen J, et al (2011). Systematic reviews to support evidence-based medicine. 2nd ed, Crc Press.
37. Von Elm E, Altman DG, Egger M, et al (2014).The Strengthening the Reporting of Observ¬ational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg, 12(12):1495-9.
38. Poorolajal J, Tajik P, Yazdizadeh B, et al (2009).Quality assessment of the reporting of cohort studies before STR-OBE statement. Iranian journal of epidemiology, 5(1):17-26.
39. Von Elm E, Altman DG, Egger M, et al. (2007).The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med,¬ 147(8):573-7.
40. Vandenbroucke JP, Von Elm E, Altman DG, et al (2007).Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. PLoS Med, 4(10):e297.
41. Kiyak HA (2008).Does orthodontic treatment affect patients’ quality of life? J Dent Educ,¬ 72(8):886-94.
42. Allen PF, Locker D (1997).Do item weights matter? An assessment using the oral health impact profile. Community Dent Health,¬ 14(3):133-8.
43. Locker D, Matear D, Stephens M, et al (2001).Comparison of the GOHAI and OHIP‐14 as measures of the oral health‐related quality of life of the elderly¬¬. Community Dent Oral Epidemiol, 29(5):373-81.
44. Petričević N, Čelebić A, Papić M, et al (2009).The Croatian version of the oral health impact profile questionnaire. Coll antropol, 33(3):841-7.
45. Kranjčić J, Mikuš A, Peršić S, et al (2014).Factors affecting oral health–related quality of life among elderly Croatian patients. Acta Stomatol Croat, 48(3):174-82.
46. Locker D, Matear D, Stephens M, et al (2001).Comparison of the GOHAI and OHIP-14 as measures of the oral health-related quality of life of the elderly. Community Dent Oral Epidemiol, 29(5):373-81.
47. Motallebnejad M, Mehdizadeh S, Najafi N, et al (2015).The evaluation of oral health-related factors on the quality of life of the elderly in Babol. Contemp Clin Dent, 6(3):313-7.
48. Rodakowska E, Mierzyńska K, Bagińska J, et al (2014).Quality of life measured by OHIP-14 and GOHAI in elderly people from Bialystok, north-east Poland. BMC Oral Health, 14:106.
49. El Osta N, Tubert-Jeannin S, Hennequin M, et al (2012).Comparison of the OHIP-14 and GOHAI as measures of oral health among elderly in Lebanon. Health Qual Life Outcomes, 10: 131.
50. Ikebe K, Hazeyama T, Enoki K, et al (2012).Comparison of GOHAI and OHIP‐14 measures in relation to objective values of oral function in elderly J apanese. Community Dent Oral Epidemiol, 40(5):406-14.
51. Masood M, Newton T, Bakri NN, et al (2017).The relationship between oral health and oral health related quality of life among elderly people in United Kingdom. J Dent, 56:78-83.
52. Miura H, Yamasaki K, Morizaki N, et al (2010).Factors influencing oral health-related quality of life (OHRQoL) among the frail elderly residing in the community with their family. Arch Gerontol Geriatr, 51(3):e62-5.
53. Rekhi A, Marya CM, Oberoi SS, et al (2016).Periodontal status and oral health-related quality of life in elderly residents of aged care homes in Delhi. Geriatr Gerontol Int, 16(4):474-80.
54. Silva AE, Demarco FF, Feldens CA (2015).Oral health-related quality of life and associated factors in Southern Brazilian elderly. Gerodontology, 32(1):35-45.
55. Östberg AL, Hall‐Lord ML (2011).Oral health‐related quality of life in older Swedish people with pain problems. Scand J Caring Sci, 25(3):510-6.
56. Tsakos G, Sheiham A, Iliffe S, et al (2009).The impact of educational level on oral health‐related quality of life in older people in London. Eur J Oral Sci, 117(3):286-92.
57. Hassel AJ, Steuker B, Rolko C, et al (2010).Oral health-related quality of life of elderly Germans--comparison of GOHAI and OHIP-14. Community Dent Health, 27(4):242-7.
58. Willumsen T, Fjaera B, Eide H (2010).Oral health‐related quality of life in patients receiving home‐care nursing: associations with aspects of dental status and xerostomia. Gerodontology, 27(4):251-7.
59. Zuluaga DJM, Montoya JAG, Contreras CI, et al (2012).Association between oral health, cognitive impairment and oral health–related quality of life. Gerodontology, 29(2):e667-73.
60. Gil‐Montoya J, Subirá C, Ramón J, et al (2008).Oral health‐related quality of life and nutritional status. J Public Health Dent, 68(2):88-93.
61. Biazevic MG, Michel-Crosato E, Iagher F, et al (2004).Impact of oral health on quality of life among the elderly population of Joacaba, Santa Catarina, Brazil. Braz Oral Res, 18(1):85-91.
62. Enoki K, Matsuda KI, Ikebe K, et al (2014).Influence of xerostomia on oral health-related quality of life in the elderly: a 5-year longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol, 117(6):716-21.
63. Hsu KJ, Lee HE, Wu YM, et al (2014).Masticatory factors as predictors of oral health-related quality of life among elderly people in Kaohsiung City, Taiwan. Qual Life Res, 23(4):1395-405.
64. Wang A, Ling J (2007).A survey of oral health-related quality of life and related influencing factors in elderly patients. Zhonghua Kou Qiang Yi Xue Za Zhi, 42(8):489-91.
65. Ikebe K, Hazeyama T, Morii K, et al (2007).Impact of masticatory performance on oral health-related quality of life for elderly Japanese. Int J Prosthodont, 20(5):478-85.
66. Leon S, Bravo-Cavicchioli D, Giacaman RA, et al (2016).Validation of the Spanish version of the oral health impact profile to assess an association between quality of life and oral health of elderly Chileans. Gerodontology, 33(1):97-105.
67. Stenman U, Ahlqwist M, Björkelund C, et al (2012).Oral health–related quality of life–associations with oral health and conditions in Swedish 70‐year‐old individuals. Gerodontology, 29(2):e440-6.
68. Zini A, Sgan-Cohen HD (2008).The effect of oral health on quality of life in an underprivileged homebound and non-homebound elderly population in Jerusalem. J Am Geriatr Soc, 56(1):99-104.
69. Atieh MA (2008).Arabic version of the geriatric oral health assessment index. Gerodontology, 25(1):34-41.
70. Hägglin C, Berggren U, Lundgren J (2005).A Swedish version of the GOHAI index. Psychometric properties and validation. Swed Dent J, 29(3):113-24.
71. Mathur VP, Jain V, Pillai RS, et al (2016).Translation and validation of H indi version of G eriatric O ral H ealth A ssessment I ndex. Gerodontology, 33(1):89-96.
72. Niesten D, Witter D, Bronkhorst E, et al (2016).Validation of a Dutch version of the Geriatric Oral Health Assessment Index (GOHAI-NL) in care-dependent and care-independent older people. BMC geriatrics, 16(1):53.
73. Petrović M, Stančić I, Popovac A, et al (2017).Oral health-related quality of life of institutionalized elderly in Serbia. Vojnosanit pregl, 74(5):402-409.
74. Naito M, Suzukamo Y, Nakayama T, et al (2006).Linguistic adaptation and validation of the General Oral Health Assessment Index (GOHAI) in an elderly Japanese population. J Public Health Dent, 66(4):273-5.
75. Othman WNW, Muttalib KA, Bakri R, et al (2006).Validation of the geriatric oral health assessment index (GOHAI) in the Malay language. J Public Health Dent, 66(3):199-204.
76. Sánchez‐García S, Heredia‐Ponce E, Juárez‐Cedillo T, et al (2010).Psychometric properties of the General Oral Health Assessment Index (GOHAI) and dental status of an elderly Mexican population. J Public Health Dent, 70(4):300-7.
77. Montes-Cruz C, Juárez-Cedillo T, Cárdenas-Bahena Á, et al (2014).Behavior of the Geriatric/General Oral Health Assessment Index (GOHAI) and Oral Impacts on Daily Performances (OIDP) in a senior adult population in Mexico City. Revista odontológica mexicana, 18(2):111-119.
78. León S, Bravo-Cavicchioli D, Correa-Beltrán G, et al (2014).Validation of the Spanish version of the Oral Health Impact Profile (OHIP-14Sp) in elderly Chileans. BMC Oral Health, 14:95.
79. Wong MC, Lo EC, McMillan AS (2002).Validation of a Chinese version of the oral health impact profile (OHIP). Community Dent Oral Epidemiol, 30(6):423-30.
80. Wong MC, Liu JK, Lo EC (2002).Translation and validation of the Chinese version of GOHAI. J Public Health Dent, 62(2):78-83.
81. Baker SR, Pankhurst CL, Robinson PG (2006).Utility of two oral health‐related quality‐of‐life measures in patients with xerostomia. Community Dent Oral Epidemiol, 34(5):351-62.
82. MacEntee MI, Weiss R, Waxier‐Morrison NE, et al (1987).Factors influencing oral health in long term care facilities. Community Dent Oral Epidemiol, 15(6):314-6.
83. Kambhu PP, Levy SM (1993).Oral hygiene care levels in Iowa intermediate care facilities. Spec Care Dentist, 13(5):209-14.
84. Kiyak HA, Grayston MN, Crinean CL (1993).Oral health problems and needs of nursing home residents. Community Dent Oral Epidemiol, 21(1):49-52.
85. Gift HC, Cherry‐Peppers G, Oldakowski RJ (1997).Oral health status and related behaviours of US nursing home residents, 1995. Gerodontology, 14(2):89-99.
86. Cohen LK. Disease prevention and oral health promotion: socio-dental sciences in action. Munksgaard; 1995.
87. Joshipura KJ, Hung H-C, Rimm EB, et al (2003).Periodontal disease, tooth loss, and incidence of ischemic stroke. Stroke, 34(1):47-52.
88. Petersen PE, Yamamoto T (2005).Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol, 33(2):81-92.
89. World Health Organization (2002). Active ageing: A policy framework. Geneva: WHO, pp.:33- 43
90. Niessen LC, Douglass CW (1992).Preventive actions for enhancing oral health. Clin Geriatr Med, 8(1):201-14.
91. Ettinger RL (1992).Oral care for the homebound and institutionalized. Clin Geriatr Med, 8(3):659-72.
92. Steele J, Walls A (1997).Strategies to improve the quality of oral health care for frail and dependent older people. Qual Health Care, 6(3):165-169.
93. Inglehart MR, Bagramian R (2002). Oral health-related quality of life: Quintessence Publishing Co. Chicago, pp. 1-6
94. Slade GD, Spencer AJ (1994).Development and evaluation of the oral health impact profile. Community Dent Health, 11(1):3-11.
95. Petersen PE, Nörtov B (1989).General and dental health in relation to life-style and social network activity among 67-year-old Danes. Scand J Prim Health Care, 7(4):225-30.
96. Locker D (1988).Measuring oral health: a conceptual framework. Community Dent Health, 5(1):3-18.
97. Kotzer RD, Lawrence HP, Clovis JB, et al (2012).Oral health-related quality of life in an aging Canadian population. Health Qual Life Outcomes, 10:50.
98. Srisilapanan P, Sheiham A (2001).The prevalence of dental impacts on daily performances in older people in Northern Thailand. Gerodontology, 18(2):102-8.
99. Frenkel H, Harvey I, Newcombe RG (2000).Oral health care among nursing home residents in Avon. Gerodontology, 17(1):33-8.
100. Nicol R, Petrina Sweeney M, McHugh S, et al (2005).Effectiveness of health care worker training on the oral health of elderly residents of nursing homes. Community Dent Oral Epidemiol, 33(2):115-24.
IssueVol 50 No 4 (2021) QRcode
SectionReview Article(s)
Older adults Geriatric Elderly Older Aged Ageing Oral health Oral hygiene Quality of life

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Azami-Aghdash S, Pournaghi-Azar F, Moosavi A, Mohseni M, Derakhshani N, Kalajahi RA. Oral Health and Related Quality of Life in Older People: A Sys-tematic Review and Meta-Analysis. Iran J Public Health. 2021;50(4):689-700.