機構老人口腔健康相關生活品質與營養狀況影響之探討

摘要研究背景：人口老化乃全球性的趨勢，世界衛生組織2004年於日內瓦宣布60歲以上人口於西元2025年將突破十億大關。依經建會統計我國65歲以上老年人口於1993年已跨越7.02%，正式邁入高齡化國家，推估2021年將高達14.4%。老年人的生活品質與健康程度息息相關，而身體健康與否更是與牙齒的健康程度有一定相關性。老年人無牙問題將影響咀嚼、營養，進而影響口腔相關生活品質。由於口腔健康相關生活品質(OHRQoL)的研究多半以口腔問題為主，對於營養狀況與口腔問題之間的關聯性少有文獻加以討論，因此有必要針對老人營養狀況與口腔問題關聯性做進一步探討。研究目的: 本研究目的在探討台灣地區安養機構65 歲以上營養狀況及老人基本人口學特質、存留齒數狀況、贗復物配戴狀況及需求之口腔健康相關生活品質(Oral Health-Related Quality of Life, OHRQoL)影響。研究方法：針對台灣地區65 歲以上老人為對象，分七個地域代表性分層抽樣，針對營養評估指標(MNA)及口腔健康相關生活品質量表(GOHAI)進行分析，統計方法使用邏輯斯迴歸分析方法找出影響機構老人營養狀況口腔健康相關生活品質之影響因素。研究結果：本研究共有402人完成問卷及口檢資料，資料顯示男性佔 38.8%，女性有61.2%；年齡層65-74 歲及75 歲以上約佔各半（59.2%， 40.8%），且具潛在營養不良危險狀況在不同的性別、行動能力等項目達到統計上顯著差異(p<0.05)。而在邏輯斯迴歸分析中，調整基本人口學及口腔狀況 (存留齒數、贗復狀況及贗復需求)後，結果顯示口腔健康相關生活品質愈差(GOHAI總分50分以下)之受測者相較於口腔健康相關生活品質較好者有5.12倍(OR, 95% CI=2.75~9.55, p<.001)的機率更具有潛在營養不良危險性，而口腔狀況(存留齒數、贗復狀況及贗復需求)與營養不良危險性則無顯著相關性。結論：依營養狀況觀點來看，口腔健康相關生活品質與營養狀況有明顯相關，口腔狀況會影響營養指標，進而對營養帶來極大危險。相對地，多變項分析後僅剩口腔健康生活品質有顯著相關，顯示口腔的問題並不直接與營養狀況有關，主要可能是透過口腔健康相關生活品質的改變，進而影響營養狀況，因此任何口腔問題及口腔問題的治療都必須以達到口腔健康相關生活品質的改善為主要目標，如此才可最終改善機構住民的營養狀況。

關鍵字

營養評估；口腔健康相關生活品質；存留齒數；贗復狀況；贗復需求

並列摘要

Abstract Background: Aging is a global trend in many societies, and in 2004 the World Health Organization estimated that the population of people aged over 60 will exceed one billion in 2025. In 1993, Taiwan government announced that the senior population in Taiwan exceeded 7.02%, and officially Taiwan became one of the aging countries. It was also estimated that the senior population will reach as high as 14.4% in 2021. Quality of life and general health are closely related. In addition, it was also reported that oral condition is related to general health. Elderly people with untreated dental problems will affect chewing ability, nutritional condition, and hence affecting the oral-related quality of life. As the oral health related quality of life (OHRQoL), there were limited research on nutritional status and oral problems. Hence, it is necessary to investigate nutritional status for the elderly oral problems. Study objectives: This purpose of this study was to investigate the effects of demographic characteristics, remaining teeth, prostheses status and needs as well as oral health related quality of life on nutritional status. Methods: The whole Taiwan area was divided into seven geographical regions. Elderly participants were recruited from institutions. The information of nutritional assessment (MNA) and oral health related quality of life scale (GOHAI) were collected and used to assess relationship. Statistical analysis included logistic regression analysis to identify significant effects on Nutritional status of institutionalized elderly. Results: In logistic regression analysis, after adjusting for socio-demographic characteristics and oral condition, elderly people with better oral health related quality of life was associated with better nutritional status. In addition, the oral condition became non-significant in the multiple logistic regression analysis. Conclusion: Our study results supported that the oral health related quality of life was more important than oral conditon in assessing nutritional status.