Using revised oral assessment guide to assess association between oral health and mortality in older inpatients: a single-center observational cohort study

• Published in: BMC oral health Vol. 25; no. 1; pp. 912 - 9
• Main Authors: Chen, Kuan-Ying, Lin, Shih-Yi, Weng, Shuo-Chun, Lee, Yu-Shan, Kuo, Fu-Hsuan, Yeh, Ya-Hui
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.06.2025; BioMed Central; BMC
• Subjects: Activities of daily living; Aged; Aged patients; Aged, 80 and over; Chronic illnesses; Chronic obstructive pulmonary disease; Clinical outcomes; Cohort analysis; Cohort Studies; Comorbidity; Data collection; Dental insurance; Dental research; Dentures; Diabetes; Female; Frailty; Geriatric Assessment - methods; Geriatrics; Health status indicators; Hospitalization; Hospitals; Humans; Infections; Inpatients; Male; Malnutrition; Medical records; Mortality; Nurses; Older acute inpatient; Older people; Oral diseases; Oral Health; Oral hygiene; Patients; Physiological aspects; Population; Retrospective Studies; Revised oral assessment guide; Risk factors; China; Taiwan; Mortality; Revised oral assessment guide; Oral health; Older acute inpatient
• ISSN: 1472-6831; 1472-6831
• DOI: 10.1186/s12903-025-06206-9

For older adults, oral health represents a critical component of overall health; nevertheless, oral health is often neglected in older acute inpatients. We implemented a retrospective cohort study to assess oral health in older inpatients by using the revised oral assessment guide (ROAG) and examined the associations of oral health and mortality. The study was executed in a 35-bed geriatric ward. The study sample comprised patients aged 65 years or older, hospitalized with an acute condition. The oral health of the patients was assessed by trained nurses using revised oral assessment guide (ROAG). Data were collected during hospitalization from admission through discharge. Medical records were assessed to glean medical and demographic data. The mean follow-up time was 1.9 (SD 1) years. Mortality data were collected from a national population register. The age adjusted Charlson comorbidity index (ACCI) was employed to assess comorbidities. Cox regression was executed to identify associated factors. 360 patients were enrolled in the study. The mean ROAG score was 11.1 (SD 2.5), and 49.2% of the patients had a ROAG score greater or equal to 11. The oral problems that were most common were related to the teeth or dentures (74.2%), followed by problems related to the gums (32.8%). Significant associations between oral health problems and various patient characteristics were observed. The risks of overall mortality (HR = 1.67, P =.003) and 2-year mortality (HR = 1.72, P =.004) were significantly higher among patients with ROAG scores of ≥ 11 than among those with ROAG scores of < 11, after adjustment for potential confounders. Among older acute inpatients, the prevalence of oral health problems was relatively high, and poor oral health was an independent mortality predictor. These findings highlight the importance of oral health care in older adults.