|Year : 2020 | Volume
| Issue : 1 | Page : 45-49
Evaluating the relationship between subjective well-being and oral function in elderly people
Humsini Ramprasad, Amit Reche, Surabhi Rahate, Shravani Deolia, Nikita Gupta
Department of Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
|Date of Submission||16-Dec-2019|
|Date of Decision||20-Dec-2019|
|Date of Acceptance||25-Dec-2019|
|Date of Web Publication||13-Oct-2020|
Dr. Amit Reche
Department of Public Health Dentistry, Sharad Pawar Dental College, DMIMS (Deemed to be University), Wardha, Maharashtra
Source of Support: None, Conflict of Interest: None
This study aims at evaluating the association between subjective well-being (SWB) and oral functions in elderly people. Materials and Methodology: A cross-sectional study was carried out in a private dental college of central part of India. A study was carried out with a structured questionnaire on 200 individuals aged above 60 years. The questionnaire consisted of demographic data, oral function, habits, and general health. The SWB scale was used to tabulate the results. Results: A total of 200 people, comprising 67% and females 33% who were in the age group of 60–80 years, were covered in this research. The demographic profiles taken in the above study were age, gender, occupation, and monthly income. It was found that there is an association of SWB with health in the previous year (0.047). Thirty-nine percent of the persons had good health and 9.5% had altered health condition. In case of smoking as a habit, 43% of the people never smoked and the remaining had the habit (P = 0.012). Dental caries was found to be associated with SWB (0.001), 48% of the people had no caries, and the rest 52% had no caries. In case of loss of taste, 71.5% had no change in taste sensations, whereas 28.5% had altered taste sensations (P = 0.005). Twenty-eight percent of the people experienced burning sensation in the mouth and the remaining 72% had no complaints (P = 0.000). Conclusion: It was found that poor oral functions such as loss of teeth and other oral conditions such as burning mouth and loss of taste caused psychological and social disturbances in elderly people.
Keywords: Elderly people, oral functions, subjective well-being
|How to cite this article:|
Ramprasad H, Reche A, Rahate S, Deolia S, Gupta N. Evaluating the relationship between subjective well-being and oral function in elderly people. J Datta Meghe Inst Med Sci Univ 2020;15:45-9
|How to cite this URL:|
Ramprasad H, Reche A, Rahate S, Deolia S, Gupta N. Evaluating the relationship between subjective well-being and oral function in elderly people. J Datta Meghe Inst Med Sci Univ [serial online] 2020 [cited 2020 Oct 27];15:45-9. Available from: http://www.journaldmims.com/text.asp?2020/15/1/45/297982
| Introduction|| |
The human life expectancy has been improved greatly since the 19th century; more health-care professionals are striving to make them to live longer. The WHO report of 2004 stated that around 236 elderly people of 10,000 suffer from psychological conditions due to mainly stress, heart disease, stroke, and cancer. The process of aging creates psychological and social problems which leads to altered health conditions. These old-aged people are often taken care by their children or their spouses or any other family members. However, in cases of developed cities, they are abandoned, thus increasing the risk of health problems, hence modern lifestyle caused more adverse effects on subjective well-being (SWB) of senior citizens.
International experts freshly redefined SWB as follows: an umbrella term for different evaluations that persons make concerning about their lives, the incidents happening to them, their bodies and minds, and the circumstances in which they live. The “SWB” is a wide phenomenon which involves person's emotional reaction, their satisfaction, and worldwide judgments of life. This evaluation is done in terms of cognitive states such as satisfaction with one's marriage, work, and life, and it can be in terms of the presence of positive emotions and moods and the absence of unpleasant affect. SWB is extensively used in relation to demographic factors such as marriage, salary, personality factors, and culture.
There are three broad categories on which the SWB scale is divided: eudemonic, evaluative, and effective. The “eudemonic approach” can be stated as self-evaluation of one's life, how much power they have over it, and whether they are talented enough to prepare for the future. The “evaluative approach” is based on a comprehensive assessment on one's life and is calculated by simply asking people; how much content they are with their life. Effective “well-being” can be stated as a “degree of positive or negative effect” a person has practiced, as well as feeling of contentment, sorrow, nervousness, and enthusiasm. High well-being and life satisfaction will significantly improve life within the four areas of health and longevity, work and income, social relations, and societal benefits. Various psychological theories related to happiness have been put up; they include telic, pleasure and pain, activity, top–down versus bottom–up, associanistic, and judgment theories. A greater proportion of elder adults experienced harms with their day-to-day life owing to various conditions of the mouth and oral cavity.
The load of oral circumstances amplified from 1990 to 2010 owing to inhabitant's growth and aging, with untreated dental caries being for the most widespread of all illnesses and injuries (WHO-2012). Diabetic patients are at risk for acute and chronic complications in the oral cavity, such as xerostomia; glossodynia; bacterial, viral, and fungal infections, especially oral candidiasis; and periodontal disease.
Most of the tobacco-dependent persons visit the physicians every year due to the various general health-related problems because of the habits, and hence, these clinicians play a major role in enhancing and influencing their behavior, to quit the habit.
There are numerous causes why people do not visit doctors shortly after observing signs. One of which is the economic obstacle; moreover, patients may have insufficient or improper knowledge to appropriately understand the significance of their symptoms to malignancy and perhaps fail to seek out help due to the fear of cancer or lack of faith in therapeutic management.
| Materials and Methodology|| |
Analyzing the “subjective well-being” in elder persons is a cross-sectional study done at a private dental college in Central India. The inclusion criterion was citizens aged above 60 years of age, and people having certain mental and physical disabilities were excluded from the study. Data were collected from each individual using a closed structural questionnaire format that included a set of questions related to demographic profile and social data (age, sex, marital status, earnings, and educations) and oral distress data (dry mouth, complexity in speech, difficulty in mastication, missing tooth, carious tooth, complexity in chewing, altered taste sensations, vague pain, swelling, and burning sensation); also, for self-related habits such as smoking and drinking, a SWB scale was used.
An updated version of the Modified Kuppuswamy scale was used to measure socioeconomic status such as education parameters and monthly income.
A total of 200 people aged above 60 years were examined under natural light conditions. The SWB scale comprises three components: first being life satisfaction, second being pleasant effects, and the third being unpleasant affects. The SWB scale is also directly related to the quality of life of an individual.
The SWB scale is ideally used to measure public health. The assessment was done using a five-point Likert scale. A total of 62 components was taken, which was divided into two subscales. The subscale 1 consisted of items numbered from 1 to 47, which refers to positive and the negative effects. The “level of agreement or disagreement” was calculated by conveying a score from “1 (strongly disagree) to 5 (strongly agree).” The subscale 2 consisted of items numbered from 48 to 62, which are used to calculate contentment or disappointment with life. Again the “level of agreement or disagreement” in this subscale was calculated by conveying a score 1 (agree) and 2 (disagree).
The entire score is the addition of all scores designated to all the 62 items of the SWB scale. The mean and standard deviation was tabulated. Chi-square test was used to check the significance, and the results were tabulated [Figure 1], [Figure 2], [Figure 3].
|Figure 1: A pie chart of the presence of swelling in only 18.5% of the population and 81.5% showing no swelling showing P = 0.249|
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|Figure 2: Population smoking 2% daily, 26.5% sometimes, and 72.5% population never smoked showing P = 0.012|
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|Figure 3: Dental caries in 48% of population and 52% had no dental caries showing P = 0.001|
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Ethical clearance was obtained from the Institutional Ethical Committee of SPDC, Sawangi (Meghe), Wardha, on 8th Oct 2019. With ethical clearance no DMIMS(DU)/IEC/2019-20/388.
| Results|| |
In [Table 1] and [Table 2], a total of 200 people aged in the range 60–80 years were covered in this research. There is a significant P value for the parameters such as health in the previous year (0.047). Thirty-nine percent of the persons had good health and 9.5% had altered health condition.
|Table 1: The distribution and P value of the subjective well-being score|
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|Table 2: The distribution and P value of the subjective well-being score|
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In case of loss of taste, 71.5% had no change in taste sensations, whereas 28.5% had altered taste sensations (P = 0.005).
| Discussion|| |
The present study assesses the association between SWB and oral discomfort in elder persons aged above 60 years. Our study projects that the oral health is a vital factor in maintaining the overall general health of the elderly people which is similar to our previous study. The study conducted by Maria Vieira et al., Brazil (2018), also establishes that the general health and oral health are related to one another.
Salary is associated more strongly with well-being than education (P = 0.005). The quality of social contacts shows stronger associations with SWB. In analyzing the relationship between SWB score and presence of any systemic diseases in the previous year, it was found that 39% people had good health condition in the previous year and 9.5% people had altered health condition, which indicated that people having a good health condition in the previous year had a good SWB score as compared to the others having a lower one. The study conducted in Brazil in 2018 by Maria Vieira et al. showed that 37% of people had better health condition in the previous year and 24% people had altered condition which also resulted in a higher SWB score which were similar to those obtained in our study. The slight difference in the percentages of the results is due to the less awareness among the older people about the existing systemic diseases they are having and neglecting its treatment.
In the present study, it was seen that 7.5% people lived alone and the rest of the 92.5% either stayed with their spouses or in a joint family. The study conducted in Brazil in the year 2009 showed that 68% of people stay with their families and 31% live alone. The slight difference in the percentages is due to the cultural differences in the lifestyle of people living in Brazil. The SWB score is higher in this case of the elderly people living together as a whole family.
It was also found in our study that 35.5% people suffer from various systemic health illnesses such as high blood pressure, asthma, and other cardiac problems, and the remaining 64.5% people live a healthy life without any disease.
The study conducted at Brazil, by Maria Vieira et al. in 2018, found that all oral health indicators (such as burning mouth, loss of taste, and dental caries) were considerably linked with the “quality of life;” hence, persons with deprived oral well-being conditions had lesser levels of life satisfaction, more stress in life. The present study also related with the above same results and concluded that the role of oral health is directly proportional in maintaining the overall general health.
In our present study, dental caries, pain in the surrounding mouth tissues, loss of taste, and burning sensation led to a decrease in the SWB score. Most of the elderly people having dental caries experienced sensitivity to hot and cold food items which, in turn, led to pain in the surrounding areas; due to this, they could not eat the food of their choice properly due to which their overall general health condition deteriorated.
Dental caries was one of the most important oral discomfort factors in our present study.
The present research highlights that the poor oral health condition (preservation of teeth and other surrounding structures) in elderly people creates physical, psychosomatic, and communal problems that openly coincide with their overall healthy being.
There is a need to create awareness regarding oral health in elderly people so that they can have a better aging process by promoting their oral as well as general health.
This will try to create a new attitude and beliefs pertaining to the oral health care of elder people.
There should be initiatives taken by the government to create the importance of maintenance of a good oral well-being. Moreover, also there should be awareness created in showing the worth of maintaining a good oral health which, in turn, will have a positive effect in general health.
| Conclusion|| |
We conclude that there is an association among oral health and the “SWB” of a person. It was found that poor oral functions such as loss of teeth and other oral conditions such as burning mouth and loss of taste caused psychological and social disturbances in elderly people. It was seen that social relations are crucial to the environment which are significant determinants of SWB in older adults.,
| Limitations|| |
For this study, a larger sample size may be needed to establish the significance and magnitude of this association. More areas except old age homes and hospitals could have been explored to get better and specific results.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Dong X, Milholland B, Vijg J. Evidence for a limit to human lifespan. Nature 2016;538:257-9.
Bag J, Sanyal D, Daniel LT, Chakrabarti A. Assessment of subjective well-being status of elderly people in old age homes in Kolkata in relation to their perceived physical health and cognitive functioning. J Ment Health Human Behav 2014;19:32-4.
Saintrain MVL, Bezerra TMM, Santos FDS, Saintrain SV, Pequeno LL, da Silva RM, et al
. Subjective well-being and oral discomfort in older people. Int Psychogeriatrics 2018;30:1509-17.
Jivraj S, Nazroo J, Vanhoutte B, Chandola T. Aging and subjective well-being in later life. J Gerontol B Psychol Sci Soc Sci 2014;69:930-41.
Rouxel P, Tsakos G, Chandola T, Richard G. Watt Oral Health – A neglected aspect of subjective well-being in later life. J Gerontol B Psychol Sci Soc Sci 2016;0:1-5.
Dande R, Gadbail AR, Sarode S, Gadbail MP, Gondivkar SM, Gawande M, et al
. Oral manifestations in diabetic and nondiabetic chronic renal failure patients receiving hemodialysis. J Contemp Dent Pract 2018;19:398-403.
Deolia S, Agarwal S, Chhabra KG, Daphle G, Sen S, Jaiswal A. Physical and psychological dependence of smokeless and smoked tobacco. J Clin Diagn Res 2018;12:ZC01-4.
Lohe VK, Bhowate RR, Sune RV, Mohod SC. Association of socioeconomic risk factor with patients delay in presentation of oral squamous cell carcinoma. J Datta Meghe Inst Med Sci Univ 2017;12:75-8. [Full text]
Diener E, Ryan K. Subjective well-being: A general overview. South Afr J Psychol 2009;39:391-406.
Diener E, Sapyta JJ, Suh E. Subjective well-being is essential to well-being. Psychol Inq 1998;9:33-7.
Camfield L, Skevington SM. Subjective well-being and quality of life. J Health Psychol 2008;13:764-75.
Kim-Prieto C, Diener ED, Tamir M, Scollon C, Diener M. Integrating the diverse definitions of happiness: A time-sequential framework of subjective well-being. J Happiness Stud 2005;6:261-300.
Mcauley E, Blissmer B, Marquez DX, Jerome GJ, Kramer AF, Katula J. Social relations, physical activity, and well-being in older adults. J Prev Med 2000;31:608-17.
Diener E. Subjective well-being. Psychol Bull 1984;95:542-75.
Pinquart M, Sörensen S. Influences of socioeconomic status, social network, and competence on subjective well-being in later life: A meta-analysis. Psychol Aging 2000;15:187-224.
Kumar S, Jain S, Wanjari A, Mandal S. Development and Validation of a Modified Frailty Risk Index as a Predictor of Mortality in Rural Elderly People. Asian J Gerontol Geriatr 2019;14:15-22. Available from: https://doi.org/10.12809/ajgg-2018-315-oa
. [Last accessed on 2019 Nov 10].
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2]