Tooth Loss, Nutrition, and Oral Health-Related Quality of Life in Older Adults: Evidence from a Structural Equation Model.

BACKGROUND

Oral health problems, particularly tooth loss, may impair nutrition and reduce oral health-related quality of life (OHRQoL) in older adults. However, the pathways linking these conditions remain unclear.

METHODS

We analyzed data from 112 older adults (≥60 years). We measured OHRQoL using the Geriatric Oral Health Assessment Index (GOHAI) and nutritional status using the Mini Nutritional Assessment (MNA), and used tooth loss as a clinical indicator. Bivariate analyses used Spearman's correlation, and structural equation modeling (SEM) with robust estimation was applied to assess direct and indirect pathways. Mediation was evaluated with bootstrap resampling.

RESULTS

The prevalence of impaired OHRQoL (GOHAI > 0) was 25.9% (95% CI: 18.6 to 34.9). Tooth loss correlated with worse nutrition (ρ = -0.32; 95% CI: -0.48 to -0.15), and poorer nutrition was associated with worse OHRQoL (ρ = -0.22; 95% CI: -0.40 to -0.03). SEM showed that tooth loss negatively affected nutrition (β = -0.21; 95% CI: -0.43 to 0.00) and that nutrition was directly associated with OHRQoL (β = -0.21; 95% CI: -0.34 to -0.08). Bootstrap analyses confirmed a direct effect of tooth loss on OHRQoL (β = 0.19; 95% CI: 0.02 to 0.36), while the indirect pathway through nutrition did not reach statistical significance.

CONCLUSIONS

Tooth loss and poor nutrition independently reduce OHRQoL in older adults. Although mediation by nutrition was not statistically significant, the findings highlight the interdependence of oral and general health and support integrated public health strategies for aging populations.