Community and Quality of Life

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So they decided to create statistics of their own, ones which would more accurately reflect the felt sense of their community's health and well-being. As alternatives to Quality of Life, many communities choose indicators related to Sustainability or Healthy Communities. All statistics provide informational feedback for reflection by the organization, community or society gathering the statistics, and therefore are an important resource for collective intelligence. The more these statistics reflect the true needs and aspirations of the community and the harmonious relationships between the community and the world around it, the more co-intelligent those statistics can be considered.

The movement to gather indicators of community health, sustainability and quality of life is a vital part of building a co-intelligent culture. For an example of a city creating its own quality of life indicators, see Measuring Community Health. Care-dependent home-dwelling older people with remaining teeth generally were less frail, scored better on physical functioning and general health and had better QoL than edentulous older people.

Notwithstanding their common dental problems, frailty, health, and QoL are better in home-dwelling older people with remaining teeth. To maintain this status, we advise not only dentists, but also health care workers and governments, to encourage people to maintain good oral health. Worldwide, many societies are aging.

Quality of Life: What is a "Livable" Community

This also counts for the Netherlands. A growing number of these older people still have their own teeth [ 3 , 4 ]. Having your own teeth is in general supposed to give better function, but consequently the risk of infections is potentially rising when compared with edentulous persons.

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Especially when older people become frail, care-dependent and home-bound, the quality of self-care often declines, particularly oral care [ 5 , 6 ]. As a result, oral problems such as dental infections and periodontitis next to tooth loss and loss of dental function can occur, which has been presumed to negatively impact general health [ 7 — 16 ]. Many studies have been performed to assess oral health in older people. Indwelling older people in nursing homes is worldwide well described in literature [ 17 , 18 ].

All studies conclude that oral health is poor in these elderly. Knowledge on oral health of community-living older people is sparse, however. It is not yet known whether the oral health of community-living older people differs from that of older people living in nursing homes. Especially the knowledge on oral health and oral status of older people with declining health who are probably heading for admittance in nursing homes in the next period if their health is getting worse and worse, is not well assessed.

The few studies yet published on oral health of community living older people suggest that many older people face oral health problems [ 19 ]. They concluded that none of the eligible studies showed whether or not poor oral health increases the likelihood of developing signs of frailty, although the reviewed studies did suggest an association between frailty and oral health.

Thus, there is a need for well-designed studies that give better insight in the oral status and oral health of community living older people with a focus on the possible associations between frailty, ADL, QoL, general health, and oral status. The three participating home care organizations located in the towns of Groningen-Haren, Hoogezand, and Winschoten covered a large area.

Quality of life - Wikipedia

The caretakers informed us if a potential participant was not able to communicate due to severe dementia or whether they were physically too ill to be interviewed. Contact information of the potential participants who were willing to take part in the study was provided by the caretakers to the researchers of the University Medical Center Groningen. Next, the researchers contacted the older people by phone. After having obtained written informed consent, the participants were invited to visit a dental care unit of the department of oral and maxillofacial surgery of the University Medical Center Groningen or, if preferred, they were visited at their own home.


An extensive structured interview see below , followed by an oral examination, was performed by either ARH or AV, both geriatric dentists. From all non-participants, demographic information and information on formal home care were known. The institutional review board of our institution provided a waiver file number M Written informed consent was obtained from all participants and the study was performed in accordance with the Declaration of Helsinki.

All data was collected by a personal interview of the participant.

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The following data were obtained during the interview:. This instrument comprises 15 items and measures losses of functions and resources in four domains: physical, cognitive, social, and psychological. Scores range from 0 to 15; a score of 4 and higher indicates moderate to severe frailty [ 22 , 23 ];. Scores range from 0 to A score of 25 or lower indicates moderate to severe cognitive impairment [ 24 ];.

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This measure includes the following subscales: physical functioning, social functioning, role limitations due to physical health problems, role limitations due to emotional problems, general mental health, vitality, bodily pain, and general health perception [ 25 ].

The total score range of all scales is 0 to , with higher scores indicating better health;. This instrument consists 14 items, range 0— A higher score indicates lower oral health-related quality of life [ 26 ]. First oral status having remaining teeth or being edentulous and wearing complete dentures was determined. The deepest periodontal pocket measured per element was noted. For presence of plaque, the index according to Mombelli et al.

When more than one tooth was present the highest score per dentition was noted. The presence of calculus score 1 or the absence of calculus score 0 was scored. Probing depth was measured at four sites of each tooth mesially, labially, distally, lingually by using a periodontal probe Merit B, Hu Friedy, Chicago, USA ; the distance between the marginal border of the mucosa and the tip of the periodontal probe was scored as the probing depth. Edentulous older people with complete dentures were examined for the fit good, acceptable, or poor stability and appearance fractured parts, wear, etc.

Additional assessments included oral hygiene and whether the participants still visited the dentist regularly did they visit the dentist for their yearly dental check-ups? Oral hygiene was rated as good in the absence of visual plaque score 0 and 1 poor when thin layers of plaque were seen score 2 and very poor when layers of plaque were present in or on the teeth or dentures score 3 according to Mombelli et al. Baseline characteristics were reported with descriptive statistics. Differences between participating and non-participating older people on age, gender, and intensity of formal home care were evaluated with Pearson Chi-Square tests and Mann-Whitney test.

Median scores, including interquartile ranges IQR , were calculated for all measurement scores, since the data were not normally distributed.

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Statistical differences between older people subgroups on oral status that differed on measurement scores were examined with Mann-Whitney tests. Chicago, Illinois. One hundred three out of a total of consecutive older people who were admitted for formal home care Fig. No information on health problems was available for non-participants. The median number of medications was 7 [IQR 4—11].

Baseline characteristics of the included care dependent community living older people persons. This 1. The oral examination showed that 39 participants had remaining teeth and 64 participants were edentulous and had complete dentures. Of the latter 64 participants, nine participants wore an implant-retained mandibular overdenture.

There were no clinical signs of peri-implant bone loss in participants with implant-retained mandibular overdentures as the peri-implant sulcus was not deepened in the patients assessed. Reasons for avoiding dental care mentioned were mobility problems not able to go to the dental office , financial aspects fear for high costs , disturbed relation with the dental office after change of dental team, cognitive problems forgot to go or forgot appointments , and dental fear.

Median scores IQR of cognitive dysfunction, frailty, and oral health related quality of life of the total population and older people subgroups who differed on oral status. Overall oral health of the assessed older people was commonly poor as well as that oral status is associated with frailty, QoL, and general health.

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Measuring Progress: Community Indicators and the Quality of Life

In the meantime, please feel free to search for ways to make a difference in your community at www. Share with facebook. Share with twitter. Share with linkedin. Share using email. Community Preferences of Older Adults This report explores the meaning of livability and describes lessons learned by PPI as part of its work to measure community livability. That index will accomplish the following: Take the wide range of individual preferences into account.

Include objective indicators to measure what a community looks like and how well it meets the varying needs of community members. Several of our research findings provide lessons for development of a livability index: Individual preferences for livability include both issues that can be addressed by public policy and others that cannot.

Community and Quality of Life Community and Quality of Life
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