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Research article
Oral Status of Elderly Patients in Long-Term Care Facilities: A Systematic Review
Yolanda Martinez-Beneyto
University of Murcia
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1523-9415
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: elderly patients who spend long periods hospitalised or those who are in a situation of institutionalisation represent a risk group in this regard, since many of them suffer a degree of dependence and need help to perform the basic personal care tasks. It is therefore important to learn more about the oral health status of this group of patients in order to make a proper assessment of the situation as well as to develop protocols for its management. The purpose of this study was to conduct a systematic review to ascertain the oral health status of elderly patients institutionalised or hospitalised for a long period of time.
Methods: a systematic review of the literature published in three different databases (PubMed, Embase and Cochrane Library) was conducted, with 12 different combinations of keywords based on the following selection criteria: studies published in the last 5 years, in English and/or Spanish and/or Portuguese, with samples of ≥30 patients, performed in patients older than 65 years, admitted to any type of institution and/or care centre for at least 7 days and in which the state of hard and/or soft tissues of the oral cavity were assessed in some way. The selected articles were subjected to a thorough analysis.
Results: The search strategy covered 1,014 articles: 689 from Pubmed and 325 from Cochrane Library. After applying the eligibility criteria, five articles were selected for our review. The level of evidence of the articles was3, with a sample consisting of 773 patients in which most of them were women with an average age older than 70 years old.
Conclusions: the oral health of patients aged more than 65 is worse than that of the rest of the population. Long-term in hospitals or being institutionalised in a retirement home makes this group susceptible to a worsening of their oral health status. It is necessary to develop protocols for the oral health care of these patients, accompanied by training programmes for the personnel.
Keywords
elderly inpatients, elderly hospitalized patients, long term hospitalization, long term inpatients, oral health, oral status
Figure 1
|
INCLUSION CRITERIA |
EXCLUSION CRITERIA |
|
Studies published in the last 5 years |
Not published un english, spanish or portuguese language |
|
Case-control, cross-sectional, longitudinal and cohort studies |
Systematic Review, Meta-Analysis, Case Report, Letter, Editorial, Congress |
|
Humans |
Children, teenagers and/or non-elderly adults |
|
Elderly patients > 65 years old |
Studies in which the essential data are missing in order to obtain a profile of homogeneous works |
|
Sample > 30 individuals |
Studies whose access to the complete text was under private subscription |
|
In studies that did not show the age range of individuals: sample whit mean age aprox. 70 years |
|
|
Entered in some type of institution or hospital center for a period > or = 7 days |
|
|
In which the situation of hard and/or soft tissues the oral cavity was evaluated in some way |
|
Table 1. Inclusion and exclusion criteria.
Table 2. Risk of bias for non-randomized studies assessed with ROBINS-I Cochrane tool.
|
Risk of Bias domains included in ROBINS-I Cochrane tool. |
Category of BIAS |
Poisson et al. |
Gerritsen et al. |
Chen et al. |
Nakayama et al. |
Murray et al. |
|
Pre-intervention domains |
|
|
|
|
|
|
|
1.Bias due to confounding. |
Confounding |
3 |
2 |
1 |
2 |
3 |
|
2. Bias in selection of participants into the study. |
Selection Bias |
3 |
1 |
1 |
2 |
2 |
|
At-intervention domain |
|
|
|
|
|
|
|
3. Bias in classification of interventions. |
Information bias |
1 |
1 |
1 |
1 |
2 |
|
Post-intervention domains |
|
|
|
|
|
|
|
4. Risk of bias due to deviations from the intended interventions (effect of assignment to intervention) |
Confounding |
2 |
2 |
1 |
1 |
1 |
|
5. Bias due to missing data |
Selection Bias |
2 |
2 |
1 |
1 |
1 |
|
6. Bias in measurement of the outcome |
Information bias |
1 |
1 |
1 |
1 |
1 |
|
7. Bias in selection of the reported result |
Reporting bias |
2 |
1 |
1 |
1 |
1 |
|
Overall Risk of BIAS for the results |
|
3 |
2 |
1 |
2 |
3 |
Possible answers: 1= Low risk of bias; 2= Moderate risk of bias 3= Serious risk of bias 4= Critical risk of bias 5= No information.
Interpretation:
Low risk of bias (1)= The study is comparable to a well-performed randomized trial with regard to this domain.
Moderate risk of bias (2)= The study is sound for a non-randomized stu
dy with regard to this domain but cannot be considered comparable to a well-performed randomized trial.
Serious risk of bias (3)=The study has some important problems in this domain.
Critical risk of bias (4)= The study is too problematic in this domain to provide any useful evidence on the effects of intervention.
No information (5) = No information on which to base a judgement about risk of bias for this domain.
Due to technical limitations, Table 3 is only available as a download in the supplementary files section.
This is a list of supplementary files associated with this preprint. Click to download.
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Research article
Oral Status of Elderly Patients in Long-Term Care Facilities: A Systematic Review
Yolanda Martinez-Beneyto
University of Murcia
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1523-9415
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 3
Posted 18 Aug, 2020
No community comments so far
No comments provided
No comments provided
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: elderly patients who spend long periods hospitalised or those who are in a situation of institutionalisation represent a risk group in this regard, since many of them suffer a degree of dependence and need help to perform the basic personal care tasks. It is therefore important to learn more about the oral health status of this group of patients in order to make a proper assessment of the situation as well as to develop protocols for its management. The purpose of this study was to conduct a systematic review to ascertain the oral health status of elderly patients institutionalised or hospitalised for a long period of time.
Methods: a systematic review of the literature published in three different databases (PubMed, Embase and Cochrane Library) was conducted, with 12 different combinations of keywords based on the following selection criteria: studies published in the last 5 years, in English and/or Spanish and/or Portuguese, with samples of ≥30 patients, performed in patients older than 65 years, admitted to any type of institution and/or care centre for at least 7 days and in which the state of hard and/or soft tissues of the oral cavity were assessed in some way. The selected articles were subjected to a thorough analysis.
Results: The search strategy covered 1,014 articles: 689 from Pubmed and 325 from Cochrane Library. After applying the eligibility criteria, five articles were selected for our review. The level of evidence of the articles was3, with a sample consisting of 773 patients in which most of them were women with an average age older than 70 years old.
Conclusions: the oral health of patients aged more than 65 is worse than that of the rest of the population. Long-term in hospitals or being institutionalised in a retirement home makes this group susceptible to a worsening of their oral health status. It is necessary to develop protocols for the oral health care of these patients, accompanied by training programmes for the personnel.
Figure 1
|
INCLUSION CRITERIA |
EXCLUSION CRITERIA |
|
Studies published in the last 5 years |
Not published un english, spanish or portuguese language |
|
Case-control, cross-sectional, longitudinal and cohort studies |
Systematic Review, Meta-Analysis, Case Report, Letter, Editorial, Congress |
|
Humans |
Children, teenagers and/or non-elderly adults |
|
Elderly patients > 65 years old |
Studies in which the essential data are missing in order to obtain a profile of homogeneous works |
|
Sample > 30 individuals |
Studies whose access to the complete text was under private subscription |
|
In studies that did not show the age range of individuals: sample whit mean age aprox. 70 years |
|
|
Entered in some type of institution or hospital center for a period > or = 7 days |
|
|
In which the situation of hard and/or soft tissues the oral cavity was evaluated in some way |
|
Table 1. Inclusion and exclusion criteria.
Table 2. Risk of bias for non-randomized studies assessed with ROBINS-I Cochrane tool.
|
Risk of Bias domains included in ROBINS-I Cochrane tool. |
Category of BIAS |
Poisson et al. |
Gerritsen et al. |
Chen et al. |
Nakayama et al. |
Murray et al. |
|
Pre-intervention domains |
|
|
|
|
|
|
|
1.Bias due to confounding. |
Confounding |
3 |
2 |
1 |
2 |
3 |
|
2. Bias in selection of participants into the study. |
Selection Bias |
3 |
1 |
1 |
2 |
2 |
|
At-intervention domain |
|
|
|
|
|
|
|
3. Bias in classification of interventions. |
Information bias |
1 |
1 |
1 |
1 |
2 |
|
Post-intervention domains |
|
|
|
|
|
|
|
4. Risk of bias due to deviations from the intended interventions (effect of assignment to intervention) |
Confounding |
2 |
2 |
1 |
1 |
1 |
|
5. Bias due to missing data |
Selection Bias |
2 |
2 |
1 |
1 |
1 |
|
6. Bias in measurement of the outcome |
Information bias |
1 |
1 |
1 |
1 |
1 |
|
7. Bias in selection of the reported result |
Reporting bias |
2 |
1 |
1 |
1 |
1 |
|
Overall Risk of BIAS for the results |
|
3 |
2 |
1 |
2 |
3 |
Possible answers: 1= Low risk of bias; 2= Moderate risk of bias 3= Serious risk of bias 4= Critical risk of bias 5= No information.
Interpretation:
Low risk of bias (1)= The study is comparable to a well-performed randomized trial with regard to this domain.
Moderate risk of bias (2)= The study is sound for a non-randomized stu
dy with regard to this domain but cannot be considered comparable to a well-performed randomized trial.
Serious risk of bias (3)=The study has some important problems in this domain.
Critical risk of bias (4)= The study is too problematic in this domain to provide any useful evidence on the effects of intervention.
No information (5) = No information on which to base a judgement about risk of bias for this domain.
Due to technical limitations, Table 3 is only available as a download in the supplementary files section.