[[alternative]]Preliminary Study on the Swallowing Ability, Oral Health and Quality of Life of the Elderly in the Community

[[abstract]]研究背景：隨著老年人口逐年增加，老年人的吞嚥問題在世界各國也漸漸受到重視。口腔與吞嚥功能會隨年紀增長而逐漸衰退，導致老年人普遍面臨吞嚥困難的問題。有研究發現吞嚥困難會降低老年人的生活品質，而口腔健康是影響吞嚥能力和生活品質的重要因素。然而目前尚缺乏研究探討老年人吞嚥能力、口腔健康與生活品質三者間的關係。因此，本研究目的是了解社區老人吞嚥能力對其生活品質的影響，以及探討口腔健康狀況在社區老人吞嚥能力與其生活品質關係中的角色，以期作為提升社區老人生活品質及預防政策之參考。研究方法：本研究採橫斷式研究設計，以方便抽樣方式進行資料蒐集，經人體試驗審查委員會(IRB)審核通過，且受試者同意簽署同意書後才進行收案。研究針對台北市及新北市社區年滿65歲以上的老人進行問卷調查，共收回173份問卷。本研究使用台灣簡明版世界衛生組織生活品質問卷(WHOQOL-BREF)、EAT-10吞嚥能力篩查工具及老年人口腔健康影響量表(OHIP-7T) 評估社區老人之生活品質、吞嚥能力及口腔健康狀況，並以SPSS 21.0統計軟體進行描述性統計、t 檢定、單因子變異數分析、皮爾森積差相關及多元迴歸之統計分析探討吞嚥能力、口腔健康狀況與生活品質之間的關係。研究結果：研究結果發現社區老人之吞嚥困難、口腔健康狀況及生活品質之間具顯著相關性。多元迴歸分析結果發現社區老人的吞嚥困難風險會顯著降低其生活品質(β = -.27，p =.020)，顯示老人的吞嚥能力越差，其生活品質越低。研究結果也發現口腔健康狀況是老年人吞嚥能力與生活品質的顯著中介變項（β =-.387， p=.001），顯示老年人的吞嚥能力會透過影響口腔健康狀況而間接地影響其生活品質。結論：社區老人之吞嚥能力是影響其生活品質的重要因素，而口腔健康狀況具顯著中介效果。研究結果不止可以提供醫療及衛政單位在預防及解決老年人吞嚥困難之參考，也可以協助提升及維持社區老年人之吞嚥能力及口腔健康狀況，進而改善其生活品質。[[abstract]]Background：The swallowing problem among older adults has become an global concern with the increase of older population in many countries around the world. Oral and swallowing functions gradually decline with age, leading to the problem of dysphagia in the elderly. Studies have found that dysphagia can reduce the quality of life of the elderly, and oral health is known as a significant risk factor affecting the swallowing ability and quality of life. However, there is a lack of research exploring the relationship among swallowing ability, oral health and quality of life in the elderly. Therefore, this study aims to understand the effect of swallowing ability on the quality of life of the community-dwelling older adults, and to explore the role of oral health status in the relationship between the swallowing ability and quality of life. The findings of the study can help to improve the quality of life of older adults and provide reference to policymakers in the formulation of prevention policies.Methods：This is a cross-sectional survey study with data collected through a convenient sampling method. Our study was approved by the Human Trials Review Board (IRB) and informed consent was obtained before data collection. The survey was conducted among older adults aged 65 years or over from Taipei City and New Taipei City and a total of 173 questionnaires were collected in the study. The Taiwan Abbreviated Version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), EAT-10 Swallowing Ability Screening Tool and Oral Health Impact Scale for the Elderly (OHIP-7T) were used to assess the quality of life, swallowing ability and oral health of the older adults in the study Descriptive statistics, t test, one-way analysis of variance, Pearson's product-difference correlation and multiple regression statistical analysis were performed using SPSS 21.0 statistical software to explore the relationship between swallowing ability, oral health status and quality of life of older adults. Results： Our study found a significant correlation between dysphagia, oral health status and quality of life of the elderly in the community. The results of multiple regression analysis showed that dysphagia was significantly associated with lower quality of life among older adults in the community (β = -.27, p =.020), indicating that the lower the swallowing ability, the lower the quality of life. Oral health was also found to have a significant mediating effect on the relationship between swallowing ability and quality of life in older adults (β =-.387, p=.001), indicating that the swallowing ability of older adults has significant indirect effect on quality of life through their oral health status. Conclusion： Swallowing ability was found to be a significant factor affecting the quality of life of older adults and oral health status was a significant mediator in the relationship between swallowing ability and quality of life. The findings of the study not only can be a reference for healthcare authorities in addressing and preventing the problem of dysphagia in older population, but also help to increase and maintain the swallowing ability and oral health status of older adults to improve their quality of life