Oral health related quality of life after stroke

Abstract

Aims: Stroke can have a significant impact on physical, psychological and social functions. Oral impairment can also be disabling as chew- ing, swallowing and speech problems are common stroke-related se- quelae. The aim was to measure oral health-related quality of life (OHR-QoL) of stroke survivors on hospital discharge into the com- munity. Methods: 43 elderly stroke survivors of mild to moderate stroke in the non-dominant hemisphere and an age/gender matched comparison group of 43 community-dwelling elderly people were re- cruited. The SF-36 measure, the General Oral Health Assessment Index (GOHAI) and an oral health transition scale were administered as a structured interview prior to a dental examination. Data were analysed using Chi-squared and independent t-tests. Results: Median SF-36 subscale scores were significantly different between groups (p < 0.05). In physical function, role-physical, role-emotional and mental health domains, stroke survivors had significantly lower scores indicating poorer health. The median GOHAI score for the stroke group was 52 and 54 for the comparison group with no significant difference between groups although more stroke survivors had diffi- culty speaking compared with the comparison group. About 75% of stroke survivors considered their appearance to be worse, half of them felt that speech was worse and about a third had difficulty chewing hard food compared with the pre-stroke condition (p < 0.05). Partici- pants were partially dentate with no significant difference in dental or prosthetic status between groups (p > 0.05). Conclusions: Health-re- lated quality of life was significantly poorer after stroke even although patients were considered physically well enough to be discharged from hospital. There was some impairment of OHR-QoL. The nature of the stroke, the hospital environment including diet and coping strategies should be taken into account when interpreting measures of health status in stroke survivors. (CRCG-HKU).