Oral health-related quality of life and depressive symptoms in older adults: Longitudinal associations of the English Longitudinal Study of Ageing (ELSA)

Background: Little is known about the relationship between oral health status and depressive symptoms in older adults in England. The aim of this study was to examine the longitudinal association between oral health parameters and depressive symptoms in older adults in England. Methods Data were obtained from the English Longitudinal Study of Aging (ELSA), which included information on self-rated oral health, oral impairment in daily life (Oral Impacts on Daily Performances, OIDP), and depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D) in 6790 adults aged ≥ 50 years. Wave 3 data were used as baseline, while Waves 5 and 7 were used for follow-up assessments. Logistic regression was used to determine whether depressive symptoms at baseline predicted self-rated oral health and OIDP and whether oral health status (at baseline) was associated with the development of depressive symptoms at follow-up assessment. Results Participants with poor self-rated oral health were at higher risk of developing depressive symptoms, even after adjusting for behavioural, clinical, and sociodemographic characteristics (OR = 1.69, 95% CI 1.38–2.07). Similar results were reported for the presence of one or more oral conditions: The OR for developing depressive symptoms at Wave 5 or 7 was 2.19 (95% CI 1.62–2.96). Participants with depressive symptoms at baseline were more likely to report poor self-rated oral health (OR = 1.93, 95% CI 1.52–2.44) or one or more oral impacts (OR = 1.86, 95% CI 1.45–2.40) at follow-up than those without depressive symptoms. Conclusions In the present study, a bidirectional association was found between depressive symptoms and poor oral health in older adults. Maintaining good oral health in older adults may be a protective factor against depressive symptoms. Therefore, more attention should be paid to promoting oral health awareness in older adults, including encouraging regular dental checkups, proper toothbrushing and flossing techniques, and healthy lifestyles.