Relationship between oral health and mental health in rural older people with chronic diseases and mediating role of sleep quality

Abstract

ObjectiveTo explore the relationship and internal mechanism between sleep quality, oral health and mental health of the older people with chronic diseases in rural Shandong, China. MethodsUsing stratified multistage cluster sampling, face-to-face interviews were conducted among 2 064 rural people aged 60 years and above and with chronic diseases in Shandong province during July – August 2020. Oral Health Impact Profile-5 (OHIP-5), Kessler Psychological Distress Scale (K10) and Pittsburgh Sleep Quality Index (PSQI) were adopted in the survey. Statistical analyses were performed with IBM SPSS 24.0. ResultsFor all the respondents, the median score (25th percentile, 75th percentile) was 9 (6, 13) for PSQI, 2 (0, 5) for OHIP, and 18 (12, 25) for K10. The sleep quality and oral health were positively correlated with mental health (rs = 0.43, P < 0.001; rs = 0.20, P < 0.001)；sleep quality was positively correlated with oral health (rs = 0.17, P < 0.001). The results of mediating effect analysis revealed that sleep quality played a partial mediation effect on the association between oral health and mental health, with an effect value of 95% confidence interval of 0.09 – 0.17 and accounting for 32.50% of the total effect. ConclusionSleep quality is a mediator between oral health and mental health among rural older people with chronic diseases; improving oral health and reducing sleep disorders may improve mental health in the population.

Keywords

• sleep quality
• oral health
• mental health
• chronic disease
• older people