Exploring Factors Affecting Oral Health Changes Among Community-Dwelling Older Adults: A Retrospective Study

Abstract

Introduction: In the era of longevity, oral health has become increasingly important for maintaining the quality of life of older adults. However, the factors that influence their oral health remain unclear. Given that oral health tends to decline with age, it is crucial to identify the early predictors of changes in the oral health of older adults. Therefore, this study identified the factors influencing changes in the oral health of Korean older adults. Methods: This retrospective study used nationally representative panel data from the 2018 and 2020 waves of the Korean Longitudinal Study of Aging. The study population of 3859 individuals aged 65 years or older was divided into four groups (good-good, good-poor, poor-good, and poor-poor groups) based on changes in their oral health as assessed by the Geriatric Oral Health Assessment Index. Data were analyzed using multinomial logistic regression to examine factors influencing changes in oral health, with the good-good group set as the reference category. Results: Individuals in the Poor-Poor group were the highest in number (33.7%). Factors affecting oral health changes included age, education level, body weight status, diabetes, heart disease, depression, cognitive impairment, and Medical aid coverage. Being underweight or overweight and having cognitive impairment contributed to declining oral health. Depression showed a dual association, being linked to both improvement and persistence of poor oral health. Furthermore, diabetes, heart disease, being underweight, and insufficient healthcare coverage perpetuated poor oral health. These factors explained 29.9% of the variance in oral health changes among older adults. Conclusion: Study findings highlight the need for multi-level actions in clinical care, community health promotion, and policy to expand dental insurance. Future research should extend longitudinal analyses, address unmet oral health needs, and draw cross-national insights to inform strategies and policies for healthy aging. (c) 2026 Korean Society of Nursing Science. Published by Elsevier BV. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).