Correlation between behavior and oral health in elderly diabetic patients: the moderating effects of various blood glucose control methods

BMC Public Health. 2025 Jul 2;25(1):2243. doi: 10.1186/s12889-025-23508-3.

Abstract

Objectives: This research evaluates the Chinese version of the Geriatric Oral Health Assessment Index (GOHAI) and Health Promoting Lifestyle Profile-II (HPLP-II) in elderly adults, investigating the correlations and moderation effects of glycemic control methods between GOHAI and HPLP-II scores in hospitalized diabetic patients.

Participants: A consecutive sample of 244 elderly diabetic patients was recruited from department of endocrinology and geriatric endocrinology at the first affiliated Hospital of China Medical University.

Methods: Data were collected using validated GOHAI and HPLP-II questionnaires. Sociodemographic and clinical variables were analyzed through univariate and multivariate regression models. Finally, moderation analysis examined how different glycemic management strategies influenced the association between health behaviors and oral health outcomes.

Findings: Pharmacological interventions were the most common glycemic control method, followed by lifestyle modifications. GOHAI scores demonstrated a significant positive correlation with HPLP-II scores. Lifestyle-based glycemic management showed superior benefits for behavioral and oral health outcomes compared to pharmacological approaches alone. However, combined strategies exhibited antagonistic effects, weakening the positive impact of health behaviors on overall oral health and mental well-being. And pharmacological treatment amplified the influence of health behavior, support and stress on general oral health, while paradoxically reducing the salience of self-actualization in this relationship.

Conclusions: Health-promoting behaviors significantly improve oral health in elderly people with diabetes. While lifestyle interventions should be prioritized for holistic health benefits, integrated glycemic management requires careful implementation to avoid unintended interference with behavioral contributions to oral health. These findings advocate for tailored lifestyle modifications as a cornerstone of diabetes care in aging populations.

Keywords: Diabetes; Exercise; GOHAI; Glycemic control; Moderating effect.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose / analysis
  • China
  • Diabetes Mellitus* / therapy
  • Female
  • Geriatric Assessment
  • Glycemic Control* / methods
  • Health Behavior*
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Oral Health* / statistics & numerical data
  • Surveys and Questionnaires

Substances

  • Blood Glucose