The Moderating Effect of Socioeconomic Factors in the Association Between Perceived Discrimination and Oral Health-Related Quality of Life in Older Adults.

Objective

To analyze the moderating effect of income and education on the association between perceived discrimination and worse oral health-related quality of life (OHRQoL) among Brazilian older adults aged ≥ 50 years.

Methods

This is a cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019). A total of 8,624 participants with complete data were included in the analytic sample, out of 9,949 eligible participants (86.7%). The outcome was worse OHRQoL assessed through the Oral Impacts on Daily Performances (OIDP), and the main exposure was self-reported perceived discrimination. Rate ratios (RR) and their respective 95% confidence intervals (95%CI) were estimated using Poisson regression adjusted for socioeconomic and demographic variables. To test the moderation hypothesis, interaction terms were included between perceived discrimination and per capita household income and education level, separately.

Results

Perceived discrimination was reported by 22.84% of participants. Individuals who reported discrimination presented higher OIDP means compared to those who never experienced discrimination (2.08 vs. 1.22). In the adjusted analysis, perceived discrimination remained significantly associated with worse OHRQoL (RR=1.71; 95%CI: 1.40-2.08). Women, individuals with lower income, and lower educational level also showed worse OHRQoL indicators. No significant moderating effect was observed for income (RR=1.15; 95%CI: 0.92-1.43) or education (RR=0.97; 95%CI: 0.78-1.21).

Conclusion

Perceived discrimination was independently associated with worse OHRQoL among Brazilian older adults, and income and education did not moderate this association.