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Updated: Apr 1, 2026

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
[The Norton Scale as predictor of health-related quality of life in institutionalized elderly]
Josefina González-Expósito1, Juan Carlos García-Román1, María Prado-Amores1
1Centro de Atención a la Dependencia de Santander, Instituto Cántabro de Servicios Sociales (ICASS), Gobierno de Cantabria, Santander, España.
Objective:
A low Norton Scale (NS) score predicts pressure ulcer risk and several adverse outcomes in the elderly. On the other hand, health-related quality of life (HRQOL) is an indicator with clinical and predictive utilities. The aim was to assess the relationship between NS and HRQOL, in a gender analysis.
Method:
Fifty-one women and 39 men, institutionalized and aged≥65 years, were evaluated through personal interview and medical records. The NS, HRQOL -with EuroQol-5D-, age, body mass index, falls, use of psychoactive drugs, cognitive function and Charlson, Barthel and Tinetti indexes, were assessed. Two regression models were developed, with EuroQol-5D as dependent variable.
Results:
The NS showed the same score in both sexes, with a median (interquartile range) value of 19 (2). Women presented a worse HRQOL, with an EuroQol-5D=0.78, whereas it was 0.87 in men (P=.02). The NS score was correlated with HRQOL in women (r=0.57; P<.001) but not in men (r=0.15; P=.36). After adjusting for confounders, the NS showed a β value of 0.54 (P=.02) in women and β=0.35 (P=.14) in men.
Conclusions:
The NS has shown to be the strongest factor on HRQOL in women, regardless of age, comorbidity and the rest of covariates. Conversely, the relationship was weaker and non-significant in men.
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