CONTENT DOMAINS OF ORAL HEALTH-RELATED QUALITY OF LIFE IN OLDER ADULTS: A SYSTEMATIC REVIEW AND CONCEPTUAL SYNTHESIS

Oral health-related quality of life (OHRQoL) is increasingly recognized as a critical outcome in geriatric oral health care, yet its conceptualization remains inconsistent, limiting cross-study comparability and clinical applicability. Therefore, we aimed to systematically review OHRQoL instruments for older adults, analyze their item content, and clarify content domains to inform a refined content map.

We searched PubMed/MEDLINE, MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), PsycINFO (Ovid), and Web of Science from inception to May 13, 2025. Studies reporting the development or validation of OHRQoL instruments in populations with mean/median age ≥60 years were included. Risk of bias was assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments Risk of Bias checklist. Item-level data were extracted and analyzed via inductive content analysis. Content domains were identified and organized to construct a content map.

A total of 33 studies were identified, including 16 distinct instruments and 589 items. Only one study received a "very good" rating for patient-reported outcome measurement development. Through content analysis, 7 major domains were identified, including oral health status, oral health self-perception, function, behavior, burden, adaptation, and overall evaluation, spanning 23 subdomains. Based on these findings, a content map was developed to organize and visually synthesize the key content domains captured by current OHRQoL instruments for older adults.

We provide an empirical map of how OHRQoL has been conceptualized and operationalized in instruments used among older adults. The content map provides an evidence for developing and refining OHRQoL instruments. It may support personalized oral health care and inform tailored interventions for older adults.