Abstract
BackgroundDisruption of the indigenous microbiota is likely related to frailty caused by undernutrition. However, the relationship between undernutrition and the oral microbiota, especially normal bacteria, is not obvious. The aim of this study was to elucidate the associations of nutritional and oral health conditions with prevalence of bacteria and fungi in the oral cavity of older individuals.MethodsForty-one institutionalized older individuals with an average age ± standard deviation of 84.6 ± 8.3 years were enrolled as participants. Body mass index (BMI) and oral health assessment tool (OHAT) scores were used to represent nutritional and oral health status. Amounts of total bacteria, streptococci, and fungi in oral specimens collected from the tongue dorsum were determined by quantitative polymerase chain reaction (PCR) assay results. This study followed the STROBE statement for reports of observational studies.ResultsThere was a significant correlation between BMI and streptococcal amount (ρ = 0.526, p < 0.001). The undernutrition group (BMI < 20) showed a significantly lower average number of oral streptococci (p = 0.003). In logistic regression models, streptococcal amount was a significant variable accounting for “not undernutrition” [odds ratio 5.68, 95% confidential interval (CI) 1.64–19.7 (p = 0.06)]. On the other hand, participants with a poor oral health condition (OHAT ≥ 5) harbored significantly higher levels of fungi (p = 0.028).ConclusionOral streptococci were found to be associated with systemic nutritional condition and oral fungi with oral health condition. Thus, in order to understand the relationship of frailty with the oral microbiota in older individuals, it is necessary to examine oral indigenous bacteria as well as etiological microorganisms.
Highlights
Disruption of the indigenous microbiota is likely related to frailty caused by undernutrition
Comparisons of health conditions and microbial amounts between participants with and without undernutrition Fifteen of the 41 participants were determined to have undernutrition based on a Body mass index (BMI) cut-off value of < 20, with the average ± standard deviation (SD) for those 17.5 ± 1.43, while that was 23.5 ± 3.49 for the participants in the group without undernutrition
Other than BMI, there were no significant differences between the groups for other systemic or oral health conditions (Table 1)
Summary
Disruption of the indigenous microbiota is likely related to frailty caused by undernutrition. The aim of this study was to elucidate the associations of nutritional and oral health conditions with prevalence of bacteria and fungi in the oral cavity of older individuals. Along with the general aging of society worldwide, frailty is gaining attention. This is a common geriatric syndrome that increases the risk of poor health outcomes, including. Indigenous microorganisms such as streptococci grow and develop a suitable microbiota based on the environment provided by the host [14]. When a normal oral microbiota is disturbed, the population of pathogenic microorganisms is increased, which causes oral and systemic diseases [17]. The oral microbiota can be affected by changes in the oral environment as well as general conditions, such as aging, immunosuppression, and medication [18,19,20]
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