Oral health determinants of incident malnutrition in community-dwelling older adults

Abstract

ObjectivePoor oral health might be a modifiable determinant of malnutrition in older age. We aimed to investigate the associations of multiple oral health characteristics with incident malnutrition in community-dwelling older adults. MethodsThis exploratory analysis is based on prospective data from 893 participants, aged 55–80 years without malnutrition in 2005/06 from the Longitudinal Aging Study Amsterdam. In 2007, 19 oral health characteristics from the domains teeth/dentures, oral hygiene, oral problems, and self-rated oral health were assessed by questionnaire. Incident malnutrition was defined as presence of low body mass index (<20 kg/m² in people <70 years, <22 kg/m² ≥70 years) and/or self-reported involuntary weight loss ≥5% in previous 6 months at any of the follow-ups (2008/09, 2012/13, 2015/16). Associations of oral aspects with incident malnutrition were analyzed by cox proportional hazard models and adjusted for confounders. ResultsThe 9-year incidence of malnutrition was 13.5%. Sixteen of 19 oral health aspects were not associated with incident malnutrition in the crude models. Adjusted hazard ratios for incident malnutrition were 2.14 (1.10–4.19, p = 0.026) for toothache while chewing, 2.10 (0.88–4.98, p = 0.094) for an unhealthy oral health status, and 1.99 (0.93–4.28, p = 0.077) for xerostomia in edentulous participants, however, the two latter ones failing to reach statistical significance. ConclusionsWe identified toothache while chewing as determinant of incident malnutrition in community-dwelling older adults, and found indications that poor oral health and xerostomia in combination with having no teeth may play a role in developing malnutrition. However, these outlined tendencies need to be proven in further studies. Clinical SignificanceRegarding the development of strategies to prevent malnutrition in older people toothache while chewing, xerostomia, and self-rated oral health would be of specific interest as these factors are modifiable and can be easily assessed by self-reports.