Oral health and chemotherapy act as cofactors in malnutrition in the elderly with other cancers than head and neck malignancies

Clin Oral Investig. 2019 Jan;23(1):235-243. doi: 10.1007/s00784-018-2430-1. Epub 2018 Apr 2.

Abstract

Objectives: This study explores whether the chemotherapy regimen has a role in inducing oral health problems and malnutrition in elderly patients with other cancers than head and neck malignancies.

Material and methods: An observational cross-sectional study was designed to compare the relationships between oral health and nutritional status between four groups of elderly differing in cancer or chemotherapy regimen. Data were collected using a questionnaire including the Mini-Nutritional Assessment (MNA), the Geriatric Oral Health Assessment Index (GOHAI) and questions about perception of xerostomia. The oral examinations recorded the number of functional dental units (PFU) and the presence of oral lesions.

Results: The sample comprised 46 patients receiving chemotherapy, 48 patients on a non-chemotherapy regimen, 45 persons in complete remission not under treatment and 53 non-cancer patients. Oral health perception was significantly worse in chemotherapy patients. They reported limiting the kinds of food they consumed, the discomfort felt when eating and took medications for oral pain. Oral lesions were frequent in chemotherapy participants. Nutritional status was related to the cancer treatment regimen (OR = 4.17; p value = 0.017), the presence of oral lesions (OR = 4.51; p value = 0.003), perception of xerostomia (OR = 3.54; p value = 0.012), the number of PFU (OR = 2.51; p value = 0.046) and GOHAI score (OR = 1.617; p value = 0.019).

Conclusion: The presence of oral lesions and the chemotherapeutic regimen were highly associated with nutritional status in older patients with cancer.

Clinical relevance: Dental professionals should be asked to intervene preventively and per-therapy to optimise oral health status in elderly patients with other cancers than head and neck malignancies.

Keywords: Cancer; Chemotherapy; Elderly; Nutrition status; Oral health.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Geriatric Assessment*
  • Humans
  • Lebanon
  • Male
  • Malnutrition / etiology*
  • Neoplasms / drug therapy*
  • Nutrition Assessment
  • Oral Health*
  • Quality of Life
  • Risk Factors
  • Xerostomia / etiology