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

Abstract

Objective: Poor 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.

Methods: This 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.

Results: The 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.

Conclusions: We 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 significance: Regarding 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.

Keywords: Aged; Community; Dentures; Nutritional status; Tooth; Xerostomia.