Advertisement

The journal of nutrition, health & aging

, Volume 22, Issue 2, pp 254–261 | Cite as

Oral health indicators for risk of malnutrition in elders

  • L. L. Wu
  • K. Y. Cheung
  • P. Y. P. Lam
  • Xiaoli Gao
Article

Abstract

Objectives

Using both clinical parameters and subjective measures of oral health, this study aimed to identify useful oral health indicators for the risk of malnutrition in elders.

Design

Cross-sectional study.

Setting

Five community centers run by non-government organizations (NGOs).

Participants

195 community dwelling elders (65 or above).

Measurements

An interviewer-administered questionnaire was completed to collect information on elders’ socio-demographic background and oral health perception and practice. Their number of teeth, number of occluding tooth pairs, dental caries, and periodontal condition were examined. General Oral Health Assessment Index (GOHAI), an instrument for assessing oral health related quality of life (OHQoL), was used as a subjective measure of oral health. The elders’ nutritional status was evaluated by using the Mini-Nutritional Assessment (MNA).

Results

The mean (SD) DFT was 3.3 (3.1). Over 60% of elders had periodontal pockets; 33% had fewer than 20 teeth and 6% were edentulous. The mean (SD) of occluding tooth pairs was 7.1 (4.8). The mean (SD) total GOHAI score was 56.4 (8.0); 60% reported negative impact of oral health on their quality of life. The mean (SD) MNA score was 25.0 (2.9); 30% had malnutrition or were at risk. After controlling for socio-demographic factors, none of the clinical indicators (dental caries, periodontal status, number of teeth, and number of occluding tooth pairs) were associated with risk of malnutrition (all p>0.05). Poorer OHQoL indicated a higher chance for malnutrition in both adjusted models (OR of 0.914; 95% CI of 0.850-0.982; p=0.014 and OR of 0.915; 95% CI of 0.852-0.984; p=0.017). Tooth loss and untreated decayed teeth (DT) were significant/marginally significant determinants of poor OHQoL.

Conclusion

Elders’ tooth loss and unmet treatment need for dental caries were associated with compromised quality of life, which indicated increased likelihood for malnutrition..

Keywords

Nutrition elderly oral health indicators oral health related quality of life Mini-Nutritional Assessment 

References

  1. 1.
    Semba RD, Blaum CS, Bartali B, Xue QL, Ricks MO, Guralnik JM, et al. Denture use, malnutrition, frailty, and mortality among older women living in the community. J. Nutr. Health Aging. 2006;10(2): 161–7.PubMedGoogle Scholar
  2. 2.
    Lesourd B. Nutrition: A major factor influencing immunity in the elderly. J. Nutr. Health Aging. 2004;8(1): 28–37.PubMedGoogle Scholar
  3. 3.
    Lee JS, Weyant RJ, Corby P, Kritchevsky SB, Harris TB, Rooks R, et al. Edentulism and nutritional status in a biracial sample of well-functioning, community-dwelling elderly: the health, aging, and body composition study. Am. J. Clin. Nutr. 2004;79(2): 295–302.PubMedGoogle Scholar
  4. 4.
    Chen CC. A framework for studying the nutritional health of community-dwelling elders. Nurs. Res. 2005;54(1): 13–21.CrossRefPubMedGoogle Scholar
  5. 5.
    Elia M, Zellipour L, Stratton RJ. To screen or not to screen for adult malnutrition? Clin. Nutr. 2005;24(6): 867–84.Google Scholar
  6. 6.
    Cuervo M, Garcia A, Ansorena D, Sanchez-Villegas A, Martinez-Gonzalez M, Astiasaran I, et al. Nutritional assessment interpretation on 22,007 spanish community-dwelling elders through the Mini Nutritional Assessment test. Public health Nutr. 2009;12(1): 82–90.CrossRefPubMedGoogle Scholar
  7. 7.
    Van Lancker A, Verhaeghe S, Van Hecke A, Vanderwee K, Goossens J, Beeckman D. The association between malnutrition and oral health status in elderly in long-term care facilities: a systematic review. Int. J. Nurs. Stud. 2012;49(12): 1568–81.CrossRefPubMedGoogle Scholar
  8. 8.
    Lopez-Jornet P, Saura-Perez M, Llevat-Espinosa N. Effect of oral health dental state and risk of malnutrition in elderly people. Geriatrics & gerontology international 2013;13(1): 43–9.CrossRefGoogle Scholar
  9. 9.
    Sahyoun NR, Lin CL, Krall E. Nutritional status of the older adult is associated with dentition status. J. Am. Diet. Assoc. 2003;103(1): 61–6.CrossRefPubMedGoogle Scholar
  10. 10.
    De Marchi RJ, Hugo FN, Hilgert JB, Padilha DM. Association between oral health status and nutritional status in south brazilian independent-living older people. Nutrition2008;24(6): 546–53.Google Scholar
  11. 11.
    Sheiham A, Steele J. Does the condition of the mouth and teeth affect the ability to eat certain foods, nutrient and dietary intake and nutritional status amongst older people? Public health Nutr. 2001;4(3): 797–803.CrossRefPubMedGoogle Scholar
  12. 12.
    El Osta N, Hennequin M, Tubert-Jeannin S, Abboud Naaman NB, El Osta L, Geahchan N. The pertinence of oral health indicators in nutritional studies in the elderly. Clin. Nutr. 2014;33(2): 316–21.CrossRefPubMedGoogle Scholar
  13. 13.
    Petersen PE, Yamamoto T. Improving the oral health of older people: The approach of the WHO Global Oral Health Programme. Community Dent. Oral Epidemiol. 2005;33(2): 81–92.CrossRefPubMedGoogle Scholar
  14. 14.
    Mesas AE, Andrade SM, Cabrera MA, Bueno VL. Oral health status and nutritional deficit in noninstitutionalized older adults in Londrina, Brazil. Revista Brasileira de Epidemiologia 2010;13(3): 434–45.CrossRefPubMedGoogle Scholar
  15. 15.
    Gil-Montoya JA, Ponce G, Sanchez Lara I, Barrios R, Llodra JC, Bravo M. Association of the oral health impact profile with malnutrition risk in Spanish elders. Arch. Gerontol. Geriatr. 2013;57(3): 398–402.CrossRefPubMedGoogle Scholar
  16. 16.
    Mojon P, Budtz-Jorgensen E, Rapin CH. Relationship between oral health and nutrition in very old people. Age Ageing. 1999;28(5): 463–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Sheiham A, Steele JG, Marcenes W, Tsakos G, Finch S, Walls AW. Prevalence of impacts of dental and oral disorders and their effects on eating among older people; a national survey in Great Britain. Community Dent. Oral Epidemiol. 2001;29(3): 195–203.CrossRefPubMedGoogle Scholar
  18. 18.
    Srisilapanan P, Malikaew P, Sheiham A. Number of teeth and nutritional status in Thai older people. Community Dent. Health. 2002;19(4): 230–6.PubMedGoogle Scholar
  19. 19.
    Kshetrimayum N, Reddy CV, Siddhana S, Manjunath M, Rudraswamy S, Sulavai S. Oral health-related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore city, India. Gerodontology 2013;30(2): 119–25.CrossRefPubMedGoogle Scholar
  20. 20.
    Allen PF. Association between diet, social resources and oral health related quality of life in edentulous patients. J. Oral Rehabil. 2005;32(9): 623–8.CrossRefPubMedGoogle Scholar
  21. 21.
    World Health Organization. International classification of impairments, disabilities, and handicaps: a manual of classification relating to the consequences of disease. Geneva: World Health Organization; 1980, p. 205.Google Scholar
  22. 22.
    Martins AM, Barreto SM, Silveira MF, Santa-Rosa TT, Pereira RD. Selfperceived oral health among Brazilian elderly individuals. Revista de saude publica 2010;44(5): 912–922.CrossRefPubMedGoogle Scholar
  23. 23.
    Locker D, Gibson B. Discrepancies between self-ratings of and satisfaction with oral health in two older adult populations. Community dentistry and oral epidemiology 2005;33(4): 280–288.CrossRefPubMedGoogle Scholar
  24. 24.
    Daly RM, Elsner RJ, Allen PF, Burke FM. Associations between self-reported dental status and diet. J. Oral Rehabil. 2003;30(10): 964–70.CrossRefPubMedGoogle Scholar
  25. 25.
    Atchison KA, Dolan TA. Development of the Geriatric Oral Health Assessment Index. J. Dent. Educ. 1990;54(11): 680–7.PubMedGoogle Scholar
  26. 26.
    Wong MC, Liu JK, Lo EC. Translation and validation of the chinese version of GOHAI. J. Public Health Dent. 2002;62(2): 78–83.CrossRefPubMedGoogle Scholar
  27. 27.
    Vellas B, Villars H, Abellan G, Soto ME, Rolland Y, Guigoz Y, et al. Overview of the MNA—its history and challenges. J. Nutr. Health Aging. 2006;10(6): 456–63; discussion 463-5.PubMedGoogle Scholar
  28. 28.
    Cereda E. Mini nutritional assessment. Curr. Opin. Clin. Nutr. Metab. Care. 2012;15(1): 29–41.CrossRefPubMedGoogle Scholar
  29. 29.
    N. El Osta, S. Tubert-Jeannin, M. Hennequin, N. Bou Abboud Naaman, L. El Osta, N. Geahchan. Oral and general health indicators for Lebanese elderly in oral surveys: review article. International Arab Journal of Dentistry. 2012;3(2): 54–61.Google Scholar
  30. 30.
    World Health Organization. Oral health surveys -basic methods, 5th edition. Geneva, 2013.Google Scholar
  31. 31.
    Gotfredsen K, Walls AW. What dentition assures oral function? Clin. Oral Implants Res. 2007;18 Suppl 3: 34–45.CrossRefGoogle Scholar
  32. 32.
    Menard S. Applied logistic regression analysis. 2nd ed. Thousand Oaks, Calif.: Sage.Google Scholar
  33. 33.
    Griep MI, Mets TF, Collys K, Ponjaert-Kristoffersen I, Massart DL. Risk of mal nutrition in retirement homes elderly persons measured by the «mininutritional assessment». J. Gerontol. A Biol. Sci. Med. Sci. 2000;55 (2): M57–63.CrossRefPubMedGoogle Scholar
  34. 34.
    El Osta N, Tubert-Jeannin S, Hennequin M, Bou Abboud Naaman N, El Osta L, Geahchan N. Comparison of the OHIP-14 and GOHAI as measures of oral health among elderly in Lebanon. Health and quality of life outcomes 2012;10:131.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    McGrath C, Bedi R. Dental services and perceived oral health: are patients better off going private? J. Dent. 2003;31(3): 217–21.CrossRefGoogle Scholar
  36. 36.
    Rong WS, Lo EC. Effect of providing outreach oral health care to institutionalised elders in Hong Kong. Oral health & preventive dentistry 2009;7(3): 261–267.Google Scholar
  37. 37.
    Ulinski KG, do Nascimento MA, Lima AM, Benetti AR, Poli-Frederico RC, Fernandes KB, et al. Factors related to oral health-related quality of life of independent brazilian elderly. Int J Dent 2013.Google Scholar
  38. 38.
    Christensen LB, Hede B, Nielsen E. A cross-sectional study of oral health and oral health-related quality of life among frail elderly persons on admission to a special oral health care programme in Copenhagen City, Denmark. Gerodontology 2012;29(2): e392–400.CrossRefPubMedGoogle Scholar
  39. 39.
    Wall TP, Brown LJ. Recent trends in dental visits and private dental insurance, 1989 and 1999. J. Am. Dent. Assoc. 2003;134(5): 621–7.CrossRefPubMedGoogle Scholar
  40. 40.
    De Visschere LM, Grooten L, Theuniers G, Vanobbergen JN. Oral hygiene of elderly people in long-term care institutions—a cross-sectional study. Gerodontology 2006;23(4): 195–204.CrossRefPubMedGoogle Scholar
  41. 41.
    Zhao L, Lin HC, Lo EC, Wong MC. Clinical and socio-demographic factors influencing the oral health-related quality of life of chinese elders. Community Dent. Health. 2011;28(3): 206–10.PubMedGoogle Scholar
  42. 42.
    Steele JG, Sanders AE, Slade GD, Allen PF, Lahti S, Nuttall N, et al. How do age and tooth loss affect oral health impacts and quality of life? A study comparing two national samples. Community Dent. Oral Epidemiol 2004;32(2): 107–14.CrossRefPubMedGoogle Scholar
  43. 43.
    Carr AJ, Gibson B, Robinson PG. Measuring quality of life: Is quality of life determined by expectations or experience? BMJ. 2001;322(7296): 1240–1243.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Niesten D, van Mourik K, van der Sanden W. The impact of frailty on oral care behavior of older people: a qualitative study. BMC oral health 2013;13: 61.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Atchison KA, Der-Martirosian C, Gift HC. Components of self-reported oral health and general health in racial and ethnic groups. J. Public Health Dent. 1998;58 (4):301–8.CrossRefPubMedGoogle Scholar
  46. 46.
    Tubert-Jeannin S, Riordan PJ, Morel-Papernot A, Porcheray S, Saby-Collet S. Validation of an oral health quality of life index (GOHAI) in france. Community Dent. Oral Epidemiol 2003;31(4): 275–84.CrossRefPubMedGoogle Scholar
  47. 47.
    Locker D, Matear D, Stephens M, Lawrence H, Payne B. Comparison of the GOHAI and OHIP-14 as measures of the oral health-related quality of life of the elderly. Community Dent. Oral Epidemiol. 2001;29(5): 373–81.CrossRefPubMedGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2017

Authors and Affiliations

  • L. L. Wu
    • 1
  • K. Y. Cheung
    • 1
  • P. Y. P. Lam
    • 1
  • Xiaoli Gao
    • 1
  1. 1.Dental Public health, Faculty of DentistryThe University of Hong KongSai Ying PunHong Kong

Personalised recommendations