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

Eva Kiesswetter, Linda M. Hengeveld, Bart JF Keijser, Dorothee Volkert, Marjolein Visser

Research output: Contribution to JournalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)73-80
Number of pages8
JournalJournal of Dentistry
Volume85
DOIs
Publication statusPublished - 1 Jun 2019

Fingerprint

Independent Living
Oral Health
Malnutrition
Toothache
Xerostomia
Mastication
Tooth
Dentures
Oral Hygiene
Proportional Hazards Models
Self Report
Health Status
Longitudinal Studies
Weight Loss
Body Mass Index

Keywords

  • Aged
  • Community
  • Dentures
  • Nutritional status
  • Tooth
  • Xerostomia

Cite this

@article{afe239e62bc3409eb2df949f619c5d28,
title = "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.",
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Oral health determinants of incident malnutrition in community-dwelling older adults. / Kiesswetter, Eva; Hengeveld, Linda M.; Keijser, Bart JF; Volkert, Dorothee; Visser, Marjolein.

In: Journal of Dentistry, Vol. 85, 01.06.2019, p. 73-80.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Oral health determinants of incident malnutrition in community-dwelling older adults

AU - Kiesswetter, Eva

AU - Hengeveld, Linda M.

AU - Keijser, Bart JF

AU - Volkert, Dorothee

AU - Visser, Marjolein

PY - 2019/6/1

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N2 - 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.

AB - 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.

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