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BMC Geriatrics
Published in: BMC Geriatrics 1/2017

Open Access 01-12-2017 | Research Article

Oral Health and nutritional status in nursing home residents—results of an explorative cross-sectional pilot study

Authors: Dirk Ziebolz, Christine Werner, Gerhard Schmalz, Ina Nitschke, Rainer Haak, Rainer F. Mausberg, Jean-François Chenot

Published in: BMC Geriatrics | Issue 1/2017

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Abstract

Background

This study was performed to assess oral and nutritional status of nursing home residents in a region of Lower Saxony, Germany. The aim was to show potential associations between oral status (dentate or edentulous), further anamnestic factors (dementia, age, smoking) and the risk for malnutrition in this population.

Methods

In this observational cross-sectional pilot study of residents from four nursing homes Mini Nutritional Assessment (MNA), Body-Mass-Index (BMI), dental status (DMF-T) and periodontal situation (PSR®/PSI) were recorded. Associations of recorded factors with oral health and nutritional status were examined in univariate and multivariate analysis.

Results

Eighty-seven residents participated in the study (mean age: 84.1 years; female: 72%, demented: 47%). Average BMI was 26.2 kg/m2; according MNA 52% were at risk for malnutrition. 48% of the residents were edentulous, and the average DMF-T of dentulous was 25.0 (3.7) (D-T: 2.0 [3.1], M-T: 15.0 [8.3], F-T: 8.0 [7.4]); PSR®/PSI 3 and 4 (need for periodontal treatment) showed 79% of residents. In univariate analysis dementia (OR 2.5 CI95 1.1–5.6) but not being edentulous (OR 2.0 CI95 0.8–5.8) were associated with being at risk for malnutrition. Dementia remained associated in multivariate analysis adjusting for age and sex, (OR 3.1 CI95 1.2–8.2) and additionally being edentulous (OR 2.8 CI95 1.1–7.3) became associated significantly. Furthermore, nursing home residents with dementia had more remaining teeth (OR 2.5 CI95 1.1–5.9).

Conclusion

Dementia was a stronger predictor for risk of malnutrition in nursing home residents than being edentulous. Further studies to elucidate the possible role of oral health as cofactor for malnutrition in dementia are needed.
Literature
1.
Müller F, Nitschke I. Oral health, dental state and nutrition in older adults. Z Gerontol Geriatr. 2005;38:334–41 [in German].CrossRefPubMed
2.
Saunders MJ, Stattmiller SP, Kirk KM. Oral health issues in the nutrition of institutionalized elders. J Nutr Elder. 2007;26:39–58.CrossRefPubMed
3.
Kluge F, Zagheni E, Loichinger E, Vogt T. The advantages of demographic change after the wave: fewer and older, but healthier, greener, and more productive? Plos One. 2014;9:e108501.CrossRefPubMedPubMedCentral
4.
Jones JA, Orner MB, Spiro A, et al. Tooth loss and dentures: patients’ perspectives. Int Dent J. 2003;5:327–34.CrossRef
5.
6.
Micheelis W, Schiffner U. The fourth German oral health study (DMS IV). In: Institut der Deutschen Zahnärzte, editor. IDZ materialienreihe band 31. Köln: Deutscher Zahnärzte Verlag DÄV; 2006 [in German].
7.
Fitzpatrick J. Oral health care needs of dependent older people: responsibilities of nurses and care staff. J Adv Nurs. 2000;32:1325–32.CrossRefPubMed
8.
De Visschere L, Grooten L, Theuniers G, Vanobbergen JN. Oral hygiene of elderly people in longterm care institutions—a cross-sectional study. Gerodontology. 2006;23:195–204.CrossRefPubMed
9.
Frenkel HF, Harvey I, Newcombe RG. Oral health care among nursing home residents in Avon. Gerodontology. 2000;17:33–8.CrossRefPubMed
10.
Vanobbergen JN, De Visschere LM. Factors contributing to the variation in oral hygiene practices and facilities in long-term care institutions for the elderly. Community Dent Health. 2005;22:260–5.PubMed
11.
Lesourd B. Protein undernutrition as the major cause of decreased immune function in the elderly: clinical and functional implications. Nutr Rev. 1995;53:86–94.CrossRef
12.
Sullivan DH, Martin W, Flaxman N, Hagen JE. Oral health problems and involuntary weight loss in a population of frail elderly. J Am Geriatr Soc. 1993;41:725–31.CrossRefPubMed
13.
Lopez-Jornet P, Saura-Perez M, Llevat-Espinosa N. Effect of oral health dental state and risk of malnutrition in elderly people. Geriatr Gerontol Int. 2013;13:43–9.CrossRefPubMed
14.
Hildebrandt GH, Dominguez BL, Schork MA, Loesche WJ. Functional units, chewing, swallowing, and food avoidance among the elderly. J Prosthet Dent. 1997;77:588–95.CrossRefPubMed
15.
Bell CL, Lee AS, Tamura BK. Malnutrition in the nursing home. Curr Opin Clin Nutr Metab Care. 2015;18:17–23.CrossRefPubMed
16.
Moreira NC, Krausch-Hofmann S, Matthys C, Vereecken C, Vanhauwaert E, Declercq A, Bekkering GE, Duyck J. Risk factors for malnutrition in older adults: a systematic review of the literature based on longitudinal data. Adv Nutr. 2016;7:507–22.CrossRefPubMed
17.
Zenthöfer A, Schröder J, Cabrera T, Rammelsberg P, Hassel AJ. Comparison of oral health among older people with and without dementia. Community Dent Health. 2014;31:27–31.PubMed
18.
Syrjälä AM, Ylöstalo P, Ruoppi P, Komulainen K, Hartikainen S, Sulkava R, Knuuttila M. Dementia and oral health among subjects aged 75 years or older. Gerodontology. 2012;29:36–42.CrossRefPubMed
19.
Chen X, Shuman SK, Hodges JS, Gatewood LC, Xu J. Patterns of tooth loss in older adults with and without dementia: a retrospective study based on a Minnesota cohort. J Am Geriatr Soc. 2010;58:2300–7.CrossRefPubMed
20.
Elsig F, Schimmel M, Duvernay E, Giannelli SV, Graf CE, Carlier S, Herrmann FR, Michel JP, Gold G, Zekry D, Müller F. Tooth loss, chewing efficiency and cognitive impairment in geriatric patients. Gerodontology. 2015;32:149–56.CrossRefPubMed
21.
Okamoto N, Morikawa M, Okamoto K, Habu N, Iwamoto J, Tomioka K, Saeki K, Yanagi M, Amano N, Kurumatani N. Relationship of tooth loss to mild memory impairment and cognitive impairment: findings from the Fujiwara-kyo study. Behav Brain Funct. 2010;31(6):77.CrossRef
22.
Luo J, Wu B, Zhao Q, Guo Q, Meng H, Yu L, Zheng L, Hong Z, Ding D. Association between tooth loss and cognitive function among 3063 Chinese older adults: a community-based study. Plos One. 2015;10:e0120986.CrossRefPubMedPubMedCentral
23.
Jordan RA, Micheelis W. The fifth German oral health study (DMS V). In: Institut der Deutschen Zahnärzte, editor. IDZ materialienreihe band 35. Köln: Deutscher Zahnärzte Verlag DÄV; 2016 [in German].
24.
Guigoz Y, Vellas B, Garry PJ. Mini nutritional assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts Res Gerontol. 1994;Supplement:11–59.
25.
Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, Albarede JL. The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999;15:116–22.CrossRefPubMed
26.
WHO. World Health Organization: oral health surveys, basic methods. 4th ed. Genf: WHO; Oral Health Unit; 1997.
27.
Meyle J, Jepsen S. The periodontal screening-index (PSI). Parodontol. 2000;11:17–21 [in German].
28.
Allison PD. Multiple regression: a primer (research methods and statistics). 1999. Pine Forge Press Series in Res
29.
WHO. World Health Organization Obesity: preventing and managing the global epidemic. Report of a WHO consultation. 2000;894:i–xii, 1–253. Epub 2001/03/10
30.
Rojer AG, Kruizenga HM, Trappenburg MC, Reijnierse EM, Sipilä S, Narici MEAN, Hogrel JY, Butler-Browne G, McPhee JS, Pääsuke M, Meskers CG, Maier AB, de van der Schueren MA. The prevalence of malnutrition according to the new ESPEN definition in four diverse populations. Clin Nutr 2015 Jun 20. doi: 10.​1016/​j.​clnu.​2015.​06.​005. [Epub ahead of print]
31.
Rejnefelt I, Andersson P, Renvert S. Oral health status in individuals with dementia living in special facilities. Int J Dent Hyg. 2006;4:67–71.CrossRefPubMed
32.
Hopcraft MS, Morgan MEAN, Satur JG, Wright FA. Edentulism and dental caries in victorian nursing homes. Gerodontology. 2012;29:512–9.CrossRef
33.
Simunković SK, Boras VV, Pandurić J, Zilić IA. Oral health among institutionalised elderly in Zagreb, Croatia. Gerodontology. 2005;22:238–41.CrossRefPubMed
34.
Rabiei M, Kasemnezhad E, Masoudi rad H, Shakiba M, Pourkay H. Prevalence of oral and dental disorders in institutionalised elderly people in Rasht, Iran. Gerodontology. 2010;27:174–7.CrossRefPubMed
35.
Northridge ME, Ue FV, Borrell LN, De La Cruz LD, Chakraborty B, Bodnar S, Marshall S, Lamster IB. Tooth loss and dental caries in community-dwelling older adults in northern Manhattan. Gerodontology. 2012;29:464–73.CrossRef
36.
Montal S, Tramini P, Triay JA, Valcarcel J. Oral hygiene and the need for treatment of the dependent institutionalised elderly. Gerodontology. 2006;23:67–72.CrossRefPubMed
37.
Gluhak C, Arnetzl GV, Kirmeier R, Jakse N, Arnetzl G. Oral status among seniors in nine nursing homes in Styria, Austria. Gerodontology. 2010;27:47–52.CrossRefPubMed
38.
Hopcraft MS, Morgan MEAN, Satur JG, Wright FA, Darby IB. Oral hygiene and periodontal disease in victorian nursing homes. Gerodontology. 2012;29:220–8.CrossRef
39.
Samson H, Strand GV, Haugejorden O. Change in oral health status among the institutionalized Norwegian elderly over a period of 16 years. Acta Odontol Scand. 2008;66:368–73.CrossRefPubMed
40.
Amorim Sena Pereira ML, de Almeida MP, Cunha De Oliveira C, Carneiro Roriz AK, Teresópolis Reis Amaral M, Lima Mello A, Barbosa Ramos L. Nutritional status of institutionalized elderly Brazilians: a study with the mini nutritional assessment. Nutr Hosp. 2014;31:1198–204.PubMed
41.
Nazemi L, Skoog I, Karlsson I, Hosseini S, Mohammadi MR, Hosseini M, Hosseinzade MJ, Mesbah-Namin SA, Baikpour M. Malnutrition, prevalence and relation to some risk factors among elderly residents of nursing homes in Tehran, Iran. Iran J Public Health. 2015;44:218–27.PubMedPubMedCentral
42.
Gordon AL, Franklin M, Bradshaw L, Logan P, Elliott R, Gladman JR. Health status of UK care home residents: a cohort study. Age Ageing. 2014;43:97–103.CrossRefPubMed
43.
Adil A, Abbasi MD, Rudmann D. Undernutrition in the nursing home: prevalence, consequences, causes and prevention. Nutr Rev. 1994;52:113–20.
44.
Lamy M, Mojon P, Kalykakis G, Legrand R, Butz-Jorgensen E. Oral status and nutrition in the institutionalized elderly. J Dent. 1999;27:443–8.CrossRefPubMed
45.
Cousson PY, Bessadet M, Nicolas E, Veyrune JL, Lesourd B, Lassauzay C. Nutritional status, dietary intake and oral quality of life in elderly complete denture wearers. Gerodontology. 2012;29:685–92.CrossRef
46.
Shinkai RS, Hatch JP, Rugh JD, Sakai S, Mobley CC, Saunders MJ. Dietary intake in edentulous subjects with good and poor quality complete dentures. J Prosthet Dent. 2002;87:490–8.CrossRefPubMed
47.
Sahyoun NR, Lin CL, Krall E. Nutritional status of the older adult is associated with dentition status. J Am Diet Assoc. 2003;103:61–6.CrossRefPubMed
48.
Wöstmann B, Michel K, Brinkert B, Melchheier-Weskott A, Rehmann P, Balkenhol M. Influence of denture improvement on the nutritional status and quality of life of geriatric patients. J Dent. 2008;36:816–21.CrossRefPubMed
49.
Volkert D, Chourdakis M, Faxen-Irving G, Frühwald T, Landi F, Suominen MH, Vandewoude M, Wirth R, Schneider SM. ESPEN guidelines on nutrition in dementia. Clin Nutr. 2015;34:1052–73.CrossRefPubMed
50.
Sanders C, Behrens S, Schwartz S, Wengreen H, Corcoran CD, Lyketsos CG, Tschanz JT. Nutritional status is associated with faster cognitive decline and worse functional impairment in the progression of dementia: the cache county dementia progression study. J Alzheimers Dis. 2016;52:33–42.CrossRefPubMed
51.
Chen X, Clark JJ, Naorungroj S. Oral health in nursing home residents with different cognitive statuses. Gerodontology. 2013;30:49–60.CrossRefPubMed
52.
Gaur S, Agnihotri R. Alzheimer’s disease and chronic periodontitis: is there an association? Geriatr Gerontol Int. 2015;15:391–404.CrossRefPubMed
Metadata
Title
Oral Health and nutritional status in nursing home residents—results of an explorative cross-sectional pilot study
Authors
Dirk Ziebolz
Christine Werner
Gerhard Schmalz
Ina Nitschke
Rainer Haak
Rainer F. Mausberg
Jean-François Chenot
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2017
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-017-0429-0

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