Background/Objectives The poor oral hygiene of nursing home (NH) residents is a matter of increasing concern, especially due to its relationship to pneumonia and other health events. Because details and related risk factors in this area are scant, and providers need to be able to easily identify those residents at most risk, this study comprehensively examined the plaque, gingival, and denture status of NH residents, as well as readily available correlates of those indicators of oral hygiene, including items from the Minimum Data Set (MDS). Design An oral hygiene assessment and chart abstract conducted on a cross-section of NH residents Setting Fourteen NHs in North Carolina Participants 506 NH residents Measurements Descriptive data from the MDS and assessments using three standardized measures: the Plaque Index for Long-Term Care (PI-LTC), the Gingival Index for Long-Term Care (GI-LTC), and the Denture Plaque Index (DPI) Results Oral hygiene scores averaged 1.7 (of 3) for the PI-LTC, 1.5 (of 4) for the GI-LTC, and 2.2 (of 4) for the DPI. Factors most strongly associated with poor oral hygiene scores included having dementia, being on hospice care, and longer length of stay. MDS ratings of gingivitis differed significantly from oral hygiene assessments. Conclusions Findings identify resident subgroups that are at especially high risk of poor oral health who can be targeted in quality improvement efforts related to oral hygiene; they also indicate need to improve the accuracy of how MDS items are completed.

BackgroundCalorie for calorie, protein is more satiating than carbohydrate or fat. However, it remains unclear whether humans perceive calories derived from these macronutrients equally and whether lean mass is associated with a tendency to “value” protein when dietary decisions are made.ObjectivesThis study aimed to determine the test-retest reliability of a novel method for quantifying macronutrient valuations in human volunteers and to determine whether “protein valuation” is associated with a higher fat-free mass index (FFMI) in older adults.MethodsA 2-alternative, forced-choice task in which 25 foods were compared in 300 trials was undertaken in 2 studies. In study 1, participants (age range 19–71 y, n = 92) attended 2 test sessions, spaced 1 wk apart. In study 2, older adults (age range 40–85 y; n = 91) completed the food-choice task and assessed the test foods for liking, expected satiety, and perceived healthiness. Body composition and habitual protein intake were assessed in both studies. Data were analyzed through the use of individual binomial logistic regressions and multilevel binomial logistic regressions.ResultsIn study 1, measures of macronutrient valuation showed excellent test-retest reliability; responses in the forced-choice task were highly correlated (week 1 compared with week 2; protein, r = 0.83, P < 0.001; carbohydrate, r = 0.90, P < 0.001; fat, r = 0.90, P < 0.001). Calorie for calorie, protein and carbohydrate were stronger predictors of choice than fat (P < 0.001). In study 2, protein was a stronger predictor than both carbohydrate (P = 0.039) and fat (P = 0.003), and a positive interaction was observed between protein valuation and FFMI (OR = 1.64; 95% CI: 1.38, 1.95; P < 0.001). This was the case after controlling for age, gender, liking for foods, and habitual protein consumption.ConclusionsTogether, these findings demonstrate that adult humans value calories derived from protein, carbohydrate, and fat differently, and that the tendency to value protein is associated with greater lean mass in older adults.

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