A Pilot Cross-Sectional Study on Oral Health and Nutritional Status of Institutionalized Older Adults: A Focus on Sarcopenia

Abstract

The global population aged over 60 will double by 2050. This pilot cross-sectional study aims at evaluating nutritional and oral health status and the prevalence of sarcopenia in older adults living in an Italian residential aged care facility. Thirty-two adults aged ≥ 65 years were included. Individual sociodemographic data and nutritional and oral health data were collected. For sarcopenia diagnosis, muscle mass, physical performance, muscle strength and anthropometric parameters were recorded. Participants underwent a nutritional screening and a dental examination. Mini Nutritional Assessment and masticatory mixing ability test were performed. The results showed that men recorded a hand strength significantly higher than that of women, 25.5 ± 7.2 Kg vs. 12.8 ± 5.9 Kg (p < 0.01), respectively. Gait speed test showed that only 20.8% of the participants had a speed of more than 0.8 m/s. A strong negative correlation between masticatory performance and the number of missing teeth was detected (r = −0.84, 95% C.I. [−0.92; −0.69], p < 0.01). Overall, a high percentage of institutionalized older adults were diagnosed as being sarcopenic. Poor oral health in older adults is a major general health problem as it may restrict both food selection and nutrient intake, representing a risk factor for sarcopenia, although longitudinal studies are needed to confirm this relationship.

Oral health assessment in institutionalized elderly: a scoping review

“…OHI score of less than -Volpe-Manhold Index [39,86] -Calculus index; ranging 0-3 [43] -Presence/absence calculus [45] -Average calculus score [94] Gingivitis/periodontitis assessment 1 [95] Pocket depth > 5.5 mm, bleeding, suppuration and / or tooth mobility class III -Approximal plaque index determined in percentages [55] Bleeding index 7 [32,35,45,55,86,93,98] -Modified sulcus bleeding index, grades 0-3 [93] -Papilla bleeding index [86] -Gingival bleeding index [32,35,98] -Presence of bleeding after probing [45] -Sulcus bleeding index [55] Gingival/gingivitis index -Food debris after rinsing, 6-point scale [86] -Debris index, ranging 0-3 [40,43,83,90] Tongue coating index 2 [76,99] -Tongue coating coverage, grades 0-4 [99] -Using the classification by Miyazaki [76] Oral hygiene assessment based on dependency 1 [92] The extent to which the patient can independently practice oral hygiene Independence of oral care 1 [76] The ability to independently perform oral selfcare Twenty chewing cycles with two-color chewing gum. After flattening, the gum was scanned and colorimetric assessment was performed [38,59] or a score was given, grades 1-5 [27] Clinical dental functionality (CDF) score 1 [96] CDF score is based on the even distribution of functional contacts in the upper and lower jaw Swallowing threshold 1 [38] The number of chewing cycles performed by the patient to chew a porti...…”

“…Masticatory difficulties (VAS 0-10) 1 [59] Visual Analog Scale to measure masticatory difficulties missed, filled teeth/surfaces (DMFT/S) index. The DMFT/S was used in 38 studies [29,35,.…”

“…Eleven studies used other periodontal measures: measurements according to the National Institute of Dental Research Criteria [53], the Periodontal Screening Index [44,58,59], Dutch Periodontal Screening Index [71], Extent and Severity Index [52] and The Miller Index score [45,76]; -National Institute of Dental Research Criteria; examination of 6 teeth on 6 sides and assessing presence or absence of dental plaque, gingival bleeding, supraand subgingival calculus, as well as probing pocket depth [53]. -Periodontal Screening Index [26]: screening 6 points per tooth and per sextant ranging from 0-4 based on probing depth, bleeding on probing and calculus.…”

A Cross-Sectional Study on the Relationship between Oral Function and Sarcopenia in Japanese Patients with Regular Dental Maintenance

“…It is a risk factor for disability, hospitalization, death, and dementia [9]. Some previous studies have investigated the relationship between oral function and sarcopenia [10][11][12][13]. However, most of them are single oral function assessments, and only a few have investigated the relationship between poor oral function and sarcopenia using all the items of the oral hypofunction test [14,15].…”

“…Oral pain, prosthetic status for missing teeth, or the fit of removable dentures may also affect oral function assessment. However, previous studies have not considered dental diseases, such as dental caries, missing teeth, or poor fit of removable dentures in participants [3,[10][11][12][13][14][15]. Kikutani defined organic masticatory disorder as a masticatory disorder caused by loss of masticatory organs due to pain in the mouth, progression of periodontal disease, and others, and mobility-impaired impaired masticatory disorder as a masticatory disorder caused by loss of oral function due to aging or disease [16].…”