Relationship between polypharmacy, xerostomia, gustatory sensitivity, and swallowing complaints in the elderly: A multidisciplinary approach

Abstract

Oral dysfunctions are common in the elderly but the literature lacks a multidisciplinary approach on the relationship between polypharmacy, saliva flow, xerostomia, taste, and swallowing complaints. This cross‐sectional study included 204 non‐institutionalized elderly (>60 years; 123 women/81 men), free of severe disabilities and non‐alcohol/tobacco consumers, from whom specific pharmacological therapies were evaluated, as well xerostomia (Xerostomia Inventory‐XI) and swallowing complaints (EAT‐10 questionnaire), salivary flow rate and gustatory sensitivity. Statistical analysis included Chi‐square, Mann–Whitney, Two‐way ANCOVA, and linear multiple regression. Polypharmacy (≥5 drugs daily), hyposalivation, and severe taste dysfunction were found in 18, 46, and 10% of the participants, respectively. Polypharmacy was related with xerostomia (p = .041) and swallowing complaints (p < .001; power = 94%), but not with taste dysfunction. Dry mouth complaint and higher risk of swallowing disorders were found in 50 and 12% of the elderly, respectively, and angiotensin‐converting enzyme (ACE) inhibitors users (n = 36) showed higher EAT‐10 scores (p = .038). Regression models showed that stimulated salivary flow rate was dependent on gender and diuretic use, while xerostomia scores were dependent on the number of medications and unstimulated saliva flow (p < .001). In conclusion, the results draw attention to the high frequency of oral and maxillofacial dysfunctions found in non‐institutionalized elderly, especially polypharmacy, xerostomia and swallowing complaints, and the side effects of drugs that can disturb the oral functions, the acceptance of food, and the adherence to oral therapies.

Oral and Mucosal Complaints among Institutionalized Care Seniors in Malopolska Voivodeship—The Utility of the Mirror Sliding Test in an Assessment of Dry Mouth

“…At the same time, it should be mentioned that we did not show differences in reported complaints between patients who underwent different types of care. This is consistent with previously published work [ 26 ]. Therefore, it should be understood that the oral health of elderly patients in an institutionalized 24-h care is poor and tends to deteriorate already before they are admitted to this type of facility [ 27 ].…”

Prevalence and Biological Correlates of Oropharyngeal Dysphagia in Outpatients of a Geriatric Evaluation Clinic: A Brief Report

“…We observed self-reported xerostomia as it was a condition frequently observed (71%) in our sample. Castelo and colleagues [9] also showed a statistically significant correlation between OD and the presence of xerostomia using the EAT-10 questionnaire (ρ = 0.26; p < 0.001). Such association reveals the importance of salivation for an adequate formation of the food bolus, which takes place in the first phase of swallowing (oral), and is perceived by the patient as an effort to swallow.…”

“…This study identified OD in 21% of the outpatient older adults using the EAT-10 questionnaire and V-VST, which is similar to previously published studies. Fernandes et al [9] also reported a prevalence of 20% in older adults. On the other hand, the presence of malnutrition was the only biological correlate identified for OD.…”

Impact of gastroplasty on salivary characteristics, dental health status and oral sensory aspects: A controlled clinical study

“…Quantitative and qualitative changes in salivary secretion can affect the oral health. In patients with chronic diseases and/or receiving pharmacological treatment, one of the most commonly reported complaints is dry mouth, 6 which has two aspects: xerostomia (subjective) and hyposalivation (objective), 7 which are not always correlated. In younger adults, hyposalivation was associated with BMI > 25 (obesity), while in those older than 50 years hyposalivation was associated with medication use 8 .…”