Masticatory function in nursing home residents: Correlation with the nutritional status and oral health–related quality of life

Abstract

Background: Masticatory function of institutionalised elders and its relationship with nutrition and oral health-related quality of life (OHRQoL) are unknown. Objectives: This multicentre cross-sectional study evaluated the influence of the presence of teeth and dentures on masticatory function (masticatory performance and swallowing threshold) in institutionalised elders. Correlation of masticatory function with nutrition and OHRQoL was also verified. Methods: Older adults (n = 344; mean age (SD) = 77.70 (9.10)), selected from nursing homes in two Brazilian cities, were classified as edentulous with or without complete dentures (CDs), and partially dentate with or without prosthesis. Masticatory performance was assessed using a two-colour chewing gum. Swallowing threshold was set by the number of chewing cycles performed until swallowing 3.7 g of peanuts. Nutrition was screened by Mini-Nutritional Assessment-Short Form and body composition. OHRQoL was evaluated through Geriatric Oral Health Assessment Index (GOHAI) and Oral Health Impact Profile (OHIP-14). The Kruskal-Wallis test and Spearman's correlation were used (α = 0.05). Results: Edentulous elders without CDs had lower masticatory performance than those with CDs and partially dentate with or without prosthesis (P < .05). Swallowing threshold of edentulous elders with CDs and partially dentate with prosthesis was greater than edentulous elders without CDs and partially dentate without prosthesis (P < .05). Masticatory function was not correlated with nutrition. Masticatory performance was correlated (P < .05) with GOHAI (r 2 = −.154) and swallowing threshold with GOHAI (r 2 = .162) and OHIP-14 (r 2 = −.146). Conclusion: The absence of teeth and dentures negatively affected the masticatory function. Although the masticatory function was not correlated with institutionalised elders' nutrition, their OHRQoL was negatively impacted.

The association of oral function with dietary intake and nutritional status among older adults: Latest evidence from epidemiological studies

“…The selected studies included 23 observational studies [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] ] (17 cross-sectional [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [33] , [34] , [35] , 37 , 38 , 40 , 42 , 43 , 45 , 46 ] and 6 longitudinal designs [ 28 , 30 , 32 , 36 , 39 , 44 ]) and 4 interventional studies [ [47] , [48] , [49] , [50] ]. The number of study participants ranged between 32 and 28,738.…”

“… Nutritional assessment or screening tools Score interpretation [ # Ref.] Mini Nutritional Assessment The lower the score, the greater the risk for malnutrition [ 25 , 29 , 31 , 35 , 37 , 38 , 43 , 44 ] Geriatric nutritional risk index The lower the score, the greater the risk for malnutrition [ 34 ] Patient-Generated Subjective Global Assessment The higher the score, the greater the risk for malnutrition [ 36 ] Prognostic nutritional index The lower the score, the greater the risk for malnutrition [ 52 ] Minimal Eating Observation and Nutrition Form version II The higher the score, the greater the risk for malnutrition [ 27 ] Malnutrition Universal Screening Tool The higher the score, the greater the risk for malnutrition [ 41 ] [ # Ref.] indicates the reference number for the studies using the tools.…”

“…Among the 17 observational cross-sectional studies [ [25] , [26] , [27] , 29 , 31 , [33] , [34] , [35] , 37 , 38 , [40] , [41] , [42] , [43] , 45 , 46 , 52 ] included in this review, 16 studies [ [26] , [27] , [28] , [29] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , 52 ] revealed an association between oral function and nutrition. One study [ 25 ] found no association. The author, publication year, setting, participants, measures (exposure and outcome), and results are summarized in Table 2 .…”

“…= 83.6 (7.6) EAT-10 MNA-SF High EAT-10 score was associated with low MNA-SF score (Poisson regression model, adjusted PR [95% CI] = 0.98 [0.97–0.99]). de Medeiros et al [ 25 ] 2020 Nursing home 344 Mean (s.d.) = 77.7 (9.1) Masticatory performance (variance of hue) MNA-SF score, BMI, muscle mass (kg), and body fat (%) The masticatory performance and swallowing threshold were not correlated with MNA-SF total score (r = −0.058, p = 0.30 for masticatory performance and r = 0.073, p = 0.20 for swallowing threshold), BMI (r = −0.015, p = 0.83 for masticatory performance and r = 0.053, p = 0.45 for swallowing threshold), muscle mass (r = 0.003, p = 0.96 for masticatory performance and r = −0.012, p = 0.86 for swallowing threshold) or body fat (r = −0.078, p = 0.26 for masticatory performance and r = 0.115, p = 0.10 for swallowing threshold).…”

“…The associations of oral aspects and function with nutritional status were also studied in older adults at a hospital, nursing home, and other health care facilities. Six studies [ 25 , 27 , 37 , 41 , 43 , 52 ] used oral function as an exposure. Among them, 3 studies found that low swallowing ability was associated with malnutrition assessed using the Malnutrition Universal Screening Tool [ 41 ], MNA-SF [ 43 ], or Minimal Eating Observation and Nutrition Form version II [ 27 ].…”