Medications That Cause Dry Mouth As an Adverse Effect in Older People: A Systematic Review and Metaanalysis

Abstract

OBJECTIVES:To assess and quantify the risk of druginduced dry mouth as a side effect in older people. DESIGN: Systematic review and metaanalysis. SETTING: A search of the literature was undertaken using Medline, Embase, Cochrane, Web of Science, and PubMed from 1990 to 2016. PARTICIPANTS: Older people (aged ≥60) who participated in intervention or observational studies investigating drug use as an exposure and xerostomia or salivary gland hypofunction as adverse drug outcomes. MEASUREMENTS: Two pairs of authors screened titles and abstracts of studies for relevance. Two authors independently extracted data, including study characteristics, definitions of exposure and outcome, and methodological quality. For the metaanalyses, random-effects models were used for pooling the data and I 2 statistics for exploring heterogeneity. RESULTS: Of 1,544 potentially relevant studies, 52 were deemed eligible for inclusion in the final review and 26 in metaanalyses. The majority of studies were of moderate methodological quality. In the intervention studies, urological medications (odds ratio (OR) = 5.91, 95% confidence interval (CI) = 4.04-8.63; I 2 = 62%), antidepressants (OR = 4.74, 95% CI = 2.69-8.32, I 2 = 21%), and psycholeptics (OR = 2.59, 95% CI = 1.79-3.95, I 2 = 0%) were significantly associated with dry mouth. In the observational studies, numbers of medications and several medication classes were significantly associated with xerostomia and salivary gland hypofunction. CONCLUSION:Medication use was significantly associated with xerostomia and salivary gland hypofunction in older adults. The risk of dry mouth was greatest for drugs used for urinary incontinence. Future research should develop a risk score for medication-induced dry mouth to assist with prescribing and medication management. J Am Geriatr Soc 66:76-84, 2018.

Self‐reported dry mouth among ageing people: a longitudinal, cross‐national study

“…mouth dryness both in 2007 and in 2012) and incident mouth dryness in both cohorts, most strongly so with xerostomia reported during daytime (Table ). Previous studies have confirmed associations between intake of various medicines and xerostomia . However, few have adjusted for confounding factors reflecting the underlying health conditions for which medication was prescribed .…”

“…Whereas a number of studies have examined cases of serious mouth dryness caused by immune‐system conditions, such as Sjøgren's syndrome, many older adults demonstrate dry mouth as a consequence of other systemic diseases and medications . Epidemiological studies have shown an increase in the prevalence of dry mouth with increasing age, although ageing per se is not a major risk factor for xerostomia .…”

Does oral dryness influence quality of life? Current perspectives in elderly dental care

“…Hence, drug-induced dry mouth is one of the most common oral problems in elderly individuals. 34 Our data showed a significantly higher mean number of administered medicines among the subjects presenting oral dryness symptoms compared to these with no symptoms. Similar observations were made by Bogucki et al, who identified a correlation between xerostomia, medication taken by patients, age, gender and past diseases.…”

Saúde bucal de idosos com 80 anos ou mais: condição, autopercepção e utilização de serviços odontológicos

“…Idosos com baixos níveis de secreção salivar podem apresentar prejuízos funcionais: paladar, fala e dificuldades para mastigar e deglutir os alimentos 20 . O uso de medicamentos está associado tanto à sensação de boca seca quanto à hipofunção da glândula salivar 21 .…”