Association between oral health-related quality of life and nutritional status among older adults in district of Kuala Pilah, Malaysia

Coexistence of low body mass index and poor oral health negatively affects activities of daily living, swallowing, and cognition after stroke

AIM

Low body mass index (BMI) and poor oral health are prevalent among older stroke patients and associated with adverse outcomes. However, their combined impact on functional recovery after stroke remains unclear. This study investigated the synergistic effects of low BMI and poor oral health on activities of daily living (ADL) independence, swallowing function, and cognitive status in post-stroke older patients.

METHODS

A retrospective cohort study was conducted on 708 hospitalized post-stroke patients aged ≥70 years. Low BMI was defined as <20 kg/m2, and poor oral health was assessed using the Revised Oral Assessment Guide (ROAG) with a score ≥13 indicating oral problems. The primary outcome was ADL independence (Functional Independence Measure-motor score >78) at discharge. Secondary outcomes included swallowing level (Food Intake Level Scale) and cognitive status (Functional Independence Measure-cognition score). Multiple regression analyses were performed to examine the associations of low BMI, poor oral health, and their combination with outcomes of interest.

RESULTS

The coexistence of low BMI and poor oral health was independently associated with lower odds of achieving ADL independence (odds ratio 0.130, 95% confidence interval [CI] 0.023-0.718), worse swallowing level (B = -0.878, 95% CI -1.280 to -0.476), and poorer cognitive status (B = -1.872, 95% CI -2.960 to -0.784) at discharge, after adjusting for confounders. The combined impact was stronger than either condition alone.

CONCLUSIONS

The coexistence of low BMI and poor oral health exerts a synergistic negative impact on functional recovery in older stroke inpatients. Comprehensive interventions integrating nutritional support, oral management, and rehabilitation are crucial to optimizing outcomes in this vulnerable population. Geriatr Gerontol Int 2024; 24: 1045-1052.

Dietary nutrient intake study among older adults: baseline Malaysian pure study

INTRODUCTION

The older adults (OA) is vulnerable to malnutrition, which may affect their health and quality of life. This study assesses the prevalence of deficiencies in dietary nutrients among the Malaysian OA stratified by residency, genders, socioeconomic status (SES) and body mass index (BMI).

METHODOLOGY

A cross-sectional study was conducted, utilizing purposive sampling, recruiting 2,299 Malaysian people aged 60 years old and above who agreed to be interviewed via a comprehensive semi-quantitative food frequency questionnaire. The nutrients intake was calculated based on the Malaysian food composition and US Department of Agriculture food composition databases. Then, the nutrients intake was compared with the Malaysian Recommended Nutrients Intake guidelines, and the prevalence of deficiencies in dietary nutrients were calculated. The median (interquartile ranges) intakes of nutrients were compared between residency (urban and rural), genders (male and female), and SES (low and middle-high) using the Mann-Whitney U test. The differences in nutrient intake between BMI categories (underweight, normal, and overweight) were identified using the Kruskal-Wallis test followed by Dunn's post hoc test.

RESULTS

The response rate was 70.3% (n = 2,299), predominantly were females (50.8%), received primary education (76.6%), were currently married (84.3%), were middle-high SES (57.7%), and had a normal BMI (59.8%). There was a notable inadequate intake prevalence of magnesium (100.0%), manganese (97.9%), zinc (95.6%), vitamin B6 (98.4%), potassium (91.0%), calcium (89.3%), vitamin B12 (80.2%), vitamin E (91.2%), and vitamin K (81.5%) among Malaysian OA. Additionally, significant differences were observed in nutrients intake levels across gender, residency, SES, and BMI within this population.

CONCLUSIONS

This study shows a high prevalence of dietary nutrients deficiency (> 80%) among the Malaysian OA, particularly for magnesium, manganese, potassium, zinc, vitamin B6, vitamin E, calcium, vitamin B12, and vitamin K. To improve the nutritional status of OA and safeguard against adverse health effects, it is necessary to formulate and execute strategies to enhance their dietary nutrient intakes. The strategies may involve intervention such as nutrient supplementation and promotion of consuming nutrient-rich foods.

Oral Health-Related Quality of Life Among Non-institutionalized Elderly in Malaysia: A Teaching Hospital-Based Survey

Background In Malaysia, the Geriatric Oral Health Assessment Index (GOHAI) has been recognized as a vital instrument for evaluating oral health-related quality of life among the elderly population. Its integration into the National Health and Morbidity Survey (NHMS) in 2018 demonstrates the country's dedication to understanding and addressing the unique oral health challenges faced by older individuals. The NHMS, led by the Ministry of Health Malaysia, serves as a crucial platform for identifying and addressing healthcare needs, while also working towards achieving sustainable development goals. This study aimed to provide valuable information for stakeholders and researchers by investigating the relationship between quality of life related to oral health and demographic factors, with the ultimate goal of enhancing oral healthcare for older individuals. Objective The objective of this research was to identify the variables that impact the Oral Health-Related Quality of Life (OHRQoL) of non-institutionalized elderly individuals who visit the Klinik Pergigian Manipal University College Malaysia (MUCM). By utilizing the OHRQoL, dental practitioners can gain insight into the elderly's oral health-related quality of life, which is crucial information for dental healthcare providers to effectively reach out to and cater to the elderly at the institution. Methodology A cross-sectional design was employed, utilizing a non-probability sampling method to select eligible elderly individuals at the clinic. A validated questionnaire comprising 18 items covering sociodemographic details and the Geriatric Oral Health Assessment Index (GOHAI) was distributed to individuals above 60 years via printed forms. One way ANOVA, unpaired t-test and multiple linear regression analysis were performed to analyze the data. Results The overall mean GOHAI score among non-institutionalized elderly attending Klinik Pergigian MUCM was 48.38±9.33, indicating poor OHRQoL. The psychosocial impact domain had a mean score of 19.33±5.21, surpassing the pain and discomfort domain with a score of 10.73±2.82, highlighting the significant impact of psychosocial factors on poor oral health-related quality of life. Multiple linear regression analysis revealed no significant associations between OHRQoL and factors such as ethnicity, living arrangements apart from spouse and family, or tertiary education among older individuals after adjusting for confounding variables. Conclusions This study indicates that sociodemographic aspects have minimal impact on the OHRQoL of seniors. Further examination is needed to understand the economic aspects of tooth replacement options and preventive measures in this age group. To enhance the OHRQoL of older adults, especially those not living in facilities like nursing homes or assisted living centers, tailored oral healthcare plans and strategies are crucial. Interdisciplinary collaboration among mental health professionals, geriatric experts, and oral healthcare providers is crucial for empowering both healthcare practitioners and seniors to maintain optimal oral health.

Research hotspots and trends of oral health in older adults from 2013 to 2023: A bibliometric and visual analysis

Background

Oral health problems seriously affect the quality of life of older adults. It is of great significance to investigate the statuses of oral health in older adults. The study aimed to analyze the current status, hotspots and frontiers of global oral health research in older adults through bibliometrics to provide references and guidance for future research in this field.

Methods

Literature on oral health in older adults from 2013 to 2023 was retrieved from the Web of Science Core Collection (WoSCC) database. CiteSpace 6.2.R4 was used for bibliometric and visual analysis, including journal and co-cited journal, country/region, institution, author, co-cited references, and keyword analysis.

Results

A total of 1430 publications related to oral health in older adults were included. The number of publications has gradually increased over the past decade. The most widely published and cited journal was Gerodontology. The most prominent contribution came from the United States of America, and the University of London and Hirohiko Hirano were the most prolific institution and author, respectively. The current research hotspots were summarized as oral hygiene interventions, oral health-related quality of life and oral health issues in older adults. Cohort studies of oral health, the relationship between oral health and frailty, and the correlation between oral health and nutritional status may be emerging research trends.

Conclusions

This study systematically analyzed the hotspots and frontiers of oral health in older adults and called for increased collaboration among countries, institutions, and authors. In addition, oral hygiene interventions for older adults, oral health-related quality of life, oral health issues, cohort studies of oral health, and the relationship between oral health and frailty or nutritional status may be the focus of future research.

Association of Oral and General Health with Nutritional Status of Older Adults Attending Two Medical Centers in Riyadh, Saudi Arabia: A Cross-Sectional Study

Malnutrition could profoundly affect older adults' oral health and quality of life, whereas oral health might, in turn, impact dietary intake and nutritional status. The present study aimed to investigate the association between general and oral health and nutritional status among older adults attending nutrition clinics at two main medical centers in Riyadh, Saudi Arabia. A cross-section study was carried out among adult patients (≥60 years) who attended a geriatric clinic or nutrition clinic at King Khalid University Hospital or King Abdulaziz Medical City, Riyadh. A validated clinician's Mini Nutritional Assessment Short-Form (MNA-SF), Oral Health Impact Profile-5 (OHIP-5), and 36-Item Short Form Survey (SF-36) were collected from each participant. A total of 261 participants with a mean age of 72.14 (±8.97) years were recruited. Diabetes (71%) and hypertension (80%) were present in the majority of patients. The overall MNA-SF score was (10 ± 3). Based on the categorization of the MNA-SF score, 65.9% were classified as malnourished or at risk of malnutrition. Participants with OHIP-5 scores higher than the median (>5) were more likely to be malnourished than those with scores at or lower than 5 (p < 0). The adjusted odd ratio for the MNA-SF score categories indicated that for a one-unit increase in the total SF-36 score, the odds of the malnourished category are 0.94 times less than the risk of malnutrition and normal nutritional status, with OR 0.97 (95% CI 0.94-0.95). Malnutrition or being at risk of malnutrition is likely associated with poor general and oral health. Healthcare providers need to incorporate dietitians into care plans to promote the nutritional health of older adults.

The Relationship between Oral Health-Related Quality of Life and Body Mass Index in an Older Population from Southern Italy: The Salus in Apulia Study

BACKGROUND

The assessment of oral health-related quality of life (OHRQoL) evaluated the impact of an individual's oral health on the patient's physical and psychosocial status. We evaluated the association between subjective OHRQoL, measured with the Oral Health Impact Profile-14 (OHIP-14) questionnaire, and unfavorable body mass index (BMI) (i.e., too high or too low) in a large population-based study on older adults from Southern Italy. Moreover, we assessed which of the seven OHIP-14 domains was the most strongly associated with an unfavorable BMI.

METHODS

We used data on a subpopulation of the Salus in Apulia Study, including 216 older adults. BMI < 18.4 kg/m2 and >30 kg/m2 were classified as unfavorable, while values between 18.5 and 30 kg/m2 were classified as ideal.

RESULTS

A higher OHIP-14 total score increased the risk of an unfavorable BMI (odds ratio (OR): 1.08, 95% confidence interval (CI): 1.01-1.15). In the model adjusted for age, sex, education, hypertension, carbohydrate consumption, and alcohol consumption, this finding was confirmed with a higher OHIP-14 total score increasing the risk of an unfavorable BMI (OR: 1.10, 95% CI: 1.01-1.22), and higher age linked to a decreased risk of an unfavorable BMI (OR: 0.89, 95% CI: 0.82-0.97). In a random forest regression model, the most important predictive domains/sub-scales of OHIP-14 in the mean decrease in the Gini coefficient for unfavorable BMI were, in order of decreasing importance, physical pain, functional limitation, psychological discomfort, physical disability, social disability, psychological disability, and handicap.

CONCLUSIONS

In older age, negative OHRQoL, particularly linked to the physical pain domain, increased the risk of being underweight or overweight and obesity.

Validation of the Malay Oral Impacts on Daily Performances and Evaluation of Oral Health-Related Quality of Life in a Multi-Ethnic Urban Malaysian Population: A Cross-Sectional Study

Oral Impacts on Daily Performances (OIDP) can be used as a generic or condition-specific oral health-related quality of life (OHRQoL) instrument. It offers different contexts on how dental conditions affect OHRQoL. This cross-sectional study aimed to validate a newly translated Malay OIDP (OIDP-M), compare OHRQoL, decayed, missing, or filled teeth (DMFT) in Malaysians, and investigate factors associated with OHRQoL. A total of 368 Malaysians were surveyed and examined for DMFT. Short-form oral health impact profile-Malaysia [S-OHIP(M)] and OIDP-M were used to measure OHRQoL. The OIDP-M was tested for reliability and validity. DMFT, S-OHIP(M), and OIDP-M between ethnicities were compared. Associations between ethnicity, DMFT, S-OHIP(M), and OIDP-M of Malays and Chinese were evaluated through partial correlation. Malays and Chinese had more filled teeth and DMFT compared with Indians. Malays reported worse OHRQoL through S-OHIP(M). Decayed teeth were positively associated with S-OHIP(M), physical, psychological, social disabilities, and handicap. For OIDP-M, decayed teeth were positively associated with OIDP-M, working, and sleeping. Missing teeth and ethnicity were positively associated with eating and speaking. Filled teeth were negatively associated with cleaning teeth. The OIDP-M was reliable and valid for evaluating OHRQoL. There were differences in DMFT and OHRQoL between ethnicities. Ethnicity affects OHRQoL, where Malays experienced worse OHRQoL due to dental problems.

Increased Oral Dryness and Negative Oral Health-Related Quality of Life in Older People with Overweight or Obesity

This cross-sectional study was to evaluate the association between the oral health-related quality of life (OHRQoL) of older Thai people with obesity and oral health indicators. General and oral conditions were assessed. Oral dryness was determined using the Xerostomia Inventory-11 (XI-11) and clinical oral dryness score (CODS). OHRQoL was evaluated by the oral health impact profile (OHIP-14). Participants were aged 60-86 years; 73 (59.3%) were overweight or obese, and 50 (40.7%) were normal weight. Older patients with obesity had almost four times the rate of hypertension (OR = 3.59; 95%CI:1.34-9.60; p = 0.002), more missing teeth (p = 0.025), and higher CODS (p = 0.014) than those without obesity. The total XI-11 scores were positively associated with the total CODS, after adjusting for BMI (r = 0.267, p = 0.003). Those with obesity had almost three times the tendency for a negative OHRQoL compared with the non-obese (OR = 2.73; 95%CI:1.12-6.71; p = 0.04). After adjusting for all related factors, the chances of predicting an OHIP-14 score of four based on obesity and total XI-11 score were 4.42 (95%CI:1.57-12.47; p = 0.005) and 1.11 (95%CI:1.02-1.20; p = 0.013), respectively. Obesity had an increasingly undesirable negative impact on the OHRQoL of older Thai people and was influenced by BMI and oral dryness.

Effects of food neophobia and oral health on the nutritional status of community-dwelling older adults

BACKGROUND

Food preferences and oral health of older adults greatly affect their nutritional intake, and old-age-related increase in food neophobia may consequently reduce food intake in older adults. This study aimed to determine the impact of food neophobia and oral health on nutritional risk in community-dwelling older adults.

METHODS

This cross-sectional study included 238 independent adults aged ≥ 65 years (mean, 76.3 ± 7.3 years). The survey items included a Food Neophobia Scale, frequency of protein intake, oral-health-related quality of life (QOL) assessment, and oral diadochokinesis (ODK; /pa/, /ta/, /ka/) as an index of oral function. Nutritional status was assessed using the Mini Nutritional Assessment®, and based on a cutoff value of 24 points, respondents were categorized as well-nourished (≥ 24 points, Group 1) or at risk of malnutrition (< 24 points, Group 2). A logistic regression model was used to calculate the adjusted odds ratio (adj-OR) with 95% confidence interval (CI) to identify risks factors for malnutrition associated with food neophobia and oral health.

RESULTS

Factors associated with the risk of malnutrition in the older population were higher food neophobia (adj-OR = 1.036, 95% CI: 1.007-1.067) and lower oral function (OR = 0.992, 95% CI: 0.985-0.999) and lower oral-health-related QOL (adj-OR = 0.963, 95% CI: 0.929-0.999).

CONCLUSIONS

Older adults at risk of developing malnutrition may have higher food neophobia and lower oral function and oral-health-related QOL. Factors contributing to preventing malnutrition include predicting the risk of malnutrition based on the oral health indicators that older people are aware of, signs appearing in the oral cavity, minor deterioration, and providing dietary guidance about food neophobia. Notably, these approaches represent novel strategies for nutrition support that can be implemented based on a multifaceted understanding of the eating habits of older adults.

Effect of Morbidities, Depression, Anxiety, and Stress on Oral Health-Related Quality of Life among Migrant Elderly Following Children in Weifang, China

This study explored the relationship between depression, anxiety, stress, morbidity, and oral health-related quality of life (OHRQoL) in the migrant elderly following children (MEFC) in Weifang, China. A total of 613 MEFC were selected using multistage cluster random sampling. The GOHAI scale was used to evaluate oral health-related quality of life. The DASS-21 scale was used to assess levels of depression, anxiety, and stress. Univariate analysis and binary logistic regression were used to analyze the correlation between these indicators and oral health-related quality of life, of which 43.9% were classified as having poor oral health. Logistic regression analysis showed that the MEFC who were of older age (OR = 0.965, p = 0.039), with hypertension (OR = 0.567, p = 0.004), with gastroenteropathy (OR = 0.263, p = 0.007), had received an outpatient service in the past year (OR = 0.669, p = 0.048), were depressed (OR = 0.338, p = 0.012), and anxious (OR = 0.414, p = 0.026) were less likely to report good oral health status. On the other hand, the MEFC with a high school education or above (OR = 1.872, p = 0.020) were more likely to report good oral health than those with primary school education and below. In conclusion, with regard to depression, anxiety, and stress: the results indicated that the fewer morbidities, the lower the level of depression and anxiety and the better the OHRQoL of MEFC. Targeted measures for government, communities, and family members were given to improve the OHRQoL of MEFC.

Impact of psychological states on periodontitis severity and oral health-related quality of life

PURPOSE

This cross-sectional study aimed to identify impacts of depression, anxiety and stress on periodontitis severity and oral health-related quality of life (OHRQoL).

METHODS

A total of 141 periodontitis patients were recruited. Psychological states were assessed using the Malay short-form Depression, Anxiety and Stress Scales (MDASS-21). Subjects were grouped as positive for depression, anxiety or stress (DAS) (positive-DAS), without DAS (non-DAS), stress-only and anxiety-only. OHRQoL was evaluated using the Malay short-form Oral Health Impact Profile (S-OHIP[M]).

RESULTS

OHRQoL was associated with MDASS-21, probing pocket depths, recession, clinical attachment levels, number of teeth present and number of teeth with mobility. S-OHIP(M) of positive-DAS subjects was associated with clinical attachment levels, number of teeth present and presence of anxiety. Anxiety-only subjects reported higher S-OHIP(M) scores compared to the non-DAS group.

CONCLUSION

OHRQoL of all subjects was negatively impacted by periodontitis severity and tooth loss. Combinations of depression, anxiety or stress led to worse periodontal status and OHRQoL. Subjects with anxiety-only experienced poorer OHRQoL compared to those without depression, anxiety and stress regardless of periodontitis severity. Possible impacts of psychological states on periodontitis and OHRQoL highlights the importance of assessing and improving psychological factors as part of periodontal therapy and to enhance OHRQoL.

Determining the factors associated with oral health-related quality of life in Chinese elders: Findings from the fourth national survey

OBJECTIVE

The purpose of this study was to assess the associations between the self-reported oral health-related quality of life (OHRQoL) of older Chinese people and their socio-economic status and oral health using data collected in the 4th National Oral Health Survey.

METHODS

After multistage stratified cluster sampling, 4332 adults aged 65-74 years participated in the study. After a clinical examination, the participants completed a structured questionnaire. A Mandarin version of the General Oral Health Assessment Index (GOHAI) was included in the questionnaire. Clinical examinations were carried out using the criteria recommended by the World Health Organization. Multivariate analysis was used to evaluate the associations of the clinical and socio-demographic variables with the GOHAI scores of the participants.

RESULTS

The weighted mean (SE) GOHAI score was 51.6 (0.0). Female sex and having more than 10 missing teeth, unrestored tooth spaces, more than 10 decayed teeth and a periodontal pocket ≥6 mm were negatively associated with the GOHAI score, while having a higher education level and living in the Eastern region of China were positively associated with the GOHAI score.

CONCLUSION

After adjustment for confounders, the OHRQoL of older Chinese individuals was mainly affected by untreated dental caries and the loss of teeth. Older Chinese individuals who were male, had a higher education level, were from the Eastern region, had no unrestored tooth spaces or deep periodontal pockets and had fewer decayed or missing teeth had higher GOHAI scores, indicating better OHRQoL.

Association between oral health-related quality of life and general health among dental patients: a cross-sectional study

Globally, the prevalence of chronic diseases is increasing significantly, causing deterioration of oral and general health and therefore quality of life. The present study was designed to assess the relationship between oral health-related quality of life and general health of dental patients. The study is part of the University's plan to achieve the United Nations Sustainable Development Goals number 1, 3, 4 and 5. Dental school students' satisfaction with their early engagement in clinical activities and research work was also evaluated. A convenience sample of 600 subjects attending dental clinics aged ≥18 years of both sexes was included in the study. Second-year dental students conducted the study under the supervision of public health staff members over two successive academic years (2015-2016 and 2016-2017). Oral health-related quality of life was assessed using the Dental Impact on Daily Living (DIDL) questionnaire. Blood pressure, random blood glucose level, body mass index, and waist circumference were measured as indicators of general health. There were statistically significant inverse correlations between DIDL scores and both mean blood pressure (r = -0.215, p < 0.001) and mean blood glucose level (r = -0.272, p < 0.001). Non-significant inverse correlations were observed between DIDL scores and both body mass index (r = -0.062, p = 0.131) and waist circumference (r = -0.040, p = 0.340). Students' satisfaction scores with research activities were high, ranging from 75.9% to 78%. Dentists must raise patients' awareness about the importance of oral health and its impact on their quality of life and general health. Participation of dental students in dental research is encouraged even in their early academic years.

Factors associated with poor oral health-related quality of life among non-institutionalized Brazilian older adults: Oral health and quality of life in older adults

AIMS

To investigate the factors associated with poor oral health-related quality of life (OHRQoL) in a sample of Brazilian older adults.

METHODS AND RESULTS

A cross-sectional study was conducted with 535 non-institutionalized elders aged 60 years or older from Piracicaba, São Paulo, Brazil. OHRQoL was measured using the Geriatric Oral Health Assessment Index (GOHAI). Data on sociodemographic characteristics, self-perceived general health status, and health-related behaviors were obtained through a structured questionnaire. Data on chronic diseases were obtained from health records. Associations between exploratory factors and low OHRQoL (% GOHAI score <30) were evaluated using multivariate Poisson regression models to estimate adjusted prevalence ratios (PRs) and confidence intervals. The mean OHRQoL score was 30 (± 4.4). In bivariate analysis, being not married, smoking, and self-rated "fair/poor" general health status were associated with lower OHRQoL. In the adjusted model, self-rated "fair/poor" general health (PR: 1.25; 95% CI: 1.05-1.48), presence of chronic diseases (PR: 1.88; 95% CI: 1.37-2.58), smoking (PR: 1.25; 95% CI: 1.02-1.53), and reason for last dental appointment (PR: 1.34; 95% CI: 1.13-1.59) were associated with poor OHRQoL.

CONCLUSION

Non-institutionalized older adults with a history of chronic diseases, who smoke, have a negative perception of their general health, and had the last dental appointment motivated by pain present significantly higher prevalence rates of poor OHRQoL.

Factors associated with the nutritional status of the older population in a selected area of Dhaka, Bangladesh

Background

Globally, older population (aged ≥60 years) comprise 11% of the total population, and 23% of them are malnourished. Lack of knowledge and education, adverse dietary habits, depression or psychological disorders, poor oral and dental health, disability, and diseases are the reported factors responsible for malnutrition among them. Geriatric people comprise 7.5% of the total population of Bangladesh, and almost a quarter are malnourished. But there is scarce data on the factors associated with the nutritional status of the older population in Bangladesh.

Methods

A cross-sectional study was conducted among 125 older individuals (male 59, female 66) living in three villages of Uttarkhan, Dhaka, Bangladesh, to identify the factors associated with their nutritional status. The Mini Nutritional Assessment scale, Geriatric Depression Scale-Short Form, and Geriatric Oral Health Assessment Index were used for assessing the nutritional status, mental health status, and oral health quality of the respondents, respectively. Information on socio-demographic characteristics, comorbidities and dietary factors, and food behaviors were gathered by a pretested semi-structured questionnaire. Ethical approval was obtained from the Institutional Review Board of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Results

The participants’ mean age was 67.9 ± 7.1 years. Most of them (53.6%) had no formal education. Among the respondents, 22.0% male and 28.8% female were malnourished. The proportion of malnourished and at risk of malnutrition among the respondents living without a partner were 28.6 and 65.3%, respectively. A significantly (p < 0.05) higher odds of having depression (OR 15.6; 95% CI 3.1–78.1), poor oral health (OR 7.3; 95% CI 1.3–41.8), and no formal education (OR 6.5; 95% CI 1.3–32.1) was observed among the malnourished respondents. Though it was not statistically significant, among the malnourished, 31.3, 25.0 and 25.0% avoided highly oily food, beef/mutton, and sugary food, respectively.

Conclusions

More than two-thirds of the older population were malnourished or at risk of malnutrition, where the female respondents were more vulnerable. Depression, inadequate oral health, and lack of education were negatively associated with the nutritional status of the older population.

Oral Health-Related Quality of Life, Oral Conditions, and Risk of Malnutrition in Older German People in Need of Care-A Cross-Sectional Study

Background: The present cross-sectional study assessed oral health, nutritional condition, and oral health-related quality of life (OHRQoL) in older German people in need of care. Methods: The participants were recruited from eight nursing homes (including three nursing homes with assisted living) and one mobile nursing service. Oral health, including dental status (decayed, missing and filled teeth (DMF-T), root caries), periodontal treatment needs, and prosthetic conditions, was recorded. Nutritional status was assessed using the screening of the “Mini Nutritional Assessment” (MNA). The OHRQoL was measured using the German short-form of the Oral Health Impact Profile (OHIP-G14) and summarized as a total sum score as well as the four dimensions “oral function”, “psychosocial impact”, “pain” and “orofacial appearance”. Statistics: Linear logistic regression analyses. Results: A total of 151 participants (age: 84.17 ± 7.8 years) were included. Most participants (60.3%) were nursing home residents. Nearly half of the individuals (47%) were edentulous and 75.4% of the dentate subjects required periodontal treatment. A total of 115 of the subjects had at least one denture. According to the MNA screening, 107 (70.9%) older people were at risk of malnutrition or already suffered from malnutrition. The median OHIP-G14 sum score was 3 (mean 5.7 ± 7.67). Regression analysis revealed MNA to be influenced by DMF-T, D-T, M-T and OHIP G14 sum score and root caries (pi < 0.01). Within the regression model, missing teeth (β: −11.9, CI95: −6.4–−1.9; p < 0.01) were the strongest influential factor on MNA, followed by DMF-T (β: 5.1, CI95: 1.7–6.2; p < 0.01). Conclusions: Older people in nursing settings show a high prevalence of oral diseases, risk of malnutrition and nearly unimpaired OHRQoL. Dental care should be fostered in these individuals, whereby OHRQoL might be a further hint for increased risk of malnutrition.

Associations of Oral Health-Related Quality of Life with age, oral status, and oral function among psychiatric inpatients in Japan: a cross-sectional study

BACKGROUND

As the general population of Japan ages, the population of hospitalized psychiatric patients is also ageing. The purpose of this study was to investigate the associations of oral health-related quality of life (OHRQoL) with age and oral health, including oral and swallowing function, among psychiatric inpatients.

METHODS

The subjects included 165 psychiatric inpatients in psychiatric hospitals in Japan. The General Oral Health Assessment Index (GOHAI) and the Eating Assessment Tool (EAT-10) were included in the questionnaire survey for the measurement of OHRQoL and the screening of dysphagia. A score ≥ 3 on the EAT-10 was defined as suspected dysphagia. Oral examinations and oral diadochokinesis (ODK) measurements for the tongue-lip motor function evaluation were conducted. The inpatients with acute psychiatric symptoms, moderate and severe dementia, and cognitive impairment that affected their ability to communicate and relate their feelings were excluded. A chi-squared test, the Mann-Whitney U test, and linear regression analysis were used for the analysis. The data were analysed at the 5% significance level.

RESULTS

A total of 100 (64.5%) psychiatric inpatients (mean age, 67.3 [SD, 14.5] years, 49% males, and 51% females) participated in this study. The means ± SDs for the decayed missing filled teeth (DMFT) index and GOHAI score were 20.6 ± 6 and 49.7 ± 7.9, respectively. The GOHAI score in the older age group (≥ 65 years) was significantly lower than that in the younger age group (< 65 years). The mean ODK scores were less than 3 times/s for all syllables. The percentage of the participants with suspected dysphagia was 45.0%. Tooth loss and suspected dysphagia were significantly associated with low GOHAI scores. The EAT-10 score was significantly correlated with the GOHAI score only after adjusting for age and sex (β = - 0.725, 95% CI - 0.97, - 0.64).

CONCLUSIONS

In hospitalized psychiatric patients, impaired oral health in the older subjects was more pronounced compared with that among general adults. Tooth loss and swallowing function were associated with OHRQoL. Therefore, oral care for the recovery of occlusal and swallowing functions may be needed to improve OHRQoL among psychiatric patients.

Health, access and nutritional issues among low-income population in Malaysia: introductory note

The current issue of BMC Public Health presents work by the Consortium of Low Income Population Research (CB40R), highlighting a comprehensive aspect of health, i.e., physical health, mental health, health behaviour and health financing; and also nutrition involving all stages of lifespan of the socioeconomic deprived group in Malaysia.Consortium of B40 Research (CB40R) reposited and harmonised shared, non-identifiable data from epidemiological studies involving low income population (B40) in Malaysia. CB40R also performed joint or mega-analyses using combined, harmonised data sets that yield collated results with enhanced statistical power, more variabilities (study population, geographical regions, ethnicities and sociocultural groups) to better understand the needs, characteristics and issues of B40 groups in Malaysia. It also aimed to develope a system/framework of minimum/standard variables to be collected in research involving B40 in future. For this special issues, members of the consortium have been invited to contribute an original article involving analysis of the health aspects, access to health and nutritional issues of the B40 samples.All the papers in this special issue have successfully highlighted the health and nutritional issues (i.e., non-communicable disease (NCD), inflammatory bowel disease (IBD), knowledge towards sexually transmitted disease (STD), low birth weight, Motoric Cognitive Risk (MCR) syndrome, urinary incontinence), mental health, oral health and inequalities among the low-income group in Malaysia, including the rural population and also the urban poor. The low-income population in Malaysia is also at risk of both under- and over nutrition, of which specific cost effective strategies are indeed needed to improve their quality of life.The low income population in Malaysia is facing various health challenges, particularly related to NCD and poor mental health, nutritional and physical function. There is a need for a sustainable intervention model to tackle the issues. It is also important to highlight that reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health.