Skip to main content
SpringerLink
Log in

Dentition status, malnutrition and mortality among older service housing residents

  • Published:
The journal of nutrition, health & aging

Abstract

Background

Oral health status and oral health problems can affect eating habits and thus consequently the nutritional status of frail older people.

Objectives

To assess older service house residents’ dentition and its associations with nutritional status and eating habits, and as well as to explore the prognostic value of dentition status for mortality.

Design

A cross-sectional study with a three-year follow-up.

Methods

In 2007, we assessed the nutritional status of all residents in service houses in the two cities of Helsinki and Espoo in Finland (N=2188). Altogether 1475 subjects (67%) participated in the study; dentition status data were available for 1369 of them. Using a personal interview and assessment, trained nurses familiar to the resident collected the subjects’ demographic data, medical history, functional and cognitive status, information on dentition status, oral symptoms, eating habits and diets. We assessed nutritional status with the Mini Nutritional Assessment (MNA), and retrieved information on mortality from central registers on 6 July 2010.

Results

Edentulousness was common; more than half of the residents (52%) had lost all their teeth: 7% (n=94) were totally edentulous without prosthesis (Group 1), 45% (n=614) had removable dentures (Group 2), and 48% (n = 661) of the residents, had some natural teeth left (Group 3). Dentition status was associated with age, gender, education and disability. According to the MNA, 13% were malnourished, 65% were at risk for malnutrition, and 22% were well nourished. Edentulousness without prosthesis was associated with malnutrition, oral symptoms and infrequent use of oral care services. In Group 1, 52% were deceased during follow-up period. The respective figures for Groups 2 and 3 were 48% and 40% (p=0.004). However, in Cox regression analysis adjusted for age, gender, comorbidity and MNA score, dentition status no longer predicted mortality.

Conclusion

Edentulousness is still common among older service housing residents. Edentulousness without prosthesis was associated with poor nutritional status, oral symptoms and infrequent use of dental services. These findings suggest the need for co-operation between nursing staff and oral care services.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Suominen-Taipale L, Nordblad A, Vehkalahti M, Aromaa A, eds. Suomalaisten aikuisten suunterveys. Terveys 2000 -tutkimus (in Finnish with English abstract). Publications of the National Public Health Institute, B16/2004, Helsinki 2004, pp 41–49 http://www.ktl.fi/attachments/suomi/julkaisut/julkaisusarja_b/2004b16.pdf

  2. Palmer CA. Important Relationships Between Diet, Nutrition, and Oral Health. Nutr Clin Care 2001;4:4–14

    Article  Google Scholar 

  3. Ekelund R. Dental state and subjective chewing ability of institutionalized elderly people. Community Dent Oral Epidemiol 1989;17:24–27

    Article  CAS  PubMed  Google Scholar 

  4. Daly RM, Elsner RJF, Allen PF, Burke FM. Associations between self-reported dental status and diet. J Oral Rehabil 2003;30:964–970

    Article  CAS  PubMed  Google Scholar 

  5. Anastassiadou V, Heath MR. Food choices and eating difficulty among elderly edentate patients in Greece. Gerodontology 2002;19:17–24

    Article  PubMed  Google Scholar 

  6. Krall E, Hayes C, Garcia R. How dentition status and masticatory function affect nutrient intake. J Am Dent Assoc 1998;129:1261–1269

    Article  CAS  PubMed  Google Scholar 

  7. Hung H-C, Willet W, Ascherio A, Rosner BA, Rimm E, Joshipura KJ. Tooth loss and dietary intake. J Am Dent Assoc 2003;134:1185–1192

    Article  CAS  PubMed  Google Scholar 

  8. Sahyoun NR, Lin CL, Krall E. Nutritional status of older adult is associated with dentition status. J Am Diet Assoc 2003;103:61–66

    Article  PubMed  Google Scholar 

  9. Marshall TA, Warren JJ, Hand JS, Xie XJ, Stumbo PJ. Oral health, nutrient intake and dietary quality in the very old. J Am Dent Assoc 2002;133:1369–1379

    Article  CAS  PubMed  Google Scholar 

  10. Smith MB, Parnell W. Teeth for life? Aspects of oral health status influencing the nutrition of older adults. Nutrition & Dietetics 2008;65:211–215

    Article  Google Scholar 

  11. Savoca MR, Arcury TA, Leng X, Chen H, Bell RA, Andersson AM, Kohrman T, Frazier RJ, Gilbert GH, Quandt SA. Severe tooth loss in older adults as a key indicator of compromised dietary quality. Public Health Nutr 2009;13(4):466–474

    Article  PubMed Central  PubMed  Google Scholar 

  12. Mojon P, Buditz-Jørgensen E, Rapin CH. Relationship between oral health and nutrition in very old people. Age Ageing 1999;28:463–468

    Article  CAS  PubMed  Google Scholar 

  13. Jung YM, Shin DS. Oral health, Nutrition, and Oral Health-Related Quality of Life Among Korean Older Adults. J Gerontol Nurs 2008;34:28–35

    Article  PubMed  Google Scholar 

  14. Kim HY, Jang MS, Chung CP, Paik DI, Park YD, Patton LL, Ku Y. Chewing function impacts oral health-related quality of life among institutionalizes and community-dwelling Korean elders. Community Dent Oral Epidemiol 2009;37:468–476

    Article  PubMed  Google Scholar 

  15. Joshipura KJ, Walter C, Willett MD, Chester W, Douglass DMD. The impact of edentulousness on food avoidance and nutrient intake. J Am Dent Assoc 1996;27:459–467

    Article  Google Scholar 

  16. Saletti A, Lindgren EY, Johansson L, Cederholm T. Nutritional Status According to Mini Nutritional Assessment in an Institutionalized Elderly Population in Sweden. Gerontology 2000;46:139–145

    Article  CAS  PubMed  Google Scholar 

  17. Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony PS, Charlton KE, Maggio M, Tsai AC, Vellas B, Sieber CC. Frequency of Malnutrition in Older Adults: A Multinational Perspective Using the Mini Nutritional Assessment. J Am Geriatric Soc 2010;58:1734–1738

    Article  Google Scholar 

  18. Suominen M, Muurinen S, Rautasalo P, Soini H, Suur-Uski I, Peiponen A, Finne-Soveri H, Pitkälä K. Malnutrition and associated factors among aged residents an all nursing homes in Helsinki. Eur J Clin Nutr 2005;59:578–583

    Article  CAS  PubMed  Google Scholar 

  19. Suominen M, Sandelin E, Soini H, Pitkälä K. How well do nurses recognize malnutrition in elderly patients? Eur J Clin Nutr 2009;63:292–296

    Article  CAS  PubMed  Google Scholar 

  20. McWhirter JP, Pennington CR. Incidence and recognition of malnutrition in hospital. BMJ 1994;308:945–948

    Article  CAS  PubMed  Google Scholar 

  21. Lamy M, Mojon Ph, Kalykakis G, Legrand R, Butz-Jorgensen E. Oral status and nutrition in institutionalized elderly. J Dent 1999;27:443–448

    Article  CAS  PubMed  Google Scholar 

  22. Soini H, Routasalo P, Lagström H. Characteristics of the Mini-Nutritional Assessment in elderly home-care patients. Eur J Clin Nutr 2004;58:64–70

    Article  CAS  PubMed  Google Scholar 

  23. Van Nes MC, Herrmann FR, Gold G, Michel JP. Does the Mini Nutritional Assessment predict hospitalization outcomes in older people? Age Ageing 2001;30:221–226

    Article  PubMed  Google Scholar 

  24. Saletti A, Johansson L, Yifter-Lindgren E, Wissing U, Österberg K, Cederholm T. Nutritional Status and a 3 -Year Follow-up in Elderly Receiving Support at Home. Gerontology 2005;51:192–198

    Article  PubMed  Google Scholar 

  25. Chan M, Lim YP, Ernest A, Tan TL. Nutritional assessment in an Asian nursing home and its association with mortality. J Nutr Health Ageing 2010;14:23–28

    Article  CAS  Google Scholar 

  26. Shimazaki Y, Soh I, Saito T, Yamashita Y, Koga T, Miyazaki H, Takehara T. Influence of Dentition Status on Physical Disability, Mental Impairment, and Mortality in institutionalized Elderly People. J Dent Res 2001;80:340–345

    Article  CAS  PubMed  Google Scholar 

  27. Hämäläinen P, Meurman JH, Keskinen E. Relationship between dental health and 10 -year mortality in a cohort of community-dwelling elderly people. Eur J Oral Sci 2003;111:291–296

    Article  PubMed  Google Scholar 

  28. Abnet CC, Qiao YL, Dawsey SM, Dong ZW, Taylor PR, Mark SD. Tooth loss is associated with increased risk of total death and death from upper gastrointestinal cancer, heart disease, and stroke in a Chinese population-based cohort. Int J Epidemiol 2005;34:467–474

    Article  PubMed  Google Scholar 

  29. Ohrui T, Matsui T, Yoshida M et al. Dental status and mortality in institutionalized eldery people. Geriatr Gerontol Int 2006;6:101–108

    Article  Google Scholar 

  30. Österberg T, Carlsson GE, Sundh V, Mellström D. Number of teeth-a predictor of mortality in 70-year-old subjects. Community Dent Oral Epidemiol 2008; 36:258–268

    Article  PubMed  Google Scholar 

  31. Holm-Pedersen P, Schultz-Larsen K, Christiansen N, Avlund K. Tooth loss and Subsequent Disability and Mortality in Old Age. J Am Geriatr Soc 2008;56(3):429–435

    Article  PubMed  Google Scholar 

  32. Charlson ME, Pompei P, Ales KL et al. A new method of classifying prognostic comorbidity in lognitudinal studies: Development and evaluation. J Chronic Dis 1987;40:373–383

    Article  CAS  PubMed  Google Scholar 

  33. Hughes CP, Berg L, Daziger WL et al. A new clinical scale for the staging of dementia. Br J Psychiatry 1982;140:566–572

    Article  CAS  PubMed  Google Scholar 

  34. Vellas BJ, Guigoz Y, Garry PJ. Facts Research and Intervention In Geriatrics: Nutrition in the Elderly. The Mini Nutritional Assessment (MNA), 1997;3rd Edn. Serdi Publishing, Paris

    Google Scholar 

  35. Soini H, Muurinen S, Rautasalo P, Sandelin E, Savikko N, Suominen M, Ainamo A, Pitkala KH. Oral and nutritional status-Is the MNA a useful tool for dental clinics. J Nutr Health Aging 2006;10:495–499

    CAS  PubMed  Google Scholar 

  36. Andersson P, Westergren A, Karlsson S, Hallberg IR, Renvert S. Oral health and nutritional status in a group of geriatric rehabilitation patients. Scand J Caring Sci 2002;16:311–318

    Article  PubMed  Google Scholar 

  37. Walls AWG, Steele JG. The relationship between oral health and nutrition in older people. Mech Ageing Dev 2004;125:853–857

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of social services and health care, Oral Health Care, City of Helsinki, Finland

    Riitta K. T. Saarela

  2. Department of social services and health care, Developmental and operational support, City of Helsinki, Finland

    H. Soini

  3. Institute of Dentistry, University of Helsinki, Helsinki, Finland

    K. Hiltunen

  4. National Institute for Health and Welfare, Helsinki, Finland

    S. Muurinen

  5. Society of Memory Disorders Expertise in Finland, Helsinki, Finland

    M. Suominen

  6. Department of General Practice, Helsinki University Central Hospital, Unit of Primary Health Care and University of Helsinki, Helsinki, Finland

    K. Pitkala

  7. Department of social services and health care, Oral Health Care, Kaikukatu 3A, P.O. Box 6452, FI-00099, City of Helsinki, Finland

    Riitta K. T. Saarela

Authors
  1. Riitta K. T. Saarela
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Soini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Hiltunen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Muurinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Suominen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K. Pitkala
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Riitta K. T. Saarela.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Saarela, R.K.T., Soini, H., Hiltunen, K. et al. Dentition status, malnutrition and mortality among older service housing residents. J Nutr Health Aging 18, 34–38 (2014). https://doi.org/10.1007/s12603-013-0358-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-013-0358-3

Key words

Search

Navigation