Centre for Education and Research on Ageing, Concord Clinical School, The University of Sydney, and the Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.
Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan.
BMC Geriatr. 2021 Apr 16;21(1):255. doi: 10.1186/s12877-021-02169-y.
Unintended weight loss and the reduction in appetite are common phenomenon among older people. Reduced appetite has been linked to medication related reductions in saliva production, reduced taste ability and poor oral health. Poor appetite can result in reduced nutrient intake ensuing weight loss. It is possible that poor appetite is a mediating step on the causal pathway between oral health and weight loss. This study investigates whether poor oral health and loss of appetite are related to weight loss.
This is an observational study where data were obtained from the Concord Health and Ageing in Men Project (CHAMP). Information on socio-demographics, appetite and health related behavior was collected by self-completed questionnaire. Intraoral assessment was conducted by calibrated oral health therapists. Height and weight were measured by trained staff. Regression analysis investigated associations between oral health and appetite as risk factors for weight loss.
Participants included 542 community dwelling older males. 99 older men (18.3%) experienced 5% or more weight loss over 3 years. Men who lost weight from baseline had lower BMI and lower body weight, had higher prevalence of frailty and depression, reported poorer appetite, and had fewer teeth (13.8 ± 9.5) than those who did not lose weight (16.3 ± 9.3). Before adjustment, the prevalence ratio (PR) for weight loss was 1.76 (95% Confidence Interval (CI), 1.19-2.59) for participants with 0-19 natural teeth present compared to those with 20 or more teeth. When adding appetite and other variables to the model, the PR for number of teeth and weight loss was unchanged: 1.78 (95% CI, 1.06-3.00). The mediation analysis showed that the indirect effect of appetite on the association between number of natural teeth on weight loss was not found to be significant.
This study found that number of natural teeth present and appetite are independently related to weight change among elderly men in Australia. Tooth loss can increase the risk of swallowing difficulty leading to change in food preference, avoidance of foods and a decrease in energy intake. Our study showed the importance of oral health interventions to encourage maintenance of 20 or more natural teeth in older people.
体重减轻和食欲减退是老年人中常见的现象。食欲减退与药物相关的唾液分泌减少、味觉能力下降和口腔健康状况不佳有关。食欲不振会导致营养摄入减少，从而导致体重下降。食欲不振可能是口腔健康与体重减轻之间因果关系的中介步骤。本研究调查了口腔健康状况差和食欲不振是否与体重减轻有关。
这是一项观察性研究，数据来自 Concord Health and Ageing in Men Project (CHAMP)。通过自我完成的问卷收集社会人口统计学、食欲和健康相关行为信息。由经过校准的口腔健康治疗师进行口腔内部评估。由经过培训的工作人员测量身高和体重。回归分析调查了口腔健康和食欲作为体重减轻风险因素之间的关联。
参与者包括 542 名居住在社区的老年男性。99 名老年男性（18.3%）在 3 年内体重减轻了 5%或更多。与体重未减轻的男性相比，体重减轻的男性 BMI 和体重较低，虚弱和抑郁的患病率较高，报告的食欲较差，牙齿较少（13.8±9.5 颗），而体重未减轻的男性则较少（16.3±9.3 颗）。在调整之前，与有 20 颗或更多牙齿的参与者相比，存在 0-19 颗天然牙齿的参与者体重减轻的患病率比为 1.76（95%置信区间（CI），1.19-2.59）。当将食欲和其他变量添加到模型中时，牙齿数量和体重减轻的患病率比保持不变：1.78（95%CI，1.06-3.00）。中介分析表明，食欲对天然牙齿数量与体重减轻之间关联的间接影响并不显著。
本研究发现，澳大利亚老年男性中存在的天然牙齿数量和食欲与体重变化独立相关。牙齿缺失会增加吞咽困难的风险，导致食物偏好改变、避免食用某些食物以及能量摄入减少。我们的研究表明，口腔健康干预措施的重要性在于鼓励老年人保持 20 颗或更多的天然牙齿。
