Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan.
Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan.
BMC Oral Health. 2024 Aug 3;24(1):887. doi: 10.1186/s12903-024-04568-0.
A new diagnostic criterion for malnutrition, the Global Leadership Initiative on Malnutrition (GLIM) criteria, has been proposed. Despite a recognized link between malnutrition and oral health, further clarification is needed regarding this association when using the GLIM criteria. This study examined the association between malnutrition and oral health in community-dwelling older adults aged ≥ 85.
This study was conducted using data from the Tokyo Oldest Old Survey on Total Health study, and altogether 519 participants ≥ 85 years were enrolled. Malnutrition was assessed using the GLIM criteria. Oral health information, on the number of teeth, maximum occlusal force (MOF), saliva production, denture-related questions (dissatisfaction and frequency of use), dental visit history in the past year, whether participants enjoyed meals, and oral-related quality of life was assessed using the Geriatric Oral Health Assessment Index (GOHAI) were collected. MOF was assessed the average values of three measurements and lower tertile by sex as decline in MOF. For GOHAI, the score for each items (Q1-Q12) was also evaluated, and further, the decline in each item (score: 1-2 points on a 5-point scale) was assessed as a "problem with each items." Oral health factors differing between those with and without malnutrition were analyzed. For differing items, malnutrition risk was evaluated using Cox regression.
Eighty-nine (17.1%) participants experienced malnutrition. Significant differences were observed in the decline in MOF, enjoyment of meals, individual scores for Q2, Q4, and Q6, and the problem with Q3, Q6, Q7, and Q11. Cox regression analysis showed that decline in MOF (odds ratio [OR]: 1.728, 95% confidence interval [CI]: 1.010-2.959), enjoyment of meals (OR: 0.502, 95% CI: 0.289-0.873), problem with Q3 (OR: 5.474, 95% CI: 1.301-23.028), Q6 (OR: 5.325, 95% CI: 1.026-27.636), and Q7 (OR: 2.867, 95% CI: 1.397-5.882) were associated with ORs of malnutrition.
Decline in MOF, enjoyment of meals, swallowing problem (problem with Q3), limit contact due to oral condition (problem with Q6), and esthetics problem (problem with Q7) were associated with malnutrition as assessed using the GLIM criteria.
新的营养不良诊断标准——全球营养不良领导倡议（GLIM）标准已经提出。尽管营养不良与口腔健康之间存在公认的联系，但在使用 GLIM 标准时，需要进一步明确这种关联。本研究旨在探讨 85 岁及以上社区居住老年人中营养不良与口腔健康之间的关系。
本研究使用了东京老年人健康综合研究的调查数据，共纳入了 519 名 85 岁及以上的参与者。使用 GLIM 标准评估营养不良。收集口腔健康信息，包括牙齿数量、最大咬合力量（MOF）、唾液分泌、义齿相关问题（满意度和使用频率）、过去一年的牙科就诊史、是否享受用餐以及口腔相关生活质量（使用老年口腔健康评估指数（GOHAI）评估）。MOF 通过三次测量的平均值和按性别划分的较低三分位数进行评估，作为 MOF 的下降。对于 GOHAI，还评估了每个项目（Q1-Q12）的得分，并且进一步评估了每个项目的下降情况（得分：5 分制的 1-2 分）作为“每个项目的问题”。分析了营养不良与无营养不良者之间存在差异的口腔健康因素。对于不同的项目，使用 Cox 回归评估营养不良的风险。
89 名（17.1%）参与者患有营养不良。在 MOF 的下降、用餐的享受、Q2、Q4 和 Q6 的个人得分以及 Q3、Q6、Q7 和 Q11 的问题方面存在显著差异。Cox 回归分析显示，MOF 的下降（优势比 [OR]：1.728，95%置信区间 [CI]：1.010-2.959）、用餐的享受（OR：0.502，95% CI：0.289-0.873）、Q3 的问题（OR：5.474，95% CI：1.301-23.028）、Q6 的问题（OR：5.325，95% CI：1.026-27.636）和 Q7 的问题（OR：2.867，95% CI：1.397-5.882）与营养不良的 OR 相关。
MOF 的下降、用餐的享受、吞咽问题（Q3 的问题）、因口腔状况导致的接触受限（Q6 的问题）以及美观问题（Q7 的问题）与 GLIM 标准评估的营养不良相关。
