Ringstad Ingrid Beate, Romskaug Rita, Santervas Leonor Roa, Fjeld Katrine Gahre, Hove Lene Hystad, Skovlund Eva, Wyller Torgeir Bruun, Jensen Janicke Liaaen
Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
J Am Geriatr Soc. 2025 Aug;73(8):2466-2474. doi: 10.1111/jgs.19564. Epub 2025 Jun 3.
Oral health is an essential part of overall health and well-being in older adults and may be influenced by medications and frailty. This study aimed to describe the prevalence of xerostomia and hyposalivation and examine their associations with xerogenic medications and frailty in acutely ill older adults.
This cross-sectional study included patients aged ≥ 70 years admitted to the Municipal In-Patient Acute Care unit in Oslo, Norway. General xerostomia was defined as a score ≥ 3 on the General Xerostomia Question (GXQ). Specific xerostomia was measured with the Summated Xerostomia Inventory (SXI). Objective dry mouth measures included unstimulated whole saliva (UWS) secretion rate and the Clinical Oral Dryness Score (CODS), with hyposalivation defined as UWS ≤ 0.1 mL/min. Examination of dentition included numbers of missing teeth and posterior occluding pairs of teeth. Medication data included total drug burden and number of xerogenic medications. Frailty was assessed using the Clinical Frailty Scale (CFS). Associations were analyzed using logistic regression models.
Among 382 patients (mean age 84 years, 72% women), general xerostomia was present in 30% and hyposalivation in 56%. Mean number (SD) of xerogenic medications was 3.7 (±2.2). The number of xerogenic medications used was significantly associated with general xerostomia in both unadjusted (OR: 1.17, 95% CI: 1.05-1.29) and adjusted models (OR: 1.13, 95% CI: 1.01-1.26). Median UWS declined numerically with increasing number of xerogenic medications. Higher CFS scores were associated with increased subjective xerostomia scores (GXQ and SXI), elevated CODS, more missing teeth, and reduced occlusion, but not with general xerostomia or hyposalivation when predefined cut-off values were applied.
Xerostomia and hyposalivation were common among acutely ill older adults. General xerostomia was associated with xerogenic medication use and frailty. Our findings highlight the need to incorporate oral health assessments into routine geriatric care and emphasize the importance of interdisciplinary collaborations.
口腔健康是老年人整体健康和幸福的重要组成部分，可能受到药物和身体虚弱的影响。本研究旨在描述急性病老年患者中口干症和唾液分泌减少的患病率，并探讨它们与致口干药物和身体虚弱之间的关联。
这项横断面研究纳入了挪威奥斯陆市住院急性护理病房中年龄≥70岁的患者。一般口干症定义为在一般口干症问题（GXQ）上得分≥3分。特定口干症用综合口干症量表（SXI）进行测量。客观口干测量包括非刺激性全唾液（UWS）分泌率和临床口腔干燥评分（CODS），唾液分泌减少定义为UWS≤0.1 mL/分钟。牙列检查包括缺失牙数量和后牙咬合对数量。药物数据包括总药物负担和致口干药物数量。使用临床衰弱量表（CFS）评估身体虚弱。使用逻辑回归模型分析关联。
在382名患者（平均年龄84岁，72%为女性）中，30%存在一般口干症，56%存在唾液分泌减少。致口干药物的平均数量（标准差）为3.7（±2.2）。在未调整模型（比值比：1.17，95%置信区间：1.05 - 1.29）和调整模型（比值比：1.13，95%置信区间：1.01 - 1.26）中，使用的致口干药物数量与一般口干症均显著相关。随着致口干药物数量的增加，UWS中位数在数值上下降。较高的CFS评分与主观口干评分（GXQ和SXI）增加、CODS升高、更多的牙齿缺失和咬合减少相关，但在应用预定义临界值时，与一般口干症或唾液分泌减少无关。
口干症和唾液分泌减少在急性病老年患者中很常见。一般口干症与致口干药物使用和身体虚弱有关。我们的研究结果强调了将口腔健康评估纳入常规老年护理的必要性，并强调了跨学科合作的重要性。
