Associations between self-assessed masticatory ability, nutritional status, prosthetic status and salivary flow rate in hospitalized elders

OBJECTIVES: To compare the association between self-assessed masticatory ability and nutritional status with general health status, salivary flow and dental/prosthetic status. DESIGN: A questionnaire and a cross-sectional clinical investigation combined with a measurement of salivary flow rates. SUBJECTS AND METHODS: A cohort of 99 elderly, non-psychiatric patients in a geriatric hospital; clinical examination to determine dental and prosthetic status, oral health and whole unstimulated (USFR) and stimulated (SSFR) salivary flow rates, examination of anthropometric measures, serum albumin level and body mass index (BMI); questionnaire designed to produce yes or no answers related to masticatory function, nutritional status, appetite and prosthesis function; mini mental score examination (MMES). MAIN OUTCOME MEASURES: USFR, SSFR, BMI, anthropometric measures and serum albumin level; complaints related to appetite and xerostomia. RESULTS: Mean age of the 99 patients was 82.5 +/- 4.04 with a MMES of > 21; 50% with malnutrition of severe or intermediate degree, and 86% with moderately or severely reduced serum albumin concentration; 55% reported recent loss of appetite and 52% had symptoms of oral dryness. Recent loss of appetite was associated with reduced serum albumin and complaints of dry mouth and lack of appetite was associated with BMI < 21, 10% weight loss during the preceding 6 months, SSFR < or = 0.5 ml min-1 and wearing dentures. Complaints on poor retention of the maxillary denture were associated with recent weight loss and SSFR < or = 0.5 ml min-1. CONCLUSIONS: Malnutrition in hospitalized elders is primarily associated with recent loss or lack of appetite whereas complaints related to dentures are associated with poor denture quality.