The Relationship between Oral Frailty and Nutritional Status in the Elderly: A Systematic Review and Meta-Analysis

Meirong Qin; Jinsu Chen; Xin Yang; Fang Shen; Dan Yang; Jing Zhang; Wei Xiao

doi:10.54097/9ejr0z92

Authors

Meirong Qin
Jinsu Chen
Xin Yang
Fang Shen
Dan Yang
Jing Zhang
Wei Xiao

DOI:

https://doi.org/10.54097/9ejr0z92

Keywords:

Oral, Oral Frailty, Nutrition, Nutritional Status, meta-analysis

Abstract

A systematic review assessing the association of deteriorating oral function with nutrient intake in older adults. Methods Comprehensive evidence gathering from CBMdisc, CNKI, Wanfang Database, PubMed, Embase, Web of Science, and Cochrane Library, to examine how oral frailty relates to dietary inadequacy among seniors. Retrieval period from June 30, 2014 to June 30, 2024.Two researchers independently screened the literature, extracted data, and assessed the quality of the included studies, using Revman 5.4 and Stata 16.0 for the systematic review. Results With an aggregate sample of 7,234 subjects across eight selected studies, the analysis contained seven cross-sectional designs and a single prospective cohort. Meta-analysis results demonstrate that malnutrition susceptibility rises markedly in the elderly with compromised masticatory capacity. (OR=1.93,95% CI:1.62-2.30), with a statistically significant difference (Z=7.27, P<0.001).Subgroup assessments confirmed stable nutritional indicators in orally frail elderly populations across studies of varying publication dates and participant numbers(P > 0.05); The study area for the Japanese subgroup showed statistical significance [OR=1.43, 95% CI:1.08-1.89, P=0.01].Conclusions Although nutritional status correlates with oral frailty in the elderly population, equivocal evidence persists regarding how tooth retention and oromotor skill deterioration impact nutritional outcomes. This necessitates greater attention to the collaborative management of oral health and nutritional status, which in turn can provide clinical decision-making and intervention strategies for preventing and controlling oral frailty in the elderly.

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References

[1] KIMBLE R, PAPACOSTA A O, LENNON L T, et al. The Relationships of Dentition, Use of Dental Prothesis and Oral Health Problems with Frailty, Disability and Diet Quality: Results from Population-Based Studies of Older Adults from the UK and USA[J]. J Nutr Health Aging, 2023,27(8): 663-672.

[2] PETERSEN P E, KANDELMAN D, ARPIN S, et al. Global oral health of older people--call for public health action[J]. Community Dent Health, 2010,27(4 Suppl 2): 257-267.

[3] PETERSEN P E. The World Oral Health Report 2003:continuous improvement of oral health in the 21st century--the approach of the WHO Global Oral Health Programme [J]. Community Dent Oral Epidemiol, 2003,31 Suppl 1: 3-23.

[4] TANAKA T, TAKAHASHI K, HIRANO H, et al. Oral Frailty as a Risk Factor for Physical Frailty and Mortality in Community-Dwelling Elderly[J]. J Gerontol A Biol Sci Med Sci, 2018,73(12): 1661-1667.

[5] KUGIMIYA Y, WATANABE Y, UEDA T, et al. Rate of oral frailty and oral hypofunction in rural community-dwelling older Japanese individuals[J]. Gerodontology, 2020,37(4): 342-352.

[6] ZHAO H, WU B, ZHOU Y, et al. Oral frailty: a concept analysis[J]. BMC Oral Health, 2024,24(1): 594.

[7] FLEURKE M, VOSKUIL D W, BENEKEN G K D. The role of the dietitian in the management of malnutrition in the elderly: A systematic review of current practices[J]. Nutr Diet, 2020,77(1): 60-75.

[8] WELLS J C, SAWAYA A L, WIBAEK R, et al. The double burden of malnutrition: aetiological pathways and consequences for health[J]. Lancet, 2020,395(10217): 75-88.

[9] RAPP L, SOURDET S, LACOSTE-FERRE M H. Oral Health and Undernutrition in the Frail Elderly Persons[J]. JOURNAL OF NUTRITION HEALTH & AGING, 2021,25(4): 484-491.

[10] IWASAKI M, MOTOKAWA K, WATANABE Y, et al. Oral hypofunction and malnutrition among community-dwelling older adults: Evidence from the Otassha study[J]. GERODONTOLOGY, 2022,39(1): 17-25.

[11] IWASAKI M, MOTOKAWA K, WATANABE Y, et al. Association between Oral Frailty and Nutritional Status Among Community-Dwelling Older Adults: The Takashimadaira Study[J]. JOURNAL OF NUTRITION HEALTH & AGING, 2020,24(9): 1003-1010.

[12] NOMURA Y, ISHII Y, SUZUKI S, et al. Nutritional Status and Oral Frailty: A Community Based Study[J]. NUTRIENTS, 2020,12(9): 2886.

[13] KAURANI P, KAKODKAR P, BHOWMICK A, et al. Association of tooth loss and nutritional status in adults: an overview of systematic reviews[J]. BMC Oral Health, 2024,24 (1): 838.

[14] STANG A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. Eur J Epidemiol, 2010,25(9): 603-605.

[15] Wells G, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses[EB/OL].[2012-06-15]. http://www.ohri.ca/ programs/ clinical_epidemiology/oxford.asp[J].

[16] XIANTAO Z, HUI L, XI C, et al. Meta-Analysis Series Part 4: Quality Assessment Tools for Observational Studies[J]. Chin J Evid Based Cardiovasc Med, 2012,4(04): 297-299.

[17] EGGER M, DAVEY S G, SCHNEIDER M, et al. Bias in meta-analysis detected by a simple, graphical test[J]. BMJ, 1997,315(7109): 629-634.

[18] NAKAGAWA S, MIURA K, ARAI E, et al. Oral frailty, appetite and dietary variety in late-stage older adults: A cross-sectional study (the STudy of lAte-stage oldeR adulTs in Tottori; START Tottori) [J]. GERIATRICS & GERONTOLOGY INTERNATIONAL, 2024,24(6): 626-633.

[19] HIRONAKA S, KUGIMIYA Y, WATANABE Y, et al. Association between oral, social, and physical frailty in community -dwelling older adults[J]. Arch Gerontol Geriatr, 2020,89: 104105.

[20] IWASAKI M, MOTOKAWA K, WATANABE Y, et al. A Two-Year Longitudinal Study of the Association between Oral Frailty and Deteriorating Nutritional Status among Community-Dwelling Older Adults[J]. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 2020,18(1): 213.

[21] IWASAKI M, SHIROBE M, MOTOKAWA K, et al. Prevalence of oral frailty and its association with dietary variety, social engagement, and physical frailty: Results from the Oral Frailty 5-Item Checklist[J]. Geriatr Gerontol Int, 2024,24(4): 371-377.

[22] HOSHINO D, HIRANO H, EDAHIRO A, et al. Association between Oral Frailty and Dietary Variety among Community-Dwelling Older Persons: A Cross-Sectional Study[J]. J Nutr Health Aging, 2021,25(3): 361-368.

[23] LINGMEI J, WEN L, PING L, et al. Research on the Status and Influencing Factors of Oral Frailty among Institutionalized Elderly Individuals[J]. Chinese Journal of Geriatric Care, 2023,21(6): 47-50, 57.

[24] JINGYI W, QIUYAN Z, WEI H, et al. Analysis of the Occurrence and Influencing Factors of Oral Frailty in Elderly Residents of Elderly Care Facilities[J]. Journal of Sichuan University(Medical Sciences), 2024,55(04): 947-957.

[25] LIU D, GAO Y, SU X. Self-care ability and associated factors in community-dwelling older adults living with oral frailty using the COM-B model[J]. J Oral Rehabil, 2024,51(8): 1530-1541.

[26] ALGHOFAILI A A, ALADEL A I, ALSOGHIER A M, et al. Association of Oral and General Health with Nutritional Status of Older Adults Attending Two Medical Centers in Riyadh, Saudi Arabia: A Cross-Sectional Study[J]. Nutrients, 2023,15 (18).

[27] ZELIG R, GOLDSTEIN S, TOUGER-DECKER R, et al. Tooth Loss and Nutritional Status in Older Adults: A Systematic Review and Meta-analysis[J]. JDR Clin Trans Res, 2022,7(1): 4-15.

[28] SHIMIZU A, FUJISHIMA I, MAEDA K, et al. Nutritional Management Enhances the Recovery of Swallowing Ability in Older Patients with Sarcopenic Dysphagia[J]. 2021,13(2): 596.

[29] KUGIMIYA Y, MOTOKAWA K, YAMAMOTO K, et al. Relationship between the rate of a decreased oral function and the nutrient intake in community-dwelling older persons: An examination using oral function-related items in a questionnaire for latter-stage elderly people[J]. 2021,58(1): 91-100.

[30] SUZUKI F, OKAMOTO S, MIYAGI S, et al. Relationship between Decreased Mineral Intake Due to Oral Frailty and Bone Mineral Density: Findings from Shika Study[J]. NUTRIENTS, 2021,13(4).

[31] THOMSON W M, CHALMERS J M, SPENCER A J, et al. The Xerostomia Inventory: a multi-item approach to measuring dry mouth[J]. Community Dent Health, 1999,16(1): 12-17.

[32] TRINDADE D, CARVALHO R, MACHADO V, et al. Prevalence of periodontitis in dentate people between 2011 and 2020: A systematic review and meta-analysis of epidemiological studies[J]. J Clin Periodontol, 2023,50(5): 604-626.

[33] CHANDRA R K. Nutrition and the immune system: an introduction [J]. Am J Clin Nutr, 1997,66(2): 460S-463S.

[34] DOMMISCH H, KUZMANOVA D, JONSSON D, et al. Effect of micronutrient malnutrition on periodontal disease and periodontal therapy[J]. Periodontol 2000, 2018,78(1): 129-153.

[35] ELMADFA I, MEYER A L. The Role of the Status of Selected Micronutrients in Shaping the Immune Function[J]. Endocr Metab Immune Disord Drug Targets, 2019,19(8): 1100-1115.

[36] TANI A, MIZUTANI S, KISHIMOTO H, et al. The Impact of Nutrition and Oral Function Exercise on among Community-Dwelling Older People[J]. Nutrients, 2023,15(7).

[37] SONG H, WEI Y, WANG Y, et al. The mediating effect of nutrition on oral frailty and fall risk in community-dwelling elderly people[J]. BMC GERIATRICS, 2024,24(1).

[38] IWASAKI M, OHTA Y, FURUSHO N, et al. Association between oral frailty and nutritional status among hemodialysis patients aged≥50years[J]. Geriatr Gerontol Int, 2024,24(9): 891-897.

[39] CAO C, LIAO S, CAO W, et al. Differences in the association of oral health knowledge, attitudes, and practices with frailty among community-dwelling older people in China[J]. BMC Oral Health, 2023,23(1): 782.

[40] OHSHIMA M, ZHU L, YAMAGUCHI Y, et al. Comparison of periodontal health status and oral health behavior between Japanese and Chinese dental students[J]. J Oral Sci, 2009,51(2): 275-281.

[41] SUTO M, SUGIYAMA T, IMAI K, et al. Studies of Health Insurance Claims Data in Japan: A Scoping Review[J]. JMA J, 2023,6(3): 233-245.