title: Relationship between oral Candida species and risk factors with reference to drugs with xerostomic side effects among institutionalised elderly in Aichi Pref., Japan.
abstract: OBJECTIVE
  To clarify the relationship between Candida carriage and drugs which have reported xerostomic side effects in the elderly.
  
  
  METHODS
  Cross-sectional study. Setting Two long-term care facilities in Aichi Pref., Japan.
  
  
  METHODS
  Eight men and 63 women with a mean age of 86 years (range 62 to 95 years) with at least some of their natural teeth.
  
  
  METHODS
  Oral examination by dentists, microbiological test by microbiologists, questionnaire interviews, and data obtained from medical files. The Candida species (CFU) was adopted as an objective variable with risk indicators being age, number of teeth, saliva flow rate, denture wearing, xerostomic drugs, activities of daily living (ADL), frequency of brushing and type of meals.
  
  
  RESULTS
  Bivariate analysis confirmed that participants with a higher number of Candida species (CFU) fell into the following categories: denture wearing (p < 0.05), older age (p < 0.05), xerostomic drugs (p < 0.10), more teeth, poor ADL, soft/liquid meals, and brushing once a day. This was in contrast to the categories of no denture wearing, younger age, no xerostomic drugs, fewer teeth, good ADL, normal meals, and brushing two or more times a day, in that order of significant probability on an ascending scale. A multiple logistics regression model confirmed that the variables of older age (80 years and over) and more teeth (six or more) had statistically significant (p < 0.05) effects on the number of Candida species present (CFU). Xerostomic drugs and the other variables had no significant effect.
  
  
  CONCLUSIONS
  Older age and more teeth had a significant effect on the number of oral Candida species in the elderly. The results of this study did not support a role of those drugs as a risk indicator for oral Candida carriage. Larger trials are needed to assess the effect of drugs on the presence of oral Candida.
authors.affiliation: Laboratory of Public Health, School of Nutritional Science, Nagoya University of Arts and Sciences, Japan. yamanaka@nuas.ac.jp
authors.forename: Katsumi
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Haruo
authors.initials: H
authors.lastname: Nakagaki
authors.forename: Ichizo
authors.initials: I
authors.lastname: Morita
authors.forename: Nobuko
authors.initials: N
authors.lastname: Maeda
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Ohara
authors.forename: Shinpei
authors.initials: S
authors.lastname: Tomatsu
authors.forename: Toshiro
authors.initials: T
authors.lastname: Nakashima
authors.forename: Yosinori
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ohta
authors.forename: Kyoko
authors.initials: K
authors.lastname: Shibata
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000302:isolation & purification*; D002353:Carrier State; D015169:Colony Count, Microbial; D003430:Cross-Sectional Studies; D003778:Dentures; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007326:Institutionalization; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D015999:Multivariate Analysis; D012307:Risk Factors; D012472:Salivation / Q000187:drug effects; D011795:Surveys and Questionnaires; D014987:Xerostomia / Q000139:chemically induced* / Q000382:microbiology*