title: The association between chewing and swallowing difficulties and nutritional status in older adults.
abstract: BACKGROUND
  The aim of this study was to investigate the associations of chewing and swallowing dysfunctions to nutritional status in older adults.
  
  
  METHODS
  This cross-sectional study comprised a convenience sample of 1065 community-dwelling older adults living in rural United States. Dietary assessment included the Block Full Length Food Frequency Questionnaire, 24-hour Food Intake Recall and Mini Nutritional Assessment. Classification of chewing and swallowing difficulties was determined by a criterion of outlined factors.
  
  
  RESULTS
  In our sample, 113 (11%) had chewing difficulties, 51 (5%) had swallowing difficulties, and 11 (1%) had both. Compared to the Dietary Reference Intakes (DRIs), the study population was deficient in calories and several nutrients. Mean daily intake in individuals reporting chewing, swallowing, or difficulties with both were 1489 ± 360, 1461 ± 374 and 1374 ± 240 calories respectively. There was no statistically significant difference between the groups. Vitamin A, vitamin E and manganese were significantly lower in those with chewing difficulties while vitamin E and magnesium were significantly lower in individuals with swallowing difficulties (p < 0.05).
  
  
  CONCLUSIONS
  These results emphasize the importance of chewing and swallowing difficulties in modulating nutritional outcomes in older adults. These co-morbidities should be monitored in this population and intake of nutrient dense foods should be increased in those at risk.
authors.affiliation: Department of Human Environmental Studies, Central Michigan University, Mount Pleasant, Michigan 48859, USA.
authors.forename: T
authors.initials: T
authors.lastname: Mann
authors.forename: R
authors.initials: R
authors.lastname: Heuberger
authors.forename: H
authors.initials: H
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003679:Deglutition; D003680:Deglutition Disorders / Q000150:complications* / Q000503:physiopathology; D004032:Diet; D002149:Energy Intake; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000150:complications; D008297:Male; D044342:Malnutrition / Q000209:etiology*; D008409:Mastication; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D012424:Rural Population; D011795:Surveys and Questionnaires; D014481:United States