title: Dentition status, malnutrition and mortality among older service housing residents.
abstract: BACKGROUND
  Oral health status and oral health problems can affect eating habits and thus consequently the nutritional status of frail older people.
  
  
  OBJECTIVE
  To assess older service house residents' dentition and its associations with nutritional status and eating habits, and as well as to explore the prognostic value of dentition status for mortality.
  
  
  METHODS
  A cross-sectional study with a three-year follow-up.
  
  
  METHODS
  In 2007, we assessed the nutritional status of all residents in service houses in the two cities of Helsinki and Espoo in Finland (N=2188). Altogether 1475 subjects (67%) participated in the study; dentition status data were available for 1369 of them. Using a personal interview and assessment, trained nurses familiar to the resident collected the subjects' demographic data, medical history, functional and cognitive status, information on dentition status, oral symptoms, eating habits and diets. We assessed nutritional status with the Mini Nutritional Assessment (MNA), and retrieved information on mortality from central registers on 6 July 2010.
  
  
  RESULTS
  Edentulousness was common; more than half of the residents (52%) had lost all their teeth: 7% (n=94) were totally edentulous without prosthesis (Group 1), 45% (n=614) had removable dentures (Group 2), and 48% (n = 661) of the residents, had some natural teeth left (Group 3). Dentition status was associated with age, gender, education and disability. According to the MNA, 13% were malnourished, 65% were at risk for malnutrition, and 22% were well nourished. Edentulousness without prosthesis was associated with malnutrition, oral symptoms and infrequent use of oral care services. In Group 1, 52% were deceased during follow-up period. The respective figures for Groups 2 and 3 were 48% and 40% (p=0.004). However, in Cox regression analysis adjusted for age, gender, comorbidity and MNA score, dentition status no longer predicted mortality.
  
  
  CONCLUSIONS
  Edentulousness is still common among older service housing residents. Edentulousness without prosthesis was associated with poor nutritional status, oral symptoms and infrequent use of dental services. These findings suggest the need for co-operation between nursing staff and oral care services.
authors.affiliation: Riitta Saarela, MSc, Department of social services and health care, Oral Health Care, Kaikukatu 3A, P.O. Box 6452, FI-00099 City of Helsinki, Phone: +358 40 336 0880, Fax: +358 9 310 42602, Email: riitta.saarela(at)hel.fi.
authors.forename: R K T
authors.initials: RK
authors.lastname: Saarela
authors.forename: H
authors.initials: H
authors.lastname: Soini
authors.forename: K
authors.initials: K
authors.lastname: Hiltunen
authors.forename: S
authors.initials: S
authors.lastname: Muurinen
authors.forename: M
authors.initials: M
authors.lastname: Suominen
authors.forename: K
authors.initials: K
authors.lastname: Pitkälä
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003729:Dental Care; D017266:Dental Prosthesis; D003817:Dentition; D006233:Persons with Disabilities; D004435:Eating; D005247:Feeding Behavior; D005260:Female; D005387:Finland; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D009059:Mouth Diseases / Q000150:complications; D009735:Nursing Homes; D015596:Nutrition Assessment; D009752:Nutritional Status; D009909:Oral Health; D015995:Prevalence; D016016:Proportional Hazards Models; D012959:Socioeconomic Factors; D016388:Tooth Loss / Q000150:complications*