title: Relationships between oral health, dysphagia and undernutrition in hospitalised elderly patients.
abstract: OBJECTIVE
  The aim of this study was to describe relationships between oral status, dysphagia and malnutrition in a hospitalised older people.
  
  
  BACKGROUND
  Undernutrition in older people is a major concern in geriatric hospital wards. Different factors can modify nutritional status like dysphagia or oral status.
  
  
  METHODS
  About 159 consecutive inpatients (108 women, 51 men) were examined. Comprehensive gerontological data at baseline and nutritional status according to BMI, MNA and serum albumin concentration, dependency according to ADL scores, dietary intake, swallowing capacities and oral status were collected. Swallowing capacities and dietary intake were reassessed 1 week after.
  
  
  RESULTS
  Mean age was 85.28 (SD 5.68). Seventy-seven patients were malnourished (MNA) and 34 had dysphagia. Oral treatment was necessary in 142 patients (89.30% of all population). Candidiasis was present in 17 patients and salivary flow reduction in 50. Patients with dysphagia had the lowest dietary intake. After 1 week, patients with dysphagia were retested and dysphagia had abated in three of them. Dysphagia and undernutrition were associated (p < 0.001), and both were related to candidiasis (p < 0.001 and p < 0.01). Dysphagia was also related to salivary hypofunction (p < 0.001), loss of posterior occluding pairs (POPs; p = 0.014), oral self-care dependency (p < 0.001) and self-feeding dependency (p < 0.001). Salivary hypofunction was related to candidiasis (p < 0.001) and loss of POPs (p < 0.05), and candidiasis to loss of POPs (p < 0.01).
  
  
  CONCLUSIONS
  Although no causality can be demonstrated, poor oral health was strongly associated with malnutrition, emphasising the importance to develop oral care strategies and to incorporate a dental examination into comprehensive gerontological assessment.
authors.affiliation: Department of Dentistry and Oral Health, CHU of Bordeaux, Bordeaux, France.|Department of Oral Public Health, UFR of Odontology, Bordeaux Segalen University, Bordeaux, France.|EA 4136 "Handicap and Nervous System", Bordeaux Segalen University, Bordeaux, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Poisson
authors.affiliation: Department of Dentistry and Oral Health, CHU of Bordeaux, Bordeaux, France.
authors.forename: Thibault
authors.initials: T
authors.lastname: Laffond
authors.affiliation: Dietetics Department, CHU of Bordeaux, Bordeaux, France.
authors.forename: Sandra
authors.initials: S
authors.lastname: Campos
authors.affiliation: Department of Dentistry and Oral Health, CHU of Bordeaux, Bordeaux, France.|Department of Prosthodontics, UFR of Odontology, Bordeaux Segalen University, Bordeaux, France.
authors.forename: Veronique
authors.initials: V
authors.lastname: Dupuis
authors.affiliation: Department of Gerontology, CHU of Bordeaux, Bordeaux, France.|RMSB, UMR 5536 CNRS, Bordeaux, France.|RMSB, UMR 5536 Bordeaux Segalen University, Bordeaux, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bourdel-Marchasson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002180:Candidiasis, Oral / Q000150:complications; D003680:Deglutition Disorders / Q000150:complications*; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications*; D009752:Nutritional Status; D009909:Oral Health; D012466:Salivary Gland Diseases / Q000150:complications
keywords: Candida; elderly; nutrition; saliva; tooth loss