Dental Criteria Could Alert for Malnutrition Risk and Inappropriate Choice of Food Texture in Older Subjects with Dementia: An Analytical Cross-Sectional Study

Abstract

Oral health indicators are usually collected to alert for the presence of infectious diseases, but the impact of poor oral health on the nutritional status of older people with dementia is often neglected. This study aims to explore the relationship between the number of posterior dental functional units (PFUs) and the anthropometric measure of malnutrition, the mid-upper arm circumference (MUAC), in older people with dementia while controlling for other variables, and to analyze whether the number of PFUs is considered when adjusting the texture of the food provided at mealtimes. A total of 103 individuals who were 70 years or older with dementia were recruited from seven institutions. Cognitive impairment was assessed using the Mini Mental State Examination. Data were collected from medical records (sociodemographic characteristics, presence of chronic diseases, prescribed medications, results of serum albumin level), as well as questionnaires (type of feeding routes, type of food texture, supplements intake, Activity of Daily Living index), clinical examinations (MUAC), and oral health parameters (PFUs, oral dryness, oral hygiene). MUAC was the dependent outcome variable. MUAC was associated with the number of PFUs (p = 0.032); participants with PFU ≤ 4 were 7.5 times more likely to have MUAC < 21 cm than others. Other associations were found between MUAC and albumin level (OR = 12.5; p = 0.001), modified food texture (OR = 4.2; p = 0.035), and length of institutional stay (OR = 5.2; p = 0.033); however, the type of oral feeding was not significantly related to the number of PFUs (p = 0.487) so there is an inadequate correlation between food texture and oral health status. Similar to MUAC, the number of PFUs could be an oral anthropometric criterion that is recorded during routine hygiene care to alert for the risk of malnutrition and the inappropriate choice of food texture in older individuals with dementia.