Associations between oral health parameters and nutritional status in geriatric populations: An umbrella review with meta-analysis

Abstract

Background: Oral health impairments may compromise dietary intake and increase malnutrition risk in older adults. This review quantified associations between oral health indicators and malnutrition risk while synthesizing qualitative evidence. Methods: Following PRISMA 2020 guidelines, we searched five databases for systematic reviews examining oral health indicators and nutritional outcomes in older adults. Quality was assessed using the JBI Critical Appraisal Checklist. RevMan 5.4 was used for meta-analyses, with sensitivity analyses using Comprehensive Meta-Analysis v3.7. Results: Sixteen systematic reviews (518,647 participants) were included. Functional problems (chewing difficulty, xerostomia) were more associated with malnutrition than structural indicators, and while edentulism was frequently related to increased risk, dentures showed mixed correlations. Meta-analysis showed malnutrition risk was associated with masticatory dysfunction (RR) (1.75; p = 0.0001) and edentulism without dentures (RR) (1.71; p < 0.0005), but not with dental prostheses (RR) (1.01; p = 0.96); tooth count showed no significant association (MD) (-0.16; p = 0.19). Conclusions: Functional oral impairment, particularly masticatory dysfunction and edentulism without dentures is more likely associated with malnutrition. Routine integration of oral and nutritional screening in geriatric care is warranted, with standardized measures needed to clarify the impact of salivary function and prosthetic rehabilitation on nutritional outcomes.