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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Geriatric Nutrition".

Deadline for manuscript submissions: closed (5 November 2024) | Viewed by 16823

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Prof. Dr. Wai Keung Leung

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Guest Editor

Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
Interests: dentistry; oral health; oral health-related quality of life; periodontics; periodontal microbiology
Special Issues, Collections and Topics in MDPI journals

Dr. Florence Mei Fung Wong

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Co-Guest Editor

School of Nursing, Tung Wah College, Hong Kong, China
Interests: nursing education; geriatric health; acute care; cardiac care; critical care; health-related quality of life; infection control
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Since oral health is closely linked to nutritional status, which determines general health, poor oral health in the elderly population has been of global concern in recent decades. “Oral Health and Nutrition in Older Adults” is a Special Issue of the high-quality, peer-reviewed journal Nutrients; it will be published in the “Geriatric Nutrition” section, which covers nutrition-related and oral health issues in the elderly population. We encourage scientists to submit experimental and theoretical results that shed light on the personal, familial, and/or environmental factors of nutrition and/or oral health in the elderly; associations between nutritional concerns and oral health in the elderly; and strategies to improve nutritional and oral health status in the elderly in order to optimize their quality of life and promote healthy aging. We welcome reviews and original articles related to the development of new technologies, policies, and strategies and their applications, to highlight the interrelations between oral health and nutrition in the elderly population. The dissemination of knowledge through various modes of promotion, as well as preventive strategies for oral health and nutrition, can improve healthcare practice in this specific population.

Prof. Dr. Wai Keung Leung
Dr. Florence Mei Fung Wong
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

aged population
dental caries
diet
eating
nutritional status
oral health
periodontitis
quality of life
tooth wear

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Published Papers (9 papers)

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Research

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9 pages, 589 KiB

Open AccessArticle

The Association of Vitamin D Levels and Dental Caries in Older Adults: A Cross-Sectional Study

by Man Hung, Amir Mohajeri, Mahsa Sadri, Elahe Khodabandeh, Ibrahim Zeitoun and Martin S. Lipsky

Nutrients 2024, 16(14), 2307; https://doi.org/10.3390/nu16142307 - 18 Jul 2024

Viewed by 2451

Abstract

Introduction: Most research examining vitamin D and dental caries focuses on children and younger adults. This study investigated the association between vitamin D levels and dental caries in older adults using data from the United States National Health and Nutrition Examination Survey from 2011 to 2016. Methods: Data were analyzed from 2723 participants aged 65 years and older who completed both dental examinations and serum 25(OH)D tests. Dental caries assessments included the decayed, missing, and filled teeth (DMFT) index and the presence of untreated dental caries. Vitamin D levels were measured as serum 25(OH)D concentrations and categorized as severely deficient (<25 nmol/L), deficient (25–49.9 nmol/L), insufficient (50–74.9 nmol/L), and normal (≥75 nmol/L). Logistic regression and Poisson regression models were used to assess the association between vitamin D levels and dental caries, adjusting for demographic factors. Results: The mean DMFT score was 17.73 ± 8.34, with 35.1% of participants having untreated dental caries. Vitamin D deficiency was associated with a 1.44 times higher likelihood of untreated caries (95% CI: 1.15, 1.81), which weakened after adjustment for demographic factors (adjusted OR: 1.23, 95% CI: 0.97, 1.55). Severe vitamin D deficiency correlated with a 1.13 times higher DMFT score (95% CI: 1.06, 1.20), with the association remaining similar after adjustment (adjusted RR: 1.12, 95% CI: 1.05, 1.20). Significant differences in vitamin D levels were observed across gender, race/ethnicity, and country of birth. Conclusions: This study suggests the potential importance of adequate vitamin D levels for maintaining dental health among older adults. Vitamin D deficiency is associated with a higher risk of poorer DMFT scores. Public health strategies that include vitamin D screening and supplementation, particularly for high-risk groups, may improve oral health outcomes in the older adult population. Further research is needed to elucidate the mechanisms by which vitamin D influences dental health and the potential for vitamin D supplementation to reduce the burden of dental caries in older adults. Full article

(This article belongs to the Special Issue Oral Health and Nutrition in Older Adults)

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9 pages, 594 KiB

Open AccessArticle

The Longitudinal Relationship between Edentulism and the Progress of Multimorbidity

by Rolla Mira, Jonathon Timothy Newton and Wael Sabbah

Nutrients 2024, 16(14), 2234; https://doi.org/10.3390/nu16142234 - 11 Jul 2024

Viewed by 1180

Abstract

Objectives: To examine the longitudinal relationship between edentulism, nutritional intake, and the progress of multimorbidity among older Americans. Methods: We used data from the Health and Retirement Study (2006–2018), a longitudinal survey of older Americans that has collected data biennially since 1992. Edentulism was assessed in 2006 while nutritional intake was assessed in 2013. Multimorbidity was indicated by five self-reported chronic conditions: diabetes, heart conditions, lung diseases, cancer, and stroke. Individuals with two or more conditions at baseline were excluded from the analysis. Nutritional intake was calculated by summing 10 nutrients (protein, vitamins C, D, B12 and E, calcium, zinc, polyunsaturated fatty acids, folate, and ß-carotene). Structural equation modelling (SEM) was used to examine the nutritional pathway between edentulism (2006) and the increase in multimorbidity from 2006 to 2018. Results: The number of individuals included in the analysis was 3463. The incidence of multimorbidity between 2006 and 2018 was 24.07%, while the percentage of edentate participants in 2006 was 16.42%. The mean total nutrition in 2013 was 4.50 (4.43, 4.55). The SEM analysis showed that edentulism was negatively associated with nutritional intake {estimate −0.15 (95%CI: −0.30, −0.01)}. A negative association was found between total nutrition and multimorbidity {estimate −0.008 (95%CI: −0.01, −0.002)}. Age, wealth, and smoking were included in the analysis and had statistically significant associations with multimorbidity. Conclusion: The analysis demonstrated a longitudinal association between edentulism, nutritional intake, and the progress of multimorbidity. Full article

(This article belongs to the Special Issue Oral Health and Nutrition in Older Adults)

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11 pages, 237 KiB

Open AccessArticle

Feasibility of Oral Function Evaluation According to Dementia Severity in Older Adults with Alzheimer’s Disease

by Maki Shirobe, Ayako Edahiro, Keiko Motokawa, Shiho Morishita, Yoshiko Motohashi, Chiaki Matsubara, Masanori Iwasaki, Yutaka Watanabe and Hirohiko Hirano

Nutrients 2024, 16(7), 992; https://doi.org/10.3390/nu16070992 - 28 Mar 2024

Viewed by 1080

Abstract

Oral function evaluation in older adults with dementia is important for determining appropriate and practical dietary support plans; however, it can be challenging due to their difficulties in comprehending instructions and cooperating during assessments. The feasibility of oral function evaluation has not been well studied. This cross-sectional study aimed to determine the feasibility of oral function evaluation in older adults with Alzheimer’s disease (AD) according to Functional Assessment Staging of Alzheimer’s Disease (FAST) stages. In total, 428 older adults with AD (45 men and 383 women; mean age: 87.2 ± 6.2 years) were included. Multilevel logistic regression models were used to examine the prevalence of participants who were unable to perform oral function evaluations, including oral diadochokinesis (ODK), repeated saliva swallow test (RSST), and modified water swallow test (MWST). In comparison to the reference category (combined FAST stage 1–3), FAST stage 7 was associated with the infeasibility of ODK (adjusted odds ratio, 95% confidence interval = 26.7, 4.2–168.6), RSST (5.9, 2.2–16.1), and MWST (8.7, 1.6–48.5, respectively). Oral function evaluation is difficult in older adults with severe AD. Simpler and more practical swallowing function assessments and indicators that can be routinely observed are required. Full article

(This article belongs to the Special Issue Oral Health and Nutrition in Older Adults)

14 pages, 285 KiB

Open AccessArticle

The Associations of Cardiometabolic and Dietary Variables with Clinical Periodontitis in Adults with and without Type 2 Diabetes: A Cross-Sectional Study

by Arpita Basu, Leigh Ann Richardson, Alicia Carlos, Neamat Hassan Abubakr, Robin L. Weltman and Jeffrey L. Ebersole

Nutrients 2024, 16(1), 81; https://doi.org/10.3390/nu16010081 - 26 Dec 2023

Cited by 1 | Viewed by 1779

Abstract

Periodontitis is a commonly occurring inflammatory oral disease affecting a large proportion of global and US adults and is characterized by the destruction of the tooth-supporting apparatus. Its etiology is multifactorial, and type 2 diabetes and diet play critical roles in its remission and progression. However, few studies have addressed nutritional and serum vitamin D status in adults with periodontitis in the presence of diabetes. A cross-sectional study (n = 78), and a sub-set of age- and BMI-matched case–control studies (n = 50), were conducted to examine differences in dietary and cardiometabolic variables, and serum vitamin D in adults with periodontitis with or without diabetes. Participants provided fasting blood samples and 24-h diet recalls on at least two different days. Data on health history, body weight, height, nutritional habits, and clinical features of periodontitis were also collected. The Mann–Whitney U Test (with exact p-value estimation by Monte Carlo simulation) was used to examine differences by diabetes status in continuous and ordinal variables. Results revealed significantly lower serum vitamin D, and dietary intake of fruits, vegetables, dairy, vitamins A and C in adults with periodontitis with vs. without diabetes in the sub-study (all p < 0.05). In the overall sample, adults with diabetes presented with higher caries risk measures and lower numbers of teeth than those without diabetes; plaque and bleeding scores did not differ by diabetes status. Finally, a significant associations of food habits was observed, especially consuming protein-rich foods twice a day with a lower bleeding score, and daily consumption of fried or fast foods with a fewer number of teeth present (all p < 0.05). The present findings show significant dietary and serum vitamin D inadequacies among adults with periodontitis, and diabetes further aggravates the observed malnourishment and oral health. Full article

(This article belongs to the Special Issue Oral Health and Nutrition in Older Adults)

10 pages, 593 KiB

Open AccessArticle

Association between Masticatory Performance, Nutritional Intake, and Frailty in Japanese Older Adults

by Mitsuzumi Okada, Yohei Hama, Ryota Futatsuya, Yoshiyuki Sasaki, Kanako Noritake, Kohei Yamaguchi, Mayuko Matsuzaki, Chieko Kubota, Akemi Hosoda and Shunsuke Minakuchi

Nutrients 2023, 15(24), 5075; https://doi.org/10.3390/nu15245075 - 12 Dec 2023

Cited by 4 | Viewed by 1980

Abstract

The older adult population in Japan is expected to increase. Therefore, long-term care and frailty prevention are important. However, the relationship between masticatory performance, nutritional intake, and frailty remains unclear. This cross-sectional study aimed to examine energy, protein, and vitamin D intake and its association with frailty and masticatory performance in older adults. Patients between January 2022 and January 2023 were recruited and divided into robust and frail groups. Masticatory performance, nutrition, frailty, and other data, such as age and sex, were evaluated through onsite measurements and a questionnaire. Logistic regression analysis was conducted with frailty as a dependent variable and masticatory performance as an independent variable, adjusting for age, sex, skeletal muscle mass, living alone, energy intake, protein–energy ratio, and vitamin D intake. No significant differences were observed between the groups regarding age or sex. The robust group showed significantly better results for protein–energy ratio, vitamin D intake, and subjective and objective masticatory performance than the frail group. Logistic regression analysis revealed a significant correlation between skeletal muscle mass, protein–energy ratio, and objective masticatory performance with frailty. Masticatory performance was associated with frailty, independent of the intake of nutrients such as energy, protein, and vitamin D. Full article

(This article belongs to the Special Issue Oral Health and Nutrition in Older Adults)

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14 pages, 315 KiB

Open AccessArticle

Association between Chewing Difficulty and Dietary Ca, Vitamin D, and Mg Intake in Korean Older Adults: 8th Korea National Health and Nutrition Examination Survey (KNHANES) (2020–2021)

by Sang-Dol Kim

Nutrients 2023, 15(23), 4983; https://doi.org/10.3390/nu15234983 - 1 Dec 2023

Viewed by 1509

Abstract

Nutrition intake plays a pivotal role in chewing difficulty (CD). This cross-sectional descriptive study aims to explore the associations between CD and the dietary intake of calcium (Ca), vitamin D, and magnesium (Mg) in adults aged 65 and older, utilizing data from the 8th Korea National Health and Nutrition Examination Survey (2020–2021). The chewing function was assessed using a 5-point scale questionnaire that inquired about discomfort experienced during mastication. “Very uncomfortable” and “uncomfortable,” two of the five response options, were categorized as being indicative of CD. Dietary intake was assessed through 24 h dietary recall interviews, and nutrient calculations were based on the 10th revised edition of the Korean Food Composition Table. Data (N = 2942) were analyzed using descriptive statistics and multi-logistic regression analyses in a composite sample plan file. Among the 2942 subjects, groups with insufficient daily nutrient intake had significantly higher odds ratios (ORs) for CD compared to their counterparts. In men, the ORs for Ca (1.56), Mg (1.75), and the combined intake of Mg (1.64) with Ca were elevated. In women, the ORs for Ca (1.74), Mg (1.53), and the combined intake of Mg (1.43) with Ca showed similar trends. After adjusting for age, family income, and family size variables, men’s ORs for Mg (1.55) and the combined intake of Mg (1.55) with Ca remained elevated, while women’s OR for Ca (1.58), Mg (1.42), and the combined intake of Mg (1.34) with Ca remained significant. Dietary vitamin D intake did not significantly impact the OR for CD. After adjusting for natural tooth numbers, self-perceived oral health, and obesity, no significant association was found between CD and these nutrients. In conclusion, this study underscores the importance of promoting the recommended daily intake of magnesium alongside dietary calcium to address CD. Full article

(This article belongs to the Special Issue Oral Health and Nutrition in Older Adults)

10 pages, 285 KiB

Open AccessArticle

Association of Oral and General Health with Nutritional Status of Older Adults Attending Two Medical Centers in Riyadh, Saudi Arabia: A Cross-Sectional Study

by Alghaliyah A. Alghofaili, Alanoud I. Aladel, Abdullah M. Alsoghier, Fatmah Othman, Mustafa M. Shoqeair, Saud M. Alqahtani, Ali M. Alnughaimish, Badryh A. Alanazi, Sara A. AI Mosallam, Azzam S. Alharbi and Mohammed Alquraishi

Nutrients 2023, 15(18), 4032; https://doi.org/10.3390/nu15184032 - 18 Sep 2023

Cited by 1 | Viewed by 2341

Abstract

Malnutrition could profoundly affect older adults’ oral health and quality of life, whereas oral health might, in turn, impact dietary intake and nutritional status. The present study aimed to investigate the association between general and oral health and nutritional status among older adults attending nutrition clinics at two main medical centers in Riyadh, Saudi Arabia. A cross-section study was carried out among adult patients (≥60 years) who attended a geriatric clinic or nutrition clinic at King Khalid University Hospital or King Abdulaziz Medical City, Riyadh. A validated clinician’s Mini Nutritional Assessment Short-Form (MNA-SF), Oral Health Impact Profile-5 (OHIP-5), and 36-Item Short Form Survey (SF-36) were collected from each participant. A total of 261 participants with a mean age of 72.14 (±8.97) years were recruited. Diabetes (71%) and hypertension (80%) were present in the majority of patients. The overall MNA-SF score was (10 ± 3). Based on the categorization of the MNA-SF score, 65.9% were classified as malnourished or at risk of malnutrition. Participants with OHIP-5 scores higher than the median (>5) were more likely to be malnourished than those with scores at or lower than 5 (p < 0). The adjusted odd ratio for the MNA-SF score categories indicated that for a one-unit increase in the total SF-36 score, the odds of the malnourished category are 0.94 times less than the risk of malnutrition and normal nutritional status, with OR 0.97 (95% CI 0.94–0.95). Malnutrition or being at risk of malnutrition is likely associated with poor general and oral health. Healthcare providers need to incorporate dietitians into care plans to promote the nutritional health of older adults. Full article

(This article belongs to the Special Issue Oral Health and Nutrition in Older Adults)

12 pages, 1831 KiB

Open AccessArticle

The Mediating Effects of Nutritional Status on the Relationship between Number of Residual Teeth and Cognitive Function among Older Adults: A Cross-Sectional Multicenter Study

by Yun Li, Xin Xia, Wenwen Wu, Xin Tian, Yuexia Hu, Birong Dong and Yanyan Wang

Nutrients 2023, 15(14), 3089; https://doi.org/10.3390/nu15143089 - 10 Jul 2023

Cited by 1 | Viewed by 1473

Abstract

The underlying mechanisms of the relationship between the number of teeth and cognition is still unclear. We aimed to construct a mediation model between the number of residual teeth and cognitive function, using nutritional status as a mediating factor. This study was completed using the West China Health and Aging Trend cohort. A total of 6634 multi-ethnic older adults, aged 50 years or older, were included. This study measured cognitive function using the Short-Portable Mental Status Questionnaire, and nutritional status was assessed using the Mini Nutritional Assessment-Short Form. The mediation analysis examined the potential mediating role of nutritional status. The pathway analysis was supplemented and validated using the structural equation modelling framework. Multiple linear regression demonstrated that a higher number of residual teeth was correlated with enhanced cognitive function (β = −0.15; 95% CI: −0.19 to −0.111). The mediation model, from the number of residual teeth to cognitive impairment, was partially mediated by nutritional status (β = −0.0608; 95% CI: −0.0762 to −0.0461). The proportion of the mediating effect, expressed as a percentage, was 40.66%. Furthermore, the estimated coefficients for the number of residual teeth and nutritional status varied across ethnic groups. This study indicated that enhancing the nutrition of older adults could reduce the adverse effects of the number of residual teeth on cognitive function among older adults. Full article

(This article belongs to the Special Issue Oral Health and Nutrition in Older Adults)

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15 pages, 14041 KiB

Open AccessReview

Functional Neuroplasticity of Adults with Partial or Complete Denture Rehabilitation with or without Implants: Evidence from fMRI Studies

by Andy Wai Kan Yeung and Wai Keung Leung

Nutrients 2023, 15(7), 1577; https://doi.org/10.3390/nu15071577 - 24 Mar 2023

Cited by 3 | Viewed by 2044

Abstract

Tooth loss may affect food ingestion and, consequently, nutrition intake. The neuroimaging literature using functional magnetic resonance imaging (fMRI) was reviewed to summarize the changes in brain functions in response to denture rehabilitation in patients with partial or complete edentulous dentition. Overall, this review covered nine fMRI studies on denture rehabilitation. Eight recruited complete edentulous patients, whereas one recruited partially edentulous patients. The risk-of-bias assessment revealed concerns regarding all nine studies. Due to the heterogeneity of the studies and the lack of brain coordinates reported, a meta-analysis could not be conducted, and this review could only summarize the findings without statistical validation. The evidence from jaw-clenching studies suggested that implant-supported fixed dentures could be the best option, as compared to implant-supported overdentures and complete dentures, as it was associated with higher brain activity levels in various brain regions, including those corresponding to the primary sensory (postcentral gyrus) and motor cortices (precentral gyrus). Gum-chewing studies indicated that perhaps the medial and middle frontal gyri were associated with food comminuting and food mixing, which could be improved by the full replacement of the dental arch, instead of only partial replacement. All the fMRI studies described the functional neuroplasticity of the patients undergoing denture rehabilitation and suggested that certain rehabilitation options were more beneficial in restoring masticatory functions, as well as their associated brain activity levels. Full article

(This article belongs to the Special Issue Oral Health and Nutrition in Older Adults)

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