Edentulism and number of medications are associated with nutritional status in older adults: a population-based cross-sectional study

LUCCA, Eduarda Willers de; MUNIZ, Francisco Wilker Mustafa Gomes; COLUSSI, Paulo Roberto Grafitti; STOFFEL, Luciana Marcon Barbosa; CRUZ, Gabriel Schmitt; MARCHI, Ana Carolina Bertoletti de

doi:10.1590/1981-86372023003320220054

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ORIGINAL • Rev Gaúch. Odontol. 71 • 2023 • https://doi.org/10.1590/1981-86372023003320220054 copy

Edentulism and number of medications are associated with nutritional status in older adults: a population-based cross-sectional study

Edentuslimo e número de medicações estão associados com estado nutricional em idosos: um estudo transversal de base populacional

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

This study evaluated the nutritional status and associated factors among older adults of a southern Brazilian city.

Methods:

A cross-sectional home-based study, with a probabilistic sample per cluster, was carried out with 282 older adults aged ≥60 years in the city of Veranópolis, Brazil. Through a structured questionnaire, socioeconomic, general and behavioral health aspects were assessed. Nutritional status was assessed using the Mini Nutritional Assessment (MAN^®) instrument, categorizing the sample into eutrophic or nutritional risk (risk of malnutrition + malnourished). Oral health was assessed by counting teeth and the use of and need for dental prosthesis. Two independent multivariate models were constructed, using number of daily medication and polypharmacy (≥2 daily medications). Logistic regression was used to verify associations.

Results:

The prevalence of nutritional risk was 14.5% (N=41). In the final multivariate analysis, users of ≥6 daily medications demonstrated a greater odds ratio (OR) of being at nutritional risk when compared to those who did not use medication daily (OR: 12.16; 95% confidence interval [95%CI]: 1.47 – 100.82). Non-edentulous older adults had 67.7% (p = 0.006) lower OR for nutritional risk when compared to edentulous.

Conclusion:

The prevalence of nutritional risk was low among this sample, and it was associated with edentulism and number of daily medications.

Indexing terms
Aged; Dental Care for Aged; Nutritional status; Nutrition surveys; Elder nutritional physiological phenomena

Variables		Eutrophics N=241 (85.5%)	Nutritional Risk N=41 (14.5%)	P-value
BMI	Mean ± SD	28.64±4.89	28.19±6.68	0.209#
Age (in years)	Mean ± SD	71.00±7.44	73.88±9.94	0.115#
Sex	Male – n (%) Female – n (%)	73 (30.3) 168 (69.7)	8 (19.5) 33 (80.5)	0.159^* * Chi-square; #Mann-Whitney.
Ethnicity/skin color	White – n (%) Non-white – n (%)	218 (90.5) 23 (9.5)	34 (82.9) 7 (17.1)	0.148^* * Chi-square; #Mann-Whitney.
Level of education	Low – n (%) Medium/High – n (%)	189 (78.4) 52 (21.6)	36 (87.8) 5 (12.2)	0.167^* * Chi-square; #Mann-Whitney.
Living area	Urban – n (%) Rural – n (%)	207 (85.9) 34 (14.1)	37 (90.2) 4 (9.8)	0.451^* * Chi-square; #Mann-Whitney.
Retirement	Not retired – n (%) Retired – n (%) Retired and working – n (%)	26 (10.8) 153 (63.5) 62 (25.7)	7 (17.1) 30 (73.2) 4 (9.8)	0.064^* * Chi-square; #Mann-Whitney.
Marital status	Married – n (%) Not-Married – n (%)	137 (56.8) 104 (43.2)	13 (31.7) 28 (68.3)	0.003^* * Chi-square; #Mann-Whitney.
Number of self-reported diseases	0 – n (%) 1 – n (%) 2 – n (%) 3 – n (%) ≥4 – n (%)	33 (13.7) 74 (30.7) 61 (25.3) 47 (19.5) 26 (10.8)	1 (2.4) 10 (24.4) 8 (19.5) 12 (29.3) 10 (24.4)	0.023^* * Chi-square; #Mann-Whitney.
Number of daily medications	0 – n (%) 1 – n (%) 2 – n (%) 3 to 5 – n (%) ≥6 – n (%)	34 (14.1) 39 (16.2) 43 (17.8) 80 (33.2) 45 (18.7)	1 (2.4) 2 (4.9) 3 (7.3) 16 (39.0) 19 (46.3)	<0.001^* * Chi-square; #Mann-Whitney.
Polypharmacy	No (<2/day) – n (%) Yes (≥2/day) – n (%)	73 (30.3) 168 (69.7)	3 (7.3) 38 (92.7)	0.002^* * Chi-square; #Mann-Whitney.
Smoking exposure	Smokers – n (%) Former smokers – n (%) Never smokers – n (%)	16 (6.6) 55 (22.8) 170 (70.5)	4 (9.8) 13 (31.7) 24 (58.5)	0.307^* * Chi-square; #Mann-Whitney.
Alcohol exposure	Yes – n (%) No – n (%)	141 (58.5) 100 (41.5)	15 (36.6) 26 (63.4)	0.009^* * Chi-square; #Mann-Whitney.
Access to the dentist	Yes – n (%) No – n (%)	118 (49.0) 123 (51.0)	13 (31.7) 28 (68.3)	0.041^* * Chi-square; #Mann-Whitney.
Need for dental prosthesis	Yes – n (%) No – n (%)	66 (27.4) 175 (72.6)	10 (24.4) 31 (75.6)	0.689^* * Chi-square; #Mann-Whitney.
Use of dental prosthesis	Yes – n (%) No – n (%)	207 (85.9) 34 (14.1)	39 (95.1) 2 (4.9)	0.102^* * Chi-square; #Mann-Whitney.
Edentulism	Yes – n (%) No – n (%)	106 (44.0) 135 (56.0)	31 (75.6) 10 (24.4)	<0.001^* * Chi-square; #Mann-Whitney.

Variables		Odds Ratio (95% CI)	P-value
Age		1.05 (1.01 – 1.09)	0.033
Sex	Male Female	Ref. 1.79 (0.79 – 4.07)	0.163
Ethnicity/skin color	White Non-white	Ref. 1.95 (0.78 – 4.90)	0.154
Level of education	Low Medium/High	Ref. 0.51 (0.19 – 1.35)	0.174
Living area	Urban Rural	Ref. 0.66 (0.22 – 1.96)	0.453
Retirement	Not retired Retired Retired and working	Ref. 0.73 (0.29 – 1.83) 0.24 (0.07 – 0.89)	0.500 0.033
Marital status	Married Not-married	Ref. 2.83 (1.40 – 5.75)	0.004
Number of self-reported diseases	0 1 2 3 ≥4	Ref. 4.46 (0.56 – 36.28) 4.33 (0.52 – 36.11) 8.43 (1.04 – 67.98) 12.69 (1.53 – 105.63)	0.162 0.176 0.045 0.019
Polypharmacy	No (<2/day) Yes (≥2/day)	Ref. 5.50 (1.65 – 18.40)	0.006
Number of daily medications	0 1 2 3 to 5 ≥6	Ref. 1.74 (0.15 – 20.09) 2.37 (0.24 – 23.84) 6.80 (0.87 – 53.34) 14.36 (1.83 – 112.59)	0.656 0.463 0.068 0.011
Smoking exposure	Smokers Former smokers Never smokers	Ref. 0.95 (0.27 – 3.30) 0.57 (0.17 – 1.83)	0.930 0.341
Alcohol exposure	Yes No	Ref. 2.44 (1.23 – 4.85)	0.011
Access to the dentist	Yes No	Ref. 2.07 (1.02 – 4.18)	0.044
Need for dental prosthesis	Yes No	Ref. 1.17 (0.54 – 2.52)	0.690
Use of dental prosthesis	Yes No	Ref. 0.31 (0.07 – 1.35)	0.120
Edentulism	Yes No	Ref. 0.25 (0.12 – 0.54)	<0.001

Variables		Odds Ratio (95%IC)	P-value
Ethnicity/skin color	White Non-White	Ref. 1.51 (0.53 – 4.31)	0.440
Retirement	Not retired Retired Retired and working	Ref. 0.61 (0.21 – 1.76) 0.45 (0.10 – 1.98)	0.363 0.293
Number of daily medications	0 1 2 3 to 5 ≥6	Ref. 2.32 (0.19 – 28.29) 2.66 (0.25 – 28.30) 7.21 (0.86 – 60.41) 12.16 (1.47 – 100.82)	0.509 0.416 0.069 0.021
Exposure to alcohol	Yes No	Ref. 1.69 (0.79 – 3.63)	0.180
Edentulism	Yes No	Ref. 0.32 (0.14 – 0.73)	0.006

Variables		Odds Ratio (95%IC)	P-value
Skin color	White Non-white	Ref. 1.45 (0.52 – 4.07)	0.475
Retirement	Not retired Retired Retired and working	Ref. 0.60 (0.22 – 1.67) 0.39 (0.09 – 1.61)	0.332 0.192
Marital status	Married Not-married	Ref. 1.83 (0.85 – 3.93)	0.120
Polypharmacy	No (<2/day) Yes (≥2/day)	Ref. 4.65 (1.33 – 16.23)	0.016
Alcohol exposure	Yes No	Ref. 1.84 (0.87 – 3.89)	0.112
Edentulism	Yes No	Ref. 0.34 (0.15 – 0.75)	0.007

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[1] Correspondence to: FWMG Muniz, E-mail: E-mail: wilkermustafa@gmail.com.