The Association between Periodontal Disease and Malnutrition in A Group of Elderly People in Thailand

Main Article Content

Kanyawat Rattanasuwan
Kunsenee Chatkittikunwong

Abstract

The aim of this study was to determine the association between periodontal disease and malnutrition status in older adults. The factor(s) which are related to malnutrition in older adults with periodontal disease were investigated.  Participants > 60 years old with functional and cognitive independent were included in this cross-sectional study.  Sociodemographic data, anthropometric measurements, self-rated chewing, periodontal status, number of teeth and functional tooth units (FTUs) were recorded.  The Mini Nutritional Assessment (MNA) was used for nutritional status assessment.  Eighty-two participants were included in the study.  Two groups including normal nutrition group (82.9%) and at risk of malnutrition group (17.1%) were found.  A significant association between periodontal disease and risk of malnutrition was not found from this study (p=0.557).  A significant difference in nutritional status was found according to education levels (p=0.009).  The percentage of participants with insomnia and osteoarthritis was significantly higher in the at risk of malnutrition group than in the other group (p=0.003 and 0.042).  It was noticeable that more participants with depression were found in the at risk of malnutrition group than in the other group (14.3% vs 1.5%).  Then an association between periodontitis and malnutrition in older adults was not found in this study.  The current study suggests an association between insomnia, osteoarthritis and depression with risk of malnutrition.  Thus, older adults with these symptoms may be at risk of malnutrition and further study is needed to answer these questions.

Article Details

How to Cite
1.
Rattanasuwan K, Chatkittikunwong K. The Association between Periodontal Disease and Malnutrition in A Group of Elderly People in Thailand. Khon Kaen Dent J [Internet]. 2023 Sep. 22 [cited 2024 Nov. 20];26(3):10-26. Available from: https://he01.tci-thaijo.org/index.php/KDJ/article/view/257876
Section
Articles
Share |

References

United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision: Key Findings and Advance Tables. New York: United Nations; 2017.

de Morais C, Oliveira B, Afonso C, Lumbers M, Raats M, de Almeida MD. Nutritional risk of European elderly. Eur J Clin Nutr 2013;67(11):1215-9.

Fávaro-Moreira NC, Krausch-Hofmann S, Matthys C, Vereecken C, Vanhauwaert E, Declercq A, et al. Risk factors for malnutrition in older adults: a systematic review of the literature based on longitudinal data. Adv Nutr 2016;7(3):507-22.

Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature--What does it tell us? J Nutr Health Aging. 2006;10(6):466-85; discussion 485-7.

Mann T, Heuberger R, Wong H. The association between chewing and swallowing difficulties and nutritional status in older adults. Aust Dent J 2013;58(2):200-6.

van Bokhorst-de van der Schueren MA, Lonterman-Monasch S, de Vries OJ, Danner SA, Kramer MH, Muller M. Prevalence and determinants for malnutrition in geriatric outpatients. Clin Nutr 2013;32(6):1007-11.

Hickson M. Malnutrition and ageing. Postgrad Med J 2006;82(963):2-8.

Saarela RK, Lindroos E, Soini H, Hiltunen K, Muurinen S, Suominen MH, et al. Dentition, nutritional status and adequacy of dietary intake among older residents in assisted living facilities. Gerodontology 2016;33(2): 225-32.

Tamura BK, Bell CL, Masaki KH, Amella EJ. Factors associated with weight loss, low BMI, and malnutrition among nursing home patients: a systematic review of the literature. J Am Med Dir Assoc 2013;14(9):649-55.

Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010;58(9): 1734-8.

Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003;22(4):415-21.

Kikuchi H, Komatsuzaki A, Ono S, Sirono M, Motoi S, Iguchi A, et al. Factors affecting dietary improvements in elderly residents of long-term care institutions receiving domiciliary dental care. Medicines (Basel) 2021;8(11):62.

Hijryana M, MacDougall M, Ariani N, Kusdhany LS, Walls AWG. Impact of periodontal disease on the quality of life of older people in indonesia: a qualitative study. JDR Clin Trans Res 2022;7(4):360-70.

Samnieng P, Ueno M, Shinada K, Zaitsu T, Wright FA, Kawaguchi Y. Oral health status and chewing ability is related to mini-nutritional assessment results in an older adult population in Thailand. J Nutr Gerontol Geriatr 2011;30(3):291-304.

Schimmel M, Katsoulis J, Genton L, Müller F. Masticatory function and nutrition in old age. Swiss Dent J 2015;125(4):449-54.

Sheiham A, Steele JG, Marcenes W, Lowe C, Finch S, Bates CJ, et al. The relationship among dental status, nutrient intake, and nutritional status in older people. J Dent Res 2001;80(2):408-13.

Srisilapanan P, Malikaew P, Sheiham A. Number of teeth and nutritional status in Thai older people. Community Dent Health 2002;19(4):230-6.

Tubtimtong P, Sinavarat P, Anunmana C. Relationship between oral health status and nutritional status in a group of older persons: number of functional units and number of teeth. M Dent J 2019;39(1):21-33.

Clark D, Kotronia E, Ramsay SE. Frailty, aging, and periodontal disease: Basic biologic considerations. Periodontol 2000. 2021;87(1):143-56.

Persson GR. Periodontal complications with age. Periodontol 2000. 2018;78(1):185-94.

Gil-Montoya JA, de Mello AL, Barrios R, Gonzalez-Moles MA, Bravo M. Oral health in the elderly patient and its impact on general well-being: a nonsystematic review. Clin Interv Aging 2015;10:461-7.

Iwasaki M, Taylor GW, Manz MC, Yoshihara A, Sato M, Muramatsu K, et al. Oral health status: relationship to nutrient and food intake among 80-year-old Japanese adults. Community Dent Oral Epidemiol 2014;42(5): 441-50.

Jansson H, Wahlin Å, Johansson V, Åkerman S, Lundegren N, Isberg PE, et al. Impact of periodontal disease experience on oral health-related quality of life. J Periodontol 2014;85(3):438-45.

Kshetrimayum N, Reddy CV, Siddhana S, Manjunath M, Rudraswamy S, Sulavai S. Oral health-related quality of life and nutritional status of institutionalized elderly population aged 60 years and above in Mysore City, India. Gerodontology 2013;30(2):119-25.

Needleman I, McGrath C, Floyd P, Biddle A. Impact of oral health on the life quality of periodontal patients. J Clin Periodontol 2004;31(6):454-7.

Tada S, Ikebe K, Kamide K, Gondo Y, Inomata C, Takeshita H, et al. Relationship between atherosclerosis and occlusal support of natural teeth with mediating effect of atheroprotective nutrients: From the SONIC study. PLoS One 2017;12(8):e0182563.

Cekici A, Kantarci A, Hasturk H, Van Dyke TE. Inflammatory and immune pathways in the pathogenesis of periodontal disease. Periodontol 2000 2014;64(1): 57-80.

Dutzan N, Vernal R, Hernandez M, Dezerega A, Rivera O, Silva N, et al. Levels of interferon-gamma and transcription factor T-bet in progressive periodontal lesions in patients with chronic periodontitis. J Periodontol 2009;80(2):290-6.

Ebersole JL, Graves CL, Gonzalez OA, Dawson D 3rd, Morford LA, Huja PE, et al. Aging, inflammation, immunity and periodontal disease. Periodontol 2000. 2016;72(1):54-75.

Wilson D, Jackson T, Sapey E, Lord JM. Frailty and sarcopenia: The potential role of an aged immune system. Ageing Res Rev 2017;36:1-10.

Parsegian K, Randall D, Curtis M, Ioannidou E. Association between periodontitis and chronic kidney disease. Periodontol 2000 2022;89(1):114-124.

Indriolo A, Greco S, Ravelli P, Fagiuoli S. What can we learn about biofilm/host interactions from the study of inflammatory bowel disease. J Clin Periodontol 2011;38(Suppl 11):36-43.

Ausavarungnirun R, Wisetsin S, Rongkiettechakorn N, Chaichalermsak S, Udompol U, Rattanasompattikul M. Association of dental and periodontal disease with chronic kidney disease in patients of a single, tertiary care centre in Thailand. BMJ Open 2016;6(7):e011836.

de Souza CM, Braosi AP, Luczyszyn SM, Olandoski M, Kotanko P, Craig RG, et al. Association among oral health parameters, periodontitis, and its treatment and mortality in patients undergoing hemodialysis. J Periodontol 2014;85(6):e169-78.

Habashneh RA, Khader YS, Alhumouz MK, Jadallah K, Ajlouni Y. The association between inflammatory bowel disease and periodontitis among Jordanians: a case-control study. J Periodontal Res 2012;47(3):293-8.

Vavricka SR, Manser CN, Hediger S, Vögelin M, Scharl M, Biedermann L, et al. Periodontitis and gingivitis in inflammatory bowel disease: a case-control study. Inflamm Bowel Dis 2013;19(13):2768-77.

Anand N, Chandrasekaran SC, Alam MN. The malnutrition inflammation complex syndrome-the micsing factor in the perio-chronic kidney disease interlink. J Clin Diagn Res 2013;7(4):763-7.

Liu C, Feng X, Li Q, Wang Y, Li Q, Hua M. Adiponectin, TNF-α and inflammatory cytokines and risk of type 2 diabetes: A systematic review and meta-analysis. Cytokine 2016;86:100-9.

Kocher T, König J, Borgnakke WS, Pink C, Meisel P. Periodontal complications of hyperglycemia/diabetes mellitus: Epidemiologic complexity and clinical challenge. Periodontol 2000 2018;78(1):59-97.

Yoshihara A, Watanabe R, Hanada N, Miyazaki H. A longitudinal study of the relationship between diet intake and dental caries and periodontal disease in elderly Japanese subjects. Gerodontology 2009;26(2): 130-6.

Hujoel PP, Lingström P. Nutrition, dental caries and periodontal disease: a narrative review. J Clin Periodontol 2017;44 (Suppl 18):S79-84.

Bawadi HA, Khader YS, Haroun TF, Al-Omari M, Tayyem RF. The association between periodontal disease, physical activity and healthy diet among adults in Jordan. J Periodontal Res 2011;46(1):74-81.

Jitapunkul S, Kamolratanakul P, Ebrahim S. The meaning of activities of daily living in a Thai elderly population: development of a new index. Age Ageing 1994;23(2):97-101.

Mahoney FI, Barthel DW. Functional evaluation: The Barthel index. Md State Med J 1965;14:61-5.

Train the Brain Forum Committee. Thai Mental State Examination (TMSE). Siriraj Hosp Gaz 1993;45:359-74.

Diabetes Prevention Program Research Group. Long-term safety, tolerability, and weight loss associated with metformin in the Diabetes Prevention Program Outcomes Study. Diabetes Care 2012;35(4):731-7.

Pilgrim AL, Robinson SM, Sayer AA, Roberts HC. An overview of appetite declines in older people. Nurs Older People 2015;27(5):29-35.

Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. World Health Organ Tech Rep Ser 2000;894:i-xii, 1-253.

Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev 1996;54(1Pt 2): S59-65.

Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J 1975;25(4):229-35.

Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963;21:533-51.

Greene JC, Vermillion JR. The simplified oral hygiene index. J Am Dent Assoc 1964;68:7-13.

López NJ, Smith PC, Gutierrez J. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial. J Periodontol 2002;73(8):911-24.

Hobdell M, Petersen PE, Clarkson J, Johnson N. Global goals for oral health in the year 2000. Fédération Dentaire Internationale. Int Dent J 1982;32(1):74-7.

Ueno M, Yanagisawa T, Shinada K, Ohara S, Kawaguchi Y. Masticatory ability and functional tooth units in Japanese adults. J Oral Rehabil 2008;35(5): 337-44.

Akin S, Kesim S, Manav TY, Ṣafak Deniz E, Öztürk A, Mazıcıoğlu M, et al. Impact of oral health on nutritional status in community-dwelling older adults in Turkey. Eur J Geriatric Gerontol 2019;1(1):29-35.

Mesas AE, Andrade SM, Cabrera MA, Bueno VL. Oral health status and nutritional deficit in noninstitutionalized older adults in Londrina, Brazil. Rev Bras Epidemiol 2010;13(3):434-45.

Nilsson H, Sanmartin Berglund J, Renvert S. Longitudinal evaluation of periodontitis and tooth loss among older adults. J Clin Periodontol 2019;46(10):1041-9.

Borges Tde F, Regalo SC, Taba M Jr, Siéssere S, Mestriner W Jr, Semprini M. Changes in masticatory performance and quality of life in individuals with chronic periodontitis. J Periodontol 2013;84(3):325-31.

Gil-Montoya JA, Ponce G, Sánchez Lara I, Barrios R, Llodra JC, Bravo M. Association of the oral health impact profile with malnutrition risk in Spanish elders. Arch Gerontol Geriatr 2013;57(3):398-402.

Dantas PPA, Colussi PRG, Dezingrini KDS, Sachetti DG, Muniz FWMG. Pairs of natural teeth rather than use of dental prosthesis are associated with nutritional status in older adults: A cross-sectional study. J Dent 2021;108:103656.

Toniazzo MP, Amorim PS, Muniz FWMG, Weidlich P. Relationship of nutritional status and oral health in elderly: systematic review with meta-analysis. Clin Nutr 2018;37(3):824-30.

Boretti G, Bickel M, Geering AH. A review of masticatory ability and efficiency. J Prosthet Dent 1995; 74(4):400-3.

Tarkowska A, Katzer L, Ahlers MO. Assessment of masticatory performance by means of a color-changeable chewing gum. J Prosthodont Res 2017; 61(1):9-19.

Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999; 15(2):116-22.

Kaiser MJ, Bauer JM, Uter W, Donini LM, Stange I, Volkert D, et al. Prospective validation of the modified mini nutritional assessment short-forms in the community, nursing home, and rehabilitation setting. J Am Geriatr Soc 2011;59(11):2124-8.

Bollwein J, Volkert D, Diekmann R, Kaiser MJ, Uter W, Vidal K, et al. Nutritional status according to the mini nutritional assessment (MNA®) and frailty in community dwelling older persons: a close relationship. J Nutr Health Aging 2013;17(4):351-6.

Johansson Y, Bachrach-Lindström M, Carstensen J, Ek AC. Malnutrition in a home-living older population: prevalence, incidence and risk factors. A prospective study. J Clin Nurs 2009;18(9):1354-64.

Rozenberg S, Body JJ, Bruyère O, Bergmann P, Brandi ML, Cooper C, et al. Effects of dairy products consumption on health: benefits and beliefs-a commentary from the Belgian Bone Club and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases. Calcif Tissue Int 2016;98(1):1-17.

Du Y, Oh C, No J. Advantage of dairy for improving aging muscle. J Obes Metab Syndr 2019;28(3):167-74.

Nyvad B, Takahashi N. Integrated hypothesis of dental caries and periodontal diseases. J Oral Microbiol 2020;12(1):1710953.

Martinon P, Fraticelli L, Giboreau A, Dussart C, Bourgeois D, Carrouel F. Nutrition as a key modifiable factor for periodontitis and main chronic diseases. J Clin Med 2021;10(2)197.

Cook Z, Kirk S, Lawrenson S, Sandford S. Use of BMI in the assessment of undernutrition in older subjects: reflecting on practice. Proc Nutr Soc 2005;64(3):313-7.

Bahat G, Tufan F, Saka B, Akin S, Ozkaya H, Yucel N, et al. Which body mass index (BMI) is better in the elderly for functional status? Arch Gerontol Geriatr 2012;54(1):78-81.

Saka B, Kaya O, Ozturk GB, Erten N, Karan MA. Malnutrition in the elderly and its relationship with other geriatric syndromes. Clin Nutr 2010;29(6):745-8.

Ülger Z, Halil M, Kalan I, Yavuz BB, Cankurtaran M, Güngör E, et al. Comprehensive assessment of malnutrition risk and related factors in a large group of community-dwelling older adults. Clin Nutr 2010; 29(4):507-11.

Kim HS, Park HM, Kim H, Lee HS, Son DH, Lee YJ. Association between the severity of periodontitis and osteoarthritis in middle-aged and older patients with type 2 diabetes mellitus: a nationwide population-based study. Arthritis Care Res (Hoboken) 2022;74(3):403-409.

Nawai A, Phongphanngam S, Khumrungsee M, Leveille SG. Factors associated with nutrition risk among community-dwelling older adults in Thailand. Geriatr Nurs 2021;42(5):1048-55.

Martel-Pelletier J, Barr AJ, Cicuttini FM, Conaghan PG, Cooper C, Goldring MB, et al. Osteoarthritis. Nat Rev Dis Primers 2016;2:16072.

Marshall M, Watt FE, Vincent TL, Dziedzic K. Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management. Nat Rev Rheumatol 2018; 14(11):641-56.

Tavares M, Lindefjeld Calabi KA, San Martin L. Systemic diseases and oral health. Dent Clin North Am 2014;58(4):797-814.

Boland M. Human digestion--a processing perspective. J Sci Food Agric 2016;96(7):2275-83.

Schirmer M, Smeekens SP, Vlamakis H, Jaeger M, Oosting M, Franzosa EA, et al. Linking the human gut microbiome to inflammatory cytokine production capacity. Cell 2016;167(4):1125-36.