Relationships between Changes in Posterior Occlusal Support Status and Risk of Protein-energy Malnutrition among the Japanese Community-dwelling Elderly

Abstract

Objective: Protein-Energy Malnutrition (PEM) among the elderly limits the daily activities and leads to a bedridden state. Oral health status in the elderly can be one of the PEM indicators. We aimed to assess the correlation between changes in posterior occlusal support status and the incidence of PEM over a 5-year period in the Japanese community-dwelling elderly. Materials and Methods: Two hundred and seventy-two subjects aged 75 years in 2003 were followed up in 2008. Posterior occlusal support without dentures in 2003 and 2008 was categorized into one of three groups based on the number of occlusal support zones (OSZ) present. According to the Eichner’s Index and changes in the values over 5 years, five groups were defined for the main exposure variables: 1) Complete: four OSZ remaining, 2) Moderate: one to three OSZ remaining, 3) Lost support: no OSZ remaining, 4) Early change: change from four to one to three OSZ, and 5) Late change: change from one to three to no OSZ. For the outcome variables, the rates of changes in protein intake, total energy intake, and BMI over 5 years were calculated and divided into two groups. The nutrition status for malnutrition was defined as A) IPE: the rates of changes in protein and total energy intake were less than or equal to the median and B) IPEB: the rates of changes in the three items were less than or equal to the median. Results: Male subjects whose posterior OSZ decreased from four to one to three over 5 years had a significantly higher risk of IPE and IPEB than those in other groups (odds ratio: 4.0 for IPE and 4.3 for IPEB). Conclusion: Male elderly participants who lost posterior occlusal support zones over 5 years experienced a decrease in protein intake and had an increased risk of PEM.