POOR NUTRITIONAL STATUS IS ASSOCIATED WITH WORSE ORAL HEALTH AND POORER QUALITY OF LIFE IN AGED CARE RESIDENTS

Abstract

Objective: As previous studies have used a variety of outcome measures and assessment tools, the relationship between nutrition and oral health in residents of aged care facilities is unclear. The aim of this study was to investigate the association of oral health status and oral health-related quality of life (OHRQol) with nutritional status among residents of aged care facilities using validated assessment tools. Design: Prospective cross-sectional clinical investigation of 65 aged care residents (>65 years). Setting: Two residential aged care facilities from Southeast Queensland, Gold Coast region, Australia. Measurements: An aged care dietitian conducted nutritional assessments using the Subjective Global Assessment (SGA). An oral health therapist performed assessments using the Oral Health Assessment Tool (OHAT) and geriatric oral health assessment index (GOHAI). Results: Of the 65 older adults, almost two thirds (62%; n=38) were malnourished; (55%; n=34 moderately malnourished and 7%; n=4 severely malnourished). Using OHAT, 82% (n=41) needed a dental referral. Malnutrition was strongly associated with poor OHRQoL (p=0.007). Edentulous (no teeth) participants were more likely to limit their contact with others due to their dentures (p=0.025) and in turn, negatively impact OHRQoL. More people who had decayed or broken natural teeth (77%) (p=0.041) had trouble eating firm foods than those who had healthy natural teeth (23%). Modified diet texture was associated with poor nutritional status (p<0.001). Access to dentists in RACFs was an identified barrier to both optimal oral health and nutritional status. Conclusion: Both malnutrition and poor oral health were common in this sample of aged care residents which contributed to poor OHRQoL. Our findings show the SGA, OHAT and GOHAI instruments are appropriate and acceptable for assessing nutrition and oral health in this population. Further research needs to investigate if early and regular oral health assessments and treatments can improve or minimise deterioration in nutritional status in aged care residents. Recommendations for future practice include increasing training and education of RACFs in terms of oral health care and its connection with nutritional status and quality of life, increased access to dental professionals in RACFs and the importance of concurrent referrals to dietitians when dental issues are identified.