Oral status and nutrition in the institutionalized elderly

To evaluate, in an elderly population, whether poor oral status might be a contributing factor to the development of undernutrition and might be associated with less eating pleasure, more subjective eating difficulty and increased mashed food consumption.

An oral examination and an evaluation of masticatory capacity were performed on 120 institutionalized elderly subjects. The nutritional assessment included serum albumin concentration, the Mini Nutritional Assessment and a questionnaire on eating habits.

Edentulous subjects without dentures or with only one complete denture had significantly lower MNA scores than edentulous subjects with two complete dentures (p < 0.05). Edentulous subjects with two complete dentures more frequently reported taking pleasure from eating (p = 0.05), and had less frequent difficulties with hard foods (p = 0.01) than edentulous subjects without dentures or with only one complete denture. Mashed food consumption (p < 0.01) was also reported more frequently in edentulous subjects without dentures or with only one complete denture. Subjects with two complete dentures had similar or better MNA scores as dentate subjects with relatively few remaining teeth (10.4 +/- 7.8 teeth). About half of the subjects (53%) could not perform the masticatory test. These subjects had lower MNA scores (p = 0.001) and a larger proportion ate mashed food (p < 0.001) compared to those who were able to perform the test.

Poor oral status (edentulous without dentures or with only one complete denture) increased difficulty in eating hard foods, increased mashed food consumption and decreased eating pleasure. It seemed also to put institutionalized subjects at higher risk of undernutrition.