The Relationship Between Xerostomia, Nutrition, and Frailty in Older Patients Undergoing Hemodialysis

Older adults receiving hemodialysis are at increased risk for xerostomia, poor nutritional status, and frailty, all of which significantly impact clinical outcomes and quality of life. This cross-sectional study examined interrelationships among xerostomia, nutrition, and frailty in patients aged 60 and older undergoing maintenance hemodialysis. Conducted between October 2022 and June 2023 in five dialysis centers, the study included 176 participants on hemodialysis for at least 3 months. Data were collected through face-to-face interviews using validated instruments: the Short Xerostomia Inventory, Mini Nutritional Assessment-Short Form, and Edmonton Frailty Scale. Pearson's correlation and path analysis using the Maximum Likelihood method were employed. Although xerostomia was reported at a low rate, many patients were at risk of malnutrition and showed varying degrees of frailty. Xerostomia was negatively associated with nutritional status and positively with frailty, while better nutritional status was linked to lower frailty. Path analysis revealed that xerostomia and nutritional status together explained nearly 50% of frailty variance. These findings underscore the importance of early identification and multidisciplinary management to reduce frailty and improve outcomes in older adults undergoing hemodialysis.