Association Between Oral-Care Refusal and Malnutrition Risk Among Adults With Intellectual Disabilities: A...

Malnutrition is common among individuals with intellectual disabilities, and behavioral resistance may limit access to routine oral care. This study examined the association between refusal of oral care and poor nutritional status.

In this cross-sectional study, conducted between February and March 2025, we assessed 55 adults with intellectual disabilities living in two designated residential support facilities for persons with disabilities in Fukuoka, Japan. Nutritional status was evaluated using the Mini Nutritional Assessment-Short Form. Oral care refusal was identified from staff records. Functional and body composition data were obtained using the Functional Independence Measure, Barthel Index, and bioelectrical impedance analysis.

The at-risk/malnourished group had significantly lower BMI, fat mass, and functional scores, and a higher rate of oral care refusal (p = 0.007). Logistic regression showed that oral care refusal [OR = 9.23 (95% confidence interval (CI): 1.10-77.33], lower fat mass [OR = 0.78 (0.66-0.92)] were independently associated with poor nutritional status (FIM-Eating [OR = 0.86 (0.53-1.39)], gender [OR = 0.44 (0.08-2.27)], age [OR = 0.96 (0.90-1.02)]). AUC was 0.90 (0.81-0.98).

Oral care refusal may indicate increased risk of malnutrition among adults with intellectual disabilities. Larger, longitudinal studies are needed to confirm these findings.