Self‑Reported Oral Health and Malnutrition Risk in Community-Dwelling Older U.S. Adults

Oral health and nutritional status are key determinants of healthy aging, yet population‑level evidence linking self‑assessed oral health to objectively defined nutritional risk in older adults is limited. We examined associations between self‑reported oral health domains and nutritional risk, defined by the Geriatric Nutritional Risk Index (GNRI), in a nationally representative sample of U.S. adults aged 60 years and older.

Cross‑sectional data from the 2009-2014 National Health and Nutrition Examination Survey were analyzed for 3898 older participants with complete oral health questionnaire and covariate data, representing approximately 44.65 million noninstitutionalized U.S. adults aged ≥60 years. Self‑reported measures included periodontal history and oral hygiene behaviors. GNRI was computed from serum albumin and body weight relative to ideal weight and dichotomized as high nutritional risk (GNRI < 98) versus low risk (GNRI ≥ 98). Weighted logistic regression models assessed associations controlling for demographic, socioeconomic, behavioral variables, and multimorbidity. Having ever received treatment for gum disease was associated with lower odds of nutritional risk [odds ratio (OR): 0.67, 95% confidence interval (CI): 0.45-0.99]. Frequent use of dental floss or interdental cleaning devices was also associated with lower odds of nutritional risk (OR: 0.57, 95% CI: 0.40-0.81). Other self‑reported oral symptoms were not significantly associated with GNRI classification.

Specific self‑assessed oral health domains were independently associated with GNRI‑defined malnutrition risk in older adults. Targeted subjective oral health measures may aid in identifying individuals at elevated nutritional risk and support integrative screening strategies in geriatric care.