The Association of Oral Processing Factors and Nutrient Intake in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

Abstract

Abstract Context Oral health and food oral-processing issues emerge with functional decline in the older adult population, potentially increasing the risk of malnutrition. Impairment of oral health is associated with poorer nutrition status; however, the relationship between oral factors and the intake of each nutrient remains poorly understood. Objective The associations between different oral factors and nutrient intakes among community-dwelling older adults were investigated. Data Sources A literature search from 5 databases (Web of Science, Scopus, Cochrane Library, Ovid [MEDLINE and Embase], and CINAHL) was completed on February 1, 2022. The search was limited to peer-reviewed articles published between the years 2012 and 2022. Data Extraction Six cross-sectional studies were included in the meta-analysis. Two authors independently completed the data extraction and summarized the study characteristics, factors adjusted for in the statistical analysis, the outcome, and summary statistics of the results. Data Analysis Meta-analyses showed evidence of a significant association between compromised oral factors (namely, denture status, chewing ability, and the number of teeth) with lower energy (weighted mean difference [WMD], –107 kcal d–1 (95% CI, –132 to –81), protein (WMD, –5.2 g d–1; 95% CI, –6.6 to –3.8), fat (WMD, –4.6 g d–1; 95% CI, –6.7 to –2.6), carbohydrate (WMD, –8.8 g d–1; 95% CI, –13.9 to –3.7), and vitamin C intakes (WMD, –12.9 mg d–1; 95% CI, –16.6 to –9.2) in older adults. Conclusion Oral health can be an indicator of compromised daily energy, protein, fat, carbohydrate, and vitamin C intakes in older adults. However, the small sample size of the studies included in this review and the heterogeneity among macronutrient studies should be considered. Because of the lack of studies covering all aspects of food oral processing (eg, salivary flow rate, tongue pressure), the associations between oral processing and nutrient intake were not thoroughly explored. Systematic Review Registration PROSPERO registration no. CRD42022308823.