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      Oral Health and nutritional status in nursing home residents—results of an explorative cross-sectional pilot study

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          This study was performed to assess oral and nutritional status of nursing home residents in a region of Lower Saxony, Germany. The aim was to show potential associations between oral status (dentate or edentulous), further anamnestic factors (dementia, age, smoking) and the risk for malnutrition in this population.


          In this observational cross-sectional pilot study of residents from four nursing homes Mini Nutritional Assessment (MNA), Body-Mass-Index (BMI), dental status (DMF-T) and periodontal situation (PSR ®/PSI) were recorded. Associations of recorded factors with oral health and nutritional status were examined in univariate and multivariate analysis.


          Eighty-seven residents participated in the study (mean age: 84.1 years; female: 72%, demented: 47%). Average BMI was 26.2 kg/m 2; according MNA 52% were at risk for malnutrition. 48% of the residents were edentulous, and the average DMF-T of dentulous was 25.0 (3.7) (D-T: 2.0 [3.1], M-T: 15.0 [8.3], F-T: 8.0 [7.4]); PSR ®/PSI 3 and 4 (need for periodontal treatment) showed 79% of residents. In univariate analysis dementia (OR 2.5 CI 95 1.1–5.6) but not being edentulous (OR 2.0 CI 95 0.8–5.8) were associated with being at risk for malnutrition. Dementia remained associated in multivariate analysis adjusting for age and sex, (OR 3.1 CI 95 1.2–8.2) and additionally being edentulous (OR 2.8 CI 95 1.1–7.3) became associated significantly. Furthermore, nursing home residents with dementia had more remaining teeth (OR 2.5 CI 95 1.1–5.9).


          Dementia was a stronger predictor for risk of malnutrition in nursing home residents than being edentulous. Further studies to elucidate the possible role of oral health as cofactor for malnutrition in dementia are needed.

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          Most cited references 39

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          The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients.

          The Mini Nutritional Assessment (MNA) has recently been designed and validated to provide a single, rapid assessment of nutritional status in elderly patients in outpatient clinics, hospitals, and nursing homes. It has been translated into several languages and validated in many clinics around the world. The MNA test is composed of simple measurements and brief questions that can be completed in about 10 min. Discriminant analysis was used to compare the findings of the MNA with the nutritional status determined by physicians, using the standard extensive nutritional assessment including complete anthropometric, clinical biochemistry, and dietary parameters. The sum of the MNA score distinguishes between elderly patients with: 1) adequate nutritional status, MNA > or = 24; 2) protein-calorie malnutrition, MNA < 17; 3) at risk of malnutrition, MNA between 17 and 23.5. With this scoring, sensitivity was found to be 96%, specificity 98%, and predictive value 97%. The MNA scale was also found to be predictive of mortality and hospital cost. Most important it is possible to identify people at risk for malnutrition, scores between 17 and 23.5, before severe changes in weight or albumin levels occur. These individuals are more likely to have a decrease in caloric intake that can be easily corrected by nutritional intervention.
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            Health status of UK care home residents: a cohort study

            Background: UK care home residents are often poorly served by existing healthcare arrangements. Published descriptions of residents’ health status have been limited by lack of detail and use of data derived from surveys drawn from social, rather than health, care records. Aim: to describe in detail the health status and healthcare resource use of UK care home residents Design and setting: a 180-day longitudinal cohort study of 227 residents across 11 UK care homes, 5 nursing and 6 residential, selected to be representative for nursing/residential status and dementia registration. Method: Barthel index (BI), Mini-mental state examination (MMSE), Neuropsychiatric index (NPI), Mini-nutritional index (MNA), EuroQoL-5D (EQ-5D), 12-item General Health Questionnaire (GHQ-12), diagnoses and medications were recorded at baseline and BI, NPI, GHQ-12 and EQ-5D at follow-up after 180 days. National Health Service (NHS) resource use data were collected from databases of local healthcare providers. Results: out of a total of 323, 227 residents were recruited. The median BI was 9 (IQR: 2.5–15.5), MMSE 13 (4–22) and number of medications 8 (5.5–10.5). The mean number of diagnoses per resident was 6.2 (SD: 4). Thirty per cent were malnourished, 66% had evidence of behavioural disturbance. Residents had contact with the NHS on average once per month. Conclusion: residents from both residential and nursing settings are dependent, cognitively impaired, have mild frequent behavioural symptoms, multimorbidity, polypharmacy and frequently use NHS resources. Effective care for such a cohort requires broad expertise from multiple disciplines delivered in a co-ordinated and managed way.
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              Dementia and oral health among subjects aged 75 years or older.

               To study the association between diagnosed dementia and oral health, focusing on the type of dementia, among an elderly population aged 75 years or older.

                Author and article information

                +49 341 97 21211 ,
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                31 January 2017
                31 January 2017
                : 17
                [1 ]ISNI 0000 0001 2230 9752, GRID grid.9647.c, Department of Cariology, Endodontology and Periodontology, , University of Leipzig, ; Liebigstr. 12, D 04103 Leipzig, Germany
                [2 ]Dental practice, Goettingen, Germany
                [3 ]ISNI 0000 0001 2230 9752, GRID grid.9647.c, Department of Prosthodontics and Materials Science, , University of Leipzig, ; Leipzig, Germany
                [4 ]ISNI 0000 0001 0482 5331, GRID grid.411984.1, Deptartment of Preventive Dentistry, Periodontology and Cariology, , University University Medical Center, ; Goettingen, Germany
                [5 ]GRID grid.5603.0, Department of General Practice, , Institute for Community Medicine, University Medicine Greifswald, ; Greifswald, Germany
                [6 ]ISNI 0000 0004 1937 0650, GRID grid.7400.3, Clinic of Geriatric and Special Care Dentistry, Center of Dentistry, , University of Zurich, ; Zurich, Switzerland
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

                Research Article
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                © The Author(s) 2017

                Geriatric medicine

                oral health, nutritional status, nursing home, dementia


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