Associations between malnutrition, poor general health and oral dryness in hospitalized elderly patients

Objective: to obtain information about the possible relationship between symptoms and signs of oral dryness and malnutrition/poor general health in hospitalized older people. Design: a cross-sectional clinical investigation with measurements of unstimulated salivary flow rates (USFR), stimulated salivary flow rates (SSFR), nutritional status, serum albumin concentration and an evaluation of symptoms of oral dryness and loss of appetite by a questionnaire. Subjects and methods: a cohort of 99 elderly non-psychiatric patients hospitalized for medical reasons; collection of demographic and health data from medical files, collection of USFR and SSFR, measurements of body mass index (BMT), lean body mass, fat body mass, serum albumin concentration; completion of a questionnaire related to symptoms of oral dryness and the patients' appreciation of their nutritional status. Main outcome measures: SSFR and USFR. Results: mean age of the 99 patients was 82.5 +/- 4.0 years. Anthropometric examinations indicated malnutrition of severe or intermediate degree in about 50% while 46% showed moderately and 40% severely reduced albumin. Loss of appetite was present in 54% and 51% complained of oral dryness; 17% had an USFR <0.1 ml/min and 26% a SSFR <0.5 ml/min. Significant associations were found between (i) reduced salivary flow rate, malnutrition and reduced serum albumin concentration, (ii) recent loss of appetite and low serum albumin concentration and (iii) complaints of oral dryness and reduced salivary flow rates. There were also significant associations between complaints of oral dryness, loss of appetite and low BMI. Conclusion: reduced salivary secretion and complaints of oral dryness could be signs of poor nutritional or general health status of elderly patients. Reduced salivary secretion and feeling of oral dryness could have a negative effect on alimentation, appetite and oral comfort.