Influence of dental status on dietary intake and survival in community-dwelling elderly subjects

Objective: to evaluate the relationships between a functional measure of dental status (FDS), the nutrients intake profile (NIP) and mortality in a community elderly population. Design: cross-sectional analysis for FDS and MP and a prospective study for mortality. Setting: the central district of Brescia, northern Italy. Participants: of the entire cohort of 70-75 year-old elderly subjects living in the district (n = 1303), 1189 subjects were interviewed and examined at baseline. Fifty-two of these were lost to follow-up; data are presented for the remaining 1137 subjects. Measurements: baseline data were collected by a door-to-door interview using a standardized questionnaire which included a section about the dietary intake in the 24 h preceding the interview The 24-h NIP was calculated and compared with the US Food and Drug Administration's 1980 Recommended Dietary Allowances to obtain a percentage value of each nutrient for each respondent. The dental examination considered the direct assessment of the number and position of residual teeth as well as the use of dentures; subjects were classified into three groups: naturally adequate or naturally inadequate dentition and denture wearers. Association of NIP with FDS was computed using ANCOVA and multiple logistic regression models. Mortality data were collected over a 78-month follow-up period. Association of survival with FDS was estimated by Kaplan-Meier analysis and multivariate Cox proportional hazard models. Results: multiple logistic regression showed a significant and independent association between the dental status and the intake of micronutrients, but not of macronutrients. Moreover, denture wearers had a dietary intake very similar to adequate dentition and substantially better than inadequate dentition. Inadequate dentition in women was associated with higher mortality than adequate dentition. In elderly women, both inadequate dental status and folate intake were significant and independent predictors of mortality in a multivariate analysis based on nutritional parameters. However, inadequate dentition did not remain an independent predictor of mortality in a general multivariate model. Conclusion: in this cohort of urban elderly people, FDS is significantly associated with the NTP and indirectly with mortality