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Oral Health Problems and Significant Weight Loss Among Community-Dwelling Older Adults

^a Division of General Internal Medicine and Geriatrics, Department of Medicine, University of Louisville, Louisville, Kentucky
^b Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts
^c Boston University Schools of Medicine and Public Health, Boston, Massachusetts
^d Department of Social and Behavioral Sciences, Boston University School of Public Health, Boston, Massachusetts

Christine S. Ritchie, University of Louisville Division of General Internal Medicine and Geriatrics, Ambulatory Care Building 3rd floor, 530 S. Jackson Street, Louisville, KY 40202 E-mail: csritchie{at}louisville.edu.

Decision Editor: William B. Ershler, MD

Background. Studies of hospitalized and institutionalized older adults suggest a relationship between poor oral health and subsequent weight loss. Given the association between weight loss and subsequent mortality and morbidity, we evaluated how oral health problems contributed to significant weight loss over a 1-year period among a representative sample of community-dwelling older adults.

Methods. The study population consisted of 563 adults aged 70 years and older living at home in rural and urban areas in six New England states. Baseline data included information regarding health status, functional status, physical activity, disease diagnoses, lifestyle behaviors, and cognitive and affective status. Dentists performed oral health assessments. One year later, participants were called and asked questions regarding their health and dietary practices and their current weight.

Results. Over the 1-year period of follow-up, approximately one third of the sample had lost 4% or more of their previous total body weight; 6% of men and 11% of women lost 10% or more of their previous body weight. Of the subjects, 37% were edentulous; most of these individuals wore full dentures. With gender, income, advanced age, and baseline weight controlled for, edentulousness remained an independent risk factor for significant weight loss (odds ratio 1.63 for 4% weight loss and 2.03 for 10% weight loss). Individuals with increasing numbers of posterior teeth and functional units were at slightly lower risk for weight loss; however, these associations did not reach statistical significance.

Conclusions. Dentate status is an important risk factor for clinically significant weight loss among community-dwelling older adults.

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