The Relationship of Dysphagia and Malnutrition to Tooth Loss in the Elderly

Abstract Malnutrition is a critical health concern for the elderly. It frequently results from impaired oral function due to tooth loss, obstructing eating and swallowing. Dysphagia and malnutrition can diminish the quality of life. Screening instruments, such as the modified water swallow test (MWST) and Eating Assessment Tool (EAT-10-ID), facilitate the early detection of dysphagia. These instruments are precise and assist in identifying dysphagia, facilitating prompt intervention. Timely identification and intervention for dysphagia and malnutrition can reduce morbidity, length of hospital stays, and health care expenditures in geriatric patients. This article examines the relationship between the dysphagia and nutritional status, as well as its association with tooth loss in the elderly in Indonesia. This study used a cross-sectional design. The participants in this study were individuals 60 years and above --a total of 130 participants who fulfilled the inclusion criteria engaged in the study. Patients were measured for the number of remaining teeth and the condition of denture use, followed by an evaluation of their nutritional health by filling out the Mini Nutritional Assessment form, and swallowing assessment was performed using two methods, objectively and subjectively. The objective method is by the MWST. Subsequently, the participant's subjective dysphagia was evaluated using the EAT-10-ID questionnaire, which is a 10-item screening instrument for assessing dysphagia risk. Multivariate analysis indicated a strong association between dysphagia, education, and malnutrition. Individuals with objective dysphagia possess a four times greater risk of malnutrition relative to those without dysphagia. Individuals with dysphagia exhibited a fourfold increased risk of malnutrition compared with those without dysphagia. Besides dysphagia, educational attainment was also related with nutritional health. Individuals with an education level of elementary school or higher exhibited a lower risk of malnutrition than those with a primary school education or less. This study indicated that patients with < 20 teeth who wore dentures exhibited a decreased percentage of dysphagia compared with those with < 20. Consequently, the diagnosis of dysphagia may be conducted with the EAT-10-ID or by subjective assessment.