Prevalence of xerostomia and hyposalivation in older adults: a systematic review and meta-analysis

BACKGROUND: Oral health challenges in older individuals are often intensified by physiological and pathological changes associated with aging, leading to several oral conditions. Xerostomia and hyposalivation are common problems affecting quality of life. Therefore, this study aimed to assess the prevalence of xerostomia and hyposalivation in older individuals aged 60 years and above. METHODS: A comprehensive search strategy was conducted across four databases (MEDLINE/PubMed, EMBASE, Scopus and ProQuest) for articles published from inception to April 2026. Studies assessing xerostomia or hyposalivation in participants aged ≥ 60 years were included, while studies involving patients with systemic conditions known to cause xerostomia and/or hyposalivation, or those who had previously undergone radiotherapy, were excluded. The quality assessment was performed using a tool adapted from Hoy et al. The pooled prevalence of xerostomia and hyposalivation were estimated using random-effects models. Subgroup analyses were also conducted to identify sources of heterogeneity. RESULTS: The inclusion of 128 eligible publications comprising 174,698 participants reporting on the prevalence of xerostomia and hyposalivation. The included studies comprised a total of 170,803 individuals for xerostomia and 10,396 individuals for hyposalivation, with reported age ranges of 60-107 years and 60-103 years, respectively. The pooled prevalence of xerostomia (n = 119 study populations) was 32.4% (95% CI: 29.6%, 35.2%; I² = 99.3%), while that of hyposalivation (n = 32) was 33.0% (95% CI: 25.7%, 42.0%; I² = 98.6%). No evidence of publication bias was observed, and all sensitivity analyses yielded results consistent with the main analyses. Subgroup analyses did not reveal any apparent sources of heterogeneity. Most of the studies were assessed as having a high risk of bias for both xerostomia and hyposalivation. CONCLUSION: The prevalence of xerostomia and hyposalivation among older adults aged ≥ 60 years was approximately one-third, indicating a considerable burden in this population. However, the high degree of heterogeneity suggests substantial variability across studies, and the pooled estimates should therefore be interpreted with caution.