Impaired taste and increased mortality in acutely hospitalized older people.

Taste ability is known to be impaired in elderly and even more so in acutely hospitalized elderly people. To our knowledge, no study has investigated the association between taste impairment and mortality. Our aim was to examine this association in acutely hospitalized older people. In a prospective study, 200 acutely hospitalized elderly people ≥70 years of age were included between November 2009 and October 2010 at the Oslo University Hospital, Norway. Exclusion criteria were cognitive impairment, nursing home residency, and terminal diseases. Comorbidity was registered with the Cumulative Illness Rating Scale, in addition to recording of age, gender, smoking, education, and number of medications. Taste ability was assessed quantitatively with the "taste strips method" in 174 patients (mean age: 84 years). Mortality until 1 January 2012 was obtained from hospital records. Fifty-six patients died during the observation period. The relative risk of death in total taste score quartile 4 compared with total taste score quartile 1 was 0.31 (95% confidence interval [95% CI]: 0.14-0.69, P = 0.004), after adjusting for age, gender, smoking, education, and Cumulative Illness Rating Scale. Adjusted 1-year mortality decreased from 30% in total taste score quartile 1 to 9% in total taste score quartile 4. Thus, impaired taste appears to be strongly associated with mortality in acutely hospitalized elderly people.

Taste ability in hospitalised older people compared with healthy, age-matched controls.

OBJECTIVE: To investigate whether taste ability is reduced in acutely hospitalised older people compared with healthy, age-matched, non- hospitalised controls. BACKGROUND: Proper gustatory function in older people is important for quality of life and enjoyment of food. Impaired taste may contribute to weight loss in elderly. MATERIAL AND METHODS: Cross- sectional study. The participants comprised two groups with age ≥ 70 years. Older people hospitalised for acute disease, home-living prior to hospital admission and with adequate cognitive function (n = 174 with mean age = 84 years). The controls (n = 63, mean age 82 years) were home-living, and healthy by their own judgement. Whole mouth gustatory function was assessed with taste strips impregnated with sweet, sour, bitter and salty taste solutions in four different concentrations each. Correct identifications were summarized, and maximum total score was 16. RESULTS: Total taste score was reduced in the hospitalised group compared with the control group (p = 0.035). The difference was mainly due to reduced ability to detect sour and bitter taste qualities (p < 0.001 and p = 0.003). CONCLUSION: Acutely hospitalised older people had significantly reduced taste ability compared with non-hospitalised controls. Sour and bitter taste qualities were mostly affected. Hospital staff should pay attention to these findings when preparing food for hospitalised older people.

The impact of oral health on taste ability in acutely hospitalized elderly.

OBJECTIVE: To investigate to what extent various oral health variables are associated with taste ability in acutely hospitalized elderly. BACKGROUND: Impaired taste may contribute to weight loss in elderly. Many frail elderly have poor oral health characterized by caries, poor oral hygiene, and dry mouth. However, the possible influence of such factors on taste ability in acutely hospitalized elderly has not been investigated. MATERIALS AND METHODS: The study was cross-sectional. A total of 174 (55 men) acutely hospitalized elderly, coming from their own homes and with adequate cognitive function, were included. Dental status, decayed teeth, oral bacteria, oral hygiene, dry mouth and tongue changes were recorded. Growth of oral bacteria was assessed with CRT® Bacteria Kit. Taste ability was evaluated with 16 taste strips impregnated with sweet, sour, salty and bitter taste solutions in 4 concentrations each. Correct identification was given score 1, and maximum total taste score was 16. RESULTS: Mean age was 84 yrs. (range 70-103 yrs.). Total taste score was significantly and markedly reduced in patients with decayed teeth, poor oral hygiene, high growth of oral bacteria and dry mouth. Sweet and salty taste were particularly impaired in patients with dry mouth. Sour taste was impaired in patients with high growth of oral bacteria. CONCLUSION: This study shows that taste ability was reduced in acutely hospitalized elderly with caries activity, high growth of oral bacteria, poor oral hygiene, and dry mouth. Our findings indicate that good oral health is important for adequate gustatory function. Maintaining proper oral hygiene in hospitalized elderly should therefore get high priority among hospital staff.

Association between oral health and body cell mass in hospitalised elderly.

OBJECTIVE: To examine whether oral health in hospitalised elderly was associated with body cell mass (BCM) measured with Bioimpedance spectroscopy. BACKGROUND: Body cell mass is the tissue producing the metabolic work necessary for all body functions. BCM is mainly muscle tissue. Low BCM is associated with diseases, ageing and poor nutritional status. Reduced oral health is also associated with these parameters; thus, BCM and oral health may be related. METHODS: Body cell mass was measured using Bioimpedance spectroscopy in 138 acutely hospitalised elderly ≥70 years. The number of own teeth, posterior occluding tooth pairs and decayed teeth were registered. Oral hygiene was registered with Mucosal-Plaque Score, an index based on assessment of plaque accumulation and mucosal/gingival inflammation. Mini Nutritional Assessment-Short Form, body mass index and handgrip strength were used as nutritional indicators. Comorbidity was assessed with Cumulative Index Rating Scale. RESULTS: Mean age was 83.2 ± 5.9 years, ranging from 70 to 101 years. Dentition status was significantly and positively associated with BCM. Reduced oral hygiene was significantly associated with low BCM. These findings remained significant after adjusting for confounders. CONCLUSION: These results show that compromised oral health was significantly associated with reduced BCM in hospitalised elderly.

Stannous fluoride in dentifrice: an effective anti-plaque agent in the elderly?

OBJECTIVE: The aim of this study was to examine differences in plaque accumulation in elderly patients using two toothpastes, with either 0.2% sodium fluoride (NaF) or 0.4% stannous fluoride (SnF(2)), but otherwise identical. BACKGROUND DATA: The prevalence of denate elderly is increasing. Plaque both causes caries and is associated with an increased mortality rate in frail elderly patients with pneumonia. Therefore, the effective removal of plaque is important. Ingredients with an anti-plaque effect, such as SnF(2), that can be used in toothpaste, are effective in plaque inhibition MATERIALS AND METHODS: Thirty-two frail elderly women, 82-98 years of age (mean, 88 years) and living in a residential home, participated in a double-blind crossover study. They brushed their teeth for 4 weeks with each toothpaste. Treatment outcome was a change in the plaque index (PI) on four anterior teeth and four molars. RESULTS: anova showed statistically significant differences between the treatments (F = 4.21, p = 0.02). A post hoc test showed that SnF(2) produced a statistically significantly lower PI than did NaF. CONCLUSION: SnF(2) in toothpaste may be effective in inhibiting plaque accumulation in the elderly.