Older age, smoking, tooth loss and denture-wearing but neither xerostomia nor salivary gland hypofunction are associated with low intakes of fruit and vegetables in older Danish adults

Global burden of TBL cancer in older adults: the role of dietary factors (1990-2021)

BACKGROUND

The incidence and mortality rates of trachea, bronchus, and lung cancers (TBL) continue to rise globally. Despite a trend of increasing cases among younger populations, the majority of patients with TBL remain concentrated in the 50 + age group. A comprehensive analysis of data from the Global Burden of Disease (GBD) database reveals that fruit-deficient diets significantly contribute to both mortality and disability-adjusted life years (DALYs) associated with TBL, particularly in patients aged 55 and older, thus posing a major global health challenge. This highlights the critical need to address the burden of this dietary risk factor in older populations. Leveraging the unparalleled value of GBD research in assessing health impacts, this study emphasizes the importance of mitigating the influence of poor dietary habits on elderly populations. The goal is to support informed public health decisions and strategies that can advance global health outcomes.

METHODS

Between 1990 and 2021, this study systematically analyzed key indicators for patients with TBL aged 55 + , including morbidity, mortality, DALYs, age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs), and age-standardized DALYs (ASDRs). A thorough risk association analysis was conducted regarding the role of fruit-poor diets in TBL incidence. Data visualization and graphing were performed using JD_GBDR (V2.32) to explore disease characteristics and risk factors, enabling rigorous analysis of the impact of dietary patterns on TBL outcomes in this demographic.

RESULTS

From 1990 to 2021, the global incidence of TBL has shown a marked increase in individuals aged 55 and older. By 2021, cases are projected to reach 2.02 million, with deaths rising to 1.8 million. Over the past 30 years, morbidity has surged by 116.82%, mortality by 99.88%, and DALYs by 80.56%. Notably, within the TBL patient group aged over 55, insufficient fruit intake has emerged as a key factor, contributing to 56,583 deaths-a 39.33% increase in mortality since 1990-and 1,200,556 DALYs, reflecting a 26.48% rise. These figures underscore the significant role of inadequate fruit intake in the disease progression of older patients with TBL, directly influencing mortality rates and DALY outcomes.

CONCLUSION

The study reveals an overall upward trajectory in global morbidity, mortality, and DALYs among patients with TBL aged 55 and older between 1990 and 2021. The growing impact of inadequate fruit intake on both mortality and disability-adjusted life years highlights the severity of this risk. Regional variations may occur due to local factors, including environment, healthcare access, and economic conditions. This research offers valuable insights into the global burden and distinct risk factors of TBL in older populations, with particular emphasis on the influence of dietary factors. Future studies and public health strategies must address these elements to effectively tackle the challenges associated with TBL.

Function, Quality of Life, and Food Intake in Patients Without Second Molar Implants: A Prospective Cohort Study

OBJECTIVES

The necessity of a second molar region implant for Kennedy Class II classification of unilateral partially edentulous arches remains controversial. This study aims to compare the effects of implant treatment in the first and second molar regions, providing a basis for planning implant treatments for Kennedy Class II dentition.

METHODS

This prospective cohort study included 16 patients with implant therapy up to the first molar and 16 patients treated up to the second molar. Bite force, masticatory function, oral health-related quality of life (OHRQoL), and food and nutrient intakes were evaluated as outcomes.

RESULTS

While the two groups showed improvements in occlusal force and masticatory function with implant treatment, the increase was significantly greater with implant treatment extending to the second molar. The improvement in OHRQoL was comparable between both groups. Furthermore, the increases in vegetable, dietary fiber, and vitamin K intakes were significantly greater in the implant treatment group extending to the second molar.

CONCLUSION

From the perspective of OHRQoL, implant treatment up to the first molar may be sufficient.

Prevalence and Associations of Xerostomia in Older Adults in Southern Brazil

OBJECTIVES

This study investigated the prevalence and associations of xerostomia in older adults in southern Brazil.

METHODS

A cross-sectional study was carried out in Pelotas, Brazil, during 2014. A representative sample of the city's older adult population (60+) was selected. The dependent variable was self-reported feeling of dry mouth in the past 6 months. Covariates included socio-economic status, schooling, gender, age, tobacco and alcohol consumption, polypharmacy, hypertension, diabetes, arthritis, depression, dentition status and use of removable dental prostheses. Descriptive analysis was carried out, and Poisson regression was used to obtain prevalence ratios and 95% confidence intervals. Analyses used STATA 15.1.

RESULTS

Most of the 1451 participants were female (63.3%). The prevalence of xerostomia was 36.7% (95% CI 34.3-39.1). Adjusted analysis showed that xerostomia was significantly more common among females (PR 1.44, 95% CI 1.22-1.74), those with less schooling (PR 1.31, 95% CI 1.10-1.51), those exposed to polypharmacy (PR 1.22, 95% CI 1.05-1.37), people with arthritis (PR 1.42, 95% CI 1.23-1.61) and those with depression symptoms (PR 1.45, 95% CI 1.23-1.70).

CONCLUSION

Xerostomia is common among older adults. Health workers need to pay attention to its associated factors for early identification and promotion of appropriate interventions, particularly the rational use of medicines.

Omega-3 long-chain polyunsaturated fatty acids and their bioactive lipids: A strategy to improve resistance to respiratory tract infectious diseases in the elderly?

Age-related changes in organ function, immune dysregulation, and the effects of senescence explain in large part the high prevalence of infections, including respiratory tract infections in older persons. Poor nutritional status in many older persons increases susceptibility to infection and worsens prognosis. Interestingly, there is an association between the amount of saturated fats in the diet and the rate of community-acquired pneumonia. Polyunsaturated fatty acids, particularly omega-3 long chain polyunsaturated fatty acids (ω-3 LC-PUFAs) including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have well-known anti-inflammatory, immunomodulatory, and antimicrobial effects, which may, in theory, be largely induced by PUFAs-derived lipids such as specialized pro-resolving mediators (SPMs). In adults, preliminary results of studies show that ω-3 LC-PUFAs supplementation can lead to SPM generation. SPMs have a crucial role in the resolution of inflammation, a factor relevant to survival from infection independent of the pathogen’s virulence. Moreover, the immune system of older adults appears to be more sensitive to ω-3 PUFAs. This review explores the effects of ω-3 LC-PUFAs, and PUFA bioactive lipid-derived SPMs in respiratory tract infections and the possible relevance of these data to infectious disease outcomes in the older population. The hypothesis that PUFAs have beneficial effects via SPM generation will need to be confirmed by animal experiments and patient-derived data.

Factors influencing xerostomia and oral health-related quality of life in polymedicated patients

OBJECTIVES

To evaluate whether the severity of xerostomia in older polymedicated patients impacts oral health-related quality of life (OHRQoL).

BACKGROUND

Medication-associated xerostomia is common in older people. Xerostomia may impair OHRQoL.

MATERIALS AND METHODS

This cross-sectional study included older hypertensive patients from two health centres. We assessed the severity of xerostomia and OHRQoL using the Xerostomia Inventory (XI) tool, and the Oral Health Impact Profile-14 (OHIP-14) instrument, respectively. We measured unstimulated (UWS) and stimulated (SWS) salivary flows. Univariate and multiple linear regression analyses evaluated the associations of XI and OHIP-14 and different explanatory variables.

RESULTS

Of the 218 patients enrolled, 51.8% had xerostomia, and 38.1% and 27.5% suffered from UWS and SWS hyposalivation, respectively. Patients with xerostomia, UWS, and SWS hyposalivation scored significantly higher on the XI. However, only those with xerostomia or UWS hyposalivation had significantly higher OHIP-14 scores. A moderate correlation was observed between XI and OHIP-14 scores. The multiple regression model showed that factors with the greatest impact on XI were the patient's complaint of xerostomia, UWS flow rate, age and sex. However, only the XI score was significantly associated with the OHIP-14 score.

CONCLUSION

Xerostomia has a negative impact on OHRQoL in older polymedicated patients, but this impact is less than in other types of xerostomia. Longitudinal studies are needed to determine whether changes in the detected explanatory variables influence XI and OHIP scores in these patients.

Evaluation of Oral Mucosal Lesions in Iranian Smokers and Non-smokers

BACKGROUND

Tobacco smoking statistics are alarming and the oral mucosa is the first human part of the body that is exposed to the toxic substances of smoking.

AIMS

Considering the high prevalence rate of tobacco-associated problems in the oral cavity and few studies on the Iranian population regarding the effects of smoking on the oral cavity, this study aimed to evaluate the relationship between smoking and oral lesions in the Iranian population.

MATERIALS AND METHODS

Observational study. In this observational study, the oral cavities of 200 participants (smokers = 100 and non-smokers = 100) were examined by a trained dental student under the supervision of an oral and maxillofacial medicine expert, and the presence of coated tongue, leukoedema, leukoplakia, smoker's palate, smoker's melanosis, erythroplakia, frictional hyperkeratosis, acute pseudomembranous candidiasis, and erythematous candidiasis were recorded. Xerostomia was evaluated based on participants' self-reporting through a questionnaire. All data were analyzed using T-test, Chi-square test, odd ratio, 95% confidence interval, Fisher's exact test, and Spearman's rank correlation coefficient.

RESULTS

The results of this study showed smoking is significantly associated with an increased risk of coated tongue (OR: 1.80, 95% CI: 1.32-3.54, P = 0.005), smoker's melanosis (OR: 6.176, 95% CI: 3.28-11.62, P = 0.00002), and frictional hyperkeratosis (OR: 1.33, 95% CI: 0.68-2.60, P = 0.005). However, no significant association was observed between smoking and leukoedema (OR: 1, 95% CI: 0.51-1.94, P = 1). None of the participants presented smoker's palate, erythroplakia, and candidiasis.

CONCLUSIONS

This study's results showed that smokers exhibited a greater chance of developing oral lesions compared to non-smokers.

Multivitamin/Multimineral Supplementation Prevents or Reverses Decline in Vitamin Biomarkers and Cellular Energy Metabolism in Healthy Older Men: A Randomized, Double-Blind, Placebo-Controlled Study

Despite the reported prevalence of micronutrient deficiencies in older adults, it is not yet established whether multivitamin/multimineral (MV/MM) supplements improve blood micronutrient status in individuals over the age of 65. Therefore, a cohort of 35 healthy men (>67 years) was recruited for an MV/MM supplementation trial. The primary endpoint was, as an indicator of micronutrient status, changes in blood micronutrient biomarkers from baseline to at least six months of supplementation with MV/MM or placebo. The secondary endpoint was basal O2 consumption in monocytes as an indicator of cellular metabolism. MV/MM supplementation improved blood concentrations of pyridoxal phosphate, calcifediol, α-tocopherol, and β-carotene concentrations throughout the cohort. By contrast, those in the placebo group generally showed declines in blood vitamin concentrations and an increased prevalence of suboptimal vitamin status during the study period. On the other hand, MV/MM supplementation did not significantly affect blood mineral concentrations, i.e., calcium, copper, iron, magnesium, and zinc. Interestingly, MV/MM supplementation prevented the decline in monocyte O2 consumption rate. Overall, MV/MM use improves or prevents declines in vitamin, but not mineral, status and limits declines in cellular O2 consumption, which may have important implications for metabolism and immune health in healthy older men.

Level of Fruit and Vegetable Intake and Its Relationship with Risk for Malnutrition in China’s Adult Labor Force: China Nutrition and Health Surveillance, 2015–2017

The purpose of this study was to analyze the fruit and vegetable intake status and examine both potential risk and protective action factors in the Chinese labor force population, while investigating the association between fruit and vegetable intake and malnutrition in this population. Data were derived from a population-based cross-sectional survey, the China Nutrition and Health Surveillance, 2015–2017. Sociodemographic information, physical measurements, and dietary intake data were collected. A total of 45,459 survey respondents aged 18–64 years old were included in the analysis. Fruit and vegetable consumption data were assessed by a food frequency questionnaire (FFQ), and the average daily intake was calculated. In 2015, the daily intake of fresh fruits, fresh vegetables, and combined fruits and vegetables among the Chinese labor force was 64.3 g, 210.0 g, and 330.0 g (median), respectively. Compared with the Dietary Guidelines for Chinese Residents (2022), 79.9% and 53.0% were at risk of inadequate fruit and vegetable intake, while 55.2% were at risk of inadequate intake of combined fruits and vegetables compared with the WHO recommendation. Multivariate logistic regression analysis showed that female gender, higher educational level, and higher income were protective factors for adequate fruit intake, while increasing age and living in the southern region were protective factors for adequate vegetable intake. The results confirmed that increasing vegetable intake helped urban labor force maintain normal BMI and control overweight. Increased fruit consumption may reduce the risk of underweight, but no clear negative association with overweight and obesity was observed. In conclusion, the consumption of fresh fruits and vegetables by the Chinese labor force was inadequate, especially for fruits. Interventions are needed to promote the daily intake of fruits and vegetables in this population. In addition, further in-depth studies in this area are recommended in populations with different health status.

Relationship between Knowledge and Attitude toward Oral Function in Middle-Aged and Older Adults

Oral hypofunction is the stage at which recovery can be expected with proper diagnosis, management, and motivation before oral dysfunction occurs. The knowledge and attitude toward oral function can influence the maintenance and improvement of oral function. However, whether middle-aged and older adults with declining oral function have knowledge of their oral function and how this knowledge and their attitude affect their oral function are unclear. Therefore, we aimed to examine (1) the relationship between knowledge and attitude toward oral function and hypofunction in individuals with suspected oral hypofunction and (2) changes in knowledge and attitude toward oral function through evaluation and education. Participants aged ≥50 years were enrolled during their first community dental clinic visit. A questionnaire assessment of knowledge and attitudes before and after oral function evaluation was performed. The oral function was initially assessed with seven criteria: oral hygiene; oral dryness; occlusal force; tongue pressure; tongue-lip motor, masticatory, and swallowing function. Associations between knowledge and attitudes and their changes were statistically analyzed. Fifty-nine participants (93.7%) were unaware of “oral hypofunction.” Associations between knowledge and attitudes and their changes in the negative to positive response groups, from 86.4% and 61.0% to 6.8% and 25.4%, respectively, after oral function evaluation, indicated that participants understood their oral function and the need for training. Middle-aged and older individuals with poor knowledge and attitudes were more likely to have a worse oral function; however, their knowledge and attitudes toward oral function could be improved through oral function assessment and education.