XEROSTOMIA, XEROGENIC MEDICATIONS AND FOOD AVOIDANCES IN SELECTED GERIATRIC GROUPS

OBJECTIVE: To study the relationship between complaints of xerostomia and salivary performance and food avoidances in four geriatric groups chosen to reflect a broad spectrum of individuals along the health-dis ease continuum. To determine whether xerogenic medications taken by th ese individuals could be associated with either complaints of xerostom ia or with food avoidances. DESIGN: Cross-sectional survey. Clinical e xaminations and interview. SETTING: A VA dental clinic and a retiremen t home. PATIENTS AND OTHER PARTICIPANTS: Subjects were 529 individuals older than 56 years of age, living both in institutions and in the co mmunity (average age 70 years). Two hundred eight persons were recruit ed from a VA Dental Clinic, 114 from a residential retirement home, an d 132 from a nursing/long-term-care facility; 75 were from an acute ca re ward and had a diagnosis of a cerebral vascular accident or other n eurological condition. OUTCOME MEASURES: Prevalence of xerostomia, den tal morbidity, salivary flow, and food avoidances. RESULTS: About 72% of the subjects experienced xerostomia sometime during the day. Stimul ated salivary flow was found to be significantly lower in individuals who complained of xerostomia than in those who did not. Fifty-five per cent of participants reported using one or more xerogenic medications, with an 86% prevalence in the nursing/long-term-care facility. Indivi duals with xerostomia had difficulty in chewing and in starting a swal low and were significantly more likely to avoid crunchy foods such as vegetables, dry foods such as bread, and sticky foods such as peanut b utter in their diets. Specific medications such as the inhalants iprat ropium and triamcinolone and the systemic agents oxybutynin and triazo lam could be statistically associated with xerostomia and/or low saliv ary flow, and/or specific food avoidances. CONCLUSION: Xerostomia appa rently affects the ability to chew and start a swallow. This leads to avoidance of certain foods, which raises the possibility that xerostom ia could contribute to undernutrition in older persons. The topically applied ipratropium and triamcinolone and the systemic agents amitript yline, oxybutynin and triazolam could be statistically associated with one or more complaints of xerostomia.