Association of oral health with body weight: a prospective study in community-dwelling older adults

  • 33 Accesses



To prevent involuntary weight loss in older people, the knowledge about factors affecting body weight (BW) is essential. Therefore, we aimed to investigate the longitudinal associations of multiple oral health aspects with BW in community-dwelling older adults.


This analysis is based on prospective data with a 10-year follow-up of 657 Dutch community-dwelling older adults (age 66.4 ± 5.8 years, 54% female) from the Longitudinal Aging Study Amsterdam. Participants’ characteristics, BW, and 12 oral health variables (teeth, dentures, nine oral problems, self-rated oral health) were assessed in 2005/07 and 2015/16. The association between oral health and BW was analyzed by mixed models and adjusted for demographic, socio-economic, smoking, health, and functional aspects considering data of both assessments.


Mean BW was 79.1 ± 13.3 kg at baseline (B) and 77.6 ± 13.8 kg at follow-up (FU). At baseline, 29.6% of the participants reported being edentulous (FU:34.4%) and 55.8% to wear dentures (FU:62.3%). Dental pain while chewing was the oral problem with the lowest (B:5.2%, FU:6.6%) and xerostomia with the highest prevalence at both examinations (B:24.3%, FU:30.0%). Most participants rated their oral status as healthy (B:65.2%, FU:66.9%). Neither edentulism and denture use nor oral problems showed a longitudinal association with BW. In contrast, self-rated oral health was associated with BW (b = 0.724, SE = 0.296, p = 0.015) after adjusting for multiple confounders.


In community-dwelling older adults self-rated oral health may indicate changes in body weight in the long term. Therefore, this simple measure could serve to identify a risk for weight loss and to initiate oral interventions in clinical practice.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1


  1. 1.

    Cederholm T, Jensen GL, Correia M, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition—a consensus report from the global clinical nutrition community. Clin Nutr. 2018.

  2. 2.

    Ritchie CS, Locher JL, Roth DL, McVie T, Sawyer P, Allman R. Unintentional weight loss predicts decline in activities of daily living function and life-space mobility over 4 years among community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2008;63:67–75.

  3. 3.

    Newman AB, Yanez D, Harris T, Duxbury A, Enright PL, Fried LP. Weight change in old age and its association with mortality. J Am Geriatr Soc. 2001;49:1309–18.

  4. 4.

    Cheng FW, Gao X, Jensen GL. Weight change and all-cause mortality in older adults: a meta-analysis. J Nutr Gerontol Geriatr. 2015;34:343–68.

  5. 5.

    Ritchie CS, Joshipura K, Hung HC, Douglass CW. Nutrition as a mediator in the relation between oral and systemic disease: associations between specific measures of adult oral health and nutrition outcomes. Crit Rev Oral Biol Med. 2002;13:291–300.

  6. 6.

    Petersen PE, Yamamoto T. Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. Community Dent oral Epidemiol. 2005;33:81–92.

  7. 7.

    van der Putten GJ, de Baat C, De Visschere L, Schols J. Poor oral health, a potential new geriatric syndrome. Gerodontology. 2014;31(Suppl 1):17–24.

  8. 8.

    De Visschere L, Janssens B, De Reu G, Duyck J, Vanobbergen J. An oral health survey of vulnerable older people in Belgium. Clin Oral Investig. 2016;20:1903–12.

  9. 9.

    De Visschere LM, Grooten L, Theuniers G, Vanobbergen JN. Oral hygiene of elderly people in long-term care institutions-a cross-sectional study. Gerodontology. 2006;23:195–204.

  10. 10.

    Tada A, Miura H. Systematic review of the association of mastication with food and nutrient intake in the independent elderly. Arch Gerontol Geriatr. 2014;59:497–505.

  11. 11.

    Kiesswetter E, Poggiogalle E, Migliaccio S, Donini LM, Sulmont-Rosse C, Feart C, et al. Functional determinants of dietary intake in community-dwelling older adults: a DEDIPAC (DEterminants of DIet and Physical ACtivity) systematic literature review. Public Health Nutr. 2018:1–18.

  12. 12.

    Munoz-Gonzalez C, Vandenberghe-Descamps M, Feron G, Canon F, Laboure H, Sulmont-Rosse C. Association between salivary hypofunction and food consumption in the elderlies. A systematic literature review. J Nutr Health Aging. 2018;22:407–19.

  13. 13.

    Xu F, Laguna L, Sarkar A. Aging-related changes in quantity and quality of saliva: Where do we stand in our understanding? J Texture Stud. 2019;50:27–35.

  14. 14.

    Turner M, Ship JA. Dry mouth and its effects on the oral health of elderly people. J Am Dent Assoc. 2007;138(9 Suppl):15S–20S.

  15. 15.

    Vlaeyen JW, Crombez G, Linton SJ. The fear-avoidance model of pain. Pain. 2016;157:1588–9.

  16. 16.

    Van Lancker A, Verhaeghe S, Van Hecke A, Vanderwee K, Goossens J, Beeckman D. The association between malnutrition and oral health status in elderly in long-term care facilities: a systematic review. Int J Nurs Stud. 2012;49:1568–81.

  17. 17.

    Ritchie CS, Joshipura K, Silliman RA, Miller B, Douglas CW. Oral health problems and significant weight loss among community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2000;55:M366–71.

  18. 18.

    Beck AM. Weight loss, mortality and associated potentially modifiable nutritional risk factors among nursing home residents-a Danish follow-up study. J Nutr Health Aging. 2015;19:96–101.

  19. 19.

    de Andrade FB, Lebrao ML, de Oliveira Duarte YA, Santos JL. Oral health and changes in weight and waist circumference among community-dwelling older adults in Brazil. J Am Dent Assoc. 2014;145:731–6.

  20. 20.

    Lee JS, Weyant RJ, Corby P, Kritchevsky SB, Harris TB, Rooks R, et al. Edentulism and nutritional status in a biracial sample of well-functioning, community-dwelling elderly: the health, aging, and body composition study. Am J Clin Nutr. 2004;79:295–302.

  21. 21.

    Weyant RJ, Newman AB, Kritchevsky SB, Bretz WA, Corby PM, Ren D, et al. Periodontal disease and weight loss in older adults. J Am Geriatr Soc. 2004;52:547–53.

  22. 22.

    Knoops KT, Slump E, de Groot LC, Wouters-Wesseling W, Brouwer ML, van Staveren WA. Body weight changes in elderly psychogeriatric nursing home residents. J Gerontol A Biol Sci Med Sci. 2005;60:536–9.

  23. 23.

    Huisman M, Poppelaars J, van der Horst M, Beekman AT, Brug J, van Tilburg TG, et al. Cohort profile: the Longitudinal Aging Study Amsterdam. Int J Epidemiol. 2011;40:868–76.

  24. 24.

    Hoogendijk EO, Deeg DJ, Poppelaars J, van der Horst M, Broese van Groenou MI, Comijs HC, et al. The Longitudinal Aging Study Amsterdam: cohort update 2016 and major findings. Eur J Epidemiol. 2016;31:927–45.

  25. 25.

    Koster A, Bosma H, Broese van Groenou MI, Kempen GI, Penninx BW, van Eijk JT, et al. Explanations of socioeconomic differences in changes in physical function in older adults: results from the Longitudinal Aging Study Amsterdam. BMC Public Health. 2006;6:244.

  26. 26.

    Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.

  27. 27.

    Berkman LF, Berkman CS, Kasl S, Freeman DH Jr., Leo L, Ostfeld AM, et al. Depressive symptoms in relation to physical health and functioning in the elderly. Am J Epidemiol. 1986;124:372–88.

  28. 28.

    van der Pols-Vijlbrief R, Wijnhoven HA, Schaap LA, Terwee CB, Visser M. Determinants of protein-energy malnutrition in community-dwelling older adults: a systematic review of observational studies. Ageing Res Rev. 2014;18:112–31.

  29. 29.

    Kiyak HA, Reichmuth M. Barriers to and enablers of older adults’ use of dental services. J Dent Educ. 2005;69:975–86.

  30. 30.

    Reinders I, Murphy RA, Martin KR, Brouwer IA, Visser M, White DK, et al. Body mass index trajectories in relation to change in lean mass and physical function: the health, aging and body composition study. J Am Geriatr Soc. 2015;63:1615–21.

  31. 31.

    Wirth R, Streicher M, Smoliner C, Kolb C, Hiesmayr M, Thiem U, et al. The impact of weight loss and low BMI on mortality of nursing home residents—results from the nutrition day in nursing homes. Clin Nutr. 2016;35:900–6.

  32. 32.

    Stock C, Jurges H, Shen J, Bozorgmehr K, Listl S. A comparison of tooth retention and replacement across 15 countries in the over 50s. Community Dent Oral Epidemiol. 2016;44:223–31.

  33. 33.

    Ikebe K, Matsuda K, Morii K, Nokubi T, Ettinger RL. The relationship between oral function and body mass index among independently living older Japanese people. Int J Prosthodont. 2006;19:539–46.

  34. 34.

    Osterberg T, Carlsson GE. Dental state, prosthodontic treatment and chewing ability—a study of five cohorts of 70-year-old subjects. J Oral Rehabil. 2007;34:553–9.

  35. 35.

    Persson GR. Periodontal complications with age. Periodontol. 2018;78:185–94.

  36. 36.

    Ferreira MC, Dias-Pereira AC, Branco-de-Almeida LS, Martins CC, Paiva SM. Impact of periodontal disease on quality of life: a systematic review. J Periodontal Res. 2017;52:651–65.

  37. 37.

    Alibhai SM, Greenwood C, Payette H. An approach to the management of unintentional weight loss in elderly people. CMAJ. 2005;172:773–80.

  38. 38.

    Abizanda P, Sinclair A, Barcons N, Lizan L, Rodriguez-Manas L. Costs of Malnutrition in Institutionalized and community-dwelling older adults: a systematic review. J Am Med Dir Assoc. 2016;17:17–23.

  39. 39.

    Morley JE. Undernutrition in older adults. Fam Pract. 2012;29(Suppl 1):i89–93.

  40. 40.

    Miller SL, Wolfe RR. The danger of weight loss in the elderly. J Nutr Health Aging. 2008;12:487–91.

  41. 41.

    Mamhidir AG, Ljunggren G, Kihlgren M, Kihlgren A, Wimo A. Underweight, weight loss and related risk factors among older adults in sheltered housing-a Swedish follow-up study. J Nutr Health Aging. 2006;10:255–62.

Download references


The Longitudinal Aging Study Amsterdam (LASA) is largely supported by a grant from the Netherlands Ministry of Health, Welfare and Sports, Directorate of Long-Term Care. The questionnaire on oral health was developed in cooperation with experts on oral health from the Academic Centre for Dentistry Amsterdam (ACTA) and the Netherlands Organization for Applied Scientific Research (TNO). Development of the questionnaire and data entry was supported in part through a grant from the Dutch Ministry for Economic Affairs (grant no. 031.20339). EK received a research fellowship from the German Research Foundation (DFG) to conduct this project (project number 398462750). MV was supported by the European Horizon 2020 PROMISS Project “PRevention Of Malnutrition In Senior Subjects in the EU,” grant agreement no. 678732. The content only reflects the author’s view and the Commission is not responsible for any use that may be made of the information it contains. MV and DV were supported by the MalNutrition in the ELderly (MaNuEL) knowledge hub, the Joint Programming Initiative “Healthy Diet for a Healthy Life.” The funding agencies supporting this work are: Germany: German Federal Ministry of Food and Agriculture (BMEL) through the Federal Office for Agriculture and Food (BLE), grant number 2815ERA09E; The Netherlands: The Netherlands Organisation for Health Research and Development (ZonMw).

Author information

Correspondence to Eva Kiesswetter.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kiesswetter, E., Keijser, B.J.F., Volkert, D. et al. Association of oral health with body weight: a prospective study in community-dwelling older adults. Eur J Clin Nutr (2019) doi:10.1038/s41430-019-0536-4

Download citation