The relationship between nutrient intake, dental status and family cohesion among older Brazilians Relação entre ingestão de nutrientes, condição dental e coesão familiar em idosos brasileiros

The aim of this study was to investigate the relationship between inadequate nutrient intake, oral health and family cohesion. This was a crosssectional study with a sample of 887 non-institutionalized elderly people from Vitória, Espírito Santo State, Brazil. Oral examination was performed by trained and calibrated examiners and three measurements were considered: number of posterior occluding pairs of natural teeth (POP), number of teeth and overall dental status. Nutrient intake was assessed by a 24-hour diet recall interview. The elderly person’s perception of family cohesion was assessed using the family adaptability and cohesion scale. People with no POP were more likely than those with 5 or more POP to have inadequate intake of vitamin C (OR = 2.79; 95%CI: 1.16-6.71), calcium (OR = 3.74; 95%CI: 1.69-8.25), riboflavin (OR = 2.49; 95%CI: 1.105.64) and zinc (OR = 3.43; 95%CI: 1.07-10.94). There was no association between elderly people’s perceptions of family cohesion and inadequate intakes. It was concluded that oral health is related to inadequate intake of important nutrients among non-institutionalized elderly people. Oral Health; Nutrition; Aged; Social Support Introduction Preventing disease in older people is an important health objective, and diet plays a primary role in achieving this goal 1,2,3,4,5. Several studies have shown that general health, quality of diet and nutrient intake are determined by multiple factors 6,7 including social support 8,9,10, socioeconomic status, culture 7,11 and oral health 12,13. Regarding oral health, current studies show an association between dental status and the mean intake of nutrients 12,13. An increase in dental impairment (e.g. edentulism, lack of prosthetic rehabilitation and lack of posterior occluding pairs of teeth) is associated with a decrease in the mean intake of vitamin C, vitamin A, calcium, fiber and protein 12,14. Previous studies have focused on identifying the relationship between oral health and mean nutrient intake or food choice, though few have investigated how much these associations within the groups represent in terms of inadequacy of nutrient intake, since the prevalence of inadequate intake of important nutrients is high among elderly people 15,16. An increasing amount of evidence shows that social support has a positive influence on dietary habits 17,18 and health status 9,19. According to the literature, family and friends are an important source of instrumental and emotional support, especially for older people 20,21. Family cohesion, which is defined as the emotional bondARTIGO ARTICLE Andrade FB et al. 114 Cad. Saúde Pública, Rio de Janeiro, 27(1):113-122, jan, 2011 ing between family members, is a key domain for family functioning 22 and is also related to an individual’s health 23. In spite of this, there is a lack of studies that explore the relationship between family cohesion and the health of older people 23, and hardly any studies have evaluated the association between this factor and adequate nutrition in older populations. Because nutrition has a strong influence on an older person’s health (particularly on their level of frailty) 24,25, the aim of this study was to investigate the relationship between nutrient intake, oral health and family cohesion. The hypothesis of the study was that impaired dentition and unbalanced families would be associated with an inadequate nutrient intake.