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LETTERS TO THE EDITOR |
Department of Epidemiology
University of Pittsburgh
130 North Bellefield Avenue, 5th Floor
Pittsburgh, PA
E-mail: leej{at}edc.pitt.edu
School of Dental Medicine
University of Pittsburgh
Pittsburgh, PA
J Paul Sticht Center on Aging
Wake Forest University
Winston-Salem, NC
National Institute on Aging
Bethesda, MD
Department of Sociology
Kent State University
Kent, OH
The Prevention Sciences Group
University of California
San Francisco, CA
Department of Epidemiology and Medicine
University of Pittsburgh
130 North Bellefield Avenue, 5th Floor
Pittsburgh, PA
Dear Sir:
We appreciate the comments by Desport regarding our recently published article (1). Desport asks how edentate elders with poor appetite and a different pattern of food group consumption had total mean energy intake similar to that of dentate elders and were more likely to gain weight. She questioned some of the methodologic approaches used in our study. Indeed, we had carefully used most of the approaches she suggested in our analyses and the results did not change.
Food intake in older adults is a complex process involving an array of physiologic and behavioral factors. In our well-functioning, community-dwelling older cohort, edentulism was associated with food choice and eating, but at this baseline examination it did not have much effect on actual energy intake (and potentially balance). Edentate elders in our cohort chose food groups that might be easier for them to chew but had a mean energy intake similar to that of dentate elders. However, because of the limitations of the dietary assessment tool (a food-frequency questionnaire), it is possible that modest differences in intake were missed. The baseline weight and mean weight change over 1 y (either absolute or relative) of the edentate elders were not significantly different from those of the dentate elders. However, when we examined whether edentulism was associated with clinically significant weight changes [usually defined as >5% of weight change during a 6–12-mo period (2)], the proportion with a weight gain of >5% of baseline weight was higher among the edentate than the dentate elders. We think that our findings manifest early adaptation of food choice and eating in highly functioning, relatively healthy, community-dwelling older adults as their dental status becomes compromised. If we look into this issue in our cohort with a longer follow-up or in other cohorts that include older adults with poorer dental and overall health status than ours, we may have different findings.
Data from a subsequent dental and periodontal examination conducted in the Health, Aging, and Body Composition (Health ABC) Study suggest that self-reported dental status among well-functioning and community-dwelling older adults is very reliable. Around 96% and 86% of the Health ABC dental and periodontal examination participants correctly reported edentulism and denture use, respectively. With additional follow-up of both self-reported oral health and examination data obtained in the Health ABC study, we hope to understand how oral health affects nutritional status over time as the health and function of this cohort decline with age.
REFERENCES
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