Periodontal Disease as a Marker of Malnutrition Risk in Community-Dwelling Older Adults

Objective Periodontal disease (PD), a prevalent condition in older adults, may impair nutritional status through reduced masticatory function, systemic inflammation, and altered dietary intake. However, few studies have examined the relationship between clinically assessed PD and validated nutritional risk metrics, that is, the Geriatric Nutritional Risk Index (GNRI). In the present study, we examined the association of PD severity with GNRI-defined malnutrition risk in a nationally representative sample of the US National Health and Nutrition Examination Survey (NHANES). Design A cross-sectional analysis from the NHANES 2009–2014. Setting and participants From the 30,468 NHANES subjects, we included 2806 participants aged ≥60 years with available PD and GNRI data, corresponding to approximately 32.64 million noninstitutionalized US individuals aged 60 years and older. Methods PD was classified according to Centers for Disease Control and Prevention/American Academy of Periodontology case definitions using full-mouth clinical examinations. Nutritional status was assessed using the GNRI calculated from serum albumin and weight-to-ideal weight ratios. GNRI scores were dichotomized as high (<98) or low (≥98) nutritional risk. Survey-weighted logistic regression models evaluated associations between PD severity and GNRI-defined malnutrition, adjusting for demographics, socioeconomics, behavioral factors, and multimorbidity. Results Severe PD was significantly associated with increased odds of being at nutritional risk. In the fully adjusted model, individuals with severe PD had 2.59 times greater odds of low GNRI scores (higher nutritional risk) compared with those with none/mild PD (OR, 2.59; 95% CI, 1.52–4.42; P < .01). No significant association was observed for moderate PD. Conclusions and Implications The present findings supported integrating oral health evaluation into nutritional screening in older age and geriatric comprehensive assessment, highlighting the need for interdisciplinary strategies to promote healthy aging.