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Oral candidiasis and nutritional deficiencies in elderly hospitalised patients

Published online by Cambridge University Press:  09 March 2007

Elena Paillaud ,
Isabelle Merlier ,
Catherine Dupeyron ,
Elisabeth Scherman ,
Joël Poupon  and
Phuong-Nhi Bories
Elena Paillaud
Affiliation:
Departement de Médecine Interne et Gériatrie, Hôpital Albert Chenevier, AP-HP, 40 rue Mesly, 94010 Creteil Cedex, France
Isabelle Merlier
Affiliation:
Departement de Médecine Interne et Gériatrie, Hôpital Albert Chenevier, AP-HP, 40 rue Mesly, 94010 Creteil Cedex, France
Catherine Dupeyron
Affiliation:
Laboratoire de Biologie, Hôpital Albert Chenevier, 40 rue Mesly, 94010, Creteil, Cedex, France
Elisabeth Scherman
Affiliation:
Laboratoire de Biologie, Hôpital Albert Chenevier, 40 rue Mesly, 94010, Creteil, Cedex, France
Joël Poupon
Affiliation:
Laboratoire de Biochimie-Toxicologie, Hôpital Fernand Widal, AP-HP, Paris, France
Phuong-Nhi Bories*
Affiliation:
Laboratoire de Biologie, Hôpital Albert Chenevier, 40 rue Mesly, 94010, Creteil, Cedex, France Laboratoire de Biochimie, Hôpital Hôtel-Dieu, AP-HP, Paris, France
*
*Corresponding author: Dr Phuong Nhi Bories, fax +33 1 49 81 31 19, email, phuong-nhi.bories@ach.ap-hop-paris.fr
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Abstract

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The prevalence of oral candidiasis and its association with malnutrition in terms of protein–energy malnutrition and mineral and vitamin depletion were evaluated in ninety-seven hospitalised older adults aged 82·1 (SD 8·6) years. Patients underwent a complete oral examination with microbiological investigation on admission to our geriatric rehabilitation unit. Patients were assessed nutritionally by evaluation of dietary intake and measurement of anthropometric variables, serum nutritional proteins, ferritin, Zn, folate, vitamins B12 and C. The prevalence of oral candidiasis was 37% (n 36); the proportion of patients with BMI <20 kg/m2 was 32% (n 31). The nutritional status of the population was studied by comparing two groups defined according to the absence (group I; n 61) or presence (group II; n 36) of oral candidiasis. The two groups did not differ on the basis of BMI and mid-arm circumference. However, group II had a smaller leg circumference, lower daily energy and protein intakes, lower albumin and transthyretin levels. Patients successfully treated with fluconazole increased their intake on day 30. The proportion of patients with hypozincaemia (<12·5 μmol/l) and vitamin C deficiency (<0·7 mg/l) was higher in group II. Treatment with antibiotics, poor oral hygiene, denture wearing, and vitamin C deficiency appeared as the most significant independent risk factors associated with oral candidiasis. The present findings show that oral candidiasis appears to be related to malnutrition and results in mucosal lesions that have a negative impact on energy intake, which may subsequently worsen nutritional status.

Keywords

MalnutritionOral candidiasisElderlyVitamin deficiency
Type
Research Article
Information
British Journal of Nutrition , Volume 92 , Issue 5 , November 2004 , pp. 861 - 867
Copyright
Copyright © The Nutrition Society 2004

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