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Anticholinergic burden and dry mouth among Finnish, community-dwelling older adults.

https://arctichealth.org/en/permalink/ahliterature294919
Source
Gerodontology. 2018 Mar; 35(1):3-10
Publication Type
Journal Article
Date
Mar-2018
Author
Antti Tiisanoja
Anna-Maija Syrjälä
Kaija Komulainen
Pasi Lampela
Sirpa Hartikainen
Heidi Taipale
Matti Knuuttila
Pekka Ylöstalo
Author Affiliation
Unit of Oral Health Sciences Research, University of Oulu, Oulu, Finland.
Source
Gerodontology. 2018 Mar; 35(1):3-10
Date
Mar-2018
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Cholinergic Antagonists - adverse effects - therapeutic use
Finland - epidemiology
Humans
Independent living
Male
Poisson Distribution
Saliva - secretion
Xerostomia - chemically induced - epidemiology
Abstract
The aim was to study whether the anticholinergic burden of drugs is related to xerostomia and salivary secretion among community-dwelling elderly people.
Anticholinergic drugs have been shown to be a risk factor for dry mouth, but little is known about the effects of cumulative exposure to anticholinergic drugs measured by anticholinergic burden on salivary secretion or xerostomia.
The study population consisted of 152 community-dwelling, dentate, non-smoking, older people from the Oral Health GeMS study. The data were collected by interviews and clinical examinations. Anticholinergic burden was determined using the Anticholinergic Drug Scale (ADS). A Poisson regression model with robust error variance was used to estimate relative risks (RR) with 95% confidence intervals (CI 95%).
Participants with a high-anticholinergic burden (ADS = 3) were more likely to have xerostomia (RR: 3.17; CI: 1.44-6.96), low-unstimulated salivary flow (
PubMed ID
28940566 View in PubMed
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Associations between oral and ocular dryness, labial and whole salivary flow rates, systemic diseases and medications in a sample of older people.

https://arctichealth.org/en/permalink/ahliterature139380
Source
Community Dent Oral Epidemiol. 2011 Jun;39(3):276-88
Publication Type
Article
Date
Jun-2011
Author
D. Smidt
L A Torpet
B. Nauntofte
K M Heegaard
A M L Pedersen
Author Affiliation
Department of Odontology, Section of Oral Medicine, Clinical Oral Physiology, Oral Pathology and Anatomy, Faculty of Health Sciences, University of Copenhagen, Denmark.
Source
Community Dent Oral Epidemiol. 2011 Jun;39(3):276-88
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Analysis of Variance
Cross-Sectional Studies
Denmark - epidemiology
Drug Therapy - statistics & numerical data
Drug-Related Side Effects and Adverse Reactions
Dry Eye Syndromes - chemically induced - epidemiology
Female
Health status
Health Surveys
Humans
Interviews as Topic
Logistic Models
Male
Odds Ratio
Prevalence
Salivation
Sex Factors
Xerostomia - chemically induced - epidemiology
Abstract
To investigate the associations between age, gender, systemic diseases, medications, labial and whole salivary flow rates and oral and ocular dryness in older people.
Symptoms of oral and ocular dryness, systemic diseases, medications (coded according to the Anatomical therapeutic chemical (ATC) classification system), tobacco and alcohol consumption were registered, and unstimulated labial (LS) and unstimulated (UWS) and chewing-stimulated (SWS) whole salivary flow rates were measured in 668 randomly selected community-dwelling elderly aged 65-95.
Presence of oral (12%) and ocular (11%) dryness was positively correlated. Oral dryness was associated with low UWS, SWS and LS, and ocular dryness with low UWS and SWS. Oral and ocular dryness was related to female gender, but not to age. Only four persons in the healthy and nonmedicated subgroups reported oral and ocular dryness. The numbers of diseases and medications were higher in the older age groups and associated with oral and ocular dryness, low UWS, SWS and LS. On average, women were slightly older, reported more oral and ocular dryness and had lower UWS, SWS, LS and higher numbers of diseases and medications. High prevalence and odds ratios for oral dryness were associated with metabolic, respiratory and neurological diseases and intake of thyroid hormones, respiratory agents (primarily glucocorticoids), psycholeptics and/or psychoanaleptics, antineoplastics, proton pump inhibitors, antidiabetics, loop diuretics, antispasmodics, quinine and bisphosphonates. Ocular dryness was especially associated with neurological diseases and intake of psycholeptics and/or psychoanaleptics. Intake of magnesium hydroxide, antithrombotics, cardiac agents, thiazides, beta-blockers, calcium channel blockers, ACE inhibitors/angiotensin II antagonists, statins, glucosamine, paracetamol/opioids, ophthalmologicals and certain combination therapies was related to oral and ocular dryness.
In older people, oral and ocular dryness are associated with low salivary flow rates, specific as well as high number of diseases and medications, but neither with age and gender per se nor with tobacco and alcohol consumption. New detailed information concerning associations between medications and oral and ocular dryness has been obtained using the ATC classification system.
PubMed ID
21070322 View in PubMed
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Oral health status and treatment needs of an insured elderly population.

https://arctichealth.org/en/permalink/ahliterature221160
Source
J Can Dent Assoc. 1993 May;59(5):465-6, 469-70, 473-5
Publication Type
Article
Date
May-1993
Author
W A MacInnis
A. Ismail
R M MacDonald
C A Friars
Author Affiliation
Faculty of dentistry, Dalhousie University, Halifax, Nova Scotia.
Source
J Can Dent Assoc. 1993 May;59(5):465-6, 469-70, 473-5
Date
May-1993
Language
English
Publication Type
Article
Keywords
Aged
Catholicism
DMF Index
Dental Care for Aged
Dental Caries - epidemiology
Dentures - statistics & numerical data
Female
Health Services Needs and Demand - statistics & numerical data
Homes for the Aged
Humans
Mouth, Edentulous - epidemiology
Nova Scotia - epidemiology
Oral Hygiene Index
Xerostomia - chemically induced - epidemiology
Abstract
The purpose of this study was to describe the oral health status and treatment needs of an elderly group of religious sisters whose dental care expenses had been covered for most of their adult life. While the residents displayed high levels of treated dental disease on examination, evidence of a need for further treatment was considered to be a reflection of their decreasing ability to manage their personal home care and the reduction in professional services available to them. The results of this study reinforce the notion that the continuous provision of preventive and educational strategies coupled with accessible treatment services are essential, especially in an aging population.
PubMed ID
8334550 View in PubMed
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Prevalence of perceived symptoms of dry mouth in an adult Swedish population--relation to age, sex and pharmacotherapy.

https://arctichealth.org/en/permalink/ahliterature72728
Source
Community Dent Oral Epidemiol. 1997 Jun;25(3):211-6
Publication Type
Article
Date
Jun-1997
Author
T. Nederfors
R. Isaksson
H. Mörnstad
C. Dahlöf
Author Affiliation
Department of Pharmacology and Clinical Pharmacology, Faculty of Odontology, Göteborg University.
Source
Community Dent Oral Epidemiol. 1997 Jun;25(3):211-6
Date
Jun-1997
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Attitude to Health
Chi-Square Distribution
Drug Therapy - adverse effects
Female
Humans
Logistic Models
Male
Middle Aged
Odds Ratio
Polypharmacy
Prevalence
Research Support, Non-U.S. Gov't
Sex Factors
Sweden - epidemiology
Xerostomia - chemically induced - epidemiology - psychology
Abstract
The aim of the study was to evaluate the prevalence of subjective perception of dry mouth in an adult population and to determine the prevalence of pharmacotherapy in this population. An additional aim was to assess a possible co-morbidity between symptoms of dry mouth and continuing pharmacotherapy. Four-thousand-two-hundred persons were selected at random from the national census register of the adult population of the southern part of the province of Halland, Sweden. The sample was stratified according to age and sex, and 300 men and an equal number of women aged 20, 30, 40, 50, 60, 70 and 80, were included. A newly developed questionnaire was mailed to each individual. In addition to questions about subjective perception of dry mouth, the subjects were asked to report on present diseases and continuing pharmacotherapy. Three-thousand-three-hundred and thirteen (80.5%) evaluable questionnaires were returned. The estimated prevalence of xerostomia in the population was 21.3% and 27.3% for men and women, respectively. This difference between the sexes was statistically significant. In non-medicated subjects, women tended to report a higher prevalence of xerostomia compared with men, 18.8% vs. 14.6%, and also among medicated subjects the estimated prevalence of dry mouth was higher for women than for men, 32.5% vs. 28.4%. There was a strong association between xerostomia and increasing age and also between xerostomia and continuing pharmacotherapy. The average prevalence of dry mouth among medicated and non-medicated subjects was 32.1% and 16.9%, respectively, the difference being statistically significant. There was also a strong association between xerostomia and the number of medications. In a logistic regression, the probability of reporting mouth dryness was significantly greater in older subjects and in women, and the probability increased with the number of medications taken. In conclusion, this epidemiological survey of an adult population has demonstrated that women, independent of age, do report a higher prevalence of xerostomia than men and that the symptom of dry mouth is strongly associated with age and pharmacotherapy. It is, however, not possible to discriminate between disease and pharmacotherapy as causal factors.
PubMed ID
9192149 View in PubMed
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Salivary conditions and drug consumption in older age groups of elderly Swedish individuals.

https://arctichealth.org/en/permalink/ahliterature233268
Source
Gerodontics. 1988 Apr;4(2):66-70
Publication Type
Article
Date
Apr-1988

Self-reported oral symptoms and signs in liver transplant recipients and a control population.

https://arctichealth.org/en/permalink/ahliterature118749
Source
Liver Transpl. 2013 Feb;19(2):155-63
Publication Type
Article
Date
Feb-2013
Author
Jaana Helenius-Hietala
Hellevi Ruokonen
Lisa Grönroos
Harri Rissanen
Liisa Suominen
Helena Isoniemi
Jukka H Meurman
Author Affiliation
Institute of Dentistry, University of Helsinki, Helsinki, Finland. jaana.s.helenius@helsinki.fi
Source
Liver Transpl. 2013 Feb;19(2):155-63
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Case-Control Studies
Chi-Square Distribution
Deglutition Disorders - chemically induced - epidemiology
Dysgeusia - chemically induced - epidemiology
End Stage Liver Disease - epidemiology - surgery
Female
Finland - epidemiology
Humans
Immunosuppressive Agents - administration & dosage - adverse effects
Liver Failure, Acute - epidemiology - surgery
Liver Transplantation - adverse effects - immunology
Logistic Models
Male
Middle Aged
Mouth Diseases - chemically induced - epidemiology - physiopathology
Odds Ratio
Oral Health
Prevalence
Risk assessment
Risk factors
Salivation
Self Report
Time Factors
Tooth Loss - chemically induced - epidemiology
Treatment Outcome
Xerostomia - chemically induced - epidemiology
Young Adult
Abstract
Recipients of liver transplantation (LT) receive lifelong immunosuppression, which causes side effects. We investigated self-reported oral symptoms and associated risk factors with the following hypothesis: symptoms and signs would differ between LT recipients of different etiology groups and also between LT recipients and a control population. Eighty-four LT recipients (64 with chronic liver disease and 20 with acute liver disease) were recruited for clinical oral and salivary examinations (median follow-up = 5.7 years). A structured questionnaire was used to record subjective oral symptoms. Matched controls (n = 252) came from the National Finnish Health 2000 survey. The prevalence of symptoms was compared between the groups, and the risk factors for oral symptoms were analyzed. Xerostomia was prevalent in 48.4% of the chronic LT recipients and in 42.1% of the acute LT recipients. This subjective feeling of dry mouth was only partly linked to objectively measured hyposalivation. The chronic transplant recipients had significantly lower unstimulated salivary flow rates than the acute transplant recipients (0.34 ± 0.31 versus 0.61 ± 0.49 mL/minute, P = 0.005). Among the chronic transplant recipients, hyposalivation with unstimulated salivary flow was associated with fewer teeth (17.7 ± 8.2 versus 21.9 ± 8.4, P = 0.047) and more dentures (33.3% versus 12.2%, P = not significant). The chronic patients reported significantly more dysphagia than their controls (23.4% versus 11.5%, P = 0.02). Increases in the number of medications increased the symptoms in all groups. In conclusion, dysphagia was significantly more prevalent among the chronic LT recipients versus the controls. The number of medications was a risk factor for dry mouth-related symptoms for both the LT recipients and the controls. The chronic transplant recipients presented with lower salivary flow rates than the acute transplant recipients. Hyposalivation correlated with generally worse oral health among the chronic transplant recipients. These differences between the chronic and acute LT recipients may have been due to differences in their medical conditions due to the different etiologies.
PubMed ID
23172817 View in PubMed
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Tolerability of 5 mg solifenacin once daily versus 5 mg oxybutynin immediate release 3 times daily: results of the VECTOR trial.

https://arctichealth.org/en/permalink/ahliterature144775
Source
J Urol. 2010 May;183(5):1892-8
Publication Type
Article
Date
May-2010
Author
Sender Herschorn
Lynn Stothers
Kevin Carlson
Blair Egerdie
Jerzy B Gajewski
Peter Pommerville
Jane Schulz
Sidney Radomski
Harold Drutz
Jack Barkin
Fran Paradiso-Hardy
Author Affiliation
Department of Surgery/Urology, University of Toronto, Toronto, Ontario, Canada. s.herschorn@utoronto.ca
Source
J Urol. 2010 May;183(5):1892-8
Date
May-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Canada - epidemiology
Chi-Square Distribution
Double-Blind Method
Drug Administration Schedule
Female
Humans
Incidence
Male
Mandelic Acids - administration & dosage - adverse effects
Middle Aged
Muscarinic Antagonists - administration & dosage - adverse effects
Questionnaires
Quinuclidines - administration & dosage
Severity of Illness Index
Tetrahydroisoquinolines - administration & dosage
Treatment Outcome
Urinary Bladder, Overactive - drug therapy
Xerostomia - chemically induced - epidemiology
Abstract
Although antimuscarinic treatment is indicated for overactive bladder, many patients discontinue it because of dry mouth. Of available antimuscarinics oxybutynin is associated with the highest dry mouth rate. We compared the safety and tolerability of 5 mg solifenacin vs 15 mg oxybutynin immediate release.
At 12 Canadian centers a total of 132 patients with overactive bladder symptoms (greater than 1 urgency episode per 24 hours, and 8 or greater micturitions per 24 hours) were randomized to 5 mg solifenacin once daily or 5 mg oxybutynin 3 times daily for 8 weeks. The primary end point was the incidence and severity of dry mouth reported after direct questioning. Efficacy end points (3-day diary documented changes in urgency, frequency, incontinence, nocturia and voided volume), and changes on the Patient Perception of Bladder Condition scale and the Overactive Bladder Questionnaire were evaluated secondarily.
Of patients on solifenacin vs oxybutynin immediate release 35% vs 83% reported dry mouth (p
Notes
Comment In: Nat Rev Urol. 2010 Jun;7(6):30320545037
PubMed ID
20303119 View in PubMed
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Xerostomia among older home care clients.

https://arctichealth.org/en/permalink/ahliterature279172
Source
Community Dent Oral Epidemiol. 2016 Jun;44(3):232-8
Publication Type
Article
Date
Jun-2016
Author
Sari Viljakainen
Irma Nykänen
Riitta Ahonen
Kaija Komulainen
Anna Liisa Suominen
Sirpa Hartikainen
Miia Tiihonen
Source
Community Dent Oral Epidemiol. 2016 Jun;44(3):232-8
Date
Jun-2016
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Cross-Sectional Studies
Depression - complications
Female
Finland - epidemiology
Health status
Home Care Services - statistics & numerical data
Humans
Male
Nutritional Status
Polypharmacy
Prescription Drugs - adverse effects
Xerostomia - chemically induced - epidemiology - etiology
Abstract
The purpose of this study was to examine drug use and other factors associated with xerostomia in home care clients aged 75 years or older.
The study sample included 270 home care clients aged =75 years living in Eastern and Central Finland. The home care clients underwent in-home interviews carried out by trained home care nurses, nutritionists, dental hygienists and pharmacists. The collected data contained information on sociodemographic factors, health and oral health status, drug use, depressive symptoms (GDS-15), cognitive functioning (MMSE), functional ability (Barthel Index, IADL) and nutrition (MNA). The primary outcome was xerostomia status (never, occasionally or continuously).
Among the home care clients, 56% (n = 150) suffered from xerostomia. Persons with continuous xerostomia used more drugs and had more depressive symptoms and a higher number of comorbidities than other home care clients. In multivariate analyses, excessive polypharmacy (OR = 1.83, 95% Cl 1.08-3.10) and depressive symptoms (OR = 1.12, 95% Cl 1.03-1.22) were associated with xerostomia.
Xerostomia is a common problem among old home care clients. Excessive polypharmacy, use of particular drug groups and depressive symptoms were associated with xerostomia. The findings support the importance of a multidisciplinary approach in the care of older home care clients.
PubMed ID
26739925 View in PubMed
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Xerostomia: prevalence and pharmacotherapy. With special reference to beta-adrenoceptor antagonists.

https://arctichealth.org/en/permalink/ahliterature11306
Source
Swed Dent J Suppl. 1996;116:1-70
Publication Type
Article
Date
1996
Author
T. Nederfors
Author Affiliation
Department of Pharmacology, Faculty of Odontology Göteborg University.
Source
Swed Dent J Suppl. 1996;116:1-70
Date
1996
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - adverse effects
Adult
Age Factors
Aged
Aged, 80 and over
Amylases - analysis - drug effects
Antihypertensive Agents - adverse effects
Atenolol - adverse effects
Comorbidity
Comparative Study
Drug Therapy - adverse effects
Female
Humans
Hypertension - drug therapy - physiopathology
Male
Metoprolol - adverse effects
Middle Aged
Placebos
Polypharmacy
Prevalence
Propranolol - adverse effects
Questionnaires
Research Support, Non-U.S. Gov't
Saliva - chemistry - drug effects - secretion
Salivary Proteins - analysis - drug effects
Secretory Rate - drug effects
Sex Factors
Sweden - epidemiology
Xerostomia - chemically induced - epidemiology
Abstract
The main objective of this thesis was to estimate the prevalence of subjectively perceived dry mouth, xerostomia, in a representative general adult population, and the possible co-morbidity between xerostomia and on-going pharmacotherapy. Further, to evaluate the effects of beta-adrenoceptor antagonists on saliva flow rate and composition. The prevalence of xerostomia was evaluated by means of a questionnaire mailed to a random sample of 4.200 adult subjects living in the southern part of the province of Halland, Sweden. Three hundred men and equally many women aged 20, 30, 40, 50, 60, 70 and 80 years were selected from the national census register. From 3311 (81%) evaluable questionnaires was concluded that, in the studied population, 21.3% of the men and 27.3% of the women reported xerostomia. The difference between the sexes was statistically significant, women reporting higher prevalence of dry mouth than men. It was also found that xerostomia was significantly age-related. Further, it was demonstrated that there was a strong co-morbidity between reported prevalence of dry mouth and on-going pharmacotherapy. Generally, no specific drug or drug-group proved to be especially xerogenic, rather, polypharmacy was strongly correlated to reported symptoms of dry mouth, and it was also a significant correlation between increasing xerostomia and the number of medications taken. The effects of beta-adrenoceptor antagonists on saliva flow rate and composition were evaluated both in healthy volunteers and in hypertensive patients. The effects of one week of treatment with the non-selective (propranolol) and the beta 1-selective (atenolol) adrenoceptor antagonists were compared with that of placebo in three different clinical trials, including 38, 11 and 19 healthy volunteers, respectively. Two of these studies were focused on the effects on whole saliva secretion rate and composition and the third study on the secretions from the parotid and the submandibular-sublingual glands. Salivary composition but not saliva flow rates were affected by the beta-adrenoceptor antagonists, and the most pronounced effects were observed for total protein composition and amylase activity, both being significantly decreased during treatment with any of the antagonists, however, more accentuated during treatment with atenolol. Twelve hypertensive patients who were well-controlled in their blood-pressure by means of monotherapy with metoprolol, a beta 1-selective adrenoceptor antagonist, were observed during four weeks of withdrawal and after re-exposure to this antihypertensive treatment. The observed effects on salivary composition were essentially the same as those found in healthy volunteers. In the hypertensive group, however, whole saliva flow rates increased significantly on drug withdrawal and decreased again on re-exposure to metoprolol.
PubMed ID
8813731 View in PubMed
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9 records – page 1 of 1.