Intervention Improves Dietary Quality among Older Adults with Dental Impairments: Results from a Pilot Study

Dental impairments in older adults are frequently accompanied by reduced dietary quality and nutritional status.  Even with dental repair, dietary quality usually remains low.  This study aims to: (1) evaluate the impact on dietary quality of an intervention among African American and White older adults with self-reported oral health problems and related eating constraints; and (2) identify characteristics of participants for whom the intervention produced positive change in dietary quality. Community-dwelling adults (n=38) experiencing oral health problems and eating constraints were enrolled in a 6-month individualized dietary intervention; evaluation used a pre-post design.  The intervention used tailoring and goal setting to promote dietary intake consistent with the Dietary Guidelines for Americans.  The primary outcome, dietary quality, was measured by the Health Eating Index 2010 (HEI) calculated from the NCI Diet History Questionnaire.  HEI includes a total score (range 0 to 100) and 12 subscales.  35 participants completed the intervention (median age=69).  Mean total HEI scores improved from 67.1 (±10.1) to 72.7 (±7.4) (p=0.0037).  Significant improvements were seen in 6 subscales: total fruit (p=0.0106), whole grains (p=0.0135), dairy (p=0.0332), total protein foods (0.0107), seafood/plant proteins (0.0104), and empty calories (0.0133).  25 participants had positive change scores for total HEI.  Positive HEI change was greater among those with low baseline HEI and poorer oral health status.  Change in HEI was unrelated to age, sex, or ethnicity. Significant dietary improvement is possible among older adults with oral health deficits.  Randomized trials are needed to confirm these findings and extend evaluation to clinical populations.