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PubMed2026

A Systematic Review and Meta-Analysis of the Global Prevalence of Dry Mouth in Older Adults.

OBJECTIVE: The objective of this study is to update prevalence estimates for xerostomia and salivary gland hypofunction (SGH) among older adults through a systematic review and meta-analysis. BACKGROUND: Dry mouth is common among older adults but is inconsistently assessed and reported. Xerostomia and SGH represent distinct conditions with different diagnostic approaches, leading to heterogeneity in prevalence estimates. MATERIALS AND METHODS: A systematic literature search of Medline (PubMed) and Web of Science was conducted from January 2018 to March 2025. This was supplemented by manual backward citation tracking of the foundational review to identify all eligible pre-2018 epidemiological studies. Only studies utilizing population-representative samples of adults aged 50 years and older with defined diagnostic criteria were included. Risk of bias was formally assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tool for Prevalence Studies. Pooled prevalence estimates were calculated using random-effects meta-analyses. (PROSPERO: CRD420251009592). RESULTS: A total of 37 studies-encompassing over 1.6 million participants-met the inclusion criteria. The pooled global prevalence of xerostomia among older adults was 21% (95% CI: 19%-23%). For SGH, the pooled prevalence measured via UWS was 12% (95% CI: 4%-24%), whereas SWS yielded a prevalence of 13% (95% CI: 3%-28%). High heterogeneity was observed across all analyses. Differences in diagnostic thresholds and saliva collection methods contributed to the observed variability. CONCLUSION: This updated meta-analysis confirms that xerostomia affects around one-fifth of older adults, while SGH is less common, depending on the diagnostic criteria used. Future research should focus on improving diagnostic consistency and sample representativeness to enable more consistent and robust estimates, and thereby better guide prevention and care in geriatric oral health.

Humans↗

PubMed2026

Symptom Networks and Core Symptoms in Patients with Solid Tumors Undergoing Chemotherapy: A Systematic Review.

OBJECTIVES: To summarize symptom network characteristics in patients with solid tumors undergoing chemotherapy and synthesize evidence on core symptoms, bridge symptoms, and temporal associations. METHODS: We systematically searched eight databases through October 2025 to identify studies that applied symptom network analysis to adults with solid tumors receiving chemotherapy. Eligible studies assessed symptoms using cross-sectional, longitudinal, or interventional designs. Two reviewers independently screened articles and extracted data on study characteristics, symptom assessment, and network outcomes. Methodological quality was assessed using the National Institutes of Health Study Quality Assessment Tool. RESULTS: Twenty-seven studies involving 13,452 participants were included, yielding 79 symptom networks. Fatigue was the most frequently identified core symptom (10/20, 50%), whereas sadness, lack of appetite, and nausea each occurred in 10% of studies, with variation across cancer types, treatment phases, and latent classes. Bridge symptoms included disturbed sleep, lack of appetite, and dry mouth (2/7, 28.6%). Studies evaluating temporal associations found that symptoms such as sadness, dyspnea, somnolence, and dry mouth predicted subsequent changes in appetite, distress, nausea, and other outcomes. Strength metrics showed acceptable stability (correlation stability coefficients: 0.28-0.83). CONCLUSIONS: Fatigue was frequently identified as a central symptom across studies, largely reflecting evidence from breast cancer studies. Core symptoms varied across cancer types, treatment phases, and latent classes, suggesting heterogeneity. IMPLICATIONS FOR NURSING PRACTICE: These findings highlight the importance of considering relationships among symptoms in clinical care. Focusing on key symptoms such as fatigue, while tailoring management strategies to cancer-specific symptom patterns, may support more effective symptom management.

Humans↗

PubMed2025

The Impact of Nutritional Status on Oral Health Outcomes and Management in Older Adults: A Systematic Review and Meta-Analysis.

OBJECTIVE: This systematic review and meta-analysis evaluated the relationship between nutritional status and the oral health of older adults (aged 75 years or older). The PECO focus question was, 'What is the occurrence, association and impact of nutritional state on the oral health outcomes and its management in older adults?' METHODS: A comprehensive literature search was performed across MEDLINE (PubMed), Embase and the Cochrane Library. Publications up to April 2025 were considered, yielding 3324 records for initial screening. Quality assessment of the included studies predominantly revealed a low to moderate risk of bias. RESULTS: Eighty-three studies were included for data analysis. Meta-analyses demonstrated that older adults at risk of malnutrition had fewer teeth (SMD = -0.29; 95% CI: -0.46, -0.11; p = 0.002). Those with < 20 teeth and who were not rehabilitated with dentures were more likely to be malnourished (OR = 4.00; 95% CI: 1.21, 13.18; p = 0.02). Malnutrition was associated with self-reported chewing problems (OR = 2.38; 95% CI: 1.74, 3.26; p < 0.0001), swallowing problems (OR = 3.18; 95% CI: 2.20, 4.61; p < 0.0001) or dry mouth (OR = 2.35; 95% CI: 1.91, 2.88; p < 0.0001). Conversely, those with oral pain showed lower odds of malnutrition risk (OR = 0.68; 95% CI: 0.52, 0.89; p = 0.005). CONCLUSIONS: Fewer teeth, existing chewing or swallowing problems, dry mouth and the absence of removable dentures where needed, were associated with malnutrition in care-dependent older adults. The current lack of longitudinal studies and proof of causality for malnutrition affecting oral health outcomes underscores the need for further research to better clarify the complex relationship between oral health and nutrition in older populations. TRIAL REGISTRATION: PROSPERO Registration: CRD420251003549.

Humans↗

PubMed2026

Association of Socioeconomic Factors With Oral Health in Older Adults: A Systematic Review and Meta-Analysis.

BACKGROUND: Oral diseases remain disproportionately prevalent among older adults. However, evidence on oral health inequalities among older adults remains dispersed across studies that have used different socioeconomic indicators and oral health measures and has not been synthesised. OBJECTIVE: To synthesise the evidence on the association between socioeconomic factors and oral health among older adults aged 75 years and older. METHODS: A systematic review and meta-analysis was conducted following PRISMA guidelines. The Medline, Embase, and CENTRAL databases were searched. Studies reporting socioeconomic factors (education, income, occupation, area-level deprivation, and multi-aspect socioeconomic position) and oral health (dentition status, dental caries, periodontal disease, dry mouth, oral function, oral health behaviours, and oral health-related quality of life (OHRQoL)) among older adults were included. Risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS: Sixty-eight studies were included. Meta-analyses showed that socioeconomic disadvantage in older adults was associated with: (1) poor dentition status: fewer natural teeth, higher prevalence of edentulism, and lacking a functional dentition; (2) more teeth with decay; (3) irregular dental attendance; and (4) poorer OHRQoL. Similar patterns were generally observed for periodontal disease, dry mouth, and oral function, although no meta-analysis could be performed due to limited evidence and heterogeneous oral health measures. CONCLUSION: Socioeconomic disadvantage was consistently associated with poor oral health in older adults. Associations were more pronounced for dentition status, reflecting the cumulative socioeconomic disadvantage over the life course. Socioeconomic factors should be considered to inform prevention, clinical decision-making and oral healthcare planning for the ageing population. TRIAL REGISTRATION: PROSPERO Registration CRD420251231319.

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