Reducing Drug-induced Xerostomia with Sorbet
Source: Crogan NL. Ann Long Term Care 2015;23:17-21.
Xerostomia, or dry mouth, is common in senior citizens, partially because of disorders that are directly associated with xerostomia (e.g., Sjogren syndrome, HIV, hepatitis C, diabetes) and, additionally, because numerous pharmacologic treatments seniors receive produce “drying” effects: anticholinergics (e.g., antimuscarinic OAB drugs, tricyclic antidepressants), sympathomimetics (e.g., milnacipran, atomoxetine), or diuretics. Although for some geriatric patients, xerostomia is merely an irksome symptom, for others it leads to impaired nutrition as well. Pharmacologic treatments (e.g., cholinergic agonists), while having some degree of efficacy, have their own adverse effect profile. Is there a simpler, kinder way to address the problem?
As part of a quality improvement program, Crogan performed a study in cognitively intact nursing home residents (n = 22) who scored positively on a xerostomia index and were consuming medications known to induce xerostomia. They directly measured the food intake and wasted food that had been provided in the facility dining room from these subjects, comparing results from the 7 days prior to intervention to results 6 weeks after intervention.
The active intervention was provision of 2 ounces of sugar-free lemon-lime sorbet prior to lunch and dinner for 6 weeks. Measured outcomes included fluid intake during meals — with decreased fluid intake suggesting less dry mouth — calorie intake, and body weight.
Pre-meal sorbet was associated with a (mean) 22% increase in food intake, and 81% of participants either maintained or gained weight. Provision of pre-meal sorbet may improve nutrition among seniors treated with medications that produce xerostomia.
Xerostomia, or dry mouth, is common in senior citizens, partially because of disorders that are directly associated with xerostomia (e.g., Sjogren syndrome, HIV, hepatitis C, diabetes) and, additionally, because numerous pharmacologic treatments seniors receive produce “drying” effects: anticholinergics (e.g., antimuscarinic OAB drugs, tricyclic antidepressants), sympathomimetics (e.g., milnacipran, atomoxetine), or diuretics.
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