STATUS KESEHATAN MULUT DAN ASUPAN MAKAN SEBAGAI FAKTOR RISIKO UNDERWEIGHT PADA LANSIA DI KOTA YOGYAKARTA
Dian Isti Angraini, Prof. DR. drg. AL Supartinah, SU, SpKGA,
2012 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar belakang: Status kesehatan mulut dan asupan makan berkontribusi terhadap status gizi lansia. Kehilangan gigi menyebabkan gangguan pengunyahan sehingga menurunkan kualitas dan kuantitas asupan makanan, yang pada akhirnya menempatkan lansia berstatus gizi underweight. Tujuan: Mengetahui faktor-faktor risiko underweight pada lansia di kota Yogyakarta. Metode Penelitian: Penelitian ini merupakan penelitian observasional dengan rancangan case control. Penelitian ini dilakukan terhadap lansia di kota Yogyakarta yang memenuhi kriteria inklusi. Subyek penelitian berjumlah 210 orang dengan matching umur dan jenis kelamin. Pengambilan sampel dilakukan secara multistage random sampling. Status kesehatan mulut dinilai berdasarkan indeks status kesehatan gigi (indeks M-T/ jumlah kehilangan gigi) dan indeks status periodontal (indeks gingiva, indeks periodontal dan indeks kebersihan mulut), asupan makan dikumpulkan dengan semi quantitative food frequency questionnaire (SQ-FFQ) dan status gizi underweight ditentukan berdasarkan BMA (Body Mass Armspan). Data dianalisis dengan uji χ 2 Mc.Nemar, χ 2 Stuart Maxwell dan conditional logistic regression. Hasil: Sebagian besar subyek adalah perempuan (73,33%). Analisis bivariat menunjukkan jumlah kehilangan gigi ≥ 21 (OR=3,67; p<0,05) dan 16-20 (OR=3,53; p<0,05) merupakan faktor risiko underweight, sedangkan indeks gingiva, indeks periodontal dan indeks kebersihan mulut bukan faktor risiko underweight. Asupan energi, protein, lemak dan karbohidrat yang kurang merupakan faktor risiko underweight dengan OR=6,3 (p<0,01); OR= 7,83 (p<0,01); OR=5,67 (p<0,01); OR=7,5 (p<0,01). Pendapatan kurang dari Rp. 808.000,00 merupakan faktor risiko underweight dengan OR=4,5 (p<0,01), sedangkan pendidikan dan status domisili bukan faktor risiko. Analisis multivariat menunjukkan faktor risiko underweight yang bermakna adalah jumlah kehilangan gigi ≥ 21 (OR=8,76) dan 16-20 (OR=6,04) ditambah dengan pendapatan kurang dari Rp.808.000,00 (OR=5,94); serta asupan lemak kurang (OR=4,88) dan asupan karbohidrat kurang (OR=5,48). Pendapatan merupakan confounding factor risiko jumlah kehilangan gigi dan asupan protein terhadap underweight. Kesimpulan: Faktor risiko underweight pada lansia adalah jumlah kehilangan gigi ≥ 16; asupan energi, protein, lemak dan karbohidrat yang kurang; dan pendapatan kurang dari Rp.808.000,00. Faktor risiko underweight pada lansia yang bermakna adalah jumlah kehilangan gigi ≥ 16, asupan lemak kurang, asupan karbohidrat kurang dan pendapatan kurang dari Rp.808.000,00.
Background: Oral health status and dietary intake contribute to nutritional status in elderly. Missing teeth cause chewing disorder that reduces quality and quantity of food intake, which finally makes the elderly have underweight nutritional status. Aim: To determine the risk factors of underweight in the elderly at Yogyakarta Municipality. Methods: The study was observational with case control design on elderly at Yogyakarta Municipality that met inclusion criteria. Subjects consisted of 210 elderly matched in age and gender. Sampling was done by multistage random sampling. Oral health status assessed by dental health status (index of missing teeth) and periodontal status (gingival index, periodontal index and oral hygiene index), dietary intake was collected by semi-quantitative food frequency questionnaire (SQ-FFQ) and underweight nutritional status was based on Body Mass Armspan (BMA). Data were analyzed using χ2 Mc.Nemar test, χ2 Stuart Maxwell and conditional logistic regression. Results: Most subjects were female (73.33%). Bivariate analysis showed the number of missing teeth ≥ 21 (OR = 3.67, p <0.05) and 16-20 (OR = 3.53, p <0.05) as risk factors of underweight, whereas the gingival index, periodontal index and oral hygiene index were not. Less intake of energy, protein, fat and carbohydrates were risk factors of underweight with OR = 6.3 (p <0.01); OR = 7.83 (p <0.01); OR = 5.67 (p <0 , 01); OR = 7.5 (p <0.01). Income less than Rp.808.000,00 as risk factor of underweight with OR = 4.5 (p <0.01), whereas education and residential status were not. Multivariate analysis showed the significant risk factors for underweight were the missing teeth ≥ 21 (OR = 8.76) and 16-20 (OR = 6.04) which increased by income less than Rp.808.000,00 (OR = 5.94), less fat intake (OR = 4.88), and less carbohydrate intake (OR = 5.48). Income was confounding factor in the risk of missing teeth and protein intake for becoming underweight. Conclusion: Risk factors for underweight in the elderly were missing teeth ≥ 16; less intake of energy, protein, fat and carbohydrate, and income less than Rp.808.000,00. Significant risk factors of underweight in elderly were missing teeth ≥ 16, less intake of fat and carbohydrate, and income less than Rp.808.000,00.
Kata Kunci : Lansia, underweight, status kesehatan mulut, asupan makan.