Association between masticatory function and sarcopenia in elderly people: A systematic review and meta-analysis

Background: The purpose of this systematic review was to explore the association between masticatory function (subjective and objective assessment) and sarcopenia in elderly people. Methods: Multiple electronic databases including PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched for all years up to October 1, 2019. Articles that evaluated occlusal force or chewing ability or difficulties in eating scores to explore the association between sarcopenia in elderly patients and healthy elderly peoples were included. A modified version of the Newcastle Ottawa Scale was used to assess study quality. The pooled standardized effect size with its corresponding 95% confidence interval for each parameter was calculated. Results: Of the 45 articles identified, three retrospective observational comparison studies, which had a lower risk of bias, were included: objective (occlusal force or chewing gum) and subjective (difficulties in eating scores) assessment were reported. Meta-analysis revealed that maximum occlusal force (standardized mean difference (SMD) = 0.36, confidence interval (CI) = 0.19-0.53, p < 0.001) was significantly lower in subjects who were diagnosed with sarcopenia than in control groups. There were significant associations between sarcopenia and chewing ability using chewing gum (odds ratio (OR) = 2.34, CI = 1.09-5.02, p = 0.03) and difficulties in eating score (OR = 2.21, CI = 1.65-2.97, p < 0.001). Conclusions: We found some limited evidence for an association between sarcopenia and masticatory function. Our meta-analysis supports an association between sarcopenia and subjective and objective masticatory function. More evidence is needed to demonstrate the association between masticatory function and sarcopenia in elderly people.