{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T06:00:10Z","timestamp":1785218410437,"version":"3.55.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Dent. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Polypharmacy, the concurrent use of five or more medications, affects the majority of community-dwelling older adults aged 65 and older in the United States. A clinically underrecognized consequence is medication-induced xerostomia and salivary hypofunction, which critically impair oral function, food selection, and nutritional status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This mini-review synthesizes mechanistic and clinical evidence linking polypharmacy-induced xerostomia to nutritional decline in older adults and proposes a clinical framework for integrated dental-medical screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative review of English-language peer-reviewed literature published between 2000 and 2025 was conducted using PubMed\/MEDLINE, CINAHL, and Cochrane databases. Studies examining xerogenic medication burden, salivary function, masticatory performance, dietary intake, and nutritional biomarkers in adults aged 60 and older were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Xerogenic medications, including diuretics, antihypertensives, antidepressants, antihistamines, and anticholinergics, are highly prevalent in older adults and exert dose-dependent suppression of salivary flow via anticholinergic, aquaporin-disrupting, and sympatholytic mechanisms. Salivary hypofunction impairs bolus formation, swallowing efficiency, and gustatory function, driving avoidance of fibrous and nutrient-dense foods. This dietary shift is associated with protein-energy malnutrition, sarcopenia, and micronutrient deficiencies. Socioeconomic and structural disparities amplify nutritional risk among low-income and minority older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The polypharmacy-xerostomia-nutrition triad represents a tractable but systematically under-addressed pathway to preventable malnutrition and functional decline. Interprofessional screening, patient-centered salivary management strategies, and expanded dental benefit coverage are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fdmed.2026.1900412","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:35:12Z","timestamp":1785216912000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The polypharmacy-xerostomia-nutrition triad: the clinical framework for older adults"],"prefix":"10.3389","volume":"7","author":[{"given":"Adam","family":"Lowenstein","sequence":"first","affiliation":[{"name":"Department of Basic and Clinical Translational Sciences, School of Dental Medicine, Tufts University","place":["Boston, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mabi L.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Translational Sciences, School of Dental Medicine, Tufts University","place":["Boston, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athena","family":"Papas","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Translational Sciences, School of Dental Medicine, Tufts University","place":["Boston, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"B1","volume-title":"World Population Ageing 2023","year":"2023"},{"key":"B2","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1001\/jamainternmed.2015.8581","article-title":"Changes in prescription and over-the-counter medication and dietary supplement use among older adults in the United States, 2005 vs 2011","volume":"176","author":"Qato","year":"2016","journal-title":"JAMA Intern Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/s12877-017-0621-2","article-title":"What is polypharmacy? 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