{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:04:25Z","timestamp":1791644665401,"version":"4.3.4"},"reference-count":28,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007700","name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007700","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/04fm87419","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Xerostomia is common among institutionalized older adults, but the relative contributions of comorbidity burden and medication-class burden remain incompletely clarified. This study evaluated their associations with Xerostomia Inventory (XI) severity and explored related salivary dysfunction and clinical oral health findings. Materials and Methods: We conducted a cross-sectional study of 90 institutionalized older adults in Bucharest, Romania. Xerostomia Inventory (XI) scores, a binary dry-mouth question, chairside salivary assessments, comorbidity categories, medication classes, oral mucosal findings, and complete denture retention and stability were recorded. Primary analyses used hierarchical regression and bootstrap statistical decomposition; secondary and exploratory analyses evaluated salivary concordance, medication classes, denture-related findings, and oral mucosal conditions. Results: Medication-class count remained associated with XI severity after adjustment for comorbidity burden (partial r = 0.445, p &lt; 0.001), whereas the association between comorbidity burden and XI was no longer significant after adjustment for medication-class count (partial r = \u22120.063, p = 0.557). Inclusion of medication-class count increased the explained variance in XI scores (\u0394R2 = 0.253, p &lt; 0.001). Bootstrap decomposition yielded similar findings, with a significant indirect estimate and a non-significant direct estimate. Among complete denture wearers, XI severity was associated with maxillary denture instability (\u03c1 = \u22120.687, n = 44). Conclusions: In this cohort, medication-class burden showed the strongest association with xerostomia severity, whereas comorbidity burden was not independently associated after adjustment. Given the cross-sectional design, these findings should be interpreted as exploratory associations and support future prospective studies integrating medication review with geriatric-prosthodontic assessment.<\/jats:p>","DOI":"10.3390\/medicina62071377","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:47:32Z","timestamp":1784508452000},"page":"1377","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comorbidity Burden, Polypharmacy and Xerostomia Severity in Institutionalized Older Adults"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0009-7460","authenticated-orcid":false,"given":"M\u0103d\u0103lina Monica","family":"Bicheru","sequence":"first","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0109-7138","authenticated-orcid":false,"given":"Andreea","family":"Zamfirescu","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Gerontology, Faculty of Midwifery and Nursing, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Preoteasa","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian Iustin","family":"Georgevici","sequence":"additional","affiliation":[{"name":"Katholisches Klinikum, Ruhr-University Bochum, 44801 Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolae Vladimir","family":"Bicheru","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Teodora","family":"Preoteasa","sequence":"additional","affiliation":[{"name":"Department of Scientific Research Methods-Ergonomics, Faculty of Dentistry, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1046\/j.1532-5415.2002.50123.x","article-title":"Xerostomia and the geriatric patient","volume":"50","author":"Ship","year":"2002","journal-title":"J. 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