JOURNAL READING

Association Between Symptoms Of Xerostomia

And Dry Eye In Older People
Michael T.M. Wanga, W. Murray Thomsonb, Jennifer P. Craig
ABSTRACT
Purpose: To explore the association between xerostomia and dry eye
symptoms in the older adult population.
Secondary analysis of data from 627 participants (346 male, 291 female),
with a mean ± SD age of 75 ± 7 years, recruited through the population-based
Methods: South Australian Dental Longitudinal Study. Participants completed the
validated Summated Xerostomia Inventory–Dutch Version questionnaire (SXI-
D), and rated their overall frequency of dry eye symptoms at baseline.
Symptomatic dry eye was reported by 31% of participants, and xerostomia by 21%. A
positive correlation was observed between dry eye symptoms and SXI-D scores
(Spearman’s rho=+0.379, p < 0.001). Overall, participants with symptomatic dry eye had
Results: higher SXI-D scores than those without (10.6 ± 3.6 vs. 8.1 ± 2.8, p < 0.001), and were
more likely to report xerostomia, with an odds ratio (95% CI) of 2.25(1.52–3.35; p <
0.001).
Symptoms of xerostomia and dry eye were relatively common in the cohort of
Conclusions older adult participants. The potentially debilitating implications of – and
positive association between – the two types of sicca symptoms support the
: routine evaluation of xerostomia symptoms as part of the assessment of dry
eye patients,and vice versa
Introduction
Sicca symptoms, including
xerostomia and dry eye, are
commonly experienced in
the older adult population,
and arerecognisedto have
potentially debilitating
impacts on comfort, quality
of life, andfunctioning
Although a positive association
between xerostomia and
xerophthalmia severity has
previously been demonstrated in a
clinic-based study of patients with
dry eye disease, the association
between the two types of sicca
symptoms has not previously been
investigated in population-based
studies. The current secondary
analysis sought to explore the
association between xerostomia and
dry eye symptoms in a population-
based longitudinal study of
community-dwelling olderadults.
Methods
Participants

• This secondary analysis used data collected during the five-year

assessment phase of the prospective, population-based South
Australian Dental Longitudinal Study (SADLS), conducted in 1996

Measurements

• Xerostomia Inventory questionnaireat baseline; this subsequently

became the SummatedXerostomia Inventory–Dutch Version (SXI-D),

Statistics

• IBM SPSS version 22.0andGraphpadPrism version 6.02.

 Results
• Table 1. Demographic characteristics and symptomology scores of
participants. Data are presented as mean ± SD, or number of participants (%
of participants).
• Fig. 1. Summated Xerostomia Inventory–Dutch Version questionnaire (SXI-D)
scores of participants by dry eye frequency scores: 1, never; 2, hardly ever; 3,
occasionally; 4, fairly often; and 5, very often. Each bar represents the mean SXI-
D score. Error bars represent standard deviation
Fig. 2. Proportion of participants reporting xerostomia symptoms by dry eye
frequency scores: 1, never; 2, hardly ever; 3, occasionally; 4, fairly often; and 5,
very often. Each bar represents the percentage of participants reporting xerostomia
symptoms. Error bars represent the 95% confidence interval.
 Discussion
In the current study, symptomatic dry
eye was reported more commonly by
almost one-third (31%) of the study
participants, while just over one-fifth
(21%) reported xerostomia;
approximately one in ten reported
both.
Both types of sicca symptoms
arerecognisedto have profound impacts
on the quality of life and day-to-day
functioning of sufferers. Dry eye
symptoms have an adverse impact on
ocular comfort, and can be associated
with transient visual disturbance,
affecting everyday tasks such as reading,
driving, computer and television use.
Xerostomia can lead to speech and
swallowing difficulties, as well as a
number of complications, including
dental caries, greater susceptibility to oral
infections, sleep disturbances, dysgeusia
and poorappetite
• Should a positive response be ascertained on
systemic enquiry, referral to oral and dental
practitioners, eye care specialists, general practice,
or rheumatology services (as appropriate) may be
indicated in order to facilitate a multidisciplinary
approach to patient care . Further assessment and
potential diagnostic work-up for Sjögren syndrome
and other underlying autoimmune or rheumatologic
conditions might also be warranted, especially in the
presence of musculoskeletal discomfort and other
systemic symptoms
Conclusion
the findings of this study show that xerostomia and dry eye
symptoms are both relatively common in the older adult
population, and that they are associated and moderately
concurrent. The potentially profound impacts on quality of life and
functionality, as well as the positive association Between the sicca
symptoms, supports the routine enquiry into xerostomia symptoms
when assessing patients presenting with dry eye, and vice versa.
The SXI is a short and effective method of capturing such
information, and its routine use in dental andophthalmic practice is
warranted