POLYPHARMACY, SALIVARY FUNCTION AND BIOCHEMISTRY, AND XEROSTOMIA IN OLDER ADULTS: AN INTEGRATIVE LITERATURE REVIEW
DOI:
https://doi.org/10.63330/aurumpub.068-050Keywords:
Aged, Hyposalivation, Polypharmacy, Saliva, XerostomiaAbstract
Population aging is associated with increasing multimorbidity and the simultaneous use of multiple medications, which increases older adults’ exposure to drugs with xerogenic and anticholinergic potential. This integrative review aimed to analyze the evidence on the association between polypharmacy, changes in salivary function and biochemistry, and xerostomia in the geriatric population. The guiding question was structured according to the PECO framework, considering older adults, exposure to polypharmacy or a higher medication burden, comparison with lower exposure when available, and outcomes related to xerostomia, hyposalivation, salivary flow, and salivary parameters. Studies published between 2021 and September 2026 were prioritized, along with earlier references considered methodologically relevant. The analyzed studies indicate an association between higher medication burden and xerostomia, with findings suggesting increased risk according to the number of medications in some populations. Anticholinergic burden showed a consistent association with hyposalivation and greater severity of dry mouth. However, the predominance of cross-sectional studies limits causal inferences. Evidence regarding salivary biochemical changes is more limited and does not consistently demonstrate independent effects of polypharmacy on salivary pH or other salivary properties. It is concluded that polypharmacy, particularly when involving anticholinergic or xerogenic drugs, is associated with xerostomia and reduced salivary function, although important gaps remain regarding biochemical changes, supporting the need for longitudinal studies and standardized salivary assessments.
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