• TanEdwin C KECKCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karoli, Duangjai Lexomboon, Gunilla Sandborgh-Englund, Ylva Haasum, and Kristina Johnell.
• Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
• J Am Geriatr Soc. 2018 Jan 1; 66 (1): 76-84.

ObjectivesTo assess and quantify the risk of drug-induced dry mouth as a side effect in older people.DesignSystematic review and metaanalysis.SettingA search of the literature was undertaken using Medline, Embase, Cochrane, Web of Science, and PubMed from 1990 to 2016.ParticipantsOlder people (aged ≥60) who participated in intervention or observational studies investigating drug use as an exposure and xerostomia or salivary gland hypofunction as adverse drug outcomes.MeasurementsTwo pairs of authors screened titles and abstracts of studies for relevance. Two authors independently extracted data, including study characteristics, definitions of exposure and outcome, and methodological quality. For the metaanalyses, random-effects models were used for pooling the data and I2 statistics for exploring heterogeneity.ResultsOf 1,544 potentially relevant studies, 52 were deemed eligible for inclusion in the final review and 26 in metaanalyses. The majority of studies were of moderate methodological quality. In the intervention studies, urological medications (odds ratio (OR) = 5.91, 95% confidence interval (CI) = 4.04-8.63; I2  = 62%), antidepressants (OR = 4.74, 95% CI = 2.69-8.32, I2  = 21%), and psycholeptics (OR = 2.59, 95% CI = 1.79-3.95, I2  = 0%) were significantly associated with dry mouth. In the observational studies, numbers of medications and several medication classes were significantly associated with xerostomia and salivary gland hypofunction.ConclusionMedication use was significantly associated with xerostomia and salivary gland hypofunction in older adults. The risk of dry mouth was greatest for drugs used for urinary incontinence. Future research should develop a risk score for medication-induced dry mouth to assist with prescribing and medication management.© 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

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