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Hu Q, Wang S, Zhang W, Qu J, Liu GH. Unraveling brain aging through the lens of oral microbiota. Neural Regen Res 2025; 20:1930-1943. [PMID: 38993126 DOI: 10.4103/nrr.nrr-d-23-01761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 05/31/2024] [Indexed: 07/13/2024] Open
Abstract
The oral cavity is a complex physiological community encompassing a wide range of microorganisms. Dysbiosis of oral microbiota can lead to various oral infectious diseases, such as periodontitis and tooth decay, and even affect systemic health, including brain aging and neurodegenerative diseases. Recent studies have highlighted how oral microbes might be involved in brain aging and neurodegeneration, indicating potential avenues for intervention strategies. In this review, we summarize clinical evidence demonstrating a link between oral microbes/oral infectious diseases and brain aging/neurodegenerative diseases, and dissect potential mechanisms by which oral microbes contribute to brain aging and neurodegeneration. We also highlight advances in therapeutic development grounded in the realm of oral microbes, with the goal of advancing brain health and promoting healthy aging.
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Affiliation(s)
- Qinchao Hu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Si Wang
- Advanced Innovation Center for Human Brain Protection and National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China
- Aging Translational Medicine Center, International Center for Aging and Cancer, Beijing Municipal Geriatric Medical Research Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Weiqi Zhang
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, China
- Aging Biomarker Consortium, Beijing, China
| | - Jing Qu
- University of Chinese Academy of Sciences, Beijing, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, China
- Aging Biomarker Consortium, Beijing, China
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, China
| | - Guang-Hui Liu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
- Advanced Innovation Center for Human Brain Protection and National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China
- Aging Translational Medicine Center, International Center for Aging and Cancer, Beijing Municipal Geriatric Medical Research Center, Xuanwu Hospital, Capital Medical University, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, China
- Aging Biomarker Consortium, Beijing, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, China
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Oh DJ, Han JW, Kim JS, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Kim KW. Masticatory Function, Sex, and Risk of Dementia Among Older Adults: A Population-Based Cohort Study. J Korean Med Sci 2024; 39:e246. [PMID: 39315441 PMCID: PMC11419966 DOI: 10.3346/jkms.2024.39.e246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 07/14/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND A decline in masticatory function may indicate brain dysfunction related to dementia, but the relationship between masticatory function and dementia risk remains unclear. This study aimed to investigate whether masticatory function is associated with the risk of cognitive decline and dementia. METHODS Data were obtained from the nationwide prospective cohort study of randomly sampled community-dwelling Koreans aged ≥ 60 years. The 5,064 non-demented participants, whose number of chewing cycles per bite was assessed by clinical interview, were followed for 8 years with biennial assessments of cognitive performance and clinical diagnoses of all-cause dementia and Alzheimer's disease (AD). Structural brain magnetic resonance imaging was collected from a subset of cohort participants and their spouses for imaging analyses. RESULTS Males who chewed ≥ 30 cycles/bite had faster decline in global cognition and memory function and were at higher risk for incident all-cause dementia (hazard ratio [HR], 2.91; 95% confidence interval [CI], 1.18-7.18) and AD (HR, 3.22; 95% CI, 1.14-9.11) compared to males with less than 10 cycles/bite. Additionally, increased chewing cycles in males were associated with reduced brain volume, particularly in regions involved in compensatory cognitive control of mastication. There was no significant association between chewing cycles and the risk of dementia or brain volume in females. CONCLUSION Older men who frequently chew their meals could be considered a notable population at risk for dementia who should be carefully assessed for their cognitive trajectories.
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Affiliation(s)
- Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Jun Sung Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jeong Lan Kim
- Department of Psychiatry, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Seok Woo Moon
- Department of Psychiatry, Konkuk University Chungju Hospital, School of Medicine, Konkuk University, Chungju, Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Dong Woo Lee
- Department of Psychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Korea.
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Lee KY, Chan CCK, Yip C, Li JTW, Hau CF, Poon SSY, Chen HM, Li KY, Burrow MF, Wong GHY, Kwong EYL, Chen H. Association between tooth loss-related speech and psychosocial impairment with cognitive function: A pilot study in Hong Kong's older population. J Oral Rehabil 2024; 51:1475-1485. [PMID: 38706150 DOI: 10.1111/joor.13718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/20/2024] [Accepted: 04/19/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Tooth loss has been associated with cognitive decline, but the underlying mechanisms involving speech and psychosocial impairment remain unclear. OBJECTIVES To investigate the impact of tooth loss-related speech and psychosocial impairment on cognitive function in Hong Kong's older population. METHODS Seventy-six Cantonese-speaking participants between the ages of 51-92 were classified into three groups: patients with complete dentures (CD), partially edentulous patients with less than 10 occluding tooth pairs (OU <10), and at least 10 occluding tooth pairs (OU ≥10). Cognitive function was assessed using the Montreal Cognitive Assessment Hong Kong Version, One-minute Verbal Fluency Task and Hayling Sentence Completion Test. Objective and subjective speech assessments were carried out using artificial intelligence speech recognition algorithm and a self-designed speech questionnaire. The impact of tooth loss on psychosocial condition was evaluated by the Reading the Mind in the Eyes Test and a self-designed questionnaire. Statistical analyses (one-way ANOVA, ANCOVA, Kruskal-Wallis test, Spearman correlation test) were performed. RESULTS Tooth loss was significantly associated with lower cognitive function (p = .008), speech accuracy (p = .018) and verbal fluency (p = .001). Correlations were found between cognitive function and speech accuracy (p < .0001). No significant difference in tooth loss-related psychosocial impact was found between the three groups. CONCLUSION While warranting larger sample sizes, this pilot study highlights the need for further research on the role of speech in the association between tooth loss and cognitive function. The potential cognitive impact of tooth retention, together with its known biological and proprioceptive benefits, supports the preservation of the natural dentition.
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Affiliation(s)
- Ka Yi Lee
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | | | - Ching Yip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Joyce Tin Wing Li
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Cheuk Fung Hau
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Sarah Suen Yue Poon
- Department of Chinese and Bilingual Studies, Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Hui Min Chen
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Kar Yan Li
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | | | - Gloria Hoi Yan Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, SAR, China
| | - Elaine Yee Lan Kwong
- Department of Chinese and Bilingual Studies, Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Hui Chen
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
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Choi YY, Lee KH. Association Between Subjective Masticatory Function and Mild Cognitive Impairment in Older Adults. Int Dent J 2024; 74:492-499. [PMID: 38584039 PMCID: PMC11123537 DOI: 10.1016/j.identj.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/09/2024] Open
Abstract
AIM This study aimed to examine the effect of subjective masticatory function on the occurrence of mild cognitive impairment (MCI) by analysing the Korean Longitudinal Study of Ageing (KLoSA) data. METHODS The study participants were 2954 KLoSA participants aged 60 years or older in the first wave (2006) who had normal cognitive function. The subjective masticatory function was determined using a survey item, and the responses were grouped into 3 categories, ie, good, moderate, and poor. The occurrence of MCI in the 3 groups was followed up until 2020. Cognitive function was assessed based on the Korean Mini-Mental State Examination score. Age, sex, education level, residence, health insurance type, smoking status, drinking status, and the number of chronic diseases were considered as potential confounders. To examine the occurrence of MCI according to subjective masticatory function, Cox proportional hazard regression analysis was performed. RESULTS Cox proportional hazard regression models adjusted for confounders yielded the following results: in men, the risk of MCI was higher in those whose subjective masticatory function was moderate and poor, as compared to those with good subjective masticatory function (adjusted hazard ratio [aHR], 1.33; 95% confidence interval [CI], 1.12-1.58; aHR, 1.23; 95% CI, 1.04-1.46). In contrast, in women, subjective masticatory function did not significantly influence the occurrence of MCI (aHR, 1.05; 95% CI, 0.89-1.24; aHR, 1.08; 95% CI, 0.92-1.28). CONCLUSIONS This study suggests that poor masticatory function may be a risk factor for MCI in older men.
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Affiliation(s)
- Yoon Young Choi
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu, Republic of Korea
| | - Kyeong Hee Lee
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu, Republic of Korea.
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Rubinstein T, Brickman AM, Cheng B, Burkett S, Park H, Annavajhala MK, Uhlemann A, Andrews H, Gutierrez J, Paster BJ, Noble JM, Papapanou PN. Periodontitis and brain magnetic resonance imaging markers of Alzheimer's disease and cognitive aging. Alzheimers Dement 2024; 20:2191-2208. [PMID: 38278517 PMCID: PMC10984451 DOI: 10.1002/alz.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/28/2024]
Abstract
INTRODUCTION We examined the association of clinical, microbiological, and host response features of periodontitis with MRI markers of atrophy/cerebrovascular disease in the Washington Heights Inwood Columbia Aging Project (WHICAP) Ancillary Study of Oral Health. METHODS We analyzed 468 participants with clinical periodontal data, microbial plaque and serum samples, and brain MRIs. We tested the association of periodontitis features with MRI features, after adjusting for multiple risk factors for Alzheimer's disease/Alzheimer's disease-related dementia (AD/ADRD). RESULTS In fully adjusted models, having more teeth was associated with lower odds for infarcts, lower white matter hyperintensity (WMH) volume, higher entorhinal cortex volume, and higher cortical thickness. Higher extent of periodontitis was associated with lower entorhinal cortex volume and lower cortical thickness. Differential associations emerged between colonization by specific bacteria/serum antibacterial IgG responses and MRI outcomes. DISCUSSION In an elderly cohort, clinical, microbiological, and serological features of periodontitis were associated with MRI findings related to ADRD risk. Further investigation of causal associations is warranted.
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Affiliation(s)
- Tom Rubinstein
- Division of PeriodonticsSection of OralDiagnostic and Rehabilitation SciencesCollege of Dental MedicineNew YorkNew YorkUSA
| | - Adam M. Brickman
- Department of NeurologyVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky CenterNew YorkNew YorkUSA
| | - Bin Cheng
- Department of BiostatisticsMailman School of Public HealthNew YorkNew YorkUSA
| | - Sandra Burkett
- Division of PeriodonticsSection of OralDiagnostic and Rehabilitation SciencesCollege of Dental MedicineNew YorkNew YorkUSA
| | - Heekuk Park
- Division of Infectious DiseasesDepartment of MedicineVagelos College of Physicians and, Surgeons, Irving Medical CenterColumbia UniversityNew YorkNew YorkUSA
| | - Medini K. Annavajhala
- Division of Infectious DiseasesDepartment of MedicineVagelos College of Physicians and, Surgeons, Irving Medical CenterColumbia UniversityNew YorkNew YorkUSA
| | - Anne‐Catrin Uhlemann
- Division of Infectious DiseasesDepartment of MedicineVagelos College of Physicians and, Surgeons, Irving Medical CenterColumbia UniversityNew YorkNew YorkUSA
| | - Howard Andrews
- Department of BiostatisticsMailman School of Public HealthNew YorkNew YorkUSA
| | - Jose Gutierrez
- Department of NeurologyVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Bruce J. Paster
- The Forsyth InstituteCambridgeMassachusettsUSA
- Department of Oral Medicine, Infection and ImmunityHarvard School of Dental MedicineBostonMassachusettsUSA
| | - James M. Noble
- Department of NeurologyVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky CenterNew YorkNew YorkUSA
| | - Panos N. Papapanou
- Division of PeriodonticsSection of OralDiagnostic and Rehabilitation SciencesCollege of Dental MedicineNew YorkNew YorkUSA
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Ochi S, Yamada K, Saito T, Saido TC, Iinuma M, Azuma K, Kubo KY. Effects of early tooth loss on chronic stress and progression of neuropathogenesis of Alzheimer's disease in adult Alzheimer's model AppNL-G-F mice. Front Aging Neurosci 2024; 16:1361847. [PMID: 38469162 PMCID: PMC10925668 DOI: 10.3389/fnagi.2024.1361847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/12/2024] [Indexed: 03/13/2024] Open
Abstract
Introduction Alzheimer's disease (AD), the most common neurodegenerative disease, is characterized by accumulated amyloid-β (Aβ) plaques, aggregated phosphorylated tau protein, gliosis-associated neuroinflammation, synaptic dysfunction, and cognitive impairment. Many cohort studies indicate that tooth loss is a risk factor for AD. The detailed mechanisms underlying the association between AD and tooth loss, however, are not yet fully understood. Methods We explored the involvement of early tooth loss in the neuropathogenesis of the adult AppNL-G-F mouse AD model. The maxillary molars were extracted bilaterally in 1-month-old male mice soon after tooth eruption. Results Plasma corticosterone levels were increased and spatial learning memory was impaired in these mice at 6 months of age. The cerebral cortex and hippocampus of AD mice with extracted teeth showed an increased accumulation of Aβ plaques and phosphorylated tau proteins, and increased secretion of the proinflammatory cytokines, including interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α), accompanied by an increased number of microglia and astrocytes, and decreased synaptophysin expression. AD mice with extracted teeth also had a shorter lifespan than the control mice. Discussion These findings revealed that long-term tooth loss is a chronic stressor, activating the recruitment of microglia and astrocytes; exacerbating neuroinflammation, Aβ deposition, phosphorylated tau accumulation, and synaptic dysfunction; and leading to spatial learning and memory impairments in AD model mice.
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Affiliation(s)
- Suzuko Ochi
- Department of Pediatric Dentistry, Asahi University School of Dentistry, Mizuho, Japan
| | - Kumiko Yamada
- Department of Health and Nutrition, Faculty of Health Science, Nagoya Women's University, Nagoya, Japan
| | - Takashi Saito
- Department of Neurocognitive Science, Institute of Brain Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takaomi C Saido
- Laboratory for Proteolytic Neuroscience, RIKEN Center for Brain Science, Wako, Japan
| | - Mitsuo Iinuma
- Department of Pediatric Dentistry, Asahi University School of Dentistry, Mizuho, Japan
| | - Kagaku Azuma
- Department of Anatomy, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kin-Ya Kubo
- Graduate School of Human Life Science, Nagoya Women's University, Nagoya, Japan
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Palomer T, Ramírez V, Ortuño D. Relationship between oral health and depression: data from the National Health Survey 2016-2017. BMC Oral Health 2024; 24:188. [PMID: 38317129 PMCID: PMC10845575 DOI: 10.1186/s12903-024-03950-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/29/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVE To evaluate the relationship between oral health status, self-perception of oral health, and depression. METHODS This cross-sectional study included 2953 individuals that were ≥ 18 years of age and participated in the Chilean National Health Survey (NHS), 2016-2017. Information on oral, dental, and mental health, and the presence or absence of depressive symptoms was collected. Secondary data analysis was carried out using STATA and included logistic regression models adjusted for sex, age, and educational level. The analyses factored in the expansion weights to estimate representative prevalences of the entire population. RESULTS Participants experiencing frequent dental or prosthesis-related discomfort while speaking (OR: 1.57; 95% CI: 1.01-2.43) were related with exhibiting suspected depression. Removable upper denture users were at a higher risk of exhibiting suspected (OR: 2.04; 95% CI: 1.11-3.74) than those not using them. Participants diagnosed with depression in the past 12 months had a similar number of teeth (median = 24) compared to those without depression (median = 25) (OR: 0.99; 95% CI: 0.96-1.02). CONCLUSION Experiencing dental or prosthesis-related difficulties in speaking is related to suspected depression or a diagnosis of depression. These findings highlight the importance of developing comprehensive healthcare approaches that consider mental health in the context of oral health.
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Affiliation(s)
| | | | - Duniel Ortuño
- Universidad de los Andes, Santiago, Chile
- Pontificia Universidad Católica de Chile, Santiago, Chile
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Wang M, Wang Z, Yu Y, Zhao D, Shen Z, Wei F. From teeth to brain: dental caries causally affects the cortical thickness of the banks of the superior temporal sulcus. BMC Oral Health 2024; 24:124. [PMID: 38263072 PMCID: PMC10807149 DOI: 10.1186/s12903-024-03899-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVES Dental caries is one of the most prevalent oral diseases and causes of tooth loss. Cross-sectional studies observed epidemiological associations between dental caries and brain degeneration disorders, while it is unknown whether dental caries causally affect the cerebral structures. This study tested whether genetically proxied DMFS (the sum of Decayed, Missing, and Filled tooth Surfaces) causally impacts the brain cortical structure using Mendelian randomization (MR). METHODS The summary-level GWAS meta-analysis data from the GLIDE consortium were used for DMFS, including 26,792 participants. ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) consortium GWAS summary data of 51,665 patients were used for brain structure. This study estimated the causal effects of DMFS on the surface area (SA) and thickness (TH) of the global cortex and functional cortical regions accessed by magnetic resonance imaging (MRI). Inverse-variance weighted (IVW) was used as the primary estimate, the MR pleiotropy residual sum and outlier (MR-PRESSO), the MR-Egger intercept test, and leave-one-out analyses were used to examine the potential horizontal pleiotropy. RESULTS Genetically proxied DMFS decreases the TH of the banks of the superior temporal sulcus (BANSSTS) with or without global weighted (weighted, β = - 0.0277 mm, 95% CI: - 0.0470 mm to - 0.0085 mm, P = 0.0047; unweighted, β = - 0.0311 mm, 95% CI: - 0.0609 mm to - 0.0012 mm, P = 0.0412). The causal associations were robust in various sensitivity analyses. CONCLUSIONS Dental caries causally decrease the cerebral cortical thickness of the BANKSSTS, a cerebral cortical region crucial for language-related functions, and is the most affected brain region in Alzheimer's disease. This investigation provides the first evidence that dental caries causally affects brain structure, proving the existence of teeth-brain axes. This study also suggested that clinicians should highlight the causal effects of dental caries on brain disorders during the diagnosis and treatments, the cortical thickness of BANKSSTS is a promising diagnostic measurement for dental caries-related brain degeneration.
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Affiliation(s)
- Mengqiao Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Ziyao Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Yajie Yu
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital/Institute of Mental Health, The Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, 100191, China
| | - Delu Zhao
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Zhiyuan Shen
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Fulan Wei
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China.
- Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China.
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Miyano T, Ayukawa Y, Anada T, Takahashi I, Furuhashi H, Tokunaga S, Hirata A, Nakashima N, Kato K, Fukuda H. Association Between Reduced Posterior Occlusal Contact and Alzheimer's Disease Onset in Older Japanese Adults: Results from the LIFE Study. J Alzheimers Dis 2024; 97:871-881. [PMID: 38160352 PMCID: PMC10894584 DOI: 10.3233/jad-230449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND An association between poor oral health and cognitive decline has been reported. Most of these studies have considered the number of teeth as a criterion, only a few studies have analyzed the relationship between occlusal status and Alzheimer's disease (AD). OBJECTIVE To elucidate whether posterior occlusal contact is associated with AD, focusing on the Eichner classification, among an older population aged 65 years or older in Japan. METHODS This study used monthly claims data of National Health Insurance in Japan from April 2017 to March 2020. The outcome was newly diagnosed AD defined according to ICD-10 code G30. The number of teeth was estimated by dental code data, and occlusal contact was divided into three categories, namely A, B, and C, according to the Eichner classification. Multivariate Cox proportional hazards models were used to analyze the association between a new diagnosis of AD and the Eichner classification. RESULTS A total of 22,687 participants were included, 560 of whom had newly diagnosed AD during a mean follow-up period of 12.2 months. The AD participants had a lower proportion of Eichner A and a higher proportion of Eichner C. After adjusting for covariates, hazard ratios (95% confidence intervals) with Eichner B and C were 1.34 (1.01-1.77) and 1.54 (1.03-2.30), respectively. CONCLUSION In older people aged≥65 years old, reduced posterior occlusal contact as well as tooth loss have an impact on AD. This study emphasizes the importance of paying attention to occlusal contacts to reduce the risk of AD.
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Affiliation(s)
- Takashi Miyano
- Department of Applied Chemistry, Graduate School of Systems Life Sciences, Kyushu University, Fukuoka, Japan
- Nissan Chemical Corporation, Tokyo, Japan
| | - Yasunori Ayukawa
- Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Takahisa Anada
- Department of Chemistry and Biochemistry, Graduate School of Engineering, Kyushu University, Fukuoka, Japan
- Institute for Materials Chemistry and Engineering, Kyushu University, Fukuoka, Japan
| | - Ichiro Takahashi
- Section of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Hiroko Furuhashi
- Department of Epidemiology and Public Health, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Akie Hirata
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Koichiro Kato
- Department of Applied Chemistry, Graduate School of Systems Life Sciences, Kyushu University, Fukuoka, Japan
- Center for Molecular Systems, Kyushu University, Fukuoka, Japan
| | - Haruhisa Fukuda
- Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Sta. Maria MT, Hasegawa Y, Khaing AMM, Salazar S, Ono T. The relationships between mastication and cognitive function: A systematic review and meta-analysis. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:375-388. [PMID: 38022390 PMCID: PMC10630119 DOI: 10.1016/j.jdsr.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 09/13/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023] Open
Abstract
Masticatory function such as chewing is expected to modify human cognitive function, and/or the possibility of improving cognitive function is also predicted. This systematic review investigated whether masticatory function affects cognitive function for older/young adults. Full articles written in English from January 2000 to April 2022 were collected using PubMed and Cochrane Library. Target outcomes were cognitive function test scores, cognitive processing speed (reaction time), and masticatory function. For each research question, two independent reviewers conducted the search and screening, data extraction, quality assessment, and risk of bias assessment. The reviewers resolved any disagreements by discussion. From 226 articles retrieved, 20 were included in this review. Older adults with lower scores on the cognitive function test had lower masticatory performance, lower chewing ability, chewing difficulty, and decreased number of teeth. An increased risk of cognitive impairment was found in older adults with masticatory dysfunction. For young adults, gum chewing significantly reduced the processing speed of cognitive tasks compared to no gum chewing. Although most of the evidence included had a low level of evidence and a high risk of bias because of the research designs, the results still suggest that mastication may be a factor in improving cognitive function.
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Affiliation(s)
- Ma. Therese Sta. Maria
- Division of Comprehensive Prosthodontics, Faculty of Dentistry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Prosthodontics, College of Dentistry, Manila Central University, Caloocan, Philippines
| | - Yoko Hasegawa
- Division of Comprehensive Prosthodontics, Faculty of Dentistry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Aye Mya Mya Khaing
- Division of Comprehensive Prosthodontics, Faculty of Dentistry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Simonne Salazar
- Department of Prosthodontics, Faculty of Dentistry, Centro Escolar University, Makati, Philippines
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
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11
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Li L, Zhang Q, Yang D, Yang S, Zhao Y, Jiang M, Wang X, Zhao L, Liu Q, Lu Z, Zhou X, Gan Y, Wu C. Tooth loss and the risk of cognitive decline and dementia: A meta-analysis of cohort studies. Front Neurol 2023; 14:1103052. [PMID: 37139053 PMCID: PMC10150074 DOI: 10.3389/fneur.2023.1103052] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/13/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Epidemiological studies have shown that tooth loss may be associated with an increased risk of cognitive decline and dementia. However, some results do not show a significant association. Therefore, we performed a meta-analysis to evaluate this association. Methods Relevant cohort studies were searched in PubMed, Embase, Web of Science (up to May 2022), and the reference lists of retrieved articles. The pooled relative risk (RR) and 95% confidence intervals were computed using a random-effects model (CI). Heterogeneity was evaluated using the I 2 statistic. Publication bias was evaluated using the Begg's and Egger's tests. Results Eighteen cohort studies met the inclusion criteria. Original studies with 356,297 participants with an average follow-up of 8.6 years (ranging from 2 to 20 years) were included in this study. The pooled RRs of tooth loss on dementia and cognitive decline were 1.15 (95% CI: 1.10-1.20; P < 0.01, I 2 = 67.4%) and 1.20 (95% CI: 1.14-1.26; P = 0.04, I 2 = 42.3%), respectively. The results of the subgroup analysis showed an increased association between tooth loss and Alzheimer's disease (AD) (RR = 1.12, 95% CI: 1.02-1.23) and vascular dementia (VaD) (RR = 1.25, 95% CI: 1.06-1.47). The results of the subgroup analysis also showed that pooled RRs varied by geographic location, sex, use of dentures, number of teeth or edentulous status, dental assessment, and follow-up duration. None of the Begg's and Egger's tests or funnel plots showed evidence of publication bias. Discussion Tooth loss is associated with a significantly increased risk of cognitive decline and dementia, suggesting that adequate natural teeth are important for cognitive function in older adults. The likely mechanisms mostly suggested include nutrition, inflammation, and neural feedback, especially deficiency of several nutrients like vitamin D.
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Affiliation(s)
- Liqing Li
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qi Zhang
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Di Yang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, Jiangxi, China
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Sule Yang
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Yulan Zhao
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Min Jiang
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Xiaofang Wang
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Ling Zhao
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Qi Liu
- Research Center of Health Policy and Innovation, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Zuxun Lu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaogang Zhou
- School of Economics and Management, East China Jiaotong University, Nanchang, Jiangxi, China
| | - Yong Gan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chunmei Wu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, Jiangxi, China
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
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12
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He F, Luo H, Yin L, Roosaar A, Axéll T, Zhao H, Ye W. Poor Oral Health as a Risk Factor for Dementia in a Swedish Population: A Cohort Study with 40 Years of Follow-Up. J Alzheimers Dis 2023; 92:171-181. [PMID: 36710668 DOI: 10.3233/jad-215177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Whether poor oral health is associated with dementia risk remains unclear. OBJECTIVE We conducted a cohort study of 14,439 participants who were followed up for up to 40 years in Uppsala County, central Sweden, aiming to explore the association between poor oral health, namely the number of tooth loss, dental plaque status, and oral mucosal lesions, and the risk of dementia. METHODS We used Cox proportional hazards regression model to derive cause-specific hazard ratios (HR) and corresponding 95% confidence intervals (CI), while adjusting for baseline potential confounders as well as a time-varying covariate, Charlson's Comorbidity Index score. RESULTS Dementia risk was substantially higher among those with a higher number of tooth loss; compared to the group with tooth loss 0-10, the HRs were 1.21 (95% CI: 1.02, 1.42), 1.17 (95% CI: 0.97, 1.40), and 1.30 (95% CI: 1.09, 1.54) respectively for groups with increasing number of tooth loss. There was some evidence of dose-risk association in this study, with a HR of 1.10 (1.04, 1.18) comparing adjacent groups (ptrend = 0.001). In a stratified analysis by attained age, tooth loss was more pronouncedly associated with the risk of dementia onset before age 80 (those with 21-32 versus 0-10 lost teeth, HR = 1.82, (95% CI: 1.32, 2.51); HR = 1.22 (95% CI: 1.10, 1.35) comparing adjacent groups, ptrend < 0.001). CONCLUSION In summary, there are some indications that poor oral health, as indicated by more tooth loss, is positively associated with an increased risk of dementia, especially for dementia onset before age 80.
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Affiliation(s)
- Fei He
- Department of Epidemiology and Health Statistics, Fujian Medical University, Fuzhou, China.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Huizi Luo
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Li Yin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ann Roosaar
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tony Axéll
- Maxillofacial Unit, Halland Hospital Halmstad, Halmstad, Sweden
| | - Hongwei Zhao
- Department of Epidemiology and Biostatistics, Texas A & M University, College Station, TX, USA
| | - Weimin Ye
- Department of Epidemiology and Health Statistics, Fujian Medical University, Fuzhou, China.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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13
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Noble JM, Papapanou PN. With Teeth, Broken, or Fixed: The Challenges of Linking Periodontitis, Neuroepidemiology, and Biomarkers of Disease. J Alzheimers Dis 2023; 93:991-994. [PMID: 37248907 DOI: 10.3233/jad-230346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Periodontitis is a chronic inflammatory, bacterially-driven disease of the tooth-supporting tissues that shares several risk factors and elements of host response with Alzheimer's disease and related dementias (ADRD). Epidemiological studies have identified relatively consistent associations between adverse oral health conditions and ADRD. In this issue of the journal, a large study from the UK Biobank further explores these relationships along with MRI cognitive biomarkers. Despite its strength due to the large sample size, challenges in the study of periodontitis and neuroepidemiology markers include potential sampling bias, appropriate assessment of exposures, and the possibility of reverse causality.
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Affiliation(s)
- James M Noble
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, GH Sergievsky Center, Columbia University, New York, NY, USA
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
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14
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Jockusch J, Hahnel S, Sobotta BBAJ, Nitschke I. The Effect of a Masticatory Muscle Training Program on Chewing Efficiency and Bite Force in People with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073778. [PMID: 35409460 PMCID: PMC8997984 DOI: 10.3390/ijerph19073778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 12/04/2022]
Abstract
Until now, no study has investigated the effects of masticatory muscle training on chewing function in people with dementia. This study aimed to investigate whether physiotherapeutic exercises for the masticatory muscles have an influence on chewing efficiency and bite force in people with dementia. In a clinical trial with stratified randomization subjects were assigned to three groups based on the Mini Mental State Examination (MMSE: group 1—28–30, group 2—25–27, group 3—18–24). Each group was divided into an experimental (ExpG, intervention) and control group (ConG, no intervention). As intervention a Masticatory Muscle Training (MaMuT) (part 1: three physiotherapeutic treatments and daily home exercises, part 2: daily home exercises only) was carried out. Chewing efficiency and bite force were recorded. The MaMuT influenced the masticatory performance regardless of the cognitive state. Bite force increased in ExpG 1 and 2. Without further training, however, the effect disappeared. Chewing efficiency increased in all ExpG. After completion of the training, the ExpG 2 and 3 showed a decrease to initial values. Subjects of ExpG 1 showed a training effect at the final examination, but a tendency toward the initial values was observed. ExpG 3 seemed to benefit most from the physiotherapeutic exercises in terms of improving chewing efficiency by the end of the intervention phase. ExpG 1 showed the greatest gain in bite force. The MaMuT program is a potential method of improving masticatory performance in people with cognitive impairment or dementia when used on a daily basis.
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Affiliation(s)
- Julia Jockusch
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Andreasstrasse 15/Box 2, 8050 Zurich, Switzerland
- Correspondence: or
| | - Sebastian Hahnel
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
| | - Bernhard B. A. J. Sobotta
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
| | - Ina Nitschke
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland
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15
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Ma K, Hasturk H, Carreras I, Dedeoglu A, Veeravalli J, Huang J, Kantarci A, Wei J. Dementia and the Risk of Periodontitis: A Population-Based Cohort Study. J Dent Res 2022; 101:270-277. [PMID: 34643147 PMCID: PMC8982009 DOI: 10.1177/00220345211037220] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Dementia and Alzheimer's disease (AD) are proposed to be comorbid with periodontitis (PD). It is unclear whether PD is associated with dementia and AD independent of confounding factors. We aimed at identifying the relationship between the longitudinal risk of developing PD in a cohort of patients with dementia and AD who did not show any signs of PD at baseline. In this retrospective cohort study, 8,640 patients with dementia without prior PD were recruited, and 8,640 individuals without dementia history were selected as propensity score-matched controls. A Cox proportional hazard model was developed to estimate the risk of developing PD over 10 y. Cumulative probability was derived to assess the time-dependent effect of dementia on PD. Of the 8,640 patients, a sensitivity test was conducted on 606 patients with AD-associated dementia and 606 non-AD propensity score-matched controls to identify the impact of AD-associated dementia on the risk for PD. Subgroup analyses on age stratification were included. Overall 2,670 patients with dementia developed PD. The relative risk of PD in these patients was significantly higher than in the nondementia group (1.825, 95% CI = 1.715 to 1.942). Cox proportional hazard models showed that patients with dementia were more likely to have PD than individuals without dementia (adjusted hazard ratio = 1.915, 95% CI = 1.766 to 2.077, P < 0.0001, log-rank test P < 0.0001). The risk of PD in patients with dementia was age dependent (P values for all ages <0.0001); younger patients with dementia were more likely to develop PD. The findings persisted for patients with AD: the relative risk (1.531, 95% CI = 1.209 to 1.939) and adjusted hazard ratio (1.667, 95% CI = 1.244 to 2.232; log-rank test P = 0.0004) of PD in patients with AD were significantly higher than the non-AD cohort. Our findings demonstrated that dementia and AD were associated with a higher risk of PD dependent of age and independent of systemic confounding factors.
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Affiliation(s)
- K.S. Ma
- Center for Global Health, Perelman
School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Graduate Institute of Biomedical
Electronics and Bioinformatics, College of Electrical Engineering and Computer
Science, National Taiwan University, Taipei,Department of Life Science, National
Taiwan University, Taipei,Department of Dentistry, Chung Shan
Medical University and Chung Shan Medical University Hospital, Taichung
| | | | - I. Carreras
- Department of Veterans Affairs, VA
Boston Healthcare System, Boston, MA, USA,Department of Neurology, School of
Medicine, Boston University, Boston, MA, USA,Department of Biochemistry, School of
Medicine, Boston University, Boston, MA, USA
| | - A. Dedeoglu
- Department of Veterans Affairs, VA
Boston Healthcare System, Boston, MA, USA,Department of Neurology, School of
Medicine, Boston University, Boston, MA, USA,Department of Radiology, Massachusetts
General Hospital and Harvard Medical School, Boston, MA, USA
| | - J.J. Veeravalli
- Department of Life Science, National
Taiwan University, Taipei
| | - J.Y. Huang
- Institute of Medicine, Chung Shan
Medical University, Taichung
| | - A. Kantarci
- Forsyth Institute, Cambridge, MA,
USA,School of Dental Medicine, Harvard
University, Boston, MA, USA,A. Kantarci, Forsyth Institute, 245 First
Street, Cambridge, MA 02142, USA.
| | - J.C. Wei
- Institute of Medicine, Chung Shan
Medical University, Taichung,Division of Allergy, Immunology and
Rheumatology, Department of Internal Medicine, Chung Shan Medical University
Hospital, Taichung, Taiwan,Graduate Institute of Integrated
Medicine, China Medical University, Taichung, Taiwan,J.C. Wei, Institute of Medicine, Chung Shan
Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung
City 40201, Taiwan.
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16
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Yang HL, Li FR, Chen PL, Cheng X, Mao C, Wu XB. Tooth Loss, Denture Use, and Cognitive Impairment in Chinese Older Adults: A Community Cohort Study. J Gerontol A Biol Sci Med Sci 2022; 77:180-187. [PMID: 33674815 DOI: 10.1093/gerona/glab056] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Evidence regarding the associations of tooth loss and denture use with incident cognitive impairment is inconclusive in older adults, and few prospective studies have examined the potential interaction between tooth loss and denture use in these specific populations. METHODS Data were assessed from 17 079 cognitively normal older adults aged ≥65 years, participating in the Chinese Longitudinal Healthy Longevity Survey. The outcome of interest was cognitive impairment (assessed by the Chinese version of Mini-Mental State Examination). The number of natural teeth and status of denture use were collected by a structural questionnaire. RESULTS A total of 6456 cases of cognitive impairment were recorded during 88 627 person-years of follow-up. We found that compared with participants with 20+ teeth, those with 10-19, 1-9, and 0 teeth had increased risks of incident cognitive impairment (p-trend < .001). Participants without dentures also had a higher risk of incident cognitive impairment, compared with those who wore dentures. Effect modification by denture use was observed (p-interaction = .010). Specifically, among those without dentures, the adjusted hazard ratio (95% confidence interval) for participants with 10-19, 1-9, and 0 teeth were 1.19 (1.08, 1.30), 1.28 (1.17, 1.39), and 1.28 (1.16, 1.41), respectively, as compared to those with 20+ teeth. In contrary, among denture users, detrimental effect was only observed among those with 0 teeth (hazard ratio 1.14, 95% confidence interval: 1.16, 1.41). CONCLUSIONS In Chinese older adults, maintaining 20+ teeth is important for cognitive health; denture use would attenuate the detrimental effects of tooth loss, especially for partial tooth loss, on cognitive impairment.
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Affiliation(s)
- Hai-Lian Yang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Fu-Rong Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Pei-Liang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xin Cheng
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
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17
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Butler L, Walker KA. The Role of Chronic Infection in Alzheimer's Disease: Instigators, Co-conspirators, or Bystanders? CURRENT CLINICAL MICROBIOLOGY REPORTS 2021; 8:199-212. [PMID: 35186664 PMCID: PMC8849576 DOI: 10.1007/s40588-021-00168-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW Herein, we provide a critical review of the clinical and translational research examining the relationship between viral and bacterial pathogens and Alzheimer's disease. In addition, we provide an overview of the biological pathways through which chronic infection may contribute to Alzheimer's disease. RECENT FINDINGS Dementia due to Alzheimer's disease is a leading cause of disability among older adults in developed countries, yet knowledge of the causative factors that promote Alzheimer's disease pathogenesis remains incomplete. Over the past several decades, numerous studies have demonstrated an association of chronic viral and bacterial infection with Alzheimer's disease. Implicated infectious agents include numerous herpesviruses (HSV-1, HHV-6, HHV-7) and various gastric, enteric, and oral bacterial species, as well as Chlamydia pneumonia and multiple spirochetes. SUMMARY Evidence supports the association between multiple pathogens and Alzheimer's disease risk. Whether these pathogens play a causal role in Alzheimer's pathophysiology remains an open question. We propose that the host immune response to active or latent infection in the periphery or in the brain triggers or accelerates the Alzheimer's disease processes, including the accumulation of amyloid-ß and pathogenic tau, and neuroinflammation. While recent research suggests that such theories are plausible, additional longitudinal studies linking microorganisms to Aß and phospho-tau development, neuroinflammation, and clinically defined Alzheimer's dementia are needed.
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Affiliation(s)
- Lauren Butler
- National Institutes of Health, National Institute on Aging, Laboratory of Behavioral Neuroscience, Baltimore, MD, United States
| | - Keenan A Walker
- National Institutes of Health, National Institute on Aging, Laboratory of Behavioral Neuroscience, Baltimore, MD, United States
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18
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Qi X, Zhu Z, Plassman BL, Wu B. Dose-Response Meta-Analysis on Tooth Loss With the Risk of Cognitive Impairment and Dementia. J Am Med Dir Assoc 2021; 22:2039-2045. [PMID: 34579934 PMCID: PMC8479246 DOI: 10.1016/j.jamda.2021.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/02/2021] [Accepted: 05/03/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To quantify the dose-response associations between tooth loss and risk of cognitive impairment and dementia. DESIGN Longitudinal studies that examined the association between tooth loss and cognitive function were systematically searched on 6 databases through March 1, 2020. The study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Risk estimates were pooled using random-effects models. The dose-response associations were assessed using generalized least squares spline models. SETTING AND PARTICIPANTS Adults from community, institution, outpatient or in-hospital were included in the meta-analysis. MEASURES Cognitive impairment and dementia were defined by neuropsychological tests, diagnostic criteria, or medical records. Tooth loss was self-reported or assessed by clinical examinations. RESULTS Fourteen studies were entered into the meta-analysis, including 34,074 participants and 4689 cases with diminished cognitive function. Participants with more tooth loss had a 1.48 times higher risk of developing cognitive impairment [95% confidence interval (CI) 1.18-1.87] and 1.28 times higher risk of being diagnosed with dementia (95% CI 1.09-1.49); however, the association was nonsignificant for participants using dentures (relative risk = 1.10, 95% CI 0.90-1.11). Eight studies were included in the dose-response analysis, and data supported the use of linear models. Each additional tooth loss was associated with a 0.014 increased relative risk of cognitive impairment and 0.011 elevated relative risks of dementia. Edentulous participants faced a 1.54 times higher risk of cognitive impairment and a 1.40 times higher risk of being diagnosed with dementia. CONCLUSIONS AND IMPLICATIONS Moderate-quality evidence suggested tooth loss was independently associated with cognitive impairment and dementia; risk of diminished cognitive function increased with incremental numbers of teeth lost. Furthermore, timely prosthodontic treatment with dentures may reduce the progression of cognitive decline related to tooth loss.
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Affiliation(s)
- Xiang Qi
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, China; Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China
| | | | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA; NYU Aging Incubator, New York University, New York, NY, USA.
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19
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Werber T, Bata Z, Vaszine ES, Berente DB, Kamondi A, Horvath AA. The Association of Periodontitis and Alzheimer's Disease: How to Hit Two Birds with One Stone. J Alzheimers Dis 2021; 84:1-21. [PMID: 34511500 DOI: 10.3233/jad-210491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Alzheimer's disease (AD) is the leading cause of cognitive impairment in the elderly. Recent evidence suggests that preventive interventional trials could significantly reduce the risk for development of dementia. Periodontitis is the most common dental disease characterized by chronic inflammation and loss of alveolar bone and perialveolar attachment of teeth. Growing number of studies propose a potential link between periodontitis and neurodegeneration. In the first part of the paper, we overview case-control studies analyzing the prevalence of periodontitis among AD patients and healthy controls. Second, we survey observational libraries and cross-sectional studies investigating the risk of cognitive decline in patients with periodontitis. Next, we describe the current view on the mechanism of periodontitis linked neural damage, highlighting bacterial invasion of neural tissue from dental plaques, and periodontitis induced systemic inflammation resulting in a neuroinflammatory process. Later, we summarize reports connecting the four most common periodontal pathogens to AD pathology. Finally, we provide a practical guide for further prevalence and interventional studies on the management of cognitively high-risk patients with and without periodontitis. In this section, we highlight strategies for risk control, patient information, dental evaluation, reporting protocol and dental procedures in the clinical management of patients with a risk for periodontitis and with diagnosed periodontitis. In conclusion, our review summarizes the current view on the association between AD and periodontitis and provides a research and intervention strategy for harmonized interventional trials and for further case-control or cross-sectional studies.
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Affiliation(s)
- Tom Werber
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zsofia Bata
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Eniko Szabo Vaszine
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Dalida Borbala Berente
- Faculty of Medicine, Semmelweis University, Budapest, Hungary.,Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary
| | - Anita Kamondi
- Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.,Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Andras Attila Horvath
- Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.,Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
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Tsuneishi M, Yamamoto T, Yamaguchi T, Kodama T, Sato T. Association between number of teeth and Alzheimer's disease using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. PLoS One 2021; 16:e0251056. [PMID: 33930067 PMCID: PMC8087029 DOI: 10.1371/journal.pone.0251056] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 04/20/2021] [Indexed: 02/06/2023] Open
Abstract
Associations of numbers of teeth present and of missing teeth with Alzheimer’s disease were cross-sectionally analyzed using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Dental care claims data of patients aged 60 years or older diagnosed with periodontitis (n = 4,009,345) or missing teeth (n = 662,182) were used to obtain information about the numbers of teeth present and of missing teeth, respectively, and they were combined with medical care claims data including the diagnosis of Alzheimer’s disease. Numbers of teeth present and of missing teeth excluding third molars were calculated using the dental formula in the claims for periodontitis and missing teeth, respectively, and categorized into three groups each. Percentages of subjects treated for Alzheimer’s disease with 20–28, 10–19, and 1–9 teeth present were 1.95%, 3.87%, and 6.86%, respectively, in patients diagnosed as having periodontitis, and those treated for Alzheimer’s disease with 1–13, 14–27, and 28 missing teeth were 2.67%, 5.51%, and 8.70%, respectively, in patients diagnosed as having missing teeth. Logistic regression models using treatment for Alzheimer’s disease as an outcome variable and adjusting for age and sex showed that odds ratios (95% confidence intervals) for patients with 10–19 and 1–9 teeth (reference: 20–28 teeth) were 1.11 (1.10–1.13) and 1.34 (1.32–1.37), respectively, (p<0.001), in patients diagnosed as having periodontitis, and odds ratios (95% confidence intervals) for patients with 14–27 missing teeth and 28 missing teeth (reference: 1–13 missing teeth) were 1.40 (1.36–1.44) and 1.81 (1.74–1.89), respectively, (p<0.001), in patients diagnosed as having missing teeth. In conclusion, the results of the present study using Japanese dental claims data showed that older people visiting dental offices with fewer teeth present and a greater number of missing teeth are more likely to have Alzheimer’s disease.
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Affiliation(s)
- Midori Tsuneishi
- Japan Dental Association Research Institute, Tokyo, Japan
- * E-mail:
| | - Tatsuo Yamamoto
- Department of Dental Sociology, Kanagawa Dental University, Yokosuka, Japan
| | - Takeyuki Yamaguchi
- Japan Dental Association Research Institute, Tokyo, Japan
- Japan Dental Association, Tokyo, Japan
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21
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Lin CW, Chen YT, Ho HH, Hsieh PS, Kuo YW, Lin JH, Liu CR, Huang YF, Chen CW, Hsu CH, Lin WY, Yang SF. Lozenges with probiotic strains enhance oral immune response and health. Oral Dis 2021; 28:1723-1732. [PMID: 33749084 DOI: 10.1111/odi.13854] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/22/2021] [Accepted: 03/15/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Probiotics participate in regulating oral microbiota and reducing the prevalence of oral diseases; however, clinical research on probiotics is insufficient. Therefore, in this study, we performed in vitro screening of potential oral protective probiotic strains and then evaluated the clinical efficacy of the selected strains on maintaining oral health. MATERIALS AND METHODS Fifty healthy individuals were recruited and randomly assigned into the placebo group and probiotics group, which included three strains of probiotics, Lactobacillus salivarius subs. salicinius AP-32, Lactobacillus paracasei ET-66, and Lactobacillus plantarum LPL28. Each group was blindly administered placebo or probiotics for four weeks. RESULTS Next-generation sequencing results showed that the oral microbiota of Lactobacillus salivarius in the oral cavity were significantly increased in subjects supplemented with mixed probiotic lozenges. The anti-bacterial activities of viable probiotics were observed within two weeks. Both IgA levels and Lactobacillus and Bifidobacterium abundances in the oral cavity were significantly increased in the experimental groups, along with a reduced formation of plaque. Most participants reported that their oral health conditions and intestinal symptoms had improved. CONCLUSIONS Overall, our clinical study suggests that oral probiotic lozenges may enhance oral immunity, modulate oral microbiota, and improve oral health.
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Affiliation(s)
- Chiao-Wen Lin
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Tzu Chen
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Hsieh-Hsun Ho
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Pei-Shan Hsieh
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Yi-Wei Kuo
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Jia-Hung Lin
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Cheng-Ruei Liu
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Yu-Fen Huang
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Ching-Wei Chen
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Chen-Hung Hsu
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Wen-Yang Lin
- Research and Development Department, Bioflag Biotech Co., Ltd, Tainan, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
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22
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Nakamura T, Zou K, Shibuya Y, Michikawa M. Oral dysfunctions and cognitive impairment/dementia. J Neurosci Res 2020; 99:518-528. [PMID: 33164225 DOI: 10.1002/jnr.24745] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 10/01/2020] [Accepted: 10/04/2020] [Indexed: 01/11/2023]
Abstract
With global increases in the aging population, the number of patients with dementia is greatly increasing, which has become a big social problem. Many studies have shown strong associations between oral disorders and systemic disorders, such as diabetes, arthritis, sepsis, aspiration pneumonia, arteriosclerosis, bacterial endocarditis, and other cardiovascular diseases. Similarly, numerous cross-sectional studies showed that patients with dementia usually have poor oral conditions and tooth loss. These have long been considered as a result of difficulty with oral care due to impaired cognitive function, memory, and physical ability in patients with dementia. Indeed, even in patients with mild cognitive impairment, oral care becomes insufficient owing to decreases in spontaneity of grooming and finger dexterity. However, recent studies have shown that tooth loss and occlusal dysfunction may affect brain function and trigger the onset of dementia found in neurodegenerative diseases including Alzheimer's disease. In this review, we highlight the relationships among aging, oral dysfunction, and the development of dementia. Increasing evidence suggests that oral dysfunction is not only a result of dementia in the elderly people, but could also be a causative factor for the onset of dementia.
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Affiliation(s)
- Tomohisa Nakamura
- Department of Biochemistry, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan.,Maxillofacial Surgery, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Kun Zou
- Department of Biochemistry, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Yasuyuki Shibuya
- Maxillofacial Surgery, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Makoto Michikawa
- Department of Biochemistry, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
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Abstract
Currently, a few of studies revealed that there is an association between mastication and cognitive impairment. There is no study of Korean adult representative samples in relation to mastication and cognitive decline. This study was to investigate the relationship between mastication and mild cognitive impairment in Korean adults.A population-based cross-sectional study was conducted in which a total of 7029 subjects (2987 men and 4042 women) over 45 years old were surveyed from the Korea Longitudinal Study on Aging (KLoSA), Round 5th survey. Logistic regression analysis was performed for the study data controlling for confounding factors such as age, gender, education, income, smoking, drinking, exercise, wearing denture, and the number of chronic diseases.Decreased chewing function is associated with mild cognitive impairment (odds ratio [OR] = 3.24, 95% confidence interval [CI] = 2.67-3.93) after controlling for confounding variables. In the participants who did not wear dentures, the reduction of chewing function was strongly correlated with mild cognitive impairment (OR = 3.97, 95% CI = 3.11-5.08).Mastication was associated with mild cognitive impairment. To prevent cognitive decline, health specialists should pay more attention to the decline of the mastication in people without dentures.
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Affiliation(s)
- Mi-Sun Kim
- Department of Dental Hygiene, Kyungdong University, Wonju, South Korea
| | - Bumjo Oh
- Department of Family Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Ji Won Yoo
- Department of Internal Medicine, School of Medicine, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University, Seoul, South Korea
- Dental Research Institute, Seoul National University, Seoul, South Korea
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24
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Important oral care needs of older French people: A cross-sectional study. Rev Epidemiol Sante Publique 2020; 68:83-90. [DOI: 10.1016/j.respe.2020.01.135] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 12/09/2019] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
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25
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Han JH, Lee HJ, Han JW, Suh SW, Lee JR, Byun S, Kim KS, Kim SY, Lee JT, Yoo E, Chang NH, Kim TH, Kim KW. Loss of Functional Dentition is Associated with Cognitive Impairment. J Alzheimers Dis 2020; 73:1313-1320. [PMID: 31929161 DOI: 10.3233/jad-190971] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although tooth loss is known to increase the risk of cognitive impairment and dementia, few studies have investigated the association between functional teeth including rehabilitated lost teeth and cognitive functionObjective:We investigated the associations of the numbers of functional teeth and functional occlusal units with cognitive impairment and cognitive function in late life. METHODS The current study was conducted as a part of the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD), a community-based elderly cohort study. We analyzed 411 participants who have agreed with the additional dental exam. Geriatric psychiatrists and neuropsychologists administered the Consortium to Establish a Registry for Alzheimer's disease Assessment Packet Clinical and Neuropsychological Assessment Battery to all participants, and dentists examined their dental status. RESULTS Higher number of functional teeth (OR = 0.955, 95% CI = 0.914-0.997, p = 0.037) and higher number of functional occlusal units (OR = 0.900, 95% CI = 0.813-0.996, p = 0.042) were associated with lower odds of cognitive impairment. When we analyzed these relationships separated by the location of teeth, only the numbers of functional teeth (OR = 0.566, 95% CI = 0.373-0.857, p = 0.007) and functional occlusal units (OR = 0.399, 95% CI = 0.213-0.748, p = 0.004) in the premolar area were associated with lower odds of cognitive impairment. CONCLUSION Loss of functional teeth and functional occlusal units (especially in the premolar region) were associated with increased cognitive impairment.
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Affiliation(s)
- Ji Hyun Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seung Wan Suh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | | | - Seonjeong Byun
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Keun Suh Kim
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Yeol Kim
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung-Tae Lee
- Department of Periodontics, Dankook University College of Dentistry Jukjeon Dental Hospital, Yongin, Korea
| | - Eunha Yoo
- Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Na-Hee Chang
- Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea.,National Institute of Dementia, Seongnam, Korea
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26
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Sureda A, Daglia M, Argüelles Castilla S, Sanadgol N, Fazel Nabavi S, Khan H, Belwal T, Jeandet P, Marchese A, Pistollato F, Forbes-Hernandez T, Battino M, Berindan-Neagoe I, D'Onofrio G, Nabavi SM. Oral microbiota and Alzheimer's disease: Do all roads lead to Rome? Pharmacol Res 2019; 151:104582. [PMID: 31794871 DOI: 10.1016/j.phrs.2019.104582] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/28/2019] [Accepted: 11/29/2019] [Indexed: 12/19/2022]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative pathology affecting milions of people worldwide associated with deposition of senile plaques. While the genetic and environmental risk factors associated with the onset and consolidation of late onset AD are heterogeneous and sporadic, growing evidence also suggests a potential link between some infectious diseases caused by oral microbiota and AD. Oral microbiota dysbiosis is purported to contribute either directly to amyloid protein production, or indirectly to neuroinflammation, occurring as a consequence of bacterial invasion. Over the last decade, the development of Human Oral Microbiome database (HOMD) has deepened our understanding of oral microbes and their different roles during the human lifetime. Oral pathogens mostly cause caries, periodontal disease, and edentulism in aged population, and, in particular, alterations of the oral microbiota causing chronic periodontal disease have been associated with the risk of AD. Here we describe how different alterations of the oral microbiota may be linked to AD, highlighting the importance of a good oral hygiene for the prevention of oral microbiota dysbiosis.
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Affiliation(s)
- Antoni Sureda
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, CIBEROBN (Physiopathology of Obesity and Nutrition), and IdisBa, Palma de Mallorca, Balearic Islands, Spain.
| | - Maria Daglia
- Department of Pharmacy, University of Naples Federico II, Naples, Italy; International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang, China
| | | | - Nima Sanadgol
- Department of Biology, Faculty of Sciences, University of Zabol, Zabol, Iran; Department of Physics and Chemistry, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto-SP, Brazil
| | - Seyed Fazel Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Tarun Belwal
- Zhejiang University, College of Biosystems Engineering and Food Science, Zhejiang Key Laboratory for Agri-Food Processing, Key Laboratory of Agro-Products Postharvest Handling of Ministry of Agriculture and Rural Affairs, Hangzhou, People's Republic of China
| | - Philippe Jeandet
- Induced Resistance and Plant Bioprotection, Faculty of Sciences, University of Reims Champagne-Ardenne, Reims Cedex 51687, France
| | | | - Francesca Pistollato
- Centre for Health & Nutrition, Universidad Europea del Atlantico, Santander, Spain
| | - Tamara Forbes-Hernandez
- Nutrition and Food Science Group, Department of Analytical and Food Chemistry, CITACA, CACTI, University of Vigo - Vigo Campus, Vigo, Spain
| | - Maurizio Battino
- Nutrition and Food Science Group, Department of Analytical and Food Chemistry, CITACA, CACTI, University of Vigo - Vigo Campus, Vigo, Spain; Dept of Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy; International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang 212013, China
| | - Ioana Berindan-Neagoe
- MEDFUTURE - Research Center for Advanced Medicine, "Iuliu-Hatieganu" University of Medicine and Pharmacy, 23 Marinescu Street, Cluj-Napoca, Romania; Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 23 Marinescu Street, 400337 Cluj-Napoca, Romania; Department of Functional Genomics and Experimental Pathology, The Oncology Institute "Prof. Dr. Ion Chiricuta", 34-36 Republicii Street, Cluj-Napoca, Romania
| | - Grazia D'Onofrio
- Unit of Geriatrics, Department of Medical Sciences, Fondazione Casa Sollievo della sofferenza, San Giovanni Rotondo, Italy
| | - Seyed Mohammad Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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27
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Kato H, Takahashi Y, Iseki C, Igari R, Sato H, Sato H, Koyama S, Tobita M, Kawanami T, Iino M, Ishizawa K, Kato T. Tooth Loss-associated Cognitive Impairment in the Elderly: A Community-based Study in Japan. Intern Med 2019; 58:1411-1416. [PMID: 30626824 PMCID: PMC6548929 DOI: 10.2169/internalmedicine.1896-18] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective Dementia is a major cause of disruption for a healthy life expectancy in Japan. It has been suggested that the number of teeth is a modifiable risk factor for cognitive impairment and dementia. We therefore examined the possible association between the cognitive function and the number of natural and artificial teeth in community-dwelling Japanese elderly individuals. Methods Among the participants in our prospective, community-based study, 210 elderly individuals (103 men and 107 women; 78.1±4.9 years; mean age±standard deviation) underwent both dental examinations and a Mini-Mental State Examination (MMSE), as well as various medical checkups, in 2016 and 2017. Results The number of natural teeth was significantly associated with an individual's MMSE score. The percentage of cognitively normal subjects (MMSE scores: 27-30) decreased significantly with a decrease in the number of natural teeth. Among the MMSE items, the calculation ability was significantly and independently associated with the number of natural teeth. Regression was calculated as the predicted score of MMSE =21+0.3× (years of schooling) +0.1× (number of natural teeth). Among individuals with 19 or fewer natural teeth, those who had a total of 20 teeth or more, including both natural and artificial teeth, had significantly higher MMSE scores than those who had 19 or fewer natural and artificial teeth combined. Conclusion The number of natural teeth was significantly associated with the cognitive function, especially the calculation ability, and the use of artificial teeth was associated with the preservation of the cognitive function in community-dwelling elderly individuals.
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Affiliation(s)
- Hajime Kato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Yamagata University Faculty of Medicine, Japan
- National Hospital Organization Yonezawa Hospital, Japan
| | - Yoshimi Takahashi
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Chifumi Iseki
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Ryosuke Igari
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Hidenori Sato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Hiroyasu Sato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Shingo Koyama
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | | | - Toru Kawanami
- National Hospital Organization Yamagata Hospital, Japan
| | - Mitsuyoshi Iino
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Yamagata University Faculty of Medicine, Japan
| | - Kenichi Ishizawa
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Takeo Kato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
- Yamagata City Office, Japan
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28
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Tooth loss causes spatial cognitive impairment in rats through decreased cerebral blood flow and increased glutamate. Arch Oral Biol 2019; 102:225-230. [PMID: 31079020 DOI: 10.1016/j.archoralbio.2019.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 05/02/2019] [Accepted: 05/05/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The loss of teeth not only causes damage to oral function but also is associated with cognitive impairment. Previous studies have reported that chewing can increase CBF, and CBF plays an important role in cognitive function. Whether the loss of teeth can lead to cognitive impairment by reducing CBF is unclear. This study aimed to investigate the changes in CBF, glutamate concentration, the expression of neuronal apoptosis-relatedBax/Bcl-2 and Caspase-3 mRNA and pyramidal cells in the hippocampus, as well as behavioral changes after tooth loss in rats. DESIGN Twelve weeks after the extraction of all maxillary molars in rats, their spatial learning and memory were tested by the Morris water maze, the CBF was detected by ASL-MRI and glutamate concentration was detected by HPLC; the expression of neuronal apoptosis-related Bax/Bcl-2 and Caspase-3 mRNA and the number of pyramidal cells in the CA1 region were also measured. RESULTS Rats with tooth loss exhibited spatial cognitive impairment in the Morris water maze, decreased CBF, increased glutamate levels andBax/Bcl-2 and Caspase-3 mRNA expression in the hippocampus; the number of pyramidal cells in the CA1 region were also reduced. CONCLUSIONS These findings suggest that the loss of teeth causes spatial cognitive impairment in rats and that the underlying mechanism might be associated with a decrease in CBF and an increase in the glutamate level in the hippocampus.
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29
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Yoo JJ, Yoon JH, Kang MJ, Kim M, Oh N. The effect of missing teeth on dementia in older people: a nationwide population-based cohort study in South Korea. BMC Oral Health 2019; 19:61. [PMID: 31023356 PMCID: PMC6485168 DOI: 10.1186/s12903-019-0750-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 03/31/2019] [Indexed: 01/25/2023] Open
Abstract
Background To determine the effect of missing teeth on the risk of dementia onset among individuals who received tooth extractions and those who did not, based on the number of missing teeth. Methods We selected individuals who had not been diagnosed or treated for dementia between 2002 to 2011 from the National Health Insurance Service-Elderly Cohort Database (NHIS-ECD). We divided participants into two cohorts, a tooth extraction and non-extraction cohort, based on tooth loss from 2002 to 2011. After propensity score matching, there were 104,903 individuals in each cohort, and we included a total of 209,806 individuals in this study. Each cohort was grouped by sex, age, residential area, health insurance eligibility, income level, history of dental caries, history of periodontal treatment, and number of extracted teeth. We analyzed the relationship between dementia onset and these variables using logistic regression analysis. Results Individuals with tooth loss had a higher risk for dementia than those without tooth loss (odds ratio [OR] = 1.18; 95% confidence interval [CI]: 1.146–1.215). Regarding the incidence of dementia, the OR increased as the number of missing teeth and age increased, and the OR was higher for women (OR = 1.33; 95% CI: 1.286–1.367) than for men, and this difference was statistically significant (P < 0.01). The incidence of dementia decreased with periodontal treatment (OR = 0.96; 95% CI: 0.932–0.992) and increased with dental caries (OR = 1.07; 95% CI: 1.035–1.101). Conclusions These results suggest that it is important to delay tooth loss and preserve the stable remaining teeth to help prevent dementia. Electronic supplementary material The online version of this article (10.1186/s12903-019-0750-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jin-Joo Yoo
- Department of Prosthodontics, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10444, Republic of Korea
| | - Joon-Ho Yoon
- Department of Prosthodontics, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10444, Republic of Korea
| | - Min-Jin Kang
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10444, Republic of Korea
| | - Manyong Kim
- Department of Prosthodontics, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10444, Republic of Korea
| | - Namsik Oh
- Department of Dentistry, College of Medicine, Inha University, 27, Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea.
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30
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Tiisanoja A, Syrjälä AM, Tertsonen M, Komulainen K, Pesonen P, Knuuttila M, Hartikainen S, Ylöstalo P. Oral diseases and inflammatory burden and Alzheimer's disease among subjects aged 75 years or older. SPECIAL CARE IN DENTISTRY 2019; 39:158-165. [DOI: 10.1111/scd.12357] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/13/2018] [Accepted: 11/23/2018] [Indexed: 01/16/2023]
Affiliation(s)
- Antti Tiisanoja
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
| | - Anna-Maija Syrjälä
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
- Dental Training Clinic; Social and Health Services; Oulu Finland
- Medical Research Center; Oulu University Hospital and University of Oulu; Oulu Finland
| | - Miia Tertsonen
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
| | - Kaija Komulainen
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
| | - Paula Pesonen
- Medical Research Center; Oulu University Hospital and University of Oulu; Oulu Finland
- Faculty of Medicine; University of Oulu; Oulu Finland
| | - Matti Knuuttila
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
- Medical Research Center; Oulu University Hospital and University of Oulu; Oulu Finland
| | - Sirpa Hartikainen
- School of Pharmacy; University of Eastern Finland; Kuopio Finland
- Research Center of Geriatric Care; University of Eastern Finland; Kuopio Finland
| | - Pekka Ylöstalo
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
- Medical Research Center; Oulu University Hospital and University of Oulu; Oulu Finland
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31
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Cardoso MG, Diniz‐Freitas M, Vázquez P, Cerqueiro S, Diz P, Limeres J. Relationship between functional masticatory units and cognitive impairment in elderly persons. J Oral Rehabil 2019; 46:417-423. [DOI: 10.1111/joor.12763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 11/30/2018] [Accepted: 01/02/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Mónica G. Cardoso
- Department of Dental Sciences, Institute of Research and Advanced Training in Health Sciences and TechnologiesCESPU Paredes Portugal
| | - Márcio Diniz‐Freitas
- Medical‐Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela (USC) Santiago de Compostela Spain
| | - Paula Vázquez
- Medical‐Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela (USC) Santiago de Compostela Spain
| | - Sandra Cerqueiro
- Assisted Living for the Elderly of Oleiros Government of Galicia (Residencia Asistida de Mayores de Oleiros, Xunta of Galicia) Oleiros Spain
| | - Pedro Diz
- Medical‐Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela (USC) Santiago de Compostela Spain
| | - Jacobo Limeres
- Medical‐Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela (USC) Santiago de Compostela Spain
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Kobayashi T, Nagai M, Da Silva JD, Galaburda AM, Rosenberg SH, Hatakeyama W, Kuwajima Y, Kondo H, Ishikawa-Nagai S. Retrograde transport of masseter muscle-derived neprilysin to hippocampus. Neurosci Lett 2019; 698:180-185. [PMID: 30639512 DOI: 10.1016/j.neulet.2019.01.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/02/2018] [Accepted: 01/10/2019] [Indexed: 11/27/2022]
Abstract
Although the effects of neprilysin (NEP), also called CD10, on the clearance of Alzheimer's disease (AD)-associated amyloid-β (Aβ) have been reported, NEP is not made in the brain, and the mechanism for the transport of NEP to the brain has not been investigated. Our hypothesis is that muscle packages NEP in exosomes in response to a neuromuscular signal and sends it to the brain via retrograde axonal transport. The masseter muscle (MM) and the trigeminal nerve (TGN) are good candidates for this mechanism by virtue of their proximity to the brain. The aim of this study was to trace the NEP protein from the MM, through the TGN, and to the hippocampus (HPC) in muscle contraction models in vitro and in vivo. NEP expression in mouse tissue lysates was analyzed by RT-PCR and Western blot. Four-week-old mice were perfused to remove blood NEP contamination. The MM expressed substantial levels of NEP protein and mRNA. On the other hand, a remarkably high level of NEP protein was measured in the TGN in the absence of mRNA. NEP protein, without the corresponding mRNA, was also detected in the HPC. These results suggested that the MM derived NEP was taken up by the TGN, which in turn permitted NEP access to the central nervous system and within it the HPC. When the MM was induced to contract by electric stimulation in freshly euthanized mice, NEP protein decreased in the MM in a stimulus time-dependent manner, while that in the TGN and the HPC increased sequentially. Furthermore, NIR-labeled exosomes tracked along the same route. Finally, carbachol induced secretion of exosomal NEP in C2C12-derived myotube cells. These results support our hypothesis that MM-derived NEP is transported along the TGN to reach the HPC following electrical or cholinergic stimulation.
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Affiliation(s)
- Takuya Kobayashi
- Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, United States
| | - Masazumi Nagai
- Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, United States.
| | - John D Da Silva
- Department of Restorative Dentistry and Biomaterials Sciences Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, United States
| | - Albert M Galaburda
- Department of Neurology Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, United States
| | - Sara H Rosenberg
- Department of Restorative Dentistry University of Illinois at Chicago, Chicago, IL, United States
| | - Wataru Hatakeyama
- Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, United States
| | - Yukinori Kuwajima
- Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, United States
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology School of Dentistry Iwate Medical University, 1-17 Uchimal, Morioka, Iwate, Japan
| | - Shigemi Ishikawa-Nagai
- Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, United States
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Chen J, Ren CJ, Wu L, Xia LY, Shao J, Leng WD, Zeng XT. Tooth Loss Is Associated With Increased Risk of Dementia and With a Dose-Response Relationship. Front Aging Neurosci 2018; 10:415. [PMID: 30618721 PMCID: PMC6305430 DOI: 10.3389/fnagi.2018.00415] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 12/03/2018] [Indexed: 12/20/2022] Open
Abstract
Objective: Both tooth loss and dementia are age-related and frequently-occurring diseases. Increasing attention has been given to explore the pathogenesis related to oral-brain function disorders. The present study was performed to evaluate the association between tooth loss and dementia through a dose-response meta-analysis. Methods: Relevant cohort studies were searched from online databases up until June 20, 2018, which examined the association between tooth loss and the risk of dementia. Literature selection according to inclusion and exclusion criteria, as well as data extraction from included studies were completed independently by two reviewers. Data syntheses in this meta-analysis were performed using Stata 12.0 software. Results: A total of 8 cohort studies were included, containing a total of 14,362 samples and 2,072 dementia patients. The result of the meta-analysis indicated that patients with tooth loss faced a 1.34 times greater risk of developing dementia (RR = 1.34,95% CI = 1.19-1.51). The result from this dose-response meta-analysis in a linear model, suggested that every missed tooth might increase the risk of dementia by 1.01 times (RR = 1.01, 95%CI = 1.00-1.02). Further subgroup analyses pointed out that tooth loss patients without dentures may have a higher risk of dementia than those with dentures (with denture: RR = 0.98, 95% CI = 0.87-1.10; without denture: RR = 1.53, 95% CI = 1.19-1.97); at the same time, the study design, study area and education level of the study participants, might also have some effect on the results. Conclusions: Tooth loss may be a risk factor for the development of dementia. In addition, there is a dose-response relationship with the increase of missing teeth.
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Affiliation(s)
- Jun Chen
- Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Chang-Ju Ren
- Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Lan Wu
- Department of Evidence-Based Medicine and Clinical Epidemiology, Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Second Clinical College of Wuhan University, Wuhan, China
| | - Ling-Yun Xia
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Jun Shao
- Department of Stomatology, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China
| | - Wei-Dong Leng
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Xian-Tao Zeng
- Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, China.,Department of Evidence-Based Medicine and Clinical Epidemiology, Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Second Clinical College of Wuhan University, Wuhan, China.,Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China.,Department of Stomatology, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China
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Vandenberghe-Descamps M, Labouré H, Septier C, Feron G, Sulmont-Rossé C. Oral comfort: A new concept to understand elderly people’s expectations in terms of food sensory characteristics. Food Qual Prefer 2018. [DOI: 10.1016/j.foodqual.2017.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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35
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Fang WL, Jiang MJ, Gu BB, Wei YM, Fan SN, Liao W, Zheng YQ, Liao SW, Xiong Y, Li Y, Xiao SH, Liu J. Tooth loss as a risk factor for dementia: systematic review and meta-analysis of 21 observational studies. BMC Psychiatry 2018; 18:345. [PMID: 30342524 PMCID: PMC6195976 DOI: 10.1186/s12888-018-1927-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tooth loss is suggested to be associated with an increased risk of dementia in many studies. But the relationship between tooth loss and dementia is not yet fully understood. This systematic review and meta-analysis aimed to determine the relative effect of tooth loss on dementia risk. METHODS An electronic search of PubMed, Scopus, Embase, and Web of Knowledge was conducted in March 2018 to identify relevant observational studies with the English language restriction. Studies were included if they assessed the relationship between tooth loss and risk of dementia. Study quality was detected by the modified Downs and Black scale. Odds risks (ORs) were pooled using a random-effects model in the crude model. RESULTS The literature search initially yielded 1574 articles, and 21 observational studies published between 1994 and 2017 were finally included for the analyses. The crude results with random-effects model showed that patients with multiple tooth loss had higher incidence of dementia (OR 2.62, 95% CI 1.90-3.61, P < 0.001, I2 = 90.40%). The association remained noted when only adjusted results were pooled from 18 studies (OR 1.55, 95% CI 1.41-1.70, P = 0.13, I2 = 28.00%). Meta-regression analysis showed that study design explained about 16.52% of heterogeneity in the crude model. The overall quality rating scores of studies ranged from 11 to 16. CONCLUSIONS Findings from this review evidenced that tooth loss is positively associated with an increased risk of dementia in adults. Future well-designed longitudinal researches examining the direct and indirect relationship between tooth loss and dementia risk are encouraged.
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Affiliation(s)
- Wen-li Fang
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Mu-jun Jiang
- grid.252957.eFaculty of Pharmacy, Bengbu Medical College, Bengbu, Anhui China
| | - Bei-bei Gu
- 0000 0004 1791 7851grid.412536.7Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Ying-mei Wei
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Sheng-nuo Fan
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Wang Liao
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Yu-qiu Zheng
- 0000 0001 2360 039Xgrid.12981.33Department of Neurology, The Seventh Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong China
| | - Shao-wei Liao
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Ying Xiong
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Yi Li
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Song-hua Xiao
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Jun Liu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, Guangdong, China. .,Laboratory of RNA and Major Diseases of Brain and Heart, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China. .,Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Saito S, Ohi T, Murakami T, Komiyama T, Miyoshi Y, Endo K, Satoh M, Asayama K, Inoue R, Kikuya M, Metoki H, Imai Y, Ohkubo T, Hattori Y. Association between tooth loss and cognitive impairment in community-dwelling older Japanese adults: a 4-year prospective cohort study from the Ohasama study. BMC Oral Health 2018; 18:142. [PMID: 30126407 PMCID: PMC6102919 DOI: 10.1186/s12903-018-0602-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 08/03/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Numerous prospective studies have investigated the association between the number of remaining teeth and dementia or cognitive decline. However, no agreement has emerged on the association between tooth loss and cognitive impairment, possibly due to past studies differing in target groups and methodologies. We aimed to investigate the association between tooth loss, as evaluated through clinical oral examinations, and the development of cognitive impairment in community-dwelling older adults while considering baseline cognitive function. METHODS This 4-year prospective cohort study followed 140 older adults (69.3% female) without cognitive impairment aged ≥65 years (mean age: 70.9 ± 4.3 years) living in the town of Ohasama, Iwate Prefecture, Japan. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) in baseline and follow-up surveys. Based on a baseline oral examination, the participants were divided into those with 0-9 teeth and those with ≥10 teeth. To investigate the association between tooth loss and cognitive impairment, we applied a multiple logistic regression analysis adjusted for age, sex, hypertension, diabetes, cerebrovascular/cardiovascular disease, hypercholesterolemia, depressive symptoms, body mass index, smoking status, drinking status, duration of education, and baseline MMSE score. RESULTS In the 4 years after the baseline survey, 27 participants (19.3%) developed cognitive impairment (i.e., MMSE scores of ≤24). Multiple logistic regression analysis indicated that participants with 0-9 teeth were more likely to develop cognitive impairment than those with ≥10 teeth were (odds ratio: 3.31; 95% confidence interval: 1.07-10.2). Age, male gender, and baseline MMSE scores were also significantly associated with cognitive impairment. CONCLUSIONS Tooth loss was independently associated with the development of cognitive impairment within 4 years among community-dwelling older adults. This finding corroborates the hypothesis that tooth loss may be a predictor or risk factor for cognitive decline.
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Affiliation(s)
- Sho Saito
- Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Takashi Ohi
- Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
- Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Takahisa Murakami
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takamasa Komiyama
- Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Yoshitada Miyoshi
- Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Kosei Endo
- Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | - Ryusuke Inoue
- Department of Medical Informatics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masahiro Kikuya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yutaka Imai
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
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Maldonado A, Laugisch O, Bürgin W, Sculean A, Eick S. Clinical periodontal variables in patients with and without dementia—a systematic review and meta-analysis. Clin Oral Investig 2018; 22:2463-2474. [DOI: 10.1007/s00784-018-2523-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 06/11/2018] [Indexed: 12/13/2022]
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Jou YT. Dental deafferentation and brain damage: A review and a hypothesis. Kaohsiung J Med Sci 2018; 34:231-237. [PMID: 29655412 DOI: 10.1016/j.kjms.2018.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/07/2017] [Accepted: 01/12/2018] [Indexed: 01/04/2023] Open
Abstract
In the last few decades, neurobiological and human brain imaging research have greatly advanced our understanding of brain mechanisms that support perception and memory, as well as their function in daily activities. Knowledge of the neurobiological mechanisms behind the deafferentation of stomatognathic systems has also expanded greatly in recent decades. In particular, current studies reveal that the peripheral deafferentations of stomatognathic systems may be projected globally into the central nervous system (CNS) and become an associated critical factor in triggering and aggravating neurodegenerative diseases. This review explores basic neurobiological mechanisms associated with the deafferentation of stomatognathic systems. Further included is a discussion on tooth loss and other dental deafferentation (DD) mechanisms, with a focus on dental and masticatory apparatuses associated with brain functions and which may underlie the changes observed in the aging brain. A new hypothesis is presented where DD and changes in the functionality of teeth and the masticatory apparatus may cause brain damage as a result of altered cerebral circulation and dysfunctional homeostasis. Furthermore, multiple recurrent reorganizations of the brain may be a triggering or contributing risk factor in the onset and progression of neurodegenerative conditions such as Alzheimer's disease (AD). A growing understanding of the association between DD and brain aging may lead to solutions in treating and preventing cognitive decline and neurodegenerative diseases.
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Affiliation(s)
- Yi-Tai Jou
- Department of Endodontics School of Dental Medicine University of Pennsylvania Philadelphia, Pennsylvania, USA.
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39
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Tooth loss is associated with accelerated cognitive decline and volumetric brain differences: a population-based study. Neurobiol Aging 2018; 67:23-30. [PMID: 29609079 DOI: 10.1016/j.neurobiolaging.2018.03.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 01/07/2023]
Abstract
Tooth loss has been related to cognitive impairment; however, its relation to structural brain differences in humans is unknown. Dementia-free participants (n = 2715) of age ≥60 years were followed up for up to 9 years. A subsample (n = 394) underwent magnetic resonance imaging at baseline. Information on tooth loss was collected at baseline, and cognitive function was assessed using the Mini-Mental State Examination at baseline and at follow-ups. Data were analyzed using linear mixed effects models and linear regression models. At baseline, 404 (14.9%) participants had partial tooth loss, and 206 (7.6%) had complete tooth loss. Tooth loss was significantly associated with a steeper cognitive decline (β: -0.18, 95% confidence interval [CI]: -0.24 to -0.11) and remained significant after adjusting for or stratifying by potential confounders. In cross-sectional analyses, persons with complete or partial tooth loss had significantly lower total brain volume (β: -28.89, 95% CI: -49.33 to -8.45) and gray matter volume (β: -22.60, 95% CI: -38.26 to -6.94). Thus, tooth loss may be a risk factor for accelerated cognitive aging.
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40
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Gusman DJR, Mello-Neto JM, Alves BES, Matheus HR, Ervolino E, Theodoro LH, de Almeida JM. Periodontal disease severity in subjects with dementia: A systematic review and meta-analysis. Arch Gerontol Geriatr 2018. [PMID: 29518672 DOI: 10.1016/j.archger.2018.02.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Despite clinical trials and reviews attempt to assess a possible relationship between dementia and periodontal disease, no meta-analysis has been performed and this issue remains undetermined. The aim of this study is to conduct a systematic review and meta-analysis to assess severity of periodontitis in subjects with dementia. METHODS The search was conducted in Pubmed, Embase/MEDLINE. Two independent reviewers extracted data and assessed the risk bias (Newcastle-Ottawa scale). Meta-analyses were performed using the means of probing depth (PD) and clinical attachment loss (CAL) in patients with or without dementia. The mean difference were analyzed (P ≤ 0.05). RESULTS Fourteen studies were included in the systematic review. In the qualitative analysis, most studies reported higher prevalence of periodontal disease in dementia patients. The studies had low risk of bias and two meta-analyses were performed for each parameter, including or not a cross-sectional study. The meta-analyses including the cross-sectional study demonstrated significant association between dementia and periodontal disease (mean difference: PD = 1.41; CAL = 1.40, P < 0.05), however, it wasn't confirmed when the cross-sectional study was removed (1.25 mm, P < 0.22) and CAL (1.20 mm, P < 0.22). CONCLUSION Although the qualitative analysis have suggested worse periodontal conditions in dementia patients, due to different study types and the high heterogeneity among them, the meta-analysis does not support the association between dementia and severity of periodontal disease.
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Affiliation(s)
- David Jonathan R Gusman
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - João M Mello-Neto
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Breno Edson S Alves
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Henrique R Matheus
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil.
| | - Letícia H Theodoro
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil.
| | - Juliano M de Almeida
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil.
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Okamoto N, Morikawa M, Amano N, Yanagi M, Takasawa S, Kurumatani N. Effects of Tooth Loss and the Apolipoprotein E ɛ4 Allele on Mild Memory Impairment in the Fujiwara-kyo Study of Japan: A Nested Case-Control Study. J Alzheimers Dis 2018; 55:575-583. [PMID: 27716671 PMCID: PMC5147497 DOI: 10.3233/jad-160638] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background: Several studies have suggested that periodontal disease can exacerbate the pro-inflammatory status of the brain. Tooth loss is one of the alternative evaluation indices of periodontal disease. There are few data on the relationship between tooth loss and memory impairment, depending on the apolipoprotein E (APOE) ɛ4 genotype. Objective: To determine if tooth loss is associated with mild memory impairment (MMI) and if this association is modified by the presence of the APOEɛ4 allele. Methods: A nested case-control study was conducted from 2007 to 2012 in Japan. Five hundred and thirty-seven Japanese subjects aged 65 years and over who were cognitively intact at baseline were analyzed. MMI at follow-up was evaluated. Results: The median number of teeth at baseline was significantly lower in MMI participants (n = 179) than in controls (n = 358) (MMI: median 21.0, interquartile range 10.0–25.0 versus controls: 24.0, 14.0–27.0). After adjustment for demographics, vascular risk factors, and APOEɛ4 allele, the multivariate adjusted odds ratio (OR) of ≤8 teeth was 1.97 (95% confidence interval [CI], 1.13–3.44) compared to 25–32 teeth. Participants with both the presence of at least 1 APOEɛ4 allele and ≤8 teeth had a higher risk of MMI compared with those with neither (OR, 2.82; 95% CI, 1.15–6.91). Those with either risk factor alone did not have a higher risk of MMI. Conclusions: A lower number of teeth is related to risk of MMI. This may be primarily true for those individuals with an APOEɛ4 allele.
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Affiliation(s)
- Nozomi Okamoto
- Department of Community Health and Epidemiology, Nara Medical University, Nara, Japan
| | - Masayuki Morikawa
- Mie Prefectural Mental Medical Center, Mie, Japan.,Department of Psychiatry, Nara Medical University, Nara, Japan
| | | | - Motokazu Yanagi
- Department of Food and Nutrition, Tezukayama University, Nara, Japan
| | - Shin Takasawa
- Department of Biochemistry, Nara Medical University, Nara, Japan
| | - Norio Kurumatani
- Department of Community Health and Epidemiology, Nara Medical University, Nara, Japan
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Oh B, Han DH, Han KT, Liu X, Ukken J, Chang C, Dounis K, Yoo JW. Association between residual teeth number in later life and incidence of dementia: A systematic review and meta-analysis. BMC Geriatr 2018; 18:48. [PMID: 29454307 PMCID: PMC5816354 DOI: 10.1186/s12877-018-0729-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 01/23/2018] [Indexed: 12/20/2022] Open
Abstract
Background It has been suggested that tooth loss in later life might increase dementia incidence. The objective of this analysis is to systematically review the current evidence on the relationship between the number of remaining teeth and dementia occurrence in later life. Methods A search of multiple databases of scientific literature was conducted with relevant parameters for articles published up to March 25th, 2017. Multiple cohort studies that reported the incidence of dementia and residual teeth in later life were found with observation periods ranging from 2.4 to 32 years. Random-effects pooled odds ratios (OR) and 95% confidence intervals (CI) were estimated to examine whether high residual tooth number in later life was associated with a decreased risk of dementia. Heterogeneity was measured by I2. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to assess the overall quality of evidence. Results The literature search initially yielded 419 articles and 11 studies (aged 52 to 75 at study enrollment, n = 28,894) were finally included for analysis. Compared to the low residual teeth number group, the high residual teeth number group was associated with a decreased risk of dementia by approximately 50% (pooled OR = 0.483; 95% CI 0.315 to 0.740; p < 0.001; I2 = 92.421%). The overall quality of evidence, however, was rated as very low. Conclusion Despite limited scientific strength, the current meta-analysis reported that a higher number of residual teeth was associated with having a lower risk of dementia occurrence in later life. Electronic supplementary material The online version of this article (10.1186/s12877-018-0729-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bumjo Oh
- Department of Family Medicine, SMG-SNG Boramae Medical Center, Seoul, South Korea
| | - Dong-Hun Han
- Department of Preventive & Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
| | - Kyu-Tae Han
- Research and Analysis Team, Ilsan National Health Insurance Hospital, Gyeonggi-do, Goyang-si, South Korea
| | - Xibei Liu
- Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Johnson Ukken
- University of Nevada School of Medicine, Reno, Nevada, USA
| | - Carina Chang
- University of Nevada School of Medicine, Reno, Nevada, USA
| | - Kiki Dounis
- Veterans Affairs Southern Nevada Healthcare System, North Las Vegas, Nevada, USA
| | - Ji Won Yoo
- Departmemnt of Internal Medicine, University of Nevada Las Vegas School of Medicine, 1701 W Charleston Blvd. #230, Las Vegas, Nevada, 89102, USA.
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Functional determinants of dietary intake in community-dwelling older adults: a DEDIPAC (DEterminants of DIet and Physical ACtivity) systematic literature review. Public Health Nutr 2018; 21:1886-1903. [DOI: 10.1017/s1368980017004244] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AbstractObjectiveThe identification of determinants of dietary intake is an important prerequisite for the development of interventions to improve diet. The present systematic literature review aimed to compile the current knowledge on individual functional determinants of dietary intake in community-dwelling older adults.DesignA systematic search was performed in PubMed, Scopus, Web of Science and the Cochrane Library. Titles, abstracts and full texts were screened according to predefined inclusion and exclusion criteria. Studies were included when focusing on dietary intake as an outcome and on chemosensory, oral, cognitive or physical function as a determinant.SettingCommunity.SubjectsOlder adults at least 65 years old without acute or specific chronic diseases.ResultsFrom initially 14 585 potentially relevant papers, thirty-six were included. For chemosensory, cognitive and physical function only a few papers were found, which reported inconsistent results regarding the relationship to dietary intake. In contrast, oral function was extensively studied (n31). Different surrogates of oral function like dental status, number of teeth, bite force or chewing problems were associated with food as well as nutrient intakes including fibre. As all except six studies had a cross-sectional design, no causal relationships could be derived.ConclusionsAmong functional determinants of dietary intake oral factors are well documented in older adults, whereas the role of other functional determinants remains unclear and needs further systematic research.
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Scannapieco FA, Cantos A. Oral inflammation and infection, and chronic medical diseases: implications for the elderly. Periodontol 2000 2018; 72:153-75. [PMID: 27501498 DOI: 10.1111/prd.12129] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2015] [Indexed: 12/12/2022]
Abstract
Oral diseases, such as caries and periodontitis, not only have local effects on the dentition and on tooth-supporting tissues but also may impact a number of systemic conditions. Emerging evidence suggests that poor oral health influences the initiation and/or progression of diseases such as atherosclerosis (with sequelae including myocardial infarction and stoke), diabetes mellitus and neurodegenerative diseases (such as Alzheimer's disease, rheumatoid arthritis and others). Aspiration of oropharyngeal (including periodontal) bacteria causes pneumonia, especially in hospitalized patients and the elderly, and may influence the course of chronic obstructive pulmonary disease. This article addresses several pertinent aspects related to the medical implications of periodontal disease in the elderly. There is moderate evidence that improved oral hygiene may help prevent aspiration pneumonia in high-risk patients. For other medical conditions, because of the absence of well-designed randomized clinical trials in elderly patients, no specific guidance can be provided regarding oral hygiene or periodontal interventions that enhance the medical management of older adults.
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The Effect of Number of Teeth and Chewing Ability on Cognitive Function of Elderly in UAE: A Pilot Study. Int J Dent 2017; 2017:5732748. [PMID: 29348749 PMCID: PMC5734010 DOI: 10.1155/2017/5732748] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/16/2017] [Accepted: 09/24/2017] [Indexed: 12/31/2022] Open
Abstract
Cognitive decline is one of the major causes of disability among the aging population. The aim of this study was to explore the relationship between oral health parameters (number of teeth, chewing ability, and presence of a denture) and cognitive function in the elderly across the UAE. Fifty persons (age ≥ 60; 71.26 ± 10.23) were enrolled in the study. Cognitive status was assessed using the standardized mini-mental state examination (SMMSE) and accordingly, cognitively normal subjects scoring ≥24 were considered as the control group and cognitively impaired individuals scoring ≤23 were considered as the low scoring group. Chewing ability was examined, number of teeth was noted, and demographical data was collected. The results of this pilot study showed that individuals with low SMMSE scores were significantly less educated (P < 0.01) and had fewer number of remaining teeth (P < 0.05) and impaired chewing ability (P < 0.05). These results demonstrate a significant link between the number of teeth, chewing ability, and cognitive function. However, this pilot study had its limitations and was the first of its kind in the UAE and Gulf region; therefore, future research addressing the limitations is needed to further explore this association.
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Lee YS, Kim HG, Hur JY, Yang K. Oral Health in Low-Income Older Adults in Korea. J Community Health Nurs 2017; 33:98-106. [PMID: 27074406 DOI: 10.1080/07370016.2016.1159441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Oral diseases among older adults are prevalent and a major public health problem, but public attention regarding this matter is quite limited. Many older adults experience limited access to oral care services. The study aimed to describe characteristics of oral health conditions, perceived oral health status, and oral health practices and to examine factors related to living status and accessibility to dental health care among 9,660 low-income older adults living in a suburban city in Korea. Approximately 42% of low-income older adults lived alone; 68% perceived their oral health as either excellent or good; and 31% reported difficulty accessing dental services. Lack of accessibility to oral care services was significantly more common in older adults with low incomes, living alone, having poor oral conditions, poor self-perceived oral health, and poor tooth-brushing behavior. Strategies to promote access to dental care services for underserved older adults should be developed to prevent further oral problems and their impact on overall health conditions.
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Affiliation(s)
- Young-Shin Lee
- a School of Nursing , San Diego State University , San Diego , California
| | - Hee-Gerl Kim
- b Department of Nursing , Gachon University , Seongnam-Si , South Korea
| | - Jung-Yi Hur
- c Seongnam-Si Visiting Public Health Center , Seongnam-Si , South Korea
| | - Kyeongra Yang
- d Lienhard School of Nursing , Pace University , Pleasantville , New York
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Karnam RR, Kumar NS, Eshwar S, Deolia S. Cognitive Ability as a Determinant of Socioeconomic and Oral Health Status among Adolescent College Students of Bengaluru, India. J Clin Diagn Res 2017; 10:ZC62-ZC66. [PMID: 28209007 DOI: 10.7860/jcdr/2016/21132.9102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 08/16/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Levels of oral health and economic status are unequally distributed throughout the population. Inequality has multiple causes and that the effect of Socio Economic Status (SES) and demographic factors, on oral health is mediated through several factors. Association between cognitive ability and oral health had been demonstrated in older age groups but adolescents and younger adults have received relatively little attention in this field. AIM To establish the role of cognitive ability as a determinant of SES and oral health status among adolescent college students of Benagluru, Karnataka, India. MATERIALS AND METHODS A cross-sectional study was conducted among 1000 adolescents aged 17-19 years. Six government and six private first grade colleges were selected by multi-stage random sampling. Cognitive ability was assessed using digit symbol substitution test and digit span test. Dental caries and periodontal status were recorded by extent of bleeding, presence of calculus, periodontal pockets, loss of attachments using Community Periodontal Index, decayed, missing and filled teeth surfaces using Decayed, Missing, Filled Teeth and Surfaces Index. SES status was assessed using Kuppuswamy scale. Chi-square test was used to check the association of cognitive ability with oral health indicators and SES status. Regression analysis was performed to assess the effect of cognitive ability on oral health indicators after adjusting for SES and effect of SES status on oral health indicators after adjusting for indicators of cognitive ability. RESULTS Significant association and negative correlation between cognitive ability and indicators for oral health was seen in the regression models. Cognitive ability attributed for nearly 30% changes in the indicators for oral health after adjusting for SES and SES attributed for nearly 25% variance in indicators for oral health after adjusting for cognitive ability. CONCLUSION There is a potential role of cognitive ability in SES and oral health.
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Affiliation(s)
- Rekha Rao Karnam
- Senior Lecturer, Department of Public Health Dentistry, KLE Dental College and Hosiptal , Bengaluru, Karnataka, India
| | | | - Shruthi Eshwar
- Reader, Department of Public Health Dentistry, KLE Dental College and Hospital , Bengaluru, Karnataka, India
| | - Shravani Deolia
- Senior Lecturer, Department of Public Health Dentistry, Sharad Pawar Dental College , Wardha, Maharasthra, India
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Tonsekar PP, Jiang SS, Yue G. Periodontal disease, tooth loss and dementia: Is there a link? A systematic review. Gerodontology 2017; 34:151-163. [DOI: 10.1111/ger.12261] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Pallavi P. Tonsekar
- Department of Periodontics; Rutgers School of Dental Medicine; Newark NJ USA
| | - Shuying S. Jiang
- Institutional Assessment and Quality Improvement; Rutgers School of Dental Medicine; Newark NJ USA
| | - Gang Yue
- Department of Periodontics; Rutgers School of Dental Medicine; Newark NJ USA
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Li J, Xu H, Pan W, Wu B. Association between tooth loss and cognitive decline: A 13-year longitudinal study of Chinese older adults. PLoS One 2017; 12:e0171404. [PMID: 28158261 PMCID: PMC5291434 DOI: 10.1371/journal.pone.0171404] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 01/18/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To examine the association between the number of teeth remaining and cognitive decline among Chinese older adults over a 13-year period. DESIGN A large national longitudinal survey of Chinese older adults. SETTING The Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998-2011). PARTICIPANTS A total of 8,153 eligible participants aged 60+ interviewed in up to six waves. MEASUREMENTS Cognitive function and teeth number were measured at each interview. Cognitive function was measured by the Mini-Mental Status Examination (MMSE). Number of natural teeth was self-reported. Individuals with severe cognitive impairment were excluded. Covariates included demographic characteristics, adult socioeconomic status characteristics, childhood socioeconomic status, health conditions, and health behaviors. Linear mixed models were applied in the analysis. RESULTS The mean teeth number at baseline was 17.5(SD = 0.1), and the mean of baseline cognitive function was 27.3(SD = 0.0). Cognitive function declined over time (β = -0.19, P < .001) after controlling covariates. But, regardless of time, more teeth were associated with better cognitive function (β = 0.01, P < .001). The interaction of teeth number and time was significant (β = 0.01, P < .001), suggesting that the participants who had more teeth showed a slower pace of cognitive decline over time than those with fewer teeth after controlling for other covariates. CONCLUSION This study showed that tooth loss was associated with cognitive decline among Chinese older adults. Further studies are needed to examine the linkages between cognitive decline and oral health status using clinical examination data.
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Affiliation(s)
- Juan Li
- Nursing School of Second Military Medical University, Shanghai, China
- Duke University School of Nursing, Durham, United States of America
| | - Hanzhang Xu
- Duke University School of Nursing, Durham, United States of America
- Duke Global Health Institute, Durham, United States of America
| | - Wei Pan
- Duke University School of Nursing, Durham, United States of America
| | - Bei Wu
- New York University Rory Meyers College of Nursing, New York, United States of America
- * E-mail:
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Tada A, Miura H. Association between mastication and cognitive status: A systematic review. Arch Gerontol Geriatr 2016; 70:44-53. [PMID: 28042986 DOI: 10.1016/j.archger.2016.12.006] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 12/07/2016] [Accepted: 12/12/2016] [Indexed: 11/15/2022]
Abstract
PURPOSE A substantial number of elderly people suffer from cognitive impairment and dementia, which are considered to have various risk factors, including masticatory dysfunction; however, the association between mastication and cognition is inconclusive. The objectives of this systematic review were to provide an overview of the literature on (1) the association between mastication and cognitive function and (2) the association between mastication and dementia incidence, in elderly people. MATERIALS AND METHODS Searches were conducted on five electronic databases (PubMed, EMBASE, CINHL, Cochrane Library, and Pro Quest) and publications were selected that met the following criteria: published between 2005 and 2015, written in English, and assessed associations between mastication and cognitive function, cognitive decline and dementia among population over 40 years old. The included publications were analyzed for study design, main conclusions, and strength of evidence by two reviewers who screened all abstracts and full-text articles, abstracted data and performed quality assessments by using a critical appraisal tool. RESULTS A total of 33 articles (22 cross-sectional, and 11 prospective cohort studies) were evaluated. Poorer mastication was associated with lower cognitive function in 15 of the 17 cross-sectional studies and steeper decline in 5 of the 6 prospective studies. Poorer mastication was one of significant risk factors for having dementia or mild memory impairment (MMI) in 4 of 5 cross-sectional studies and for the incidence of dementia or MMI in 4 of 5 prospective studies. CONCLUSIONS Most studies point to a positive association between mastication and cognitive function, including dementia among elderly people.
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Affiliation(s)
- Akio Tada
- Department of Health Science, Hyogo University, 2301 Shinzaike Hiraoka-cho, Kakogawa, Hyogo 675-0195, Japan.
| | - Hiroko Miura
- Department of International Health and Collaboration, National Institute of Public Health, 2-3-6, Minami, Wako, Saitama 351-0197, Japan
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