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Mameno T, Tsujioka Y, Fukutake M, Murotani Y, Takahashi T, Hatta K, Gondo Y, Kamide K, Ishizaki T, Masui Y, Mihara Y, Nishimura Y, Hagino H, Higashi K, Akema S, Maeda Y, Kabayama M, Akasaka H, Rakugi H, Sugimoto K, Okubo H, Sasaki S, Ikebe K. Relationship between the number of teeth, occlusal force, occlusal contact area, and dietary hardness in older Japanese adults: The SONIC study. J Prosthodont Res 2024; 68:400-406. [PMID: 37648481 DOI: 10.2186/jpr.jpr_d_23_00050] [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: 09/01/2023]
Abstract
PURPOSE Individuals with impaired masticatory function tend to prefer soft foods, which results in decreased masticatory muscle activity. This study examined the association between the oral condition (number of teeth, occlusal force, and occlusal contact area) and dietary hardness using a daily dietary questionnaire. METHODS This cross-sectional study evaluated 1841 participants aged 69-71 and 79-81 years. Registered dentists examined the number of teeth, occlusal force, and occlusal contact area. Dietary hardness was defined as the estimated masticatory muscle activity required for a habitual diet. Habitual diet during the preceding month was assessed using a brief self-administered diet history questionnaire. Confounding factors, such as age, sex, socioeconomic status, smoking habits, history of chronic diseases (hypertension, hyperlipidemia, and diabetes), and cognitive function were also evaluated. Multivariate linear regression analyses were performed to assess the association between dietary hardness and each oral condition. RESULTS Occlusal force (standardized regression coefficients [β]=0.08, P < 0.01) and occlusal contact area (β=0.06, P < 0.01) were significantly associated with dietary hardness after adjusting for the confounding factors. Number of teeth was not significantly associated with dietary hardness. In addition, the associations between dietary hardness, sex, and a history of diabetes were stronger than those between dietary hardness and oral factors. CONCLUSIONS Occlusal force and contact area were significantly associated with dietary hardness as estimated from the masticatory muscle activity using a daily diet questionnaire.
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Affiliation(s)
- Tomoaki Mameno
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshitaka Tsujioka
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Motoyoshi Fukutake
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuki Murotani
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Toshihito Takahashi
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kodai Hatta
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Osaka University Graduate School of Human Sciences, Osaka, Japan
| | - Kei Kamide
- Department of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yukie Masui
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yusuke Mihara
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuichi Nishimura
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiromasa Hagino
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kotaro Higashi
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Suzuna Akema
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshinobu Maeda
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Mai Kabayama
- Department of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ken Sugimoto
- Department of General Geriatric Medicine, Kawasaki Medical School, Okayama, Japan
| | - Hitomi Okubo
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
- Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
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Hensel ALJ, Nicholson K, Anderson KK, Gomaa NA. Biopsychosocial factors in oral and systemic diseases: a scoping review. FRONTIERS IN ORAL HEALTH 2024; 5:1378467. [PMID: 38872985 PMCID: PMC11169703 DOI: 10.3389/froh.2024.1378467] [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: 01/29/2024] [Accepted: 05/15/2024] [Indexed: 06/15/2024] Open
Abstract
Background The association between chronic oral diseases and other major systemic health conditions, commonly referred to as the oral-systemic health connection, has been previously studied with several underlying common risk factors and pathways linking both groups of diseases. Psychosocial factors contribute to an increased susceptibility to chronic oral and non-oral diseases. The aim of this review is to summarize the current state of knowledge on the role of psychosocial stress in chronic oral and systemic diseases. Methods A search strategy was built and a literature search was conducted using four databases (CINAHL, Embase, Medline, PsycINFO). A combination of search terms related to psychosocial stress, systemic disease, and oral conditions were used. Studies were eligible for inclusion if they included human adults (aged 18 years and older), included psychosocial factors as an exposure measure, and outcome measures of both an oral and systemic condition. Only English-language articles were considered. Pilot testing of the data extraction form and calibration were conducted and data were extracted independently by one researcher. Results A total of fifteen articles out of eighty full-text articles screened were determined to be eligible for inclusion in this review. Periodontal disease was the most commonly studied oral disease, measured in 53% of included articles, with the most commonly studied systemic diseases being of mental health conditions (40%) and diabetes (47%). Psychosocial stress was measured using a range of psychometric indicators and/or biomarkers, including perceived stress, individual behaviours, childhood adversity, and cortisol. In total, fourteen studies found a positive association between measures of psychosocial stress and oral-systemic health. Conclusion Psychosocial stress may be a common contributor to both chronic oral and non-oral diseases.
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Affiliation(s)
- Abby L. J. Hensel
- Dentistry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Kathryn Nicholson
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Kelly K. Anderson
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Children's Health, Lawson Health Research Institute, London, ON, Canada
| | - Noha A. Gomaa
- Dentistry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Children's Health, Lawson Health Research Institute, London, ON, Canada
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Ho DSM, Zaitsu T, Ihira H, Iwasaki M, Yoshihara A, Suzuki S, Inoue M, Yamagishi K, Yasuda N, Aida J, Shinozaki T, Goto A, Tsugane S, Sawada N. Association Between Oral Malodor and Dementia: An 11-Year Follow-Up Study in Japan. J Alzheimers Dis Rep 2024; 8:805-816. [PMID: 38910945 PMCID: PMC11191629 DOI: 10.3233/adr-240015] [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: 01/23/2024] [Accepted: 04/15/2024] [Indexed: 06/25/2024] Open
Abstract
Background As infrequent social interaction is a potential risk of dementia, oral malodor may increase the risk of dementia, including Alzheimer's disease. Objective This study investigated the association between malodor and dementia. Methods We used the Japan Public Health Center-based Prospective Study data obtained at Yokote City. A total of 1,493 individuals aged 56 to 75 years underwent a dental examination and self-reported survey from May 2005 to January 2006. Follow-up for the onset of dementia was conducted using long-term care insurance data from 2006 to 2016. Hazard ratios of oral malodor on dementia were estimated by the Cox proportional hazards model. The inverse probability-weighted Cox model was used as a sensitivity analysis. Results The study comprised 1493 participants (53.6% women) with a mean age of 65.6 (SD = 5.8) years old; at the end of the follow-up, 6.4% (n = 96) developed dementia, and the percentage was 20.7 in severe malodor group. Throughout 15274.133 person-years of follow-up, the average incidence rate for the onset of dementia per 1000 person-years was 6.29. The highest incidence rate was seen in participants with severe malodor (22.4 per 1000 person-years). After adjusting for confounders, compared to those with no malodor, there was a 3.8 (95% confidence interval: 1.5 to 9.4) times greater hazard of developing dementia in participants with severe malodor. The inverse probability weighted Cox model confirmed the same trend with an adjusted marginal hazard ratio of 4.4 (1.2 to 16.4). CONCLUSIONS A significant association between oral malodor and the onset of dementia exists.
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Affiliation(s)
- Duc Sy Minh Ho
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Faculty of Odonto-Stomatology, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Takashi Zaitsu
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hikaru Ihira
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Masanori Iwasaki
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Faculty of Dentistry and Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Seitaro Suzuki
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Manami Inoue
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Institute of Medicine, Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Nobufumi Yasuda
- Department of Public Health, Kochi University Medical School, Kochi, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Atsuhi Goto
- Department of Health Data Science, Graduate School of Data Science, Yokohama University, Yokohama, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- International University of Health and Welfare Graduate School of Public Health, Tokyo, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
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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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Hedberg L, Kumar A, Skott P, Smedberg JI, Seiger Å, Sandborgh-Englund G, Nordin LE, Kåreholt I, Tzortzakakis A, Westman E, Trulsson M, Ekman U. White matter abnormalities mediate the association between masticatory dysfunction and cognition among older adults. J Oral Rehabil 2023; 50:1422-1431. [PMID: 37710915 DOI: 10.1111/joor.13584] [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: 09/24/2022] [Revised: 06/30/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Masticatory parameters, such as reduced number of teeth and posterior contacts, have been shown to be associated with reduced cognitive status. The underlying mechanisms that affect these associations, are however, not well understood. OBJECTIVES The study aims to investigate the association between masticatory dysfunction and cognition and explore the mediating effect of brain structure. METHODS In this cross-sectional study, 45 older adults with subjective masticatory dysfunction (mean age 72.3 ± 4.0 years) were included. Mini-Mental State Examination score <25, brain trauma, neurological disease, neurodegenerative disorders, depression or poor Swedish language skills were criteria for exclusion. Cognitive functions (executive function and episodic memory) and masticatory dysfunction defined by functional occluding status (FOS; the number of occluding units and number of remaining teeth) were analysed with partial correlation models. Structural magnetic resonance imaging was performed on 28 feasible participants. Multiple regression analyses were performed to evaluate the predictive value of brain structure and white matter hypointensities (WM-hypo) on cognitive functions. A mediation analysis was applied to assess significant predictor/s of the association between FOS and cognition. RESULTS Both episodic memory and executive functions were positively correlated with FOS. WM-hypo predicted cognitive status (executive function, p ≤ .01). WM-hypo mediated 66.6% (p = 0.06) of the association between FOS and executive functions. CONCLUSION Associations between FOS and cognitive functions are reported, where FOS, a potential modifiable risk factor, was related to both episodic memory and executive functions. The mediating effect of WM-hypo on the association between FOS and executive functions highlights the impact of the vascularisation of the brain on the link between mastication and cognition. The present study provides increased knowledge that bridges the gap between masticatory dysfunction and cognition.
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Affiliation(s)
- Linn Hedberg
- Folktandvården Eastmaninstitutet, Stockholm, Sweden
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
| | - Abhishek Kumar
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
| | - Pia Skott
- Folktandvården Eastmaninstitutet, Stockholm, Sweden
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
| | - Jan-Ivan Smedberg
- Folktandvården Eastmaninstitutet, Stockholm, Sweden
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Åke Seiger
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Gunilla Sandborgh-Englund
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
| | - Love Engström Nordin
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Department of Diagnostic Medical Physics, Karolinska University Hospital, Stockholm, Sweden
| | - Ingemar Kåreholt
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Antonios Tzortzakakis
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mats Trulsson
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Academic Centre for Geriatric Dentistry, Stockholm, Sweden
| | - Urban Ekman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit, Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
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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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Oue H, Hatakeyama R, Ishida E, Yokoi M, Tsuga K. Experimental tooth loss affects spatial learning function and blood-brain barrier of mice. Oral Dis 2023; 29:2907-2916. [PMID: 36114741 DOI: 10.1111/odi.14379] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/28/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aims to investigate how experimental tooth loss affected learning, memory function, and brain pathophysiology in mice. MATERIALS AND METHODS The mice (C57BL/6 J, 2-month-old, male) were divided into tooth loss and control groups. The behavioral test battery was performed at 6 and 12 months after tooth extraction. The protein levels of the tight junctions in the brains of the mice were analyzed. Hippocampal astrocyte was measured using immunohistochemical staining. RESULTS The results of behavioral tests and biochemical analysis performed during the 6 months observation period did not show significant differences between the groups. However, the escape latency in the tooth loss group was significantly longer than that in the control group at the 12 months after tooth extraction. The level of claudin-5 decreased in the tooth loss group. Additionally, hippocampal astrogliosis was found in the tooth loss group. CONCLUSIONS Experimental tooth loss reduced the level of claudin-5 and caused astrogliosis in the brains of mice, which was accompanied by deterioration of learning functions. This study may provide a new insight about the association between tooth loss and cognitive dysfunction.
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Affiliation(s)
- Hiroshi Oue
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Rie Hatakeyama
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Eri Ishida
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Miyuki Yokoi
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Preisser J, Moss K, Finlayson T, Jones J, Weintraub J. Prediction Model Development and Validation of 12-Year Incident Edentulism of Older Adults in the United States. JDR Clin Trans Res 2023; 8:384-393. [PMID: 35945823 PMCID: PMC10504805 DOI: 10.1177/23800844221112062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
INTRODUCTION Edentulism affects health and quality of life. OBJECTIVES Identify factors that predict older adults becoming edentulous over 12 y in the US Health and Retirement Study (HRS) by developing and validating a prediction model. METHODS The HRS includes data on a representative sample of US adults aged >50 y. Selection criteria included participants in 2006 and 2018 who answered, "Have you lost all of your upper and lower natural permanent teeth?" Persons who answered "no" in 2006 and "yes" in 2018 experienced incident edentulism. Excluding 2006 edentulous, the data set (n = 4,288) was split into selection (70%, n = 3,002) and test data (30%, n = 1,286), and Monte Carlo cross-validation was applied to 500 random partitions of the selection data into training (n = 1,716) and validation (n = 1,286) data sets. Fitted logistic models from the training data sets were applied to the validation data sets to obtain area under the curve (AUC) for 32 candidate models. Six variables were included in all models (age, race/ethnicity, gender, education, smoking, last dental visit) while all combinations of 5 variables (income, alcohol use, self-rated health, loneliness, cognitive status) were considered for inclusion. The best parsimonious model based on highest mean AUC was fitted to the selection data set to obtain a final prediction equation. It was applied to the test data to estimate AUC and 95% confidence interval using 1,000 bootstrap samples. RESULTS From 2006 to 2018, 9.7% of older adults became edentulous. The 2006 mean (SD) age was 66.7 (8.7) for newly edentulous and 66.3 (8.4) for dentate (P = 0.31). The baseline 6-variable model mean AUC was 0.740. The 7-variable model with cognition had AUC = 0.749 and test data AUC = 0.748 (95% confidence interval, 0.715-0.781), modestly improving prediction. Negligible improvement was gained from adding more variables. CONCLUSION Cognition information improved the 12-y prediction of becoming edentulous beyond the modifiable risk factors of smoking and dental care use, as well as nonmodifiable demographic factors. KNOWLEDGE TRANSFER STATEMENT This prediction modeling and validation study identifies cognition as well as modifiable (dental care use, smoking) and nonmodifiable factors (race, ethnicity, gender, age, education) associated with incident complete tooth loss in the United States. This information is useful for the public, dental care providers, and health policy makers in improving approaches to preventive care, oral and general health, and quality of life for older adults.
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Affiliation(s)
- J.S. Preisser
- Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - K. Moss
- Division of Comprehensive Oral Health University of North Carolina at Chapel Hill, Adams School of Dentistry, Chapel Hill, NC, USA
| | - T.L. Finlayson
- Health Management and Policy, San Diego State University School of Public Health, San Diego, CA, USA
| | - J.A. Jones
- University of Detroit Mercy, Detroit, MI, USA
| | - J.A. Weintraub
- Division of Pediatric and Public Health, University of North Carolina at Chapel Hill, Adams School of Dentistry, Chapel Hill, NC, USA
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Jones J, Moss K, Finlayson T, Preisser J, Weintraub J. Edentulism Predicts Cognitive Decline in the US Health and Retirement Cohort Study. J Dent Res 2023; 102:863-870. [PMID: 37314011 PMCID: PMC10399082 DOI: 10.1177/00220345231167805] [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] [Indexed: 06/15/2023] Open
Abstract
This longitudinal cohort study examines if 1) cognitive decline varies by birth cohort, adjusting for covariates, and 2) edentulism and nonuse of dental care predict 10-y cognitive decline (2008-2018). The Health and Retirement Study (HRS) features a representative sample of US adults over age 50. Eligibility criteria included having cognitive interview data available and responding to the question, "Have you lost all of your upper and lower natural permanent teeth?" at 2+ time points between 2006 and 2018. Use of dental care in the past 2 y was assessed. Linear mixed models for repeated measures estimated the trajectories of mean cognition over time for the birth cohorts, adjusted for baseline cognition, dentition status, dental care use, and covariates (demographic characteristics, health behaviors, and medical conditions). Cohort-by-time interaction terms were included to assess if cognitive decline varied by birth cohort. Ten-year change in cognition status (measured by HRS Cogtot27)-categorized as dementia (<7); cognitive impairment, not demented (7-11) 7≤Cogtot27<12; and normal (≥12)-was also investigated according to birth cohort, dentition status, and dental care use. Mean (SD) baseline age was 63.4 (10.1) y (n = 22,728). Older birth cohorts had greater cognitive decline than younger cohorts. Linear mixed-model estimates and 95% confidence intervals for protective factors for cognitive decline included higher baseline cognition (HRS Cogtot27) (0.49; 0.48-0.50), use of dental care in the past 2 y (0.17; 0.10-0.23), and covariates such as greater household wealth and being married. Risk increased with being edentulous (-0.42; -0.56 to -0.28), history of stroke or diabetes, less education, Medicaid recipient, current smoker, loneliness, and poor/fair self-rated health. Edentulism and irregular dental care are among important predictors of cognitive decline. Tooth retention and regular dental care throughout life appear to be important for maintaining oral and cognitive health.
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Affiliation(s)
- J.A. Jones
- University of Detroit Mercy School of Dentistry, Detroit, MI, USA
| | - K. Moss
- Division of Comprehensive Oral Health, University of North Carolina at Chapel Hill, Adams School of Dentistry, Chapel Hill, NC, USA
| | - T.L. Finlayson
- Health Management and Policy, San Diego State University School of Public Health, San Diego, CA, USA
| | - J.S. Preisser
- Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - J.A. Weintraub
- Division of Pediatric and Public Health, University of North Carolina at Chapel Hill, Adams School of Dentistry, Chapel Hill, NC, USA
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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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11
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Peres MA, Peres KG, Chan A, Wu B, Mittinty M. Investigating the causal effect of cognition on the self-reported loss of functional dentition using marginal structural models: The Panel on Health and Ageing of Singaporean Elderly study. J Clin Periodontol 2023; 50:408-417. [PMID: 36384159 DOI: 10.1111/jcpe.13752] [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: 12/06/2021] [Revised: 09/02/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Abstract
AIM To assess the effect of cognition on the loss of functional dentition. MATERIALS AND METHODS We used data from the three waves of the Panel on Health and Ageing of Singaporean Elderly study (n = 4990 at baseline, 774 complete cases analysed) over 6 years (2009-2015). The outcome was the loss of functional dentition (<21 teeth). The exposure was cognitive impairment, while baseline confounders included age, sex, education, and ethnicity. Time-varying confounders included income, living arrangements, smoking, diabetes, depressive symptoms, cardiovascular disease, and body mass index. We used marginal structural mean models with inverse probability treatment weighted. RESULTS The mean age of the participants was 70.2 years at baseline. The proportion of participants with loss of functional dentition increased from 74.6% to 89.9% over 6 years. Women, ethnic Chinese, less educated, smokers, people with diabetes, and individuals with depression had a higher proportion of loss of functional dentition than their counterparts. Loss of functional dentition was 1.8 times higher (odds ratio 1.80; 95% confidence interval 0.88-3.69) among those with cognitive impairment after taking well-known confounders into account. CONCLUSIONS After accounting for the time-varying exposure and confounding evidence, the association between cognition and functional dentition among the elderly in Singapore remains uncertain.
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Affiliation(s)
- Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Karen G Peres
- National Dental Research Institute Singapore, National Dental Centre, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Angelique Chan
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - Bei Wu
- Hartford Institute for Geriatric Nursing, Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Murthy Mittinty
- Faculty of Health and Medical Sciences, School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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12
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Cunha Feio Leal MD, Amaral Junior FLD, Silva Arruda BFD, Kurosawa JAA, Vieira AA, Maia JCC, Scalfoni VVB, Silveira Junior AMD, Feijó MO, Albuquerque FBAD, Marta MHM, Normando MPN, Silva AGOCD, Trindade FCPD, Siqueira Mendes FDCCD, Sosthenes MCK. The Masticatory Activity Interference in Quantitative Estimation of CA1, CA3 and Dentate Gyrus Hippocampal Astrocytes of Aged Murine Models and under Environmental Stimulation. Int J Mol Sci 2023; 24:ijms24076529. [PMID: 37047502 PMCID: PMC10095286 DOI: 10.3390/ijms24076529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/22/2023] [Accepted: 03/01/2023] [Indexed: 04/03/2023] Open
Abstract
Studies indicating the influence of masticatory dysfunction, due to a soft diet or lack of molars, on impairing spatial memory and learning have led to research about neuronal connections between areas and cell populations possibly affected. In this sense, with scarce detailed data on the subfields of hippocampus in dementia neurodegeneration, there is no information about astrocytic responses in its different layers. Thus, considering this context, the present study evaluated the effects of deprivation and rehabilitation of masticatory activity, aging, and environmental enrichment on the stereological quantification of hippocampal astrocytes from layers CA1, CA3, and DG. For this purpose, we examined mature (6-month-old; 6M), and aged (18-month-old; 18M) mice, subjected to distinct masticatory regimens and environments. Three different regimens of masticatory activity were applied: continuous normal mastication with hard pellets (HD); normal mastication followed by deprived mastication with equal periods of pellets followed by soft powder (HD/SD); or rehabilitated masticatory activity with equal periods of HD, followed by powder, followed by pellets (HD/SD/HD). Under each specific regimen, half of the animals were raised in standard cages (impoverished environment (IE)) and the other half in enriched cages (enriched environment (EE)), mimicking sedentary or active lifestyles. Microscopic stereological, systematic, and random sampling approaches with an optical dissector of GFAP-immunolabeled astrocytes were done, allowing for an astrocyte numerical estimate. Stratum moleculare and hilus, from the dentate gyrus (DG) and Strata Lacunosum-Moleculare, Oriens, and Radiatum, similarly to the dentate gyrus, showed no significant change in any of the investigated variables (age, diet, or environment) in these layers. However, in Stratum radiatum, it was possible to observe significant differences associated with diet regimens and age. Therefore, diet-related differences were found when the HD 18M IE group was compared to the HD/SD/HD 18-month-old group in the same environment (IE) (p = 0.007). In the present study, we present modulatory factors (masticatory function, environmental enrichment, and aging) for the differentiated quantitative laminar response in the hippocampal regions, suggesting other studies to read the plasticity and responsiveness of astrocytes, including the molecular background.
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Affiliation(s)
- Marília da Cunha Feio Leal
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém 66073-005, PA, Brazil
| | - Fabio Leite do Amaral Junior
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém 66073-005, PA, Brazil
| | - Bernardo Freire da Silva Arruda
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém 66073-005, PA, Brazil
| | | | - Amanda Almeida Vieira
- Curso de Medicina, Centro Universitário do Estado do Pará, Belém 66613-903, PA, Brazil
| | | | | | - Antonio Morais da Silveira Junior
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém 66073-005, PA, Brazil
| | - Matheus Oliveira Feijó
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém 66073-005, PA, Brazil
| | - Fernanda Beatriz Araújo de Albuquerque
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém 66073-005, PA, Brazil
| | | | | | - Alana Gabriele Oliveira Cabeça da Silva
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém 66073-005, PA, Brazil
| | - Fernanda Catharina Pires da Trindade
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém 66073-005, PA, Brazil
| | - Fabíola de Carvalho Chaves de Siqueira Mendes
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém 66073-005, PA, Brazil
- Curso de Medicina, Centro Universitário do Estado do Pará, Belém 66613-903, PA, Brazil
| | - Marcia Consentino Kronka Sosthenes
- Laboratório de Investigações em Neurodegeneração e Infecção, Instituto de Ciências Biológicas, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém 66073-005, PA, Brazil
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13
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Budală DG, Balcoș C, Armencia A, Virvescu DI, Lupu CI, Baciu ER, Vasluianu RI, Tatarciuc M, Luchian I. Does the Loss of Teeth Have an Impact on Geriatric Patients’ Cognitive Status? J Clin Med 2023; 12:jcm12062328. [PMID: 36983327 PMCID: PMC10058759 DOI: 10.3390/jcm12062328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
Significant changes in the microstructure of the brain cause dementia and other mental declines associated with aging and disease. Although research has established a connection between oral health and dementia, the underlying pathologic mechanisms are still unknown. Aim: Our aim was to evaluate dentures’ impact on the cognitive state of geriatric patients. Material and methods: A total of 108 individuals seeking treatment at the Faculty of Dental Medicine in Iasi, Romania, participated in the study, which ran from May 2022 to October 2022. Cognitive dysfunction was assessed using the Mini-Mental State Examination. The acquired data were analyzed with IBM SPSS 26.0, and the p-value was set at 0.05. Results: The average value of the MMSE score was 21.81 ± 3.872. Differences between groups of wearer/non-wearer subjects were statistically significant for most of the questions in the questionnaire. Linear regression analysis showed that individuals with a high MMSE score have prosthodontic treatment. A decrease in the MMSE score is associated with a decrease in masticatory efficiency (B = 1.513, p = 0.268). Conclusions: This study provides further evidence that tooth loss is associated with worse cognitive performance. It is thus conceivable that the necessary effects can be achieved by increasing the efforts dedicated to preventing tooth loss in the adult population.
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Affiliation(s)
- Dana Gabriela Budală
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Carina Balcoș
- Department of Surgery, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence: (C.B.); (M.T.); Tel.: +40-745-533-607 (C.B.); +40-726-687-830 (M.T.)
| | - Adina Armencia
- Department of Surgery, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dragoș Ioan Virvescu
- Department of Odontology-Periodontology, Fixed Restorations, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Costin Iulian Lupu
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Raluca Baciu
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Roxana Ionela Vasluianu
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Monica Tatarciuc
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence: (C.B.); (M.T.); Tel.: +40-745-533-607 (C.B.); +40-726-687-830 (M.T.)
| | - Ionuț Luchian
- Department of Odontology-Periodontology, Fixed Restorations, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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14
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Matsuyama Y. Time-varying exposure analysis of the relationship between sustained natural dentition and cognitive decline. J Clin Periodontol 2023; 50:727-735. [PMID: 36734069 DOI: 10.1111/jcpe.13786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/03/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023]
Abstract
AIM Tooth loss and cognitive decline progress over time and influence each other. This study estimated the impact of sustaining natural dentition on cognitive function in U.S. adults, accounting for the fact that dental and cognitive statuses change over time. MATERIALS AND METHODS Data from adults aged ≥51 years who participated in five waves of the Health and Retirement Study from 2004 to 2016 (n = 10,953) were analysed. The impact of retaining some natural teeth from 2006 to 2012 on cognitive function score (0-27) and cognitive impairment (defined as having a cognitive function score of <12) in 2016 was evaluated using the doubly robust targeted maximum likelihood estimation method by considering both time-invariant and time-varying confounders, including cognitive function at baseline and during follow-up. RESULTS Respondents with some natural teeth between 2006 and 2012 had a 0.40 point (95% confidence interval [CI]: 0.10-0.71) higher cognitive function score and 3.27 percentage point (95% CI: 0.11-6.66) lower cognitive impairment prevalence in 2016 than those with complete tooth loss. CONCLUSIONS Considering past cognitive function assessed at multiple time points, sustained natural dentition was associated with better cognitive function.
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Affiliation(s)
- Yusuke Matsuyama
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
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15
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Matsuyama Y, Fujiwara T, Murayama H, Machida M, Inoue S, Shobugawa Y. Differences in Brain Volume by Tooth Loss and Cognitive Function in Older Japanese Adults. Am J Geriatr Psychiatry 2022; 30:1271-1279. [PMID: 35831211 DOI: 10.1016/j.jagp.2022.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND We investigated the association between tooth loss and structural brain volume and its mediating effect on the association between tooth loss and cognitive function in older Japanese. METHODS A cross-sectional study was conducted by using the data of 494 randomly sampled community-dwelling individuals aged 65-84 years living in Tokamachi City, Japan. Total brain volume (TBV), gray matter volume (GMV), white matter volume (WMV), and hippocampal volume (HV) were measured with magnetic resonance imaging. The association of self-reported number of teeth (≥20, 1-19, and 0) with cognitive function assessed with the Japanese version of the Quick Mild Cognitive Impairment screen and structural brain volume was examined. Causal mediation analysis was performed to evaluate the mediating effect of structural brain volume. Age, sex, socioeconomic status, health behavior, comorbid conditions, and total intracranial volume were adjusted. RESULTS Respondents with no teeth showed lower cognitive function (coefficient = -4.01; 95% confidence interval [CI]: -7.19, -0.82), lower TBV (coefficient = -10.34; 95% CI: -22.84, 2.17), and lower GMV (coefficient = -6.92; 95% CI: -14.84, 0.99) than those with ≥20 teeth (P for trends were 0.003, 0.035, and 0.047, respectively). The number of teeth was not significantly associated with WMV or HV. GMV showed a significant mediating effect on the association between the number of teeth and cognitive function (coefficient = -0.38; 95% CI: -1.14, -0.002, corresponding to 9.0% of the total effect), whereas TBV did not. CONCLUSIONS GMV was suggested to mediate the relationship between tooth loss and lower cognitive function.
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Affiliation(s)
- Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University (YM, TF), Tokyo, Japan.
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (YM, TF), Tokyo, Japan
| | - Hiroshi Murayama
- Research Team for Social participation and Community Health, Tokyo Metropolitan Institute of Gerontology (HM), Tokyo, Japan
| | - Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University (MM, SI), Tokyo, Japan; Department of Infection Prevention and Control, Tokyo Medical University Hospital (MM), Tokyo, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University (MM, SI), Tokyo, Japan
| | - Yugo Shobugawa
- Department of Active Ageing (donated by Tokamachi city, Niigata Japan), Niigata University Graduate School of Medical and Dental Sciences (YS), Niigata, Japan
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16
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Chen H, Wu YY, Zhang W. Age accelerated effect of tooth loss on cognitive function among Chinese older adults. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2022.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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17
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Blazer DG. From Mouth to Brain: Tooth Loss and Cognitive Impairment. Am J Geriatr Psychiatry 2022; 30:1280-1282. [PMID: 35914984 DOI: 10.1016/j.jagp.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Dan G Blazer
- JP Gibbons Professor Emeritus of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Cary, NC.
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18
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Lu Y, Pang Q, Wu Q, Luo B, Tang X, Jiang Q. Molar loss further exacerbates 2-VO-induced cognitive impairment associated with the activation of p38MAPK/NFκB pathway. Front Aging Neurosci 2022; 14:930016. [DOI: 10.3389/fnagi.2022.930016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
BackgroundVascular dementia is characterized by reduced cognitive function due to chronic cerebral hypoperfusion and has become a significant public health challenge as the global population ages. Recent studies suggested that molar loss, a common problem among the elderly, may trigger the development of cognitive decline. Our previous study found that the molar loss affected cognitive dysfunction, and the astrocytes in the hippocampus of chronic cerebral ischemia rats were affected, but the underlying mechanism is unclear.MethodsIn this study, we established the animal model of molar loss with 2-VO rats and the Morris water maze was used to test the cognitive ability of rats in each group. The damage to neurons was observed via Nissl staining, and neuronal apoptosis was analyzed by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay in the hippocampus of the rats. Quantitative Real-Time PCR and immunohistochemistry and histology (IHC) were used to detect the expression of p38MAPK, NFκB, caspase 3, and iNOS in the hippocampus. The astrocytes were detected by IHC and Immunofluorescence analysis for GFAP. After 2-VO MO surgery, rats were administered DMSO or p38MAPK inhibitor (SB203580) by intrathecal injection.ResultsThe Morris water maze test showed that the molar loss aggravated spatial memory learning ability with chronic cerebral ischemia decreased in the rats. The neuronal damage and more apoptotic cells were observed in the hippocampus of 2-VO rats. After the molar loss, the mRNA and protein expression of iNOS, p38MAPK, NFκB, and caspase 3 were further upregulated in 2-VO rats. Molar loss upregulated GFAP expression, and the p38MAPK-positive cells were labeled with the astrocyte marker GFAP. SB203580 reduced cognitive impairment and apoptosis of hippocampal neurons in 2-VO rats following the molar loss.ConclusionMolar loss can aggravate cognitive impairment in 2-VO rats to a certain extent. The mechanism of molar loss exacerbating the cognitive decline in 2-VO rats may be associated with the activation of the p38MAPK-NFκB-caspase 3 signaling pathway, which induces neuronal apoptosis.
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Yamamoto‐Kuramoto K, Kiuchi S, Kusama T, Kondo K, Takeuchi K, Osaka K, Aida J. Subjective cognitive complaints and dental clinic visits: A cross‐sectional study from the Japan Gerontological Evaluation Study. Geriatr Gerontol Int 2022; 22:773-778. [DOI: 10.1111/ggi.14455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/04/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Kinumi Yamamoto‐Kuramoto
- Department of International and Community Oral Health Tohoku University Graduate School of Dentistry Sendai Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health Tohoku University Graduate School of Dentistry Sendai Japan
- Frontier Research Institute for Interdisciplinary Sciences Tohoku University Sendai Japan
| | - Taro Kusama
- Department of International and Community Oral Health Tohoku University Graduate School of Dentistry Sendai Japan
- Division of Regional Community Development, Liaison Center for Innovative Dentistry Tohoku University Graduate School of Dentistry Sendai Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences Chiba University Chiba Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science National Center for Geriatrics and Gerontology Obu Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health Tohoku University Graduate School of Dentistry Sendai Japan
- Division of Regional Community Development, Liaison Center for Innovative Dentistry Tohoku University Graduate School of Dentistry Sendai Japan
| | - Ken Osaka
- Department of International and Community Oral Health Tohoku University Graduate School of Dentistry Sendai Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan
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20
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Case Report: Modulation of Effective Connectivity in Brain Networks after Prosthodontic Tooth Loss Repair. SIGNALS 2022. [DOI: 10.3390/signals3030033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION. Recent neuroimaging studies suggest that dental loss replacements induce changes in neuroplasticity as well as in correlated connectivity between brain networks. However, as the typical temporal delay in detecting brain activity by neuroimaging cannot account for the influence one neural system exerts over another in a context of real activation (“effective” connectivity), it seems of interest to approach this dynamic aspect of brain networking in the time frame of milliseconds by exploiting electroencephalographic (EEG) data. MATERIAL AND METHODS. The present study describes one subject who received a new prosthodontic provisional implant in substitution for previous dental repairs. Two EEG sessions led with a portable device were recorded before and after positioning the new dental implant. By following MATLAB-EEGLAB processing supported by the plugins FIELDTRIP and SIFT, the independent component analysis (ICA) derived from EEG raw signals was rendered as current density fields and interpolated with the dipoles generated by each electrode for a dynamic study of the effective connectivity. One more recording session was undertaken six months after the placement of the final implant. RESULTS. Compared to the baseline, the new prosthodontic implant induced a novel modulation of the neuroplasticity in sensory-motor areas which was maintained following the definitive implant after six months, as revealed by changes in the effective connectivity from the basal strong enslavement of a single brain area over the others, to an equilibrate inter-related connectivity evenly distributed along the frontotemporal regions of both hemispheres. CONCLUSIONS. The rapid shift of the effective connectivity after positioning the new prosthodontic implant and its substantial stability after six months suggest the possibility that synaptic modifications, induced by novel sensory motor conditions, modulate the neuroplasticity and reshape the final dynamic frame of the interarea connectivity. Moreover, given the viability of the EEG practice, this approach could be of some interest in assessing the association between oral pathophysiology and neuronal networking.
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21
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Kiuchi S, Kusama T, Sugiyama K, Yamamoto T, Cooray U, Yamamoto T, Kondo K, Osaka K, Aida J. Longitudinal Association Between Oral Status and Cognitive Decline Using Fixed-effects Analysis. J Epidemiol 2022; 32:330-336. [PMID: 33518591 PMCID: PMC9189315 DOI: 10.2188/jea.je20200476] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 01/11/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Although the feasibility of randomized trials for investigating the long-term association between oral health and cognitive decline is low, deriving causal inferences from observational data is challenging. We aimed to investigate the association between poor oral status and subjective cognitive complaints (SCC) using fixed-effects model to eliminate the confounding effect of unobserved time-invariant factors. METHODS We used data from Japan Gerontological Evaluation Study (JAGES) which was conducted in 2010, 2013, and 2016. β regression coefficients and 95% confidence intervals [CIs] were calculated using fixed-effects models to determine the effect of deteriorating oral status on developing SCC. Onset of SCC was evaluated using the Kihon Checklist-Cognitive function score. Four oral status variables were used: awareness of swallowing difficulty, decline in masticatory function, dry mouth, and number of teeth. RESULTS We included 13,594 participants (55.8% women) without SCC at baseline. The mean age was 72.4 (standard deviation [SD], 5.1) years for men and 72.4 (SD, 4.9) years for women. Within the 6-year follow-up, 26.6% of men and 24.9% of women developed SCC. The probability of developing SCC was significantly higher when participants acquired swallowing difficulty (β = 0.088; 95% CI, 0.065-0.111 for men and β = 0.077; 95% CI, 0.057-0.097 for women), decline in masticatory function (β = 0.039; 95% CI, 0.021-0.057 for men and β = 0.030; 95% CI, 0.013-0.046 for women), dry mouth (β = 0.026; 95% CI, 0.005-0.048 for men and β = 0.064; 95% CI, 0.045-0.083 for women), and tooth loss (β = 0.043; 95% CI, 0.001-0.085 for men and β = 0.058; 95% CI, 0.015-0.102 for women). CONCLUSION The findings suggest that good oral health needs to be maintained to prevent the development of SCC, which increases the risk for future dementia.
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Affiliation(s)
- Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
| | - Kemmyo Sugiyama
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
| | - Takafumi Yamamoto
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
| | - Upul Cooray
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
| | - Tatsuo Yamamoto
- Department of Dental Sociology, Kanagawa Dental University, Kanagawa, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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22
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Harding A, Kanagasingam S, Welbury R, Singhrao SK. Periodontitis as a Risk Factor for Alzheimer's Disease: The Experimental Journey So Far, with Hope of Therapy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:241-260. [PMID: 35612802 DOI: 10.1007/978-3-030-96881-6_13] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontitis and Alzheimer's disease (AD) exist globally within the adult population. Given that the risk of AD incidence doubles within 10 years from the time of periodontal disease diagnosis, there is a window of opportunity for slowing down or preventing AD by risk-reduction-based intervention. Literature appraisal on the shared risk factors of these diseases suggests a shift to a healthy lifestyle would be beneficial. Generalised (chronic) periodontitis with an established dysbiotic polymicrobial aetiology affects the tooth supporting tissues with eventual tooth loss. The cause of AD remains unknown, however two neurohistopathological lesions - amyloid-beta plaques and neurofibrillary tangles, together with the clinical history, provide AD diagnosis at autopsy. Historically, prominence was given to the two hallmark lesions but now emphasis is placed on cerebral inflammation and what triggers it. Low socioeconomic status promotes poor lifestyles that compromise oral and personal hygiene along with reliance on poor dietary intake. Taken together with advancing age and a declining immune protection, these risk factors may negatively impact on periodontitis and AD. These factors also provide a tangible solution to controlling pathogenic bacteria indigenous to the oral and gastrointestinal tract microbioes in vulnerable subjects. The focus here is on Porphyromonas gingivalis, one of several important bacterial pathogens associated with both periodontitis and AD. Recent research has enabled advances in our knowledge of the armoury of P. gingivalis via reproduction of all clinical and neuropathological hallmark lesions of AD and chronic periodontal disease in vitro and in vivo experimental models, thus paving the way for better future management.
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Affiliation(s)
- Alice Harding
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Shalini Kanagasingam
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Richard Welbury
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Sim K Singhrao
- Brain and Behavior Centre, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK.
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23
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Khalaila R, Vitman-Schorr A, Cohn-Schwartz E. A prospective association between tooth status and cognitive performance among older adults in Europe. Aging Ment Health 2022; 26:499-506. [PMID: 33635723 DOI: 10.1080/13607863.2021.1891201] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study set out to examine both the longitudinal association between tooth status and cognitive performance among older adults in Europe, and the mediating effects of loneliness and quality of life on this association. METHODS We conducted a prospective analysis using data from 38,614 participants aged 50 or older, taken from the Survey of Health, Ageing and Retirement in Europe (SHARE) of 2013 (baseline) and 2015 (follow up). Bootstrapping with resampling strategies was used for testing a multiple mediator model. RESULTS The average age of participants was 66.9 (SD = 9.4). About 23% of the participants had full sets of their own teeth and 38.2% had missing teeth fully replaced by dental implants or dentures. Participants who had partially replaced teeth (B = 0.038, p < 0.001), and with fully replaced teeth (B = 0.041, p < 0.001), or had all their teeth in place (B = 0.055, p < 0.001), had better cognitive performance compared to those who did not replace their missing teeth. It was also found that quality of life and loneliness partially mediated these relationships - Having all teeth in place or replacing all or partially missing teeth was found to affect cognitive performance also via improved quality of life and through lower loneliness. CONCLUSION In later life, poor tooth status can be directly associated with cognitive decline and indirectly linked to cognitive performance, in light of decreasing quality of life and increasing loneliness. Clinicians should be aware of both the impact of poor tooth status on cognitive status and the implications for the wellbeing of older adults.
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Affiliation(s)
- Rabia Khalaila
- Nursing Department, Zefat Academic College, Zefat, Israel
| | | | - Ella Cohn-Schwartz
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
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24
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Lee H, Kim D, Jung A, Chae W. Ethnicity, Social, and Clinical Risk Factors to Tooth Loss among Older Adults in the U.S., NHANES 2011-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2382. [PMID: 35206567 PMCID: PMC8875070 DOI: 10.3390/ijerph19042382] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/01/2022] [Accepted: 02/10/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Many older adults suffer from poor oral health, including tooth loss, and disparities among racial/ethnic and socially disadvantaged populations continue to exist. METHODS Data were obtained from the National Health and Nutrition Examination Survey among the adult population in the U.S. The prevalence of edentulism and multiple regression models were conducted on 15,821 adults, including Asians, Blacks, Hispanics, Whites, and others to assess the relationships between tooth loss and their predictors. RESULTS The prevalence of complete tooth loss increased with age from 0.7% for ages 20-44 to 20.2% for ages 65 and over. There are disparities in complete tooth loss regarding race/ethnicity, with the highest percentages (9%) among Whites and Blacks and the lowest percentages among Asians (3%) and Hispanics (4%). After adjusting for predictors, their impact on tooth loss was not consistent within racial/ethnic groups, as Asians had more tooth loss from Model 1 (β = -1.974, p < 0.0001) to Model 5 (β = -1.1705, p < 0.0001). CONCLUSION Tooth loss was significantly higher among older adults and racial/ethnic groups even after controlling for other predictors among a nationally representative sample. The findings point to the fact that subgroup-tailored preventions are necessary.
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Affiliation(s)
- Haeok Lee
- Nursing Department, University of Massachusetts Boston, Robert and Donna Manning College of Nursing and Health Sciences, Boston, MA 02125, USA;
| | - Deogwoon Kim
- Nursing Department, University of Massachusetts Boston, Robert and Donna Manning College of Nursing and Health Sciences, Boston, MA 02125, USA;
| | - Andrew Jung
- College of Dentistry, New York University, New York, NY 10012, USA;
| | - Wonjeong Chae
- Office of Strategic Planning, Healthcare Policy and Strategy Task Force, Yonsei University Health System, Seoul 03722, Korea;
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25
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Wang X, Hu J, Jiang Q. Tooth Loss-Associated Mechanisms That Negatively Affect Cognitive Function: A Systematic Review of Animal Experiments Based on Occlusal Support Loss and Cognitive Impairment. Front Neurosci 2022; 16:811335. [PMID: 35221901 PMCID: PMC8866659 DOI: 10.3389/fnins.2022.811335] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/18/2022] [Indexed: 12/15/2022] Open
Abstract
BackgroundThere is a dose-response relationship between tooth loss and cognitive impairment, while tooth loss can be an independent risk factor for Alzheimer's disease (AD) and vascular dementia (VaD). Tooth loss can also accelerate nerve damage and neurodegeneration. However, the associated mechanisms remain poorly understood.ObjectiveTo conduct a systematic review of animal experiments on cognitive decline caused by the loss of occlusal support performed over the past 10 years and summarize the possible underlying mechanisms.Methods“Tooth Loss,” “Edentulous,” “Tooth Extraction and Memory Loss,” “Cognition Impairment,” and “Dementia” were used as keywords to search PubMed, Embase, SCI, ScienceDirect, and OpenGrey. A total of 1,317 related articles from 2010 to 2021 were retrieved, 26 of which were included in the review after screening according to predetermined inclusion and exclusion criteria. Comprehensiveness was evaluated using ARRIVE guidelines and the risk of bias was assessed using SYCLE'S risk of bias tool.ResultsThe putative mechanisms underlying the cognitive impairment resulting from the loss of occlusal support are as follows: (1) The mechanical pathway, whereby tooth loss leads to masticatory motor system functional disorders. Masticatory organ activity and cerebral blood flow decrease. With reduced afferent stimulation of peripheral receptors (such as in the periodontal membrane) the strength of the connections between neural pathways is decreased, and the corresponding brain regions degenerate; (2) the aggravation pathway, in which tooth loss aggravates existing neurodegenerative changes. Tooth loss can accelerates nerve damage through apoptosis and mitochondrial autophagy, increases amyloid deposition in the brain; and (3) the long-term inflammatory stress pathway, which involves metabolic disorders, microbial-gut-brain axis, the activation of microglia and astrocytes, and inflammatory cascade effect in central nervous system.ConclusionThe loss of occlusal support may lead to cognitive dysfunction through the reduction of chewing-related stimuli, aggravation of nerve damage, and long-term inflammatory stress.
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26
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Alantie S, Tyrkkö J, Makkonen T, Renvall K. Is Old Age Just a Number in Language Skills? Language Performance and Its Relation to Age, Education, Gender, Cognitive Screening, and Dentition in Very Old Finnish Speakers. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:274-291. [PMID: 34929110 DOI: 10.1044/2021_jslhr-21-00178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE This study reports on how very old (VO) Finnish people without dementia perform in the Western Aphasia Battery (WAB) and two verbal fluency tasks and which demographic factors predict the performance. METHOD The study included fifty 80- to 100-year-old community-dwelling Finnish speakers with no dementing illnesses or speech-language disabilities, who completed the WAB and two verbal fluency tasks. Multifactorial statistical analyses with recursive partitioning were carried out to determine the significant predictors out of five predictor variables (age, gender, education, dentition, and Mini-Mental State Examination [MMSE]) for four response variables (WAB Aphasia Quotient [AQ], Language Quotient [LQ], semantic, and phonemic word fluencies). RESULTS Overall, individual variation was notable in VO speakers. All predictor variables were statistically significantly associated with one or more of the language skills. Age was the most significant predictor; the critical age of 85-86 years was associated with a decline in WAB-AQ and semantic fluency. Poor dentition and the MMSE score both predicted a decline in WAB-LQ and phonemic fluency. A high level of education was positively associated with the skills of the best-performing individuals in WAB-AQ, WAB-LQ, and semantic fluency. CONCLUSIONS VO age is a significant factor contributing to language performance. However, a younger age, a good cognitive performance, intact teeth, and a higher educational level also seem to have a preservative power as regards language skills. Gender differences should be interpreted with caution. The results of this study provide culture- and language-specific normative data, which aids in differentiating typical aging from the signs of acute or degenerative neuropathology to ensure appropriate medical and therapeutic interventions.
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Affiliation(s)
- Sonja Alantie
- Department of Psychology and Speech-Language Pathology, University of Turku, Finland
- Speech-Language Pathology, Tampere University Hospital, Finland
| | - Jukka Tyrkkö
- Department of Languages, Linnaeus University, Växjö, Sweden
| | - Tanja Makkonen
- Department of Psychology and Speech-Language Pathology, University of Turku, Finland
- Speech-Language Pathology, Tampere University Hospital, Finland
| | - Kati Renvall
- Department of Psychology and Speech-Language Pathology, University of Turku, Finland
- Department of Cognitive Science, Macquarie University, Sydney, New South Wales, Australia
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27
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Galindo-Moreno P, Lopez-Chaichio L, Padial-Molina M, Avila-Ortiz G, O'Valle F, Ravida A, Catena A. The impact of tooth loss on cognitive function. Clin Oral Investig 2021; 26:3493-3500. [PMID: 34881401 PMCID: PMC8979879 DOI: 10.1007/s00784-021-04318-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/23/2021] [Indexed: 11/05/2022]
Abstract
Objective To investigate if there is epidemiological evidence of an association between edentulism and cognitive decline beside that currently available from limited sample-sized case series and cross-sectional studies considering limited co-variables. Materials and methods Data from two USA national health surveys [NHIS 2014–2017 and NHANES 2005–2018] were analyzed using multinomial logistic regression to study the impact of type of edentulism and number of remaining teeth on memory and concentration problems. Age, gender, socioeconomic status, education level, cardiovascular health index, body mass index, exercise, alcohol, smoking habits, and anxiety and depression were used as covariates. Results The combined population sample was 102,291 individuals. Age, socioeconomic status, educational level, anxiety and depression levels, and edentulism showed the highest odds ratios for cognitive decline. Number of teeth present in the mouth was found to be a predictor of cognitive status. This association showed a gradient effect, so that the lower the number of teeth, the greater the risk of exhibiting cognitive decline. Conclusions Edentulism was found among the higher ORs for cognitive impairment. Clinical relevance Maintenance of functional teeth through the promotion of oral health may contribute to the preservation of memory/concentration and other essential cognitive functions. Thus, increasing and efficiently coordinating efforts aimed at preventing of tooth loss in the adult population could substantially contribute to reduce the incidence of cognitive impairment. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04318-4.
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Affiliation(s)
- Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Campus Universitario de Cartuja, s/n, 18071, Granada, Spain.
| | - Lucia Lopez-Chaichio
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Campus Universitario de Cartuja, s/n, 18071, Granada, Spain.,PhD Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Campus Universitario de Cartuja, s/n, 18071, Granada, Spain
| | - Gustavo Avila-Ortiz
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Francisco O'Valle
- Department of Pathology and IBIMER, School of Medicine, University of Granada, Granada, Spain.,Instituto Biosanitario de Granada (Ibs.GRANADA), University of Granada, Granada, Spain
| | - Andrea Ravida
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Andres Catena
- Department of Experimental Psychology, School of Psychology, University of Granada, Granada, Spain
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28
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Kiuchi S, Cooray U, Kusama T, Yamamoto T, Abbas H, Nakazawa N, Kondo K, Osaka K, Aida J. Oral Status and Dementia Onset: Mediation of Nutritional and Social Factors. J Dent Res 2021; 101:420-427. [PMID: 34796750 DOI: 10.1177/00220345211049399] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Some modifiable risk factors for dementia are closely related to oral health. Although eating and speaking abilities are fundamental oral functions, limited studies have focused on the effect of malnutrition and lack of social interaction between oral health and dementia. We investigated the mediating effects of nutritional and social factors on the association between the number of teeth and the incidence of dementia. This 6-y cohort study used data from the Japan Gerontological Evaluation Study targeting older adults aged 65 y and above. The number of teeth (exposure) and covariates in 2010 (baseline survey), mediators (weight loss, vegetable and fruit intake, homeboundness, social network) in 2013, and the onset of dementia (outcome) between 2013 and 2016 were obtained. The Karlson-Holm-Breen mediation method was applied. A total of 35,744 participants were included (54.0% women). The mean age at baseline was 73.1 ± 5.5 y for men and 73.2 ± 5.5 y for women. A total of 1,776 participants (5.0%) had dementia during the follow-up period. There was a significant total effect of the number of teeth on the onset of dementia (hazard ratio, 1.14; 95% CI, 1.01-1.28). Controlling for nutritional and social mediators, the effect of the number of teeth was reduced to 1.10 (95% CI, 0.98-1.25), leaving an indirect effect of 1.03 (95% CI, 1.02-1.04). In the sex-stratified analysis, the proportion mediated by weight loss was 6.35% for men and 4.07% for women. The proportions mediated by vegetable and fruit intake and homeboundness were 4.44% and 4.83% for men and 8.45% and 0.93% for women, respectively. Furthermore, the proportion mediated by social networks was 13.79% for men and 4.00% for women. Tooth loss was associated with the onset of dementia. Nutritional and social factors partially mediated this association.
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Affiliation(s)
- S Kiuchi
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - U Cooray
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - T Kusama
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan.,Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi, Japan
| | - T Yamamoto
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - H Abbas
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - N Nakazawa
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - K Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - K Osaka
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Miyagi, Japan
| | - J Aida
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi, Japan.,Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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29
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Abstract
There is a link between oral health and systemic health. Conditions such as dementia and pneumonia are associated with poor oral health. Frail older people receive regular care from medical and nursing staff but tend not to see dentists regularly or only seek treatment when there is a dental problem. Collaboration between dentists and other health professionals is therefore increasingly important. Oral health should be assessed regularly. This enables early referral to a dentist. Anticholinergic drugs, particularly in polypharmacy, can have a profound deleterious effect on salivary function and oral health. A medication review may enable the anticholinergic burden to be reduced. In addition to regular brushing, oral preventive products may be appropriate in frail older people.
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Affiliation(s)
- Alan Deutsch
- Bondi Junction Dental Centre, Sydney.,Centre for Education and Research on Ageing, Concord Repatriation General Hospital, Sydney.,Faculty of Medicine and Health, University of Sydney
| | - Emma Jay
- Bondi Junction Dental Centre, Sydney.,Centre for Education and Research on Ageing, Concord Repatriation General Hospital, Sydney.,Faculty of Medicine and Health, University of Sydney
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30
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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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31
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Xu S, Huang X, Gong Y, Sun J. Association between tooth loss rate and risk of mild cognitive impairment in older adults: a population-based longitudinal study. Aging (Albany NY) 2021; 13:21599-21609. [PMID: 34495870 PMCID: PMC8457613 DOI: 10.18632/aging.203504] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/19/2021] [Indexed: 12/13/2022]
Abstract
Mild cognitive impairment (MCI) is a symptomatic predementia phase of the trajectory of cognitive decline, and its prevalence increases with age. Although the relationship between oral health and MCI have been explored previously, it is uncertain whether individuals with different tooth loss rates have altered MCI risks. We hereby conducted a longitudinal study by using data from the Chinese Longitudinal Healthy Longevity Survey to investigate the association. Tooth loss rate was defined as the difference of teeth between two interview waves divided by years of interval; participants were then grouped into four categories: stable, no tooth loss; mild, 0-1 tooth loss; middle, 1-2 tooth loss; and severe, more than 2 tooth loss per year. Cognitive function was assessed by the Chinese version of Mini-Mental State Examination. We used the generalized estimating equation model to estimate the odds ratio (OR) and the 95% confidence intervals (CIs) and applied the restricted cubic spline function to explore the dose-response association. Among 11,862 participants, 3,966 developed MCI in a median follow-up time of 5.93 years. Higher tooth loss rate was associated with an increased risk of MCI in elderly subjects. Compared with subjects with stable tooth, the corresponding ORs (95% CIs) were 0.94 (0.85-1.03), 1.16 (1.04-1.29) and 1.28 (1.17-1.40) for subjects with the mild, middle and severe rate of tooth loss. A nonlinear dose-response relationship was detected (Pnon-linearity = 0.0165). Similar results were observed in the subgroup analyses stratified by sex, age at baseline, and number of teeth at baseline. The positive association was only observed among denture nonwearers (OR middle vs stable: 1.19; 1.06-1.35; OR severe vs stable: 1.35; 1.22-1.50), but not among denture wearers. In conclusion, among elderly population in China, higher rate of tooth loss may be associated with an increased risk of MCI, while denture wearers may be less likely to develop MCI.
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Affiliation(s)
- Shuyu Xu
- Department of Implantology, School and Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
| | - Xi Huang
- Department of Stomatology, First Affiliated Hospital of Soochow University, Jiangsu Province, China
| | - Yin Gong
- Department of Stomatology, First Affiliated Hospital of Soochow University, Jiangsu Province, China
| | - Jiangwei Sun
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
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Jockusch J, Hopfenmüller W, Nitschke I. Chewing function and related parameters as a function of the degree of dementia: Is there a link between the brain and the mouth? J Oral Rehabil 2021; 48:1160-1172. [PMID: 34288029 PMCID: PMC9291087 DOI: 10.1111/joor.13231] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 06/23/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023]
Abstract
Background To date, no study has investigated the association between chewing function and related parameters as a function of the degree of dementia using a finer subdivision of the values of the Mini‐Mental State Examination (MMSE). Objective This study aimed to investigate the differences in chewing function and related parameters as a function of the degree of dementia. Methods An analysis of cross‐sectional data obtained from the OrBiD (Oral Health, Bite Force, and Dementia) pilot study was performed. The participants were stratified into five groups based on the outcomes of the MMSE (no dementia, MMSE 28–30; mild cognitive impairment, MMSE 25–27; mild dementia, MMSE 18–24; moderate dementia, MMSE 10–17; severe dementia, MMSE <10). The chewing efficiency, maximum occlusal force and related parameters (number of supporting zones, number of teeth, Eichner index, tooth/denture status, denture quality, and dental treatment needs) were recorded. Results The MMSE groups showed significantly different chewing efficiencies (p = .003, Jonckheere‐Terpstra test) and maximum occlusal forces (p = .003, Jonckheere‐Terpstra test), but the number of supporting zones (p = .055, chi‐square test) and the number of natural teeth (p = .126, chi‐square test) were not different. The Eichner index, tooth/denture status, denture quality and dental treatment need showed no significant associations with the degree of dementia. Conclusion An improvement in the usability of the measurement methods for assessing chewing function in people with dementia is needed. Research involving people with dementia is necessary because the nutritional situation often deteriorates rapidly within a multifactorial system, which includes chewing ability and oral health.
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Affiliation(s)
- Julia Jockusch
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland
| | - Werner Hopfenmüller
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ina Nitschke
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, Leipzig, Germany
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Tiwari T, Tranby E, Thakkar-Samtani M, Frantsve-Hawley J. Determinants of Tooth Loss in a Medicaid Adult Population. JDR Clin Trans Res 2021; 7:289-297. [PMID: 34269110 DOI: 10.1177/23800844211022277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The objective of this retrospective cohort study is to examine the determinants of tooth loss in a Medicaid-enrolled population using claims data from 2016 to 2018. METHODS Deidentified administrative claims data for Medicaid-enrolled adults between the ages of 50 and 90 y in 2016 to 2018 were examined using the IBM Watson MarketScan Medicaid Database. The sample size was 91,468. The entire sample was divided into 2 cohorts: no tooth loss cohort (n = 54,786) and tooth loss cohort (n = 36,682). The tooth loss cohort was further divided into 2 groups: 1 to 5 teeth lost (n = 29,141) and 6 or more teeth lost (n = 7,541). Tooth loss was described by age, gender, race, number of commodities, and if periodontal treatment was performed. Logistic regression models were conducted to examine factors associated with tooth loss. RESULTS Within the tooth loss cohort, the patients who had periodontal treatment had higher odds of losing at least 1 tooth (odds ratio [OR], 1.15; confidence interval [CI], 1.10-1.20) and lower odds of losing 6 or more teeth (OR, 0.25; CI, 0.22-0.29). In the regression analysis, the predictive margins of tooth loss for 1 tooth and 6 or more teeth follow a linear path. Compared to no comorbidities, the odds of losing 6 or more teeth increased with 1, 2, or 3+ comorbidities. KNOWLEDGE TRANSFER STATEMENT This study provides significant information about the quantification of comorbidities and its direct correlation with the increased odds of tooth loss. This study also highlighted the protective effect of periodontal treatment on tooth loss. This knowledge can be useful to dental care providers to understand the risk of tooth loss in their patient population.
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Affiliation(s)
- T Tiwari
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - E Tranby
- DentaQuest Partnership for Oral Health Advancement, MA, USA
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Singhal A, Alofi A, Garcia RI, Sabik LM. Medicaid adult dental benefits and oral health of low-income older adults. J Am Dent Assoc 2021; 152:551-559.e1. [PMID: 34176569 DOI: 10.1016/j.adaj.2021.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 02/13/2021] [Accepted: 03/07/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Older adults are keeping their natural teeth longer, spurring calls for dental coverage under Medicare. Although Medicare dental coverage would benefit all older adults, the poorest among them are already eligible for dental benefits through Medicaid. The authors examine the association between states' Medicaid adult dental benefits and dental care use and tooth loss among low-income older adults. METHODS Using the Behavioral Risk Factor Surveillance System data from 2014, 2016, and 2018, the authors examined adults 65 years or older. The outcomes examined included annual dental visit and partial and complete tooth loss. Poisson regressions were used to obtain risk ratios after adjusting for covariates. RESULTS States' Medicaid adult dental benefits were significantly associated with dental care use, with low-income older adults in states with no coverage having the lowest probability of visiting a dentist (risk ratio [RR], 0.83; 95% CI, 0.74 to 0.94), followed by emergency-only coverage (RR, 0.91; 95% CI, 0.84 to 0.98) and limited benefits (RR, 0.91; 95% CI, 0.85 to 0.98) relative to states with extensive benefits. There were no significant differences in either partial or complete tooth loss. CONCLUSIONS States' Medicaid adult dental benefits are significantly associated with dental visits among low-income seniors. Providing comprehensive dental benefits under Medicaid can improve access to dental care among low-income older adults. PRACTICAL IMPLICATIONS As the older adult patient population grows, the poorest older adults may face barriers to dental care in the absence of dental coverage. Dental professionals must engage in advocating for comprehensive dental coverage, especially for vulnerable populations.
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Koyanagi A, Smith L, Shin JI, Oh H, Kostev K, Jacob L, Abduljabbar AS, Haro JM. Multimorbidity and Subjective Cognitive Complaints: Findings from 48 Low- and Middle-Income Countries of the World Health Survey 2002-2004. J Alzheimers Dis 2021; 81:1737-1747. [PMID: 33998540 DOI: 10.3233/jad-201592] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Data on the association between multimorbidity and subjective cognitive complaints (SCC) are lacking from low- and middle-income countries (LMICs). OBJECTIVE To assess the association between multimorbidity and SCC among adults from 48 LMICs. METHODS Cross-sectional, community-based data were analyzed from the World Health Survey 2002-2004. Ten chronic conditions (angina, arthritis, asthma, chronic back pain, depression, diabetes, edentulism, hearing problems, tuberculosis, visual impairment) were assessed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). Multivariable linear regression and mediation analyses were conducted to explore the associations. RESULTS A total of 224,842 individuals aged≥18 years [mean (SD) age 38.3 (16.0) years; 49.3% males] constituted the final sample. Compared to no chronic conditions, the mean SCC score was higher by 7.13 (95% CI = 6.57-7.69), 14.84 (95% CI = 13.91-15.77), 21.10 (95% CI = 19.49-22.70), 27.48 (95% CI = 25.20-29.76), and 33.99 (95% CI = 31.45-36.53) points for 1, 2, 3, 4, and≥5 chronic conditions. Estimates by sex and age groups (18-44, 45-64,≥65 years) were similar. Nearly 30% of the association between multimorbidity (i.e.,≥2 chronic conditions) and SCC was explained by psychological factors (i.e., perceived stress, sleep problems, anxiety symptoms). CONCLUSION Multimorbidity is associated with SCC among adults in LMICs. Future studies should investigate whether addressing psychological factors in people with multimorbidity can improve cognitive function, and whether screening for SCC in individuals with multimorbidity can be a useful tool to identify individuals at particularly high risk for future cognitive decline.
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Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, Barcelona, Spain.,ICREA, Barcelona, Spain
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Karel Kostev
- Philipps University of Marburg, Marburg, Germany
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | | | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, Barcelona, Spain.,King Saud University, Riyadh, Saudi Arabia
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36
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Da Silva JD, Ni SC, Lee C, Elani H, Ho K, Thomas C, Kuwajima Y, Ishida Y, Kobayashi T, Ishikawa-Nagai S. Association between cognitive health and masticatory conditions: a descriptive study of the national database of the universal healthcare system in Japan. Aging (Albany NY) 2021; 13:7943-7952. [PMID: 33739304 PMCID: PMC8034966 DOI: 10.18632/aging.202843] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/05/2021] [Indexed: 12/02/2022]
Abstract
Cognitive health is subject to decline with increasing numbers of lost teeth which impacts mastication. This study is a descriptive data analysis of the association between masticatory and cognitive conditions using a large database. We obtained the dental and medical records from Japan's universal healthcare system (UHCS) from the national database in 2017. The data from 94% of the Japanese population aged 65 and over is included. It is inclusive of diagnostic codes for various types of cognitive impairment, as well as dental treatment records from 2012 to 2017. The cognitive impairment group was compared to those without a diagnosis of cognitive impairment. Crude odds ratio between loss of mastication with natural teeth (exposure) and cognitive impairments (outcome) were compared. Patients who have lost masticatory function are likely to have cognitive impairment with an odds ratio of 1.89 (p<0.0001) for early elderly (aged 65-75) and 1.33 (p<0.0001) for advanced elderly (over 75). Patients who are edentulous and function with complete dentures are likely to have cognitive impairment with an odds ratio of 2.38 (p<0.0001) and 1.38 (p<0.0001), respectively. The data shows a convincing and significant result of an association between cognitive health and oral health, related to masticatory conditions.
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Affiliation(s)
- John D Da Silva
- Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Shy Chwen Ni
- Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Cliff Lee
- Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Hawazin Elani
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Kailing Ho
- DMD Candidate, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Carlos Thomas
- DMD Candidate, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Yukinori Kuwajima
- Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Yoshiki Ishida
- Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | | | - Shigemi Ishikawa-Nagai
- Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA.,Iwate Medical University, School of Dental Medicine, Japan
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37
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Amengual-Peñafiel L, Córdova LA, Constanza Jara-Sepúlveda M, Brañes-Aroca M, Marchesani-Carrasco F, Cartes-Velásquez R. Osteoimmunology drives dental implant osseointegration: A new paradigm for implant dentistry. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:12-19. [PMID: 33737990 PMCID: PMC7946347 DOI: 10.1016/j.jdsr.2021.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/30/2020] [Accepted: 01/14/2021] [Indexed: 01/08/2023] Open
Abstract
There is a complex interaction between titanium dental implants, bone, and the immune system. Among them, specific immune cells, macrophages play a crucial role in the osseointegration dynamics. Infiltrating macrophages and resident macrophages (osteomacs) contribute to achieving an early pro-regenerative peri-implant environment. Also, multinucleated giant cells (MNGCs) in the bone-implant interface and their polarization ability, maintain a peri-implant immunological balance to preserve osseointegration integrity. However, dental implants can display cumulative levels of antigens (ions, nano and microparticles and bacterial antigens) at the implant–tissue interface activating an immune-inflammatory response. If the inflammation is not resolved or reactivated due to the stress signals and the immunogenicity of elements present, this could lead implants to aseptic loosening, infections, and subsequent bone loss. Therefore, to maintain osseointegration and prevent bone loss of implants, a better understanding of the osteoimmunology of the peri-implant environment would lead to the development of new therapeutic approaches. In this line, depicting osteoimmunological mechanisms, we discuss immunomodulatory strategies to improve and preserve a long-term functional integration between dental implants and the human body. Scientific field of dental science: implant dentistry.
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Affiliation(s)
| | - Luis A Córdova
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Chile, Chile.,Department of Oral and Maxillofacial Surgery, Clínica Las Condes, Santiago, Chile.,Department of Oral and Maxillofacial Surgery, Complejo Hospitalario San José. Craneofacial Translational Research Laboratory, Faculty of Dentistry, University of Chile, Santiago, Chile
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Lopez-Jornet P, Zamora Lavella C, Pons-Fuster Lopez E, Tvarijonaviciute A. Oral Health Status in Older People with Dementia: A Case-Control Study. J Clin Med 2021; 10:jcm10030477. [PMID: 33514062 PMCID: PMC7865865 DOI: 10.3390/jcm10030477] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 12/28/2022] Open
Abstract
Dementia is characterized by a range of cognitive defects with impaired activities of daily living that have implications for patient oral health. Objectives. A case-control study was made of the impact of dementia upon oral health. A total of 152 patients were included: 69 with dementia and 83 controls from the region of Murcia (Spain). The Global Deterioration Scale (GDS) was used to classify the patients and an oral exploration was carried out. Odds ratios (ORs) and confidence intervals (CIs) were estimated using regression models. The patients with more severe disease were significantly more likely to have fewer natural teeth (OR 11.00, 95%CI 1.28–23.22; p = 0.001), a higher plaque index (p = 0.001), and a greater bleeding index (p = 0.001) than the control group. These findings suggest that older adults with dementia have deficient oral health. A higher bleeding index increases the risk of deterioration of cognitive function. The oral hygiene and health of older people with dementia need to be improved.
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Affiliation(s)
- Pia Lopez-Jornet
- . Department Stomatology School of Medicine, Biomedical Research Institute (IMIB-Arrixaca), Faculty of Medicine and Odontology, University of Murcia, Adv Marques de los Velez s/n, 30008 Murcia, Spain
- Correspondence:
| | - Carmen Zamora Lavella
- . Faculty of Medicine and Odontology, University of Murcia, 30008 Murcia, Spain; (C.Z.L.); (E.P.-F.L.)
| | - Eduardo Pons-Fuster Lopez
- . Faculty of Medicine and Odontology, University of Murcia, 30008 Murcia, Spain; (C.Z.L.); (E.P.-F.L.)
| | - Asta Tvarijonaviciute
- . Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence ‘Campus Mare Nostrum’, University of Murcia, Espinardo, 30100 Murcia, Spain;
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Badewy R, Singh H, Quiñonez C, Singhal S. Impact of Poor Oral Health on Community-Dwelling Seniors: A Scoping Review. Health Serv Insights 2021; 14:1178632921989734. [PMID: 33597810 PMCID: PMC7841244 DOI: 10.1177/1178632921989734] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/31/2020] [Indexed: 12/29/2022] Open
Abstract
The aim of this scoping review was to determine health-related impacts of poor oral health among community-dwelling seniors. Using MeSH terms and keywords such as elderly, general health, geriatrics, 3 electronic databases-Medline, CINAHL, and Age Line were searched. Title and abstracts were independently screened by 3 reviewers, followed by full-texts review. A total of 131 articles met our inclusion criteria, the majority of these studies were prospective cohort (77%, n = 103), and conducted in Japan (42 %, n = 55). These studies were categorized into 16 general health outcomes, with mortality (24%, n = 34), and mental health disorders (21%, n = 30) being the most common outcomes linked with poor oral health. 90% (n = 120) of the included studies reported that poor oral health in seniors can subsequently lead to a higher risk of poor general health outcomes among this population. Improving access to oral healthcare services for elderly can help not only reduce the burden of oral diseases in this population group but also address the morbidity and mortality associated with other general health diseases and conditions caused due to poor oral health. Findings from this study can help identify shortcomings in existing oral healthcare programs for elderly and develop future programs and services to improve access and utilization of oral care services by elderly.
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Affiliation(s)
- Rana Badewy
- Faculty of Dentistry, University of
Toronto, Toronto, ON, Canada
| | | | - Carlos Quiñonez
- Faculty of Dentistry, Director of
Graduate Program in Dental Public Health, University of Toronto, Toronto, ON,
Canada
| | - Sonica Singhal
- Faculty of Dentistry, University of
Toronto, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON,
Canada
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40
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Lin CS, Lin HH, Fann SW, Lee WJ, Hsu ML, Wang SJ, Fuh JL. Association between tooth loss and gray matter volume in cognitive impairment. Brain Imaging Behav 2021; 14:396-407. [PMID: 32170642 DOI: 10.1007/s11682-020-00267-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Previous studies have reported an association between tooth loss and gray matter volume (GMV) in healthy adults. The study aims to elucidate the link between tooth loss, brain volume differences, and cognitive impairment by investigating the total and regional differences in GMV associated with tooth loss in older people with and without cognitive impairment. Forty older participants with mild cognitive impairment or Alzheimer's disease [the cognitive impairment (CI) group] and 30 age- and sex-matched healthy participants [the control (CON) group] received T1-weighted magnetic resonance imaging scans and assessments of oral functions, including masticatory performance (MP) and the number of missing teeth (NMT). Voxel-based morphometry was used to assess the total and regional GMV, including that of the medial temporal lobe and motor-related areas. (A) When the total intracranial volume and age were controlled for, an increased MP was associated with a larger GMV in the premotor cortex in the CON group. (B) In the CI group, an increased NMT was significantly correlated with smaller regional GMV of the bilateral primary motor cortex and the premotor cortex. (C) In the CI group, but not the CON group, an increased NMT was associated with both smaller total GMV and regional GMV of the left medial temporal lobe, including the left hippocampus and parahippocampus. Tooth loss may be preferentially related to the structural differences in the medial temporal lobe in cognitively impaired older people. Further research is required to understand the mechanisms of the relationships.
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Affiliation(s)
- Chia-Shu Lin
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei City, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei City, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei City, Taiwan
| | - Hsiao-Han Lin
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei City, Taiwan
| | - Shin-Woei Fann
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei City, Taiwan, 122
| | - Wei-Ju Lee
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei City, Taiwan
| | - Ming-Lun Hsu
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei City, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taipei City, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei City, Taiwan, 122. .,Faculty of Medicine, National Yang-Ming University, Taipei City, Taiwan.
| | - Jong-Ling Fuh
- Brain Research Center, National Yang-Ming University, Taipei City, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei City, Taiwan, 122. .,Faculty of Medicine, National Yang-Ming University, Taipei City, Taiwan.
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Shah PD, Badner VM. Association between asthma and severe tooth loss in the adult population of the United States. J Asthma 2020; 59:462-468. [PMID: 33356681 DOI: 10.1080/02770903.2020.1856868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to investigate the association between asthma and severe tooth loss in the U.S. (United States) adult population. METHODS Data were analyzed from the national health and nutritional examination survey (NHANES), 2009-2014. Study-participants were classified into current, former, and never asthmatics based on their asthma status. Former-asthmatics were excluded. The case definition of severe tooth loss (outcome variable) was having 9 or fewer remaining permanent teeth. Characteristics of our study-sample were identified based on the descriptive statistical analyses. Logistic regression analyses were performed to examine the association between asthma and severe tooth. Multivariable models were constructed to control for the known common clinical, demographic, and lifestyle factors. Each analysis accounted for the examination sample weights and the complex clustered design of the continuous NHANES. RESULTS Total study-participants were 14,184 representing ≈185.77 million U.S. adults. Prevalence of asthma was 8.99% in our study-sample, and 8.78% had severe tooth loss. Current-asthmatic adults had 34% higher odds of severe tooth loss as compared to their reference group of never-asthmatics adults in the U.S. after controlling for age, race or ethnicity, gender, diabetes, smoking, body mass index, education, and family income-to-poverty ratio. CONCLUSION In the United States, as compared to never-asthmatic adults, current-asthmatic adults were more likely to have severe tooth-loss. Oral health promotion is therefore recommended through medical-dental integration to ensure overall health for asthmatic adults.
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Affiliation(s)
- Parth D Shah
- Division of Population Health and Community Dentistry, Department of Dentistry and Oral & Maxillofacial Surgery, Jacobi Medical Center in affiliation with the Albert Einstein College of Medicine, Bronx, NY, USA
| | - Victor M Badner
- Department of Dentistry and Oral & Maxillofacial Surgery, Jacobi Medical Center in affiliation with the Albert Einstein College of Medicine, Bronx, NY, USA
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Lopez-Chaichio L, Padial-Molina M, O'Valle F, Gil-Montoya JA, Catena A, Galindo-Moreno P. Oral health and healthy chewing for healthy cognitive ageing: A comprehensive narrative review. Gerodontology 2020; 38:126-135. [PMID: 33179281 DOI: 10.1111/ger.12510] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 09/11/2020] [Accepted: 10/24/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Ageing leads to physiological cognitive decline that it is worsened in people with neurodegenerative diseases such as Alzheimer's disease. Despite the ongoing search for a solution to this cognitive decline, no effective remedies have been established. It has been determined that modifiable external factors, such as oral health and occlusal function, prevent cognitive decline. OBJECTIVE To analyse the primary interactions between occlusal function and cognitive functions. MAIN FINDINGS Masticatory function is related to cognitive functions. In particular, current evidence, from both animal and human studies, suggests that the activation of masticatory muscles and proper mastication, with natural teeth or dental prosthesis, induces the release of several mediators and the activation of specific brain areas. Together, they result in higher neuronal activity, neurotrophic support, blood flow and the prevention of amyloid-beta plaque formation. Thus, all the components of the masticatory system must work together in order to preserve cognitive function. CONCLUSIONS Available evidence suggests that oral and cognitive health are more interconnected than previously thought. Therefore, maintenance and adequate restoration of the whole masticatory system are important for the prevention of cognitive decline. In summary, oral and chewing health lead to healthy cognitive ageing.
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Affiliation(s)
- Lucia Lopez-Chaichio
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Francisco O'Valle
- Department of Pathology and IBIMER, School of Medicine, University of Granada, Granada, Spain.,Biosanitary Institute of Granada (ibs.Granada), University of Granada, Granada, Spain
| | - Jose Antonio Gil-Montoya
- Biosanitary Institute of Granada (ibs.Granada), University of Granada, Granada, Spain.,Department of Gerodontology, School of Dentistry, University of Granada, Granada, Spain
| | - Andres Catena
- Mind, Brain and Behavior Research Center, University of Granada, Granada, Spain
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
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43
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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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44
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Liu YCG, Lan SJ, Hirano H, Lin LM, Hori K, Lin CS, Zwetchkenbaum S, Minakuchi S, Teng AYT. Update and review of the gerodontology prospective for 2020's: Linking the interactions of oral (hypo)-functions to health vs. systemic diseases. J Dent Sci 2020; 16:757-773. [PMID: 33854730 PMCID: PMC8025188 DOI: 10.1016/j.jds.2020.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/03/2020] [Indexed: 02/07/2023] Open
Abstract
New lines of evidence suggest that the oral-systemic medical links and oral hypo-function are progressively transcending beyond the traditional clinical signs and symptoms of oral diseases. Research into the dysbiotic microbiome, host immune/inflammatory regulations and patho-physiologic changes and subsequent adaptations through the oral-systemic measures under ageism points to pathways leading to mastication deficiency, dysphagia, signature brain activities for (neuro)-cognition circuitries, dementia and certain cancers of the digestive system as well. Therefore, the coming era of oral health-linked systemic disorders will likely reshape the future of diagnostics in oral geriatrics, treatment modalities and professional therapies in clinical disciplines. In parallel to these highlights, a recent international symposium was jointly held by the International Association of Gerontology and Geriatrics (IAGG), Japanese Society of Gerodontology (JSG), the representative of USA and Taiwan Academy of Geriatric Dentistry (TAGD) on Oct 25th, 2019. Herein, specific notes are briefly addressed and updated for a summative prospective from this symposium and the recent literature.
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Affiliation(s)
- Yen Chun G. Liu
- Center for Osteoimmunology & Biotechnology Research (COBR) and Dept. of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan
- Corresponding author. Dept. of Oral Hygiene & COBR, College of Dental Medicine, Kaohsiung Medical University; No. 100, Shih-Chun 1st Rd, Kaohsiung 807, Taiwan. Fax: +886 07 3223141.
| | - Shou-Jen Lan
- Dept. of Healthcare Administration, Asia University, Tai-Chung, Taiwan
| | - Hirohiko Hirano
- Research Team for Promoting Independence & Mental Health, and Dentistry & Oral Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Li-min Lin
- Div. of Oral Pathology & Oral Maxillo-facial Radiology, School of Dentistry, Kaohsiung Medical University & KMU-Hospital, Kaohsiung, Taiwan
| | - Kazuhiro Hori
- Div. of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Chia-shu Lin
- Dept. of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Samuel Zwetchkenbaum
- Rhode Island Dept. of Health, Rhode Island, USA
- School of Public Health, Brown University, Providence, RI, USA
| | - Shunsuke Minakuchi
- Gerodontology & Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Andy Yen-Tung Teng
- Center for Osteoimmunology & Biotechnology Research (COBR) and Dept. of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan
- Center for Osteoimmunology & Biotechnology Research (COBR) and School of Dentistry, College of Dental Medicine, Kaohsiung Medical University and KMU-Hospital, Kaohsiung, Taiwan
- Corresponding author. Center for Osteoimmunology and Biotechnology Research (COBR), College of Dental Medicine, Kaohsiung Medical University (KMU) & KMU-Hospital, Kaohsiung, Taiwan.
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45
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Tan D, Foster S, Korgaonkar MS, Oxenham V, Whittle T, Klineberg I. The role of progressive oral implant rehabilitation in mastication, cognition and oral health‐related quality of life outcomes—A pilot to define the protocol. J Oral Rehabil 2020; 47:1368-1381. [DOI: 10.1111/joor.13085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Daniel Tan
- Department of Oral Rehabilitation School of Dentistry Faculty of Medicine and Health University of Sydney Sydney Australia
| | - Sheryl Foster
- School of Health Sciences Faculty of Medicine and Health University of Sydney Sydney Australia
- Radiology Department Westmead Hospital Sydney Australia
| | - Mayuresh S. Korgaonkar
- School of Health Sciences Faculty of Medicine and Health University of Sydney Sydney Australia
- Brain Dynamics Centre Westmead Institute for Medical Research, University of Sydney Sydney Australia
| | - Vincent Oxenham
- Department of Psychology Faculty of Medicine, Health and Human Sciences Macquarie University Sydney Australia
| | - Terry Whittle
- Department of Oral Rehabilitation School of Dentistry Faculty of Medicine and Health University of Sydney Sydney Australia
| | - Iven Klineberg
- Department of Oral Rehabilitation School of Dentistry Faculty of Medicine and Health University of Sydney Sydney Australia
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46
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Abstract
Multimorbidity (the coexistence of two or more chronic conditions) is common, is likely to be on the increase and has a major impact on quality of life, increased risk of mortality, and significant financial costs to the health and social care system. Multimorbidity is strongly associated with increasing age and is also directly linked to socioeconomic status. A substantial body of scientific evidence has shown an association between specific oral diseases and a range of other health conditions. Less is known, however, about the inter-relationships between oral diseases and multiple other health conditions. As multimorbidity is increasingly becoming the norm, rather than the exception, a profound shift is now needed in the training of oral health professionals, and the practice and delivery of dental care. A more integrated and coordinated approach to training and care is needed, which will require radical system-level reform and redesign of how health and dental services are commissioned, delivered and financed. Truly multidisciplinary teamwork requires system reform to facilitate effective joint working. The pattern of disease in society is changing and the dental profession needs to respond accordingly.
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Affiliation(s)
- Richard G Watt
- Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, London, WC1E 6BT, UK.
| | - Stefan Serban
- School of Dentistry, University of Leeds, Clarendon Way, Leeds, LS2 9LU, UK
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47
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Piancino MG, Tortarolo A, Polimeni A, Bramanti E, Bramanti P. Altered mastication adversely impacts morpho-functional features of the hippocampus: A systematic review on animal studies in three different experimental conditions involving the masticatory function. PLoS One 2020; 15:e0237872. [PMID: 32817680 PMCID: PMC7446800 DOI: 10.1371/journal.pone.0237872] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023] Open
Abstract
Recent results have established that masticatory function plays a role not only in the balance of the stomatognathic system and in the central motor control, but also in the trophism of the hippocampus and in the cognitive activity. These implications have been shown in clinical studies and in animal researches as well, by means of histological, biochemical and behavioural techniques. This systematic review describes the effects of three forms of experimentally altered mastication, namely soft-diet feeding, molar extraction and bite-raising, on the trophism and function of the hippocampus in animal models. Through a systematic search of PubMed, Embase, Web of Science, Scopus, OpenGray and GrayMatters, 645 articles were identified, 33 full text articles were assessed for eligibility and 28 articles were included in the review process. The comprehensiveness of reporting was evaluated with the ARRIVE guidelines and the risk of bias with the SYRCLE RoB tool. The literature reviewed agrees that a disturbed mastication is significantly associated with a reduced number of hippocampal pyramidal neurons in Cornu Ammonis (CA)1 and CA3, downregulation of Brain Derived Neurotrophic Factor (BDNF), reduced synaptic activity, reduced neurogenesis in the Dentate Gyrus (DG), glial proliferation, and reduced performances in behavioural tests, indicating memory impairment and reduced spatial orientation. Moreover, while the bite-raised condition, characterized by occlusal instability, is known to be a source of stress, soft-diet feeding and molar extractions were not consistently associated with a stress response. More research is needed to clarify this topic. The emerging role of chewing in the preservation of hippocampal trophism, neurogenesis and synaptic activity is worthy of interest and may contribute to the study of neurodegenerative diseases in new and potentially relevant ways.
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Affiliation(s)
- Maria Grazia Piancino
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
- * E-mail:
| | - Alessandro Tortarolo
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillo-Facial Science, Sapienza University of Rome, Rome, Italy
| | - Ennio Bramanti
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy
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48
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Han SH, Wu B, Burr JA. Edentulism and Trajectories of Cognitive Functioning Among Older Adults: The Role of Dental Care Service Utilization. J Aging Health 2020; 32:744-752. [PMID: 31130037 PMCID: PMC10676023 DOI: 10.1177/0898264319851654] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Objective: This study examined the associations between edentulism, dental care service utilization, and cognitive functioning trajectories among older adults. Method: Longitudinal data from the Health and Retirement Study (2006-2014) were employed to examine individuals aged 51 and older who were identified as having normal cognition at baseline (N = 12,405). Cognitive functioning was measured with a modified version of the Telephone Interview for Cognition Status. Edentulism was self-reported as total tooth loss at baseline. Dental care service utilization was measured by self-report of having visited a dentist at least once during the previous 2 years. Results: The results indicated that edentulism and dental care service utilization were independently associated with cognitive decline during the observation period. Findings also showed that dental care service utilization moderated the association between edentulism and cognitive decline. Discussion: The findings suggested that providing access to dental services may promote cognitive health and potentially reduce health care expenditures.
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Affiliation(s)
| | - Bei Wu
- New York University, New York City, USA
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49
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Matsushita K, Yamada-Furukawa M, Kurosawa M, Shikama Y. Periodontal Disease and Periodontal Disease-Related Bacteria Involved in the Pathogenesis of Alzheimer's Disease. J Inflamm Res 2020; 13:275-283. [PMID: 32636667 PMCID: PMC7335281 DOI: 10.2147/jir.s255309] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/29/2020] [Indexed: 12/11/2022] Open
Abstract
Alzheimer’s disease (AD) is the most common cause of dementia, and it exhibits pathological properties such as deposition of extracellular amyloid β (Aβ) and abnormally phosphorylated Tau in nerve cells and a decrease of synapses. Conventionally, drugs targeting Aβ and its related molecules have been developed on the basis of the amyloid cascade hypothesis, but sufficient effects on the disease have not been obtained in past clinical trials. On the other hand, it has been pointed out that chronic inflammation and microbial infection in the brain may be involved in the pathogenesis of AD. Recently, attention has been focused on the relationship between the periodontopathic bacterium Porphylomonas gingivalis and AD. P. gingivalis and its toxins have been detected in autopsy brain tissues from patients with AD. In addition, pathological conditions of AD are formed or exacerbated in mice infected with P. gingivalis. Compounds that target the toxins of P. gingivalis ameliorate the pathogenesis of AD triggered by P. gingivalis infection. These findings indicate that the pathological condition of AD may be regulated by controlling the bacteria in the oral cavity and the body. In the current aging society, the importance of oral and periodontal care for preventing the onset of AD will increase.
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Affiliation(s)
- Kenji Matsushita
- Department of Oral Disease Research, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Masae Yamada-Furukawa
- Department of Oral Disease Research, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Mie Kurosawa
- Department of Oral Disease Research, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Yosuke Shikama
- Department of Oral Disease Research, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
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50
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Dintica CS, Marseglia A, Wårdh I, Stjernfeldt Elgestad P, Rizzuto D, Shang Y, Xu W, Pedersen NL. The relation of poor mastication with cognition and dementia risk: a population-based longitudinal study. Aging (Albany NY) 2020; 12:8536-8548. [PMID: 32353829 PMCID: PMC7244038 DOI: 10.18632/aging.103156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 04/17/2020] [Indexed: 12/14/2022]
Abstract
We investigated the effect of poor masticatory ability on cognitive trajectories and dementia risk in older adults. 544 cognitively intact adults aged ≥50 were followed for up to 22 years. Cognitive domains (verbal, spatial/fluid, memory, and perceptual speed) were assessed at baseline and follow-ups. Dementia was ascertained according to standard criteria. Masticatory ability was assessed using the Eichner Index and categorized according to the number of posterior occlusal zones: A (all four), B (3-1), and C (none). At baseline, 147 (27.0%) participants were in Eichner category A, 169 (31.1%) in B and 228 (41.9%) in C. After the age of 65, participants in Eichner category B and C showed an accelerated decline in spatial/fluid abilities (β: -0.16, 95% CI: -0.30 to -0.03) and (β: -0.15, 95% CI: -0.28 to -0.02), respectively. Over the follow-up, 52 incident dementia cases were identified. Eichner categories B or C were not associated with an increased risk of dementia, compared to category A (Hazard Ratio [HR]: 0.83, 95% CI: 0.39 to 1.76 and HR: 0.63, 95% CI: 0.30 to 1.29, respectively). Poor masticatory ability is associated with an accelerated cognitive decline in fluid/spatial abilities, however it was not related to a higher risk of dementia.
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Affiliation(s)
- Christina S Dintica
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Anna Marseglia
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Inger Wårdh
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden.,Academic Centre of Geriatric Dentistry, Karolinska Institute, Stockholm, Sweden
| | - Per Stjernfeldt Elgestad
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden.,Academic Centre of Geriatric Dentistry, Karolinska Institute, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden.,The Stockholm Gerontology Research Center- Äldrecentrum, Stockholm, Sweden
| | - Ying Shang
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.,Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
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