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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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Chen Y, Li C, Fan Y, Jiao L, Silverman M, Ishimaru M, Wang J, Van Pelt AJ, Wang R. Associations of oral health status and swallowing function with cognitive impairment in the aging population: a cross-sectional study. BMC Oral Health 2023; 23:912. [PMID: 37993856 PMCID: PMC10666324 DOI: 10.1186/s12903-023-03640-5] [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: 09/20/2022] [Accepted: 11/08/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND The purpose of this study was to investigate the relationships of oral health status and swallowing function with cognitive impairment in community-dwelling older adults from Changsha, Hunan Province, China. METHODS In this cross-sectional study, we analyzed the data of 215 participants aged ≥ 50 years which were retrieved from the Xiangya and Panasonic mild cognitive impairment (MCI) Study, a community-based study conducted among the residents of the urban areas of Hunan province in China. Demographic information of all participants was collected. We determined oral function by evaluating oral hygiene, oral dryness, occlusal force, tongue pressure, chewing function, swallowing function, remaining teeth number, and other indicators. The mini-mental state examination (MMSE) was used to screen for cognitive function. The relationship between each oral function evaluation item and cognitive function was investigated using correlation analysis. The associations between oral health status and swallowing function with cognitive impairment were inferred using multiple regression analysis. RESULTS The general characteristics of participants showed statistically significant correlation coefficients in number of teeth remaining (p = 0.003) and number of teeth lost (p < 0.0001). Almost half of the 25 participants (48%) were aged from 70-80 years. Only 25 older adults (11.6% of the participants) were determined to have cognitive impairment by MMSE sores less than 24. Tongue pressure in male participants was the only significant independent variable that was associated with cognitive impairment (p = 0.01971). The results indicate that male participants with lower MMSE scores had a relative deficiency in tongue pressure. CONCLUSIONS In this cross-sectional study, the oral health status and swallowing function of participants were in relatively good condition and showed low correlations with cognitive impairment. However, lower tongue pressures were associated with lower MMSE scores in males, indicating it could serve as a novel oral function index for evaluating cognitive impairment.
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Affiliation(s)
- Yong Chen
- Laboratory of Food Oral Processing, School of Food Science & Biotechnology, Zhejiang Gongshang University, Hangzhou, Zhejiang, China
| | - Canyang Li
- Rehabilitation Medicine Department, Speech and Language Pathology Therapy Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yongmei Fan
- Rehabilitation Medicine Department, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lili Jiao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, of Central South University, Changsha, Hunan, China
| | - Matthew Silverman
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | | | - Jing Wang
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Alice J Van Pelt
- Section of Gastroenterology, Jr. VA Hospital, Edward Hines, Hines, IL, USA
- Division of Gastroenterology and Nutrition, Loyola University Stritch School of Medicine, Maywood, IL, USA
| | - Rumi Wang
- Rehabilitation Medicine Department, Speech and Language Pathology Therapy Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
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Jockusch J, Hahnel S, Sobotta BBAJ, Nitschke I. The Effect of a Masticatory Muscle Training Program on Chewing Efficiency and Bite Force in People with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073778. [PMID: 35409460 PMCID: PMC8997984 DOI: 10.3390/ijerph19073778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 12/04/2022]
Abstract
Until now, no study has investigated the effects of masticatory muscle training on chewing function in people with dementia. This study aimed to investigate whether physiotherapeutic exercises for the masticatory muscles have an influence on chewing efficiency and bite force in people with dementia. In a clinical trial with stratified randomization subjects were assigned to three groups based on the Mini Mental State Examination (MMSE: group 1—28–30, group 2—25–27, group 3—18–24). Each group was divided into an experimental (ExpG, intervention) and control group (ConG, no intervention). As intervention a Masticatory Muscle Training (MaMuT) (part 1: three physiotherapeutic treatments and daily home exercises, part 2: daily home exercises only) was carried out. Chewing efficiency and bite force were recorded. The MaMuT influenced the masticatory performance regardless of the cognitive state. Bite force increased in ExpG 1 and 2. Without further training, however, the effect disappeared. Chewing efficiency increased in all ExpG. After completion of the training, the ExpG 2 and 3 showed a decrease to initial values. Subjects of ExpG 1 showed a training effect at the final examination, but a tendency toward the initial values was observed. ExpG 3 seemed to benefit most from the physiotherapeutic exercises in terms of improving chewing efficiency by the end of the intervention phase. ExpG 1 showed the greatest gain in bite force. The MaMuT program is a potential method of improving masticatory performance in people with cognitive impairment or dementia when used on a daily basis.
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Affiliation(s)
- Julia Jockusch
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Andreasstrasse 15/Box 2, 8050 Zurich, Switzerland
- Correspondence: or
| | - Sebastian Hahnel
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
| | - Bernhard B. A. J. Sobotta
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
| | - Ina Nitschke
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland
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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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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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Abstract
BACKGROUND: Mastication improves cognitive function by activating cerebral cortical activity, and it is important to demonstrate the cognitive effects of masticatory training using a variety of different interventions. OBJECTIVE: This study aimed to evaluate the effects of masticatory exercise on cognitive function in healthy older adults living in the community. METHODS: For six weeks, twelve participants performed a masticatory exercise using a NOSICK exerciser device, and thirteen subjects performed daily life without masticatory exercises. Trail Making Test, Digit Span Test, and Stroop test were used to measure the cognitive function. RESULTS: The participants in the experimental group showed significant improvements in TMT-A/B (p= 0.001 and 0.004), DST-forward (p= 0.001), and ST-word (p= 0.001). The effect sizes after the intervention were calculated as (1.2 and 0.8) for TMT-A/B, (0.8 and 0.2) for Digit Span Test forward/backward, and (0.6 and 0.2) for Stroop test color/word. CONCLUSIONS: We suggest that the masticatory exercises improve cognitive function in healthy older adults. Therefore, masticatory exercises can be used as a therapeutic exercise during cognitive rehabilitation.
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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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Associations of Food-Chewing Discomfort with Health Behaviors and Cognitive and Physical Health Using Pooled Data from the Korean Health Panel (2010-2013). Nutrients 2020; 12:nu12072105. [PMID: 32708584 PMCID: PMC7400811 DOI: 10.3390/nu12072105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 11/17/2022] Open
Abstract
Using 4 years of pooled data from the Korean Health Panel (2010-2013), the prevalence of food-chewing discomfort in adults over the age of 19 was investigated and the cross-sectional relationship between food-chewing discomfort and health behaviors and cognitive and physical health was identified. The prevalence of food-chewing discomfort was 31%: young adults (<40 years), 17.9%; middle-aged adults (40-64 years), 28.9%; and older adults (≥65 years), 57.1% (p < 0.0001). When food-chewing discomfort was sometimes, often, or always rather than never, odds ratios (ORs) were analyzed after controlling for sociodemographic characteristics. Significant OR results of target variables were smoking (OR 1.15, 1.37, 1.50), drinking (1.08, 0.87, 0.73), problem drinking (1.87, 1.67, 1.34), abstinence from drinking (1.23, 1.34, 1.42), nonphysical activity (OR 0.87 only significant, 0.94 nonsignificant, 1.10 nonsignificant), memory decline (2.07, 2.56, 3.31), decision-making difficulty (1.76, 2.78, 4.37), limitation of daily life due to illness (2.29, 3.60, 3.92), and the presence of a chronic disease (1.28, 1.62, 1.73), respectively. In conclusion, there were associations of food-chewing discomfort with increased smoking and decreased alcohol consumption, with increased difficulty in decision-making and memory decline, limitations in daily life due to disease, and the presence of chronic diseases. Therefore, it is necessary to investigate the causal relationship between chewing and health behaviors and cognitive and physical health through longitudinal studies.
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ALFotawi R, Alzahrani S, Alhefdhi R, Altamimi A, Alfadhel A, Alshareef A, Aldawsari B, Sonbol S, Alsubaie F, Alwahibi A, Al-Sinaidi A. The relation between teeth loss and cognitive decline among Saudi population in the city of Riyadh: A pilot study. Saudi Dent J 2019; 32:232-241. [PMID: 32647470 PMCID: PMC7336006 DOI: 10.1016/j.sdentj.2019.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/20/2019] [Accepted: 09/25/2019] [Indexed: 01/12/2023] Open
Abstract
Background Teeth are necessary for sensory input to the brain during the chewing process, but how the decrease in this sensory input, due to loss of teeth, may cause weak memory and lead to cognitive decline is not well understood. This pilot public survey aiming to assess the correlation between the number of missing teeth, periodontal disease, and cognitive skill in the city of Riyadh. Material& Methods A multicenter cross-sectional survey, targeting geriatric population aged ≥60 years, was performed in Riyadh City, Saudi Arabia. The Montreal Cognitive Assessment (MoCA) was conducted to all participants to assess their cognitive function. Assessment of oral health status was carried out, including the number of present dentation and their periodontal status. Community periodontal-index (CPI) was used to assess the periodontal condition. The primary variables were number of missing teeth, periodontal disease and MoCA test scores. Chi-square test and Pearson’s correlation coefficients were computed and the significant P- value was set at <0.05. Results Of 95 participants, overall, 57 (60%) and 38 (40%) were male and female, respectively, with a mean age of 65.67 ± 6.32 years. Females showed more significant cognitive decline than males (P < 0.001). Cognitive decline was significantly high in participants with low educational level 19 (95%), unemployment 41 (79%), and lower income people 26 (79%), while being cognitive intact was significantly higher in highly educated 13 (87%), retired 21 (62%), and higher income people 28 (74%) at (P < 0.001). An advanced age and greater number of missing teeth are associated with lower MoCA test scores. No statistical significant correlation with regard to periodontal disease and MoCA test scores. Conclusion Based on the preliminary data, positive correlation was confirmed when the number of missing teeth and cognitive skill were assessed. Therefore, larger, multi-center regional surveys are needed to investigate further this relationship.
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Affiliation(s)
- Randa ALFotawi
- Oral and Maxillofacial Department, Dental Faculty, King Saud University, Saudi Arabia
| | - Sarah Alzahrani
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Reem Alhefdhi
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Asma Altamimi
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Alia Alfadhel
- Dept. of Dentistry, Saudi, Ministry of Health, AlBaha Region, Saudi Arabia
| | - Ahmed Alshareef
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Bader Aldawsari
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Saleh Sonbol
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Faisal Alsubaie
- Dental Intern, Collage of Dentistry, King Saud University, Riyadh, Saudia Arabia
| | - Abdulrahman Alwahibi
- Psychiatry Dept. King Saud University Medical city, collage of Medicine, King Saud University, Riyadh, Saudia Arabia
| | - Aljoharah Al-Sinaidi
- Department of Periodontics and Community Dentistry, Dept of Periodontology Dental Faculty, King Saud University Riyadh, Saudi Arabia
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Northridge ME, Chakraborty B, Salehabadi SM, Metcalf SS, Kunzel C, Greenblatt AP, Borrell LN, Cheng B, Marshall SE, Lamster IB. Does Medicaid Coverage Modify the Relationship between Glycemic Status and Teeth Present in Older Adults? J Health Care Poor Underserved 2019; 29:1509-1528. [PMID: 30449760 DOI: 10.1353/hpu.2018.0109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Understanding the relationships among diabetes, teeth present, and dental insurance is essential to improving primary and oral health care. Participants were older adults who attended senior centers in northern Manhattan (New York, N.Y.). Sociodemographic, health, and health care information were obtained via intake interviews, number of teeth present via clinical dental examinations, and glycemic status via measurement of glycosylated hemoglobin (HbA1c). Complete data on dental insurance coverage status for 785 participants were available for analysis (1,015 after multiple imputation). For participants with no dental insurance and any private/other dental insurance, number of teeth present is less for participants with diabetes than for participants without diabetes; however, for participants with Medicaid coverage only, the relationship is reversed. Potential explanations include the limited range of dental services covered under the Medicaid program, inadequate diabetes screening and monitoring of Medicaid recipients, and the poor oral and general health of Medicaid recipients.
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Alvarenga MOP, Ferreira RDO, Magno MB, Fagundes NCF, Maia LC, Lima RR. Masticatory Dysfunction by Extensive Tooth Loss as a Risk Factor for Cognitive Deficit: A Systematic Review and Meta-Analysis. Front Physiol 2019; 10:832. [PMID: 31333490 PMCID: PMC6618904 DOI: 10.3389/fphys.2019.00832] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 06/17/2019] [Indexed: 01/20/2023] Open
Abstract
Background: An amount of cognition decline is normal with aging; however, intrinsic and extrinsic risk factors may exacerbate it, affecting social and occupational tasks. Masticatory dysfunction (MD), as a general term, refers to an impairment in the masticatory function triggered by a structural factor, such as tooth loss; functional factors, such as weaker bite force or a poorer masticatory performance; or both factors. MD acting as a source of chronic stress, promotes functional and morphological changes on the hippocampus, a brain area crucial for learning and memory abilities. This study aimed to synthesize evidence on the association between MD and cognitive deficit (CD), and demonstrate whether might be adequately considered as a risk factor. Methods: Observational studies were screened in seven online databases; the search strategy (PECO) was focused in observational studies with humans as a population (P), presenting groups exposed (E), and non-exposed (C) to tooth loss, in which cognition parameters were measured and compared between groups (O). The final selection included only those studies comparing the effect in cognition between subjects having ≥20 remaining teeth and <20 remaining teeth, considering the latter as a structural factor triggering MD by the literature. Searching and data extraction were conducted following PRISMA guidelines. Qualitative and risk of bias evaluations were performed. The meta-analysis (MA) was constructed including the odds ratio (OR) and its 95% confidence interval (CI) comparing two groups—with/without MD. The level of evidence was rated by Grading Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: In total, 5,666 citations were identified, 14 accomplished our eligibility criteria, and nine were include in the MA. The MA demonstrates that individuals with MD had 46% higher chance to presented CD (OR 2.24 [1.73, 2.90], p < 0.00001, I2 = 46%). The level of evidence was rated as low by GRADE. Conclusion: Despite the low certainty in evidence, according to our MA, MD is positively associated with increased risk of CD. However, more studies including other factors underlying MD and similar measurements should be conducted to obtain a strong estimate of the risk.
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Affiliation(s)
- María Olimpia Paz Alvarenga
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Railson de Oliveira Ferreira
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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Choi S, Kim K, Chang J, Kim SM, Kim SJ, Cho HJ, Park SM. Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia. J Am Geriatr Soc 2019; 67:1234-1239. [PMID: 30874308 DOI: 10.1111/jgs.15828] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/13/2019] [Accepted: 01/25/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Although chronic periodontitis has been associated with Alzheimer's disease, the effect of chronic periodontitis on vascular dementia as well as the role of lifestyle behaviors such as smoking, alcohol consumption, and physical activity in this association are still unclear. DESIGN Retrospective cohort study. SETTING Population based. PARTICIPANTS The study population was derived from the Korean National Health Insurance Service-Health Screening Cohort. Among 262 349 participants, diagnosis of chronic periodontitis was determined during 2003-2004. MEASUREMENTS Starting from 2005, participants were followed up for overall dementia, Alzheimer's disease, and vascular dementia until 2015. Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of dementia according to chronic periodontitis. RESULTS Compared with nonchronic periodontitis participants, chronic periodontitis patients had elevated risk for overall dementia (aHR = 1.06; 95% CI = 1.01-1.11) and Alzheimer's disease (aHR = 1.05; 95% CI = 1.00-1.11). There was a tendency toward increased vascular dementia risk among chronic periodontitis patients (aHR = 1.10; 95% CI = 0.98-1.22). The risk-increasing effect of chronic periodontitis on dementia tended to be stronger among participants with healthy lifestyle behaviors including never-smokers and those who exercised and did not consume alcohol. CONCLUSION Chronic periodontitis may be associated with a higher risk of developing dementia. Future studies that investigate whether preventing chronic periodontitis may lead to reduced risk of dementia are needed.
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Affiliation(s)
- Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
| | - Kyuwoong Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
| | - Sung Min Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea
| | - Seon Jip Kim
- Department of Preventive Dentistry and Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Hyun-Jae Cho
- Department of Preventive Dentistry and Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea.,Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
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13
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Cardoso MG, Diniz‐Freitas M, Vázquez P, Cerqueiro S, Diz P, Limeres J. Relationship between functional masticatory units and cognitive impairment in elderly persons. J Oral Rehabil 2019; 46:417-423. [DOI: 10.1111/joor.12763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 11/30/2018] [Accepted: 01/02/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Mónica G. Cardoso
- Department of Dental Sciences, Institute of Research and Advanced Training in Health Sciences and TechnologiesCESPU Paredes Portugal
| | - Márcio Diniz‐Freitas
- Medical‐Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela (USC) Santiago de Compostela Spain
| | - Paula Vázquez
- Medical‐Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela (USC) Santiago de Compostela Spain
| | - Sandra Cerqueiro
- Assisted Living for the Elderly of Oleiros Government of Galicia (Residencia Asistida de Mayores de Oleiros, Xunta of Galicia) Oleiros Spain
| | - Pedro Diz
- Medical‐Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela (USC) Santiago de Compostela Spain
| | - Jacobo Limeres
- Medical‐Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela (USC) Santiago de Compostela Spain
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14
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Kuroki A, Sugita N, Komatsu S, Wakasugi M, Yokoseki A, Yoshihara A, Kobayashi T, Nakamura K, Momotsu T, Endo N, Sato K, Narita I, Yoshie H. The number of remaining teeth as a risk indicator of cognitive impairment: A cross-sectional clinical study in Sado Island. Clin Exp Dent Res 2018; 4:291-296. [PMID: 30603112 PMCID: PMC6305911 DOI: 10.1002/cre2.147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 12/27/2022] Open
Abstract
Most studies that have demonstrated an association between number of remaining teeth and cognitive impairment have treated teeth as a continuous variable, although the relationship is nonlinear. The aim of this cross-sectional study was to determine the critical number of remaining teeth in hospital outpatients at which the association with cognitive impairment becomes apparent. Japanese adults living on Sado Island who visited Sado General Hospital were invited to participate in Project in Sado for Total Health. In total, 2,530 adults were interviewed and had their teeth counted; 1,476 of these individuals also completed the Mini-Mental State Examination (MMSE) and underwent measurement of their serum high-sensitivity C-reactive protein (hsCRP) levels. Patients on dialysis and those with hsCRP ≥ 10 mg/L were excluded. The final study group consisted of 565 adults (290 men and 275 women) of mean age 69.8 (range 29-91) years. An MMSE score < 24 was considered to indicate cognitive impairment. The subjects were categorized according to whether they had an edentulous jaw or one to 10, 11-20, 21-27, or ≥28 remaining teeth. One hundred twenty-eight of the 565 study participants were diagnosed to have cognitive impairment. Multiple logistic regression analysis revealed associations of cognitive impairment with older age, ischemic heart disease, smoking, and alcohol consumption. After adjustment for covariates, having one to 10 remaining teeth was significantly associated with cognitive impairment. There is a significant association between having only one to 10 remaining teeth and cognitive impairment in hospital outpatients.
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Affiliation(s)
- Ayumi Kuroki
- Division of Periodontology, Department of Oral Biological Science Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Noriko Sugita
- Division of Periodontology, Department of Oral Biological Science Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | | | - Minako Wakasugi
- Division of Comprehensive Geriatrics in Community Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Akio Yokoseki
- Department of Molecular Neuroscience, Resource Branch for Brain Disease Research, Brain Research Institute University of Niigata Niigata Japan
| | - Akihiro Yoshihara
- Department of Oral Health and Welfare Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Tetsuo Kobayashi
- Division of Periodontology, Department of Oral Biological Science Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
- General Dentistry and Clinical Education Unit Niigata University Medical and Dental Hospital Niigata Japan
| | - Kazutoshi Nakamura
- Division of Preventive Medicine Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | | | - Naoto Endo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | | | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Hiromasa Yoshie
- Division of Periodontology, Department of Oral Biological Science Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
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15
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Fang WL, Jiang MJ, Gu BB, Wei YM, Fan SN, Liao W, Zheng YQ, Liao SW, Xiong Y, Li Y, Xiao SH, Liu J. Tooth loss as a risk factor for dementia: systematic review and meta-analysis of 21 observational studies. BMC Psychiatry 2018; 18:345. [PMID: 30342524 PMCID: PMC6195976 DOI: 10.1186/s12888-018-1927-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tooth loss is suggested to be associated with an increased risk of dementia in many studies. But the relationship between tooth loss and dementia is not yet fully understood. This systematic review and meta-analysis aimed to determine the relative effect of tooth loss on dementia risk. METHODS An electronic search of PubMed, Scopus, Embase, and Web of Knowledge was conducted in March 2018 to identify relevant observational studies with the English language restriction. Studies were included if they assessed the relationship between tooth loss and risk of dementia. Study quality was detected by the modified Downs and Black scale. Odds risks (ORs) were pooled using a random-effects model in the crude model. RESULTS The literature search initially yielded 1574 articles, and 21 observational studies published between 1994 and 2017 were finally included for the analyses. The crude results with random-effects model showed that patients with multiple tooth loss had higher incidence of dementia (OR 2.62, 95% CI 1.90-3.61, P < 0.001, I2 = 90.40%). The association remained noted when only adjusted results were pooled from 18 studies (OR 1.55, 95% CI 1.41-1.70, P = 0.13, I2 = 28.00%). Meta-regression analysis showed that study design explained about 16.52% of heterogeneity in the crude model. The overall quality rating scores of studies ranged from 11 to 16. CONCLUSIONS Findings from this review evidenced that tooth loss is positively associated with an increased risk of dementia in adults. Future well-designed longitudinal researches examining the direct and indirect relationship between tooth loss and dementia risk are encouraged.
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Affiliation(s)
- Wen-li Fang
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Mu-jun Jiang
- grid.252957.eFaculty of Pharmacy, Bengbu Medical College, Bengbu, Anhui China
| | - Bei-bei Gu
- 0000 0004 1791 7851grid.412536.7Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Ying-mei Wei
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Sheng-nuo Fan
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Wang Liao
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Yu-qiu Zheng
- 0000 0001 2360 039Xgrid.12981.33Department of Neurology, The Seventh Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong China
| | - Shao-wei Liao
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Ying Xiong
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Yi Li
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Song-hua Xiao
- 0000 0004 1791 7851grid.412536.7Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120 Guangdong China
| | - Jun Liu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, Guangdong, China. .,Laboratory of RNA and Major Diseases of Brain and Heart, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China. .,Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China.
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16
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Shin MS, Shin YJ, Karna S, Kim HD. Rehabilitation of lost teeth related to maintenance of cognitive function. Oral Dis 2018; 25:290-299. [PMID: 30129990 DOI: 10.1111/odi.12960] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/05/2018] [Accepted: 07/30/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE As the era of aging comes, cognitive impairment (CI) is increasing. The impact of rehabilitation of lost tooth on CI remains unclear. This study aimed to investigate whether non-rehabilitated lost teeth (NRLT) is associated with CI among Korean elders. METHODS A total of 280 elders comprising of 140 cases and 140 age-sex-matched controls were included in this cross-sectional study. CI was assessed using the Mini-Mental Status Examination (MMSE). NRLT was evaluated using panoramic radiograph and oral examination. NRLT was categorized into low (≤4) and high (≥5). Age, sex, education, drinking, smoking, exercise, obesity, hypertension, subclinical atherosclerosis, glucose, cholesterol, depression, and denture-wearing were considered as confounders. Conditional multivariate logistic regression analysis was applied to assess the adjusted association. RESULTS NRLT was associated with increased CI after controlling for confounders (odds ratio [OR] = 1.06, 95% confidence interval [95% CFI]: 1.00-1.13). However, lost teeth were not associated with CI. Those with high NRLT (≥5) compared to those with low NRLT (≤4) was more likely to have CI by 2.7 times (OR = 2.74, 95% CFI = 1.28-5.86). CONCLUSION Our data showed that NRLT was independently associated with CI. Hence, rehabilitation of the lost teeth could be important for the maintenance of cognitive function.
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Affiliation(s)
- Myung-Seop Shin
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yoo Jin Shin
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.,BK21 PLUS Life Science, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sandeep Karna
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.,BK21 PLUS Life Science, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyun-Duck Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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17
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Tooth loss is associated with accelerated cognitive decline and volumetric brain differences: a population-based study. Neurobiol Aging 2018; 67:23-30. [PMID: 29609079 DOI: 10.1016/j.neurobiolaging.2018.03.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 01/07/2023]
Abstract
Tooth loss has been related to cognitive impairment; however, its relation to structural brain differences in humans is unknown. Dementia-free participants (n = 2715) of age ≥60 years were followed up for up to 9 years. A subsample (n = 394) underwent magnetic resonance imaging at baseline. Information on tooth loss was collected at baseline, and cognitive function was assessed using the Mini-Mental State Examination at baseline and at follow-ups. Data were analyzed using linear mixed effects models and linear regression models. At baseline, 404 (14.9%) participants had partial tooth loss, and 206 (7.6%) had complete tooth loss. Tooth loss was significantly associated with a steeper cognitive decline (β: -0.18, 95% confidence interval [CI]: -0.24 to -0.11) and remained significant after adjusting for or stratifying by potential confounders. In cross-sectional analyses, persons with complete or partial tooth loss had significantly lower total brain volume (β: -28.89, 95% CI: -49.33 to -8.45) and gray matter volume (β: -22.60, 95% CI: -38.26 to -6.94). Thus, tooth loss may be a risk factor for accelerated cognitive aging.
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18
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The Effect of Number of Teeth and Chewing Ability on Cognitive Function of Elderly in UAE: A Pilot Study. Int J Dent 2017; 2017:5732748. [PMID: 29348749 PMCID: PMC5734010 DOI: 10.1155/2017/5732748] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/16/2017] [Accepted: 09/24/2017] [Indexed: 12/31/2022] Open
Abstract
Cognitive decline is one of the major causes of disability among the aging population. The aim of this study was to explore the relationship between oral health parameters (number of teeth, chewing ability, and presence of a denture) and cognitive function in the elderly across the UAE. Fifty persons (age ≥ 60; 71.26 ± 10.23) were enrolled in the study. Cognitive status was assessed using the standardized mini-mental state examination (SMMSE) and accordingly, cognitively normal subjects scoring ≥24 were considered as the control group and cognitively impaired individuals scoring ≤23 were considered as the low scoring group. Chewing ability was examined, number of teeth was noted, and demographical data was collected. The results of this pilot study showed that individuals with low SMMSE scores were significantly less educated (P < 0.01) and had fewer number of remaining teeth (P < 0.05) and impaired chewing ability (P < 0.05). These results demonstrate a significant link between the number of teeth, chewing ability, and cognitive function. However, this pilot study had its limitations and was the first of its kind in the UAE and Gulf region; therefore, future research addressing the limitations is needed to further explore this association.
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19
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Genetic and Environmental Basis in Phenotype Correlation Between Physical Function and Cognition in Aging Chinese Twins. Twin Res Hum Genet 2017; 20:60-65. [PMID: 28105965 DOI: 10.1017/thg.2016.98] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Although the correlation between cognition and physical function has been well studied in the general population, the genetic and environmental nature of the correlation has been rarely investigated. We conducted a classical twin analysis on cognitive and physical function, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), handgrip strength, five-times-sit-to-stand test (FTSST), near visual acuity, and number of teeth lost in 379 complete twin pairs. Bivariate twin models were fitted to estimate the genetic and environmental correlation between physical and cognitive function. Bivariate analysis showed mildly positively genetic correlations between cognition and FEV1, r G = 0.23 [95% CI: 0.03, 0.62], as well as FVC, r G = 0.35 [95% CI: 0.06, 1.00]. We found that FTSST and cognition presented very high common environmental correlation, r C = -1.00 [95% CI: -1.00, -0.57], and low but significant unique environmental correlation, r E = -0.11 [95% CI: -0.22, -0.01], all in the negative direction. Meanwhile, near visual acuity and cognition also showed unique environmental correlation, r E = 0.16 [95% CI: 0.03, 0.27]. We found no significantly genetic correlation for cognition with handgrip strength, FTSST, near visual acuity, and number of teeth lost. Cognitive function was genetically related to pulmonary function. The FTSST and cognition shared almost the same common environmental factors but only part of the unique environmental factors, both with negative correlation. In contrast, near visual acuity and cognition may positively share part of the unique environmental factors.
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20
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The Relationship Between Oral Health and Cognitive Status of the Elderly. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.14973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Rozas NS, Sadowsky JM, Jeter CB. Strategies to improve dental health in elderly patients with cognitive impairment. J Am Dent Assoc 2017; 148:236-245.e3. [DOI: 10.1016/j.adaj.2016.12.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 11/08/2016] [Accepted: 12/12/2016] [Indexed: 12/18/2022]
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22
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Tonsekar PP, Jiang SS, Yue G. Periodontal disease, tooth loss and dementia: Is there a link? A systematic review. Gerodontology 2017; 34:151-163. [DOI: 10.1111/ger.12261] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Pallavi P. Tonsekar
- Department of Periodontics; Rutgers School of Dental Medicine; Newark NJ USA
| | - Shuying S. Jiang
- Institutional Assessment and Quality Improvement; Rutgers School of Dental Medicine; Newark NJ USA
| | - Gang Yue
- Department of Periodontics; Rutgers School of Dental Medicine; Newark NJ USA
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23
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Tada A, Miura H. Association between mastication and cognitive status: A systematic review. Arch Gerontol Geriatr 2016; 70:44-53. [PMID: 28042986 DOI: 10.1016/j.archger.2016.12.006] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 12/07/2016] [Accepted: 12/12/2016] [Indexed: 11/15/2022]
Abstract
PURPOSE A substantial number of elderly people suffer from cognitive impairment and dementia, which are considered to have various risk factors, including masticatory dysfunction; however, the association between mastication and cognition is inconclusive. The objectives of this systematic review were to provide an overview of the literature on (1) the association between mastication and cognitive function and (2) the association between mastication and dementia incidence, in elderly people. MATERIALS AND METHODS Searches were conducted on five electronic databases (PubMed, EMBASE, CINHL, Cochrane Library, and Pro Quest) and publications were selected that met the following criteria: published between 2005 and 2015, written in English, and assessed associations between mastication and cognitive function, cognitive decline and dementia among population over 40 years old. The included publications were analyzed for study design, main conclusions, and strength of evidence by two reviewers who screened all abstracts and full-text articles, abstracted data and performed quality assessments by using a critical appraisal tool. RESULTS A total of 33 articles (22 cross-sectional, and 11 prospective cohort studies) were evaluated. Poorer mastication was associated with lower cognitive function in 15 of the 17 cross-sectional studies and steeper decline in 5 of the 6 prospective studies. Poorer mastication was one of significant risk factors for having dementia or mild memory impairment (MMI) in 4 of 5 cross-sectional studies and for the incidence of dementia or MMI in 4 of 5 prospective studies. CONCLUSIONS Most studies point to a positive association between mastication and cognitive function, including dementia among elderly people.
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Affiliation(s)
- Akio Tada
- Department of Health Science, Hyogo University, 2301 Shinzaike Hiraoka-cho, Kakogawa, Hyogo 675-0195, Japan.
| | - Hiroko Miura
- Department of International Health and Collaboration, National Institute of Public Health, 2-3-6, Minami, Wako, Saitama 351-0197, Japan
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24
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Lee YT, Lee HC, Hu CJ, Huang LK, Chao SP, Lin CP, Su ECY, Lee YC, Chen CC. Periodontitis as a Modifiable Risk Factor for Dementia: A Nationwide Population-Based Cohort Study. J Am Geriatr Soc 2016; 65:301-305. [PMID: 27685603 DOI: 10.1111/jgs.14449] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To determine whether periodontitis is a modifiable risk factor for dementia. DESIGN Prospective cohort study. SETTING National Health Insurance Research Database in Taiwan. PARTICIPANTS Individuals aged 65 and older with periodontitis (n = 3,028) and an age- and sex-matched control group (n = 3,028). MEASUREMENTS Individuals with periodontitis were compared age- and sex-matched controls with for incidence density and hazard ratio (HR) of new-onset dementia. Periodontitis was defined according to International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 523.3-5 diagnosed by dentists. To ensure diagnostic validity, only those who had concurrently received antibiotic therapies, periodontal treatment other than scaling, or scaling more than twice per year performed by certified dentists were included. Dementia was defined according to ICD-9-CM codes 290.0-290.4, 294.1, 331.0-331.2. RESULTS After adjustment for confounding factors, the risk of developing dementia was calculated to be higher for participants with periodontitis (HR = 1.16, 95% confidence interval = 1.01-1.32, P = .03) than for those without. CONCLUSION Periodontitis is associated with greater risk of developing dementia. Periodontal infection is treatable, so it might be a modifiable risk factor for dementia. Clinicians must devote greater attention to this potential association in an effort to develop new preventive and therapeutic strategies for dementia.
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Affiliation(s)
- Yao-Tung Lee
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chaur-Jongh Hu
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Brain and Consciousness Research Center, Taipei Medical University, Taipei City, Taiwan
| | - Li-Kai Huang
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Brain and Consciousness Research Center, Taipei Medical University, Taipei City, Taiwan
| | - Shu-Ping Chao
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Brain and Consciousness Research Center, Taipei Medical University, Taipei City, Taiwan
| | - Chia-Pei Lin
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Emily Chia-Yu Su
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
| | - Yi-Chen Lee
- Department of Health Administration, Tzu-Chi University of Science and Technology, Hualien, Taiwan
| | - Chu-Chieh Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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25
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Zenthöfer A, Baumgart D, Cabrera T, Rammelsberg P, Schröder J, Corcodel N, Hassel AJ. Poor dental hygiene and periodontal health in nursing home residents with dementia: an observational study. Odontology 2016; 105:208-213. [PMID: 27160268 DOI: 10.1007/s10266-016-0246-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 04/07/2016] [Indexed: 10/21/2022]
Abstract
Poor oral health conditions are well documented in the institutionalized elderly, but the literature is lacking research on relationships between dementia and periodontal health in nursing home residents. The purpose of this cohort study, therefore, was to assess whether dementia is associated with poor oral health/denture hygiene and an increased risk of periodontal disease in the institutionalized elderly. A total of 219 participants were assessed using the Mini Mental State Examination (MMSE) to determine cognitive state. According to the MMSE outcome, participants scoring ≤20 were assigned to dementia group (D) and those scoring >20 to the non-dementia group (ND), respectively. For each of the groups D and ND, Gingival Bleeding Index (GBI) and Denture Hygiene Index (DHI) linear regression models were used with the confounders age, gender, dementia, number of comorbidities and number of permanent medications. To assess the risk factors for severe periodontitis as measured by the Community Index of Periodontal Treatment Needs, a logistic regression analysis was performed. Statistical analysis revealed no significant differences of GBI as well of DHI for demented and healthy subjects (p > 0.05). Severe periodontitis was detected in 66 % of participants with dementia. The logistic regression showed a 2.9 times increased risk among demented participants (p = 0.006). Oral hygiene, denture hygiene and periodontal health are poor in nursing home residents. The severity of oral problems, primarily periodontitis, seems to be enhanced in subjects suffering from dementia. Longitudinal observations are needed to clarify the cause-reaction relationship.
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Affiliation(s)
- Andreas Zenthöfer
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Dominik Baumgart
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Tomas Cabrera
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Johannes Schröder
- Institute of Gerontology, University of Heidelberg, Heidelberg, Germany.,Section of Geriatric Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Nicoleta Corcodel
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Alexander Jochen Hassel
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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Zhu J, Li X, Zhu F, Chen L, Zhang C, McGrath C, He F, Xiao Y, Jin L. Multiple tooth loss is associated with vascular cognitive impairment in subjects with acute ischemic stroke. J Periodontal Res 2015; 50:683-8. [PMID: 25495425 DOI: 10.1111/jre.12251] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Emerging evidence shows that tooth loss is associated with cognitive impairment and dementia. Vascular cognitive impairment (VCI) is a common consequence of ischemic stroke. This study investigated the association of tooth loss with VCI in patients with acute stroke. MATERIAL AND METHODS A total of 161 subjects with acute ischemic stroke were recruited. Within 1 wk after admission, fasting blood tests were undertaken and the number of teeth present was recorded. VCI was evaluated with the Montreal Cognitive Assessment (MoCA). RESULTS The patients with loss of ≥ 8 teeth exhibited significantly lower MoCA values as compared to those with loss of ≤ 7 teeth (13.2 ± 6.6 vs. 17.3 ± 6.0, p < 0.001). Multivariate logistic regression analysis showed that loss of ≥ 8 teeth (OR = 3.1, 95% CI: 1.2-7.9, p = 0.02) and stroke history (OR = 3.8, 95% CI: 1.1-14.1, p = 0.04) were significantly associated with VCI (MoCA score ≤ 20.0). CONCLUSION Within the limitations of this study, the current findings provide the first evidence that multiple tooth loss is independently associated with VCI in patients with acute ischemic stroke.
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Affiliation(s)
- J Zhu
- Department of Neurology, the Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, China
| | - X Li
- Private dental practice, Hong Kong, China
| | - F Zhu
- Department of Neurology, the Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, China
| | - L Chen
- Department of Neurology, the Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, China
| | - C Zhang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - C McGrath
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - F He
- Clinical Laboratory, the Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, China
| | - Y Xiao
- Department of Ultrasonography, the Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, China
| | - L Jin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Xu X, Cao B, Wang J, Yu T, Li Y. Decision-making deficits associated with disrupted synchronization between basolateral amygdala and anterior cingulate cortex in rats after tooth loss. Prog Neuropsychopharmacol Biol Psychiatry 2015; 60:26-35. [PMID: 25684327 DOI: 10.1016/j.pnpbp.2015.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 02/05/2015] [Indexed: 12/09/2022]
Abstract
Human studies have shown that multiple teeth loss was significantly associated with cognitive impairment, dementia and Alzheimer's disease. However, the causal relationship between tooth loss and cognitive deficits has not been clarified. Rodents demonstrate human-like cognitive faculties. In this study by performing rat gambling task (RGT), we reported that prolonged tooth loss condition by extracting all left molars in the rats led to an increase in the proportion of poor decision-makers, and decrease in the proportion of good decision-makers compared with controls. No influence was detected on the general activity and motivation after tooth loss. Recent experiments have shown that decision-making performances in the RGT rely on the functional integrity of the amygdala and anterior cingulate cortex (ACC). The theta band brain oscillation has been acknowledged for extensive cognitive functions. Here, we performed multiple-electrode array recordings of local field potential (LFP) in anesthetized rats. The results exhibited an increase in accumulative power of the theta frequency of LFP in the basolateral amygdala (BLA) and decrease of theta power in the ACC in tooth loss rats. Furthermore, cross-correlation analysis displayed that tooth loss suppressed the synchronization of theta frequency of LFP between the BLA and ACC, indicating reduced neuronal communications between these two regions. In conclusion, we demonstrate for the first time that tooth loss leads to higher-order cognitive deficits accompanied by the alteration of theta frequency of LFP in brain circuitries and disruption of neural network integrity.
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Affiliation(s)
- Xiaoxiang Xu
- Department of Biomedical Science, City University of Hong Kong, Hong Kong, China; Centre for Biosystems, Neuroscience, and Nanotechnology, City University of Hong Kong, Hong Kong, China
| | - Bing Cao
- Department of Biomedical Science, City University of Hong Kong, Hong Kong, China; Centre for Biosystems, Neuroscience, and Nanotechnology, City University of Hong Kong, Hong Kong, China
| | - Jun Wang
- Department of Biomedical Science, City University of Hong Kong, Hong Kong, China; Centre for Biosystems, Neuroscience, and Nanotechnology, City University of Hong Kong, Hong Kong, China
| | - Tianran Yu
- Department of Biomedical Science, City University of Hong Kong, Hong Kong, China; Centre for Biosystems, Neuroscience, and Nanotechnology, City University of Hong Kong, Hong Kong, China
| | - Ying Li
- Department of Biomedical Science, City University of Hong Kong, Hong Kong, China; Centre for Biosystems, Neuroscience, and Nanotechnology, City University of Hong Kong, Hong Kong, China.
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28
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Luo J, Wu B, Zhao Q, Guo Q, Meng H, Yu L, Zheng L, Hong Z, Ding D. Association between tooth loss and cognitive function among 3063 Chinese older adults: a community-based study. PLoS One 2015; 10:e0120986. [PMID: 25803052 PMCID: PMC4372206 DOI: 10.1371/journal.pone.0120986] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 02/09/2015] [Indexed: 11/18/2022] Open
Abstract
Background Oral health has been found to be associated with cognitive function in basic research and epidemiology studies. Most of these studies had no comprehensive clinical diagnosis on cognitive function. This study firstly reported the association between tooth loss and cognitive function among Chinese older population. Methods The study included 3,063 community dwelling older adults aged 60 or above from the Shanghai Aging Study. Number of teeth missing was obtained from self-reporting questionnaire and confirmed by trained interviewers. Participants were diagnosed as “dementia”, “mild cognitive impairment (MCI)”, or “cognitive normal” by neurologists using DSM-IV and Petersen criteria. Multivariate logistic regression model was applied to examine the association between number of teeth missing and cognitive function. Results The study participants had an average of 10.2 teeth lost. Individuals with dementia lost 18.7 teeth on average, much higher than those with MCI (11.8) and cognitive normal (9.3) (p<0.001). After adjusted for sex, age, education year, living alone, body mass index, cigarette smoking, alcohol drinking, anxiety, depression, heart disease, hypertension, diabetes, and APOE-ε4, tooth loss of >16 were significantly associated with dementia with an OR of 1.56 (95%CI 1.12-2.18). Conclusion Having over 16 missing teeth was associated with severe cognitive impairment among Chinese older adults. Poor oral health might be considered as a related factor of neurodegenerative symptom among older Chinese population.
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Affiliation(s)
- Jianfeng Luo
- Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China
- Institute of Neurology, Huashan Hospital, Fudan University, WHO Collaborating Center for Research and Training in Neurosciences, Shanghai, China
| | - Bei Wu
- School of Nursing and Global Health Institute, Duke University, Durham, North Carolina, United States of America
- School of Sociology and Political Sciences, Shanghai University, Shanghai, China
- * E-mail: (DD); (BW)
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital, Fudan University, WHO Collaborating Center for Research and Training in Neurosciences, Shanghai, China
| | - Qihao Guo
- Institute of Neurology, Huashan Hospital, Fudan University, WHO Collaborating Center for Research and Training in Neurosciences, Shanghai, China
| | - Haijiao Meng
- Institute of Neurology, Huashan Hospital, Fudan University, WHO Collaborating Center for Research and Training in Neurosciences, Shanghai, China
| | - Lirong Yu
- Institute of Neurology, Huashan Hospital, Fudan University, WHO Collaborating Center for Research and Training in Neurosciences, Shanghai, China
| | - Li Zheng
- Institute of Neurology, Huashan Hospital, Fudan University, WHO Collaborating Center for Research and Training in Neurosciences, Shanghai, China
| | - Zhen Hong
- Institute of Neurology, Huashan Hospital, Fudan University, WHO Collaborating Center for Research and Training in Neurosciences, Shanghai, China
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, WHO Collaborating Center for Research and Training in Neurosciences, Shanghai, China
- * E-mail: (DD); (BW)
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Gaur S, Agnihotri R. Alzheimer's disease and chronic periodontitis: is there an association? Geriatr Gerontol Int 2014; 15:391-404. [PMID: 25511390 DOI: 10.1111/ggi.12425] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 12/17/2022]
Abstract
Alzheimer's disease, an affliction of old age, is one of the leading causes for dementia worldwide. Various risk factors including family history, genetics and infections have been implicated in its pathogenesis. The cognitive decline in this condition is mainly a result of the formation of amyloid deposits that provoke neuroinflammation, ultimately resulting in cell death. Recently, an association between peripheral inflammation and Alzheimer's disease was hypothesized. It was suggested that chronic systemic inflammation worsened the inflammatory processes in the brain. This was mainly attributed to increased levels of pro-inflammatory mediators, such as interleukin-1, interleukin -6 and tumor necrosis factor-α in the plasma. As chronic periodontitis is a widespread peripheral immunoinflammatory condition, it has been proposed to play a significant role in the aggravation of Alzheimer's disease. With this background, the current review focuses on the relationship between Alzheimer's disease and chronic periodontitis, and its therapeutic implications.
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Affiliation(s)
- Sumit Gaur
- Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
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30
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Del Brutto OH, Gardener H, Del Brutto VJ, Maestre GE, Zambrano M, Montenegro JE, Wright CB. Edentulism associates with worse cognitive performance in community-dwelling elders in rural Ecuador: results of the Atahualpa project. J Community Health 2014; 39:1097-100. [PMID: 24627152 PMCID: PMC11003771 DOI: 10.1007/s10900-014-9857-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Studies in industrialized nations suggest that severe edentulism correlates with cognitive impairment, but there is little information on this association in underserved populations. We conducted a community-based study to assess whether edentulism associates with cognitive impairment in elders living in rural Ecuador. Atahualpa residents aged ≥60 years were identified during a door-to-door census and evaluated using the Montreal Cognitive Assessment (MoCA). Persons were classified into two groups according to whether they have severe edentulism (<10 remaining teeth) or not. In addition, a questionnaire allowed self-rating of oral health. A total of 274 persons (mean age 69.6 ± 7.7 years; 59% women) were included. Persons with <10 remaining teeth (n = 116) have significantly lower MoCA scores than those with ≥10 teeth (n =158), after adjusting for demographics, cardiovascular risk factors, depression and dementia (β = -1.06, p = 0.03). Self-rated poor oral health was more prevalent among persons with <10 teeth (p < 0.0001), but did not correlate with MoCA scores (good vs. poor, β = -0.89, p = 0.89). Severe edentulism is associated with poor cognitive performance in elders living in rural Ecuador. Public health campaigns directed to improve oral health may facilitate early recognition of persons with cognitive impairment in underserved populations.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador,
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31
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Vargas EA, Gallardo ÁMR, Manrrique GG, Murcia-Paredes LM, Riaño MCA. Prevalence of dementia in Colombian populations. Dement Neuropsychol 2014; 8:323-329. [PMID: 29213921 PMCID: PMC5619179 DOI: 10.1590/s1980-57642014dn84000004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
With the gradual increase in the life expectancy of the population due to
scientific progress and public health at the service of society, the prevalence
of dementia has been increasing at different rates worldwide. Currently, the
prevalence rates range between 5% and 7% (6.4% in the U.S. and up to 8.5 % in
Latin America) in subjects older than 60 years. The lowest prevalence rate
(2.1%) has been reported from sub-Saharan Africa, probably due to selective
mortality under 60 years of age. By contrast, a very high prevalence of dementia
(23.6% dementia in individuals >60 years) was observed in the city of Neiva,
Southern Colombia. We believe that this high rate could be explained by the
presence of several risk factors such as very low schooling, low socio-economic
strata, chronic diseases, the inclusion of geriatric homes among others, and
additional unknown factors.
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Affiliation(s)
- Efraín Amaya Vargas
- Neurologist, Professor of Medicine Program and Member of the Group DNEUROPSY - Surcolombiana University
| | - Ángela Magnolia Ríos Gallardo
- Psychologist, PhD Psychology Focusing on Cognitive Neuroscience. Teacher and Director of the Group DNEUROPSY - Surcolombiana University
| | - Guillermo González Manrrique
- Neurologist. Health Specialist in Management. Head of the Area of Neurophysiology University Hospital in Neiva. Professor and Member of the Group DNEUROPSY - Surcolombiana University
| | - Lina M Murcia-Paredes
- Psychologist. Specialist in Health Psychology, Masters Student in Psychology. Member of Group DNEUROPSY - Surcolombiana University
| | - María Consuelo Angarita Riaño
- General Medical. Specialist in Management of Health Organizations. Master's Student in Public Health. Area Leader for Public Health. Department of Health - Huila
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Ohara Y, Hirano H, Watanabe Y, Obuchi S, Yoshida H, Fujiwara Y, Ihara K, Kawai H, Mataki S. Factors associated with self-rated oral health among community-dwelling older Japanese: A cross-sectional study. Geriatr Gerontol Int 2014; 15:755-61. [PMID: 25244626 DOI: 10.1111/ggi.12345] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2014] [Indexed: 12/24/2022]
Abstract
OBJECTIVES A cross-sectional study was carried out to investigate the determinants of self-rated oral health among community-dwelling older people in Japan. METHODS The participants were 897 (357 men and 540 women) aged 65 years and over who participated in a comprehensive geriatric health examination, which included an oral examination, a face-to-face interview assessing cognitive function, questionnaires regarding depressive symptoms and functional capacity, and a medical examination. The oral examination measured indices of oral health status: number of present teeth, number of functional teeth, occlusal force and amount of resting saliva. Multiple logistic regression analyses were carried out to determine the factors associated with poor self-rated oral health. RESULTS The mean age of the participants was 73.5 ± 5.0 years. The prevalence of poor and rather poor self-rated oral health was 11.5% and 29.5%, respectively. Multiple logistic regression analyses showed that the number of present teeth (odds ratio [OR] 0.97, 95% confidence intervals [CI] 0.95-0.99), difficulty in mastication (OR 3.20, CI 2.18-4.70), presence of xerostomia (OR 1.43, CI 1.02-2.01), total score on the MoCA-J (OR 1.06, CI 1.01-1.11), and reduction in frequency of leaving the house (OR 1.64, CI 1.12-2.41) were significantly associated with poor self-rated oral health. CONCLUSIONS The present results suggested that self-rated oral health was a significant factor in oral health status as well as overall well-being among community-dwelling older Japanese people.
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Affiliation(s)
- Yuki Ohara
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Graduate School, Section of Oral Health Care Education, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yutaka Watanabe
- Department of Oral Disease, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Shuichi Obuchi
- Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hideyo Yoshida
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kazushige Ihara
- Department of Social Medicine, School of Medicine, Toho University, Tokyo, Japan
| | - Hisashi Kawai
- Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shiro Mataki
- Graduate School, Section of Behavioral Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
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Listl S. Oral health conditions and cognitive functioning in middle and later adulthood. BMC Oral Health 2014; 14:70. [PMID: 24923362 PMCID: PMC4067064 DOI: 10.1186/1472-6831-14-70] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 06/10/2014] [Indexed: 11/17/2022] Open
Abstract
Background The purpose of the present study was to examine the impact of oral health conditions on cognitive functioning on basis of data samples from several European countries. Methods Secondary analyses were conducted of data from wave 2 of the Survey of Health, Ageing, and Retirement in Europe (SHARE) which includes 14 European countries and is intended to be representative of each country’s middle and later adulthood population. Information on word recall, verbal fluency, and numeracy as well as information on chewing ability and denture wearing status was available for a total of 28,693 persons aged 50+. Multivariate regression analysis was used to detect influences of oral health parameters on cognitive functioning (p < 0.05). Results Persons with good chewing ability or without dentures had significantly better word recall, verbal fluency, and numeracy skills than persons with chewing impairment or with dentures. The observed patterns of parameter estimates imply differential oral health impacts on numeracy compared to word recall and verbal fluency. Conclusions The present study provides novel large-scale epidemiological evidence supportive of an association between oral health and cognitive functioning. Future research should intend to verify the precise causal links between oral health conditions, various cognitive dimensions, and their neural correlates.
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Affiliation(s)
- Stefan Listl
- Department of Conservative Dentistry, University of Heidelberg, Heidelberg, Germany.
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Tsuruga K, Sugawara N, Yasui-Furukori N, Takahashi I, Tsuchimine S, Kaneda A, Nakaji S, Nakamura K. A positive correlation between serum amyloid β levels and depressive symptoms among community-dwelling elderly individuals in Japan. Neuropsychiatr Dis Treat 2014; 10:1621-7. [PMID: 25210455 PMCID: PMC4156004 DOI: 10.2147/ndt.s67205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Amyloid beta (Aβ) levels have been associated with an increased risk of Alzheimer's disease (AD). As depression is common before the onset of AD, serum Aβ levels could be associated with depressive symptoms. The aim of this study was to investigate whether serum Aβ levels are associated with depressive symptoms and/or cognitive function in community-dwelling elderly individuals. METHODS We examined the association between serum Aβ levels and depression among 419 Japanese community-dwelling elderly individuals aged 60 years and over. Subjects were divided into two subgroups: younger elderly between 60 and 69 years old and older elderly over 69 years old. The Mini-Mental State Examination (MMSE) was used to assess cognitive function, and symptoms of depression were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The ability to perform activities of daily living was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Serum Aβ levels were measured with a human amyloid beta enzyme-linked immunosorbent assay kit. RESULTS After controlling for potential confounding variables, a multiple linear regression analysis showed that increased levels of serum Aβ40 and Aβ42 were associated with higher CES-D scores in the older elderly subgroup. Under the same condition, multiple regression showed that serum Aβ levels were not associated with MMSE scores among the total subjects, younger elderly, or older elderly. CONCLUSION Serum Aβ levels were associated with depressive symptoms in community-dwelling elderly individuals. The present study indicates the possibility that serum Aβ may be involved in the development of late-onset depression.
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Affiliation(s)
- Koji Tsuruga
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Norio Sugawara
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Ippei Takahashi
- Department of Social Medicine, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Shoko Tsuchimine
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Ayako Kaneda
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Shigeyuki Nakaji
- Department of Social Medicine, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
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