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Costa RTF, de Oliveira Limirio JPJ, Vasconcelos BCDE, Pellizzer EP, Moraes SLDD. Rehabilitation with dental prostheses and its influence on brain activity: A systematic review. J Prosthet Dent 2024; 131:403-409. [PMID: 35305835 DOI: 10.1016/j.prosdent.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM The consequences of edentulism depend on its complexity and are far-reaching, but limited evidence regarding its association with neurologic health is available. PURPOSE The purpose of this systematic review was to establish the relationship between oral prosthetic rehabilitation and the regional increase in brain activity. MATERIAL AND METHODS This systematic review was registered in the International Prospective Register of Systematic Reviews (CRD42021262247), and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed. Randomized clinical trials, prospective studies comparing the brain activity of patients rehabilitated with and without the use of dental prostheses, and studies that analyzed the human brain by using noninvasive techniques were used as inclusion criteria. The risk of bias in each study was assessed by using the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I). RESULTS The search was carried out in the PubMed/MEDLINE, Embase, Cochrane Library, and https://clinicaltrials.gov databases up to June 2021. After a search conducted by 2 reviewers, 8 articles were included in the review. A regional increase in blood flow and regional cerebral activity during dental prosthesis use was identified in the studies. CONCLUSIONS A positive association was found between the different types of prosthetic rehabilitation and brain function. Prostheses may preserve and restore neurological health.
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Affiliation(s)
| | | | | | - Eduardo Piza Pellizzer
- Full Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil.
| | - Sandra Lúcia Dantas de Moraes
- Associate Professor, Division of Oral Rehabilitation, Faculty of Dentistry, University of Pernambuco (UPE), Recife, Brazil
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Esmaeili A, Ebrahimpour S, Hefshejani KF, Esmaeili A. Molecular mechanisms underlying the effect of tooth shortening on memory dysfunction in Wistar male rat. Arch Oral Biol 2024; 159:105878. [PMID: 38171058 DOI: 10.1016/j.archoralbio.2023.105878] [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: 11/18/2023] [Revised: 12/15/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE We investigated the effects of molar tooth shortening on the mRNA expression of the AβPP/BACE1, BDNF/TrkB, and Bax/Bcl-2 signaling pathways in the Wistar male rat hippocampal regions. DESIGN Four groups (n = 5 per group) of male Wistar rats (control, SRM (shortened right molar), SLM (shortened left molar), and SBM (shortened bilateral molar)) were used. RNA was isolated from the hippocampus and transformed into cDNA. Real-time quantitative PCR was used to evaluate the mRNA expression levels of AβPP, BACE1, Bax, Bcl-2, BDNF, and TrkB. RESULTS Differential mRNA expression was observed in rat groups. SBM significantly upregulated the AβPP, BACE1, and Bax mRNA expressions, whereas the expression levels of Bcl-2, BDNF, and TrkB were decreased. SRM and SLM approximately had the same effect on the expression enhancement of AβPP, BACE1, and Bax; however, SRM was more effective than SLM in increasing the expression of these genes. CONCLUSIONS Symmetrical molar teeth shortening affected the mRNA expression of AβPP and BACE1, which is related to learning and memory dysfunction.
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Affiliation(s)
- Ali Esmaeili
- Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shiva Ebrahimpour
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | | | - Abolghasem Esmaeili
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran.
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Luo H, Wu B, González H, Stickel A, Kaste L, Tarraf W, Daviglus M, Sanders A, Cai J. Tooth Loss, Periodontal Disease, and Mild Cognitive Impairment Among Hispanic/Latino Immigrants: The Moderating Effects of Age at Immigration. J Gerontol A Biol Sci Med Sci 2023; 78:949-957. [PMID: 36049219 PMCID: PMC10235192 DOI: 10.1093/gerona/glac178] [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: 04/30/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The objectives were to assess (a) the association between poor oral health and mild cognitive impairment (MCI) in Hispanic/Latino immigrants and (b) potential modification effects on this association by age at immigration. METHODS Data were from the Hispanic Community Health Study/Study of Latinos and its ancillary study-the Study of Latinos-Investigation of Neurocognitive Aging. MCI, a binary outcome variable, defined by the National Institute on Aging-Alzheimer's Association criteria. The main exposure was significant tooth loss (STL), defined as a loss of 8 or more teeth, and periodontitis, classified using the Centers for Disease Control and Prevention and American Academy of Periodontology case classification. Multiple logistic regression was used to assess the association between STL/periodontitis and MCI and test moderation effects of age at immigration. The analytical sample comprised 5 709 Hispanic/Latino adult immigrants. RESULTS Hispanic/Latino immigrants with STL (adjusted odds ratio [AOR] = 1.36, 95% confidence interval [CI]: 1.01-1.85) were more likely to have MCI than those with greater tooth retention. Overall, migration to the United States after age 18 was associated with greater odds of MCI than migration at a younger age. A significant interaction effect between STL and age at immigration revealed that the effect of STL on MCI is even higher in those who immigrated to the United States at ages 35-49 years. CONCLUSIONS STL is a significant risk factor for MCI and age at immigration had a modification effect on the association between STL and MCI. Better access to dental care, health education on risk factors of MCI, and promotion of good oral health may mitigate the burden of cognitive impairment in Hispanics/Latinos.
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Affiliation(s)
- Huabin Luo
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York City, New York, USA
| | - Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, San Diego, California, USA
| | - Ariana Stickel
- Department of Neurosciences, University of California, San Diego, San Diego, California, USA
| | - Linda M Kaste
- Department of Pediatric Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Wassim Tarraf
- Department of Healthcare Sciences, Wayne State University, Institute of Gerontology, Detroit, Michigan, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, Illinois, USA
| | - Anne E Sanders
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Ebrahimpour S, Esmaeili A, Esmaeili A, Sattari K, Forouzandeh Hafshejani K. Molar tooth shortening induces learning and memory impairment in Wistar rat. Oral Dis 2023; 29:1356-1366. [PMID: 34862999 DOI: 10.1111/odi.14093] [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: 08/14/2021] [Revised: 10/26/2021] [Accepted: 11/28/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to investigate the relationship between different patterns of molar crown loss and the association between symmetrical and asymmetrical shortening molar teeth with memory impairment. MATERIALS AND METHODS Male Wistar rats were divided into four groups (n = 10) including control, SLM (shortened left molar), SRM (shortened right molar), and SBM (shortened bilateral molar) groups. Morris water maze (MWM) and passive avoidance test (PAT) were performed to assess spatial and fear memory, respectively. Besides, histological assessment of hippocampus and gingival tissues was done. RESULTS In the MWM test, SBM and SLM groups had higher escape latency over training trials and spent less time in the target quadrant in the probe trial (p < 0.01). In the PAT, step-through latency was significantly reduced in three groups, and time spent in the dark compartment increased in SBM (p < 0.01) and SLM (p < 0.05) groups. In addition, each teeth shortening group indicated a reduction in density (p < 0.01) and thickness layer (p < 0.05) of pyramidal cells. Gingival was normal after shortening of the molar crown. CONCLUSIONS Different patterns of molar teeth shortening induced learning and memory impairment; however, symmetrical molar teeth shortening has more effects on memory impairment.
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Affiliation(s)
- Shiva Ebrahimpour
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | - Abolghasem Esmaeili
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | - Ali Esmaeili
- School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kimiya Sattari
- School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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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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Turnbull N, Cherdsakul P, Chanaboon S, Hughes D, Tudpor K. Tooth Loss, Cognitive Impairment and Fall Risk: A Cross-Sectional Study of Older Adults in Rural Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16015. [PMID: 36498085 PMCID: PMC9735973 DOI: 10.3390/ijerph192316015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Tooth loss is associated with both cognitive impairment and fall risk. However, the relationships between these variables are complex and bidirectional. Observed associations have been reported in separate studies but data on rural-dwelling older adults remain sparse. This cross-sectional study investigated socioeconomic and dental factors affecting cognitive functions, and the association between tooth loss, cognitive functioning, and fall risk. Two hundred and thirty-one rural-dwelling older adults (60−74 years old) were recruited from a single Dental Service Unit. Cognitive function and fall risk were assessed with the Mini-Mental State Examination and the Morse Fall Scale, respectively. Oral examinations were performed by a dentist using the Community Periodontal Index of Treatment Needs form. 38.1%, had >16 tooth loss. Socioeconomic data and health status were obtained from a questionnaire and interviews. Age, Activities of Daily Living (ADL) score, and the number of teeth lost was significantly associated with impaired cognitive function. Chi-square analysis showed that cognitive function was also associated with fall risk. Past research suggests that much cognitive impairment and fall risk is induced by tooth loss. Service planners need to be aware of the complex bidirectional relationships between these variables and give higher priority to dental services that can improve the general health status and social functioning of older rural adults.
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Affiliation(s)
- Niruwan Turnbull
- Faculty of Public Health, Mahasarakham University, Maha Sarakham 44150, Thailand
- Public Health and Environmental Policy in Southeast Asia Research Unit (PHEP-SEA), Mahasarakham University, Maha Sarakham 44150, Thailand
| | | | - Sutin Chanaboon
- Sirindhorn College of Public Health Khon Kaen, Khon Kaen 40000, Thailand
| | - David Hughes
- Faculty of Medicine, Health & Life Science, Swansea University, Swansea SA2 8PP, UK
| | - Kukiat Tudpor
- Faculty of Public Health, Mahasarakham University, Maha Sarakham 44150, Thailand
- Public Health and Environmental Policy in Southeast Asia Research Unit (PHEP-SEA), Mahasarakham University, Maha Sarakham 44150, Thailand
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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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Kim MS, Han DH. Does reduced chewing ability efficiency influence cognitive function? Results of a 10-year national cohort study. Medicine (Baltimore) 2022; 101:e29270. [PMID: 35758356 PMCID: PMC9276352 DOI: 10.1097/md.0000000000029270] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 04/29/2022] [Indexed: 11/25/2022] Open
Abstract
A growing body of literature suggests that oral health can influence cognitive function during aging. However, it is currently unclear whether reduced masticatory efficiency influences cognitive impairment in longitudinal studies.This study sought to investigate the effects of reduced chewing ability on the incidence of cognitive impairment using national representative data from 10 years of follow-up in Korea. Among the 10,254 people recruited in 2006 (1st wave), 7568 with normal cognitive function were selected. The participants were followed up every 2 years. The number of participants followed up until the 6th wave was 5020 in 2016. Chewing ability and scores on the Mini-Mental State Examination were recorded using self-reported questionnaires. Risk factors for dementia taken from systematic literature reviews were used as covariates. We performed logistic regression and created general estimating equation models after controlling for all covariates to assess the relationship between chewing ability and cognitive decline. Decreased chewing function was associated with mild cognitive impairment after controlling for confounding variables.The odds ratio for cognitive impairment was about 1.28 times higher than in people with poor chewing function as in those with good chewing function. We identified changes in chewing function from the 1st wave to the 6th wave; the odds ratios were 2.21 (95% confidence interval = 1.90-2.58) in the good-poor group and 2.11 (95% confidence interval = 1.74-2.55) in the poor-poor group.We identified an impairment in cognitive function in the poor (poor-poor and good-poor) chewing ability group. Therefore, we have confirmed that reduced mastication efficiency may contribute to a deterioration in cognitive function. People with deteriorated chewing ability must be given additional attention to aid in the prevention of cognitive decline.
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Affiliation(s)
- Mi-Sun Kim
- Department of Dental Hygiene, Kyungdong University, Gangwon-do, South Korea
| | - Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
- Dental Research Institute, Seoul National University, Seoul, South Korea
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Hite NJ, Sudheimer KD, Anderson L, Sarko DK. Spatial Learning and Memory in the Naked Mole-Rat: Evolutionary Adaptations to a Subterranean Niche. Front Ecol Evol 2022. [DOI: 10.3389/fevo.2022.879989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Evolutionary adaptation to a subterranean habitat consisting of extensive underground tunnel systems would presumably require adept spatial learning and memory, however, such capabilities have not been characterized to date in naked mole-rats (Heterocephalus glaber) which, like other members of Bathyergidae, are subterranean rodents. The goal of this study was to develop a method for effectively assessing spatial learning and memory by modifying a Hebb-Williams maze for use with these subterranean rodents. Established behavioral tests to assess spatial learning and memory have primarily focused on, and have been optimized for, more typical laboratory rodent species such as mice and rats. In the current study, we utilized species-appropriate motivators, analyzed learning curves associated with maze performance, and tested memory retention in naked mole-rats. Using a modified Hebb-Williams maze, naked mole-rats underwent 3 days of training, consisting of five trials per day wherein they could freely explore the maze in search of the reward chamber. Memory retention was then tested 1 day, 1 week, and 1 month following the last day of training. Performance was analyzed based on latency to the reward chamber, errors made, and distance traveled to reach the reward chamber. Overall, this study established a behavioral paradigm for assessing maze navigation, spatial learning, and spatial memory in subterranean rodents, including optimization of rewards and environmental motivators.
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Atanda AJ, Livinski AA, London SD, Boroumand S, Weatherspoon D, Iafolla TJ, Dye BA. Tooth retention, health, and quality of life in older adults: a scoping review. BMC Oral Health 2022; 22:185. [PMID: 35585618 PMCID: PMC9118621 DOI: 10.1186/s12903-022-02210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This scoping review describes the relationship between tooth retention, health, and quality of life in older adults. METHODS Seven databases were searched for English language articles for subjects ≥ 65 y from 1981 to 2021. Exposure was tooth retention (≥ 20), and outcomes were general/systemic health and quality of life. Methodological quality was assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias 2.0 tool. RESULTS 140 articles were included, only four were randomized trials. Inter-rater agreement (κ) regarding study inclusion was 0.924. Most were assessed with low risk of bias (n = 103) and of good quality (n = 96). Most studies were conducted in Japan (n = 60) and Europe (n = 51) and only nine in the US. Tooth retention was referred to as "functional dentition" in 132 studies and "shortened dental arch" in 19 studies. Study outcomes were broadly synthesized as (1) cognitive decline/functional dependence, (2) health status/chronic diseases, (3) nutrition, and (4) quality of life. DISCUSSION There is a positive relationship between tooth retention, overall health, and quality of life. Older adults retaining ≥ 20 teeth are less likely to experience poorer health. Having < 20 teeth increases the likelihood for functional dependence and onset of disability, and may affect successful ageing. This review supports the general finding that the more teeth older adults retain as they age, the less likely they are to have adverse health outcomes. However, significant knowledge gaps remain which can limit decision-making affecting successful ageing for many older adults. This review highlights the need to consider, as an important marker of oral health and function, the retention of a functional minimum of a natural dentition, rather than a simple numeric score of missing teeth.
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Affiliation(s)
- Adejare Jay Atanda
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA.
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA.
| | - Alicia A Livinski
- National Institutes of Health Library, Office of Research Services, OD, National Institutes of Health, Bethesda, MD, USA
| | - Steven D London
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
- School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Shahdokht Boroumand
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
| | | | - Timothy J Iafolla
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
| | - Bruce A Dye
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA.
- School of Dental Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
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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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Padmanabhan H, Vijayakumar SS, N P, Kumar VA. Comparison of the effect of conventional and implant-retained overdentures on brain activity and cognition in a geriatric population - A Functional MRI study. J Prosthodont Res 2021; 66:431-437. [PMID: 34657904 DOI: 10.2186/jpr.jpr_d_21_00099] [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: 11/06/2022]
Abstract
PURPOSE This study aims to evaluate the effect of rehabilitation with complete dentures versus implant-retained overdenture on activity in various parts of the brain cognition in a geriatric edentulous population via Functional MRI (fMRI) studies and the Mini-Mental State Examination (MMSE). METHODS Ten completely edentulous patients were rehabilitated with both complete dentures and two-implant retained overdentures for three months each. fMRI studies were performed for each modality during chewing and recall tasks at three time periods: T0: Completely Edentulous(CE) T1: after three months of wearing Conventional Complete Dentures(CD) and T2: after three months of wearing Implant-retained Overdentures (IOD). The Z scores obtained from the fMRI at these phases of examination were tabulated and correlated with MMSE scores obtained at the corresponding time periods. RESULTS Z scores obtained during the memory recall tasks at T2 were the greatest (Prefrontal Cortex (p=0.059) and Hippocampus (p=0.036). The MMSE scores obtained were significantly higher for the IODs when compared to the CDs and Baseline values (p < 0.05)Conclusion: IODs may potentially result in superior sensory feedback in edentulous patients and lead to improved cognitive performance when compared to conventional complete dentures.
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Affiliation(s)
- Harini Padmanabhan
- Department of Prosthodontics, Crown and Bridge, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Siddharth S Vijayakumar
- Department of Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Parthasarathy N
- Department of Prosthodontics, Crown and Bridge, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - V Anand Kumar
- Department of Prosthodontics, Crown and Bridge, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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Hu X, Zhang J, Qiu Y, Liu Z. Periodontal disease and the risk of Alzheimer's disease and mild cognitive impairment: a systematic review and meta-analysis. Psychogeriatrics 2021; 21:813-825. [PMID: 34247432 DOI: 10.1111/psyg.12743] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/08/2021] [Accepted: 06/24/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Results of studies on the association between periodontal disease (PD) and Alzheimer's disease (AD) or mild cognitive impairment (MCI) are inconsistent, and a previous meta-analysis published in 2017 included inadequate studies and is thus outmoded. This study aims to systematically evaluate the correlation between PD and the risk of AD or MCI. METHODS The following electronic databases were screened by two investigators independently, without restriction of language: CENTRAL (Cochrane library), PubMed (MEDLINE), EMBASE, China National Knowledge Interne, China Science and Technology Journal Database, Wanfang Data, www.ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform. Meta-analysis was conducted using random-effects model or fixed-effects model according to the heterogeneity of included studies. RESULTS Thirteen eligible studies, of which eight reported AD (291 114 participants) and eight reported MCI (4805 participants), were included in this meta-analysis. The pooled results showed that compared with the non-PD population, the risk of AD and MCI in PD patients was significantly higher (for AD: odds ratio (OR) = 1.78, 95% CI 1.15-2.76; for MCI: OR = 1.60, 95% CI 1.24-2.06), and especially in those with severe PD (for AD: OR = 4.89, 95% CI 1.60-14.97; for MCI, OR = 2.32, 95% CI 1.24-4.36). CONCLUSIONS This meta-analysis indicated that PD was related to an elevated risk of AD and cognitive impairment, and that it should receive early intervention.
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Affiliation(s)
- Xin Hu
- School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Jing Zhang
- School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Yulan Qiu
- School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Zhaonan Liu
- School of Medicine, Shanghai Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
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Elmorsy AA, Zaki M, Elbahnaswi H, Moussa AR, Elboraey AN. The Effect of Alteration of Vertical Dimension of Occlusion on Brain Activity in Complete Denture Wearers. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The establishment of appropriate vertical dimension of occlusion (VDO) is paramount for successful and functioning complete dentures (CDs).
AIM: The aim of this study was to assess the effect of alteration of VDO on the brain activity in CD wearers.
MATERIALS AND METHODS: Ten completely edentulous patients participated in this study. Each patient received three sets of CDs: one control set and two duplicates’ CDs. The control CDs was designed with appropriate VDO (control - VDO), while the duplicate CDs were designated as followed: one with VDO lowered by –3 mm (low - VDO) the other one VDO was increased by +5 mm (high - VDO). The effect of alteration of VDO on brain activity was assessed by measuring alpha waves changes using electroencephalogram (EEG) before and after chewing gum. Statistical analysis was carried out using one-way ANOVA and dependent t-test. The significance level was set at p < 0.05.
RESULTS: There was a significant increase in the alpha waves mean values after chewing (p < 0.05) gum compared to before except for low - VDO CDs (p > 0.05). The control-VDO revealed a statistically significant higher mean values compared to the duplicate dentures. CDs with high - VDO showed higher mean value than low - VDO dentures, however, it was statistically insignificant (p > 0.05).
CONCLUSION: Appropriate determination of VDO is not only important for the success of CDs but also for the functional augmentation of brain activity.
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Guo H, Chang S, Pi X, Hua F, Jiang H, Liu C, Du M. The Effect of Periodontitis on Dementia and Cognitive Impairment: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136823. [PMID: 34202071 PMCID: PMC8297088 DOI: 10.3390/ijerph18136823] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/12/2021] [Accepted: 06/19/2021] [Indexed: 12/23/2022]
Abstract
The association between periodontal disease and dementia/cognitive impairment continues to receive increasing attention. However, whether periodontal disease is a risk factor for dementia/cognitive impairment is still uncertain. This meta-analysis was conducted to comprehensively analyze the effect of periodontitis on dementia and cognitive impairment, and to assess the periodontal status of dementia patients at the same time. A literature search was undertaken on 19 October 2020 using PubMed, Web of Science, and Embase with different search terms. Two evaluators screened studies according to inclusion and exclusion criteria, and a third evaluator was involved if there were disagreements; this process was the same as that used for data extraction. Included studies were assessed with the Newcastle-Ottawa Scale (NOS), and results were analyzed using software Review Manager 5.2. Twenty observational studies were included. In the comparison between periodontitis and cognitive impairment, the odds ratio (OR) was 1.77 (95% confidence interval (CI), 1.31–2.38), which indicated that there was a strong relationship between periodontitis and cognitive impairment. There was no statistical significance in the effect of periodontitis on dementia (OR = 1.59; 95%CI, 0.92–2.76). The subgroup analysis revealed that moderate or severe periodontitis was significantly associated with dementia (OR = 2.13; 95%CI, 1.25–3.64). The mean difference (MD) of the community periodontal index (CPI) and clinical attachment level (CAL) was 0.25 (95%CI, 0.09–0.40) and 1.22 (95%CI, 0.61–1.83), respectively. In this meta-analysis, there was an association between periodontitis and cognitive impairment, and moderate or severe periodontitis was a risk factor for dementia. Additionally, the deterioration of periodontal status was observed among dementia patients.
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Affiliation(s)
- Haiying Guo
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; (H.G.); (S.C.); (X.P.); (F.H.); (H.J.)
| | - Shuli Chang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; (H.G.); (S.C.); (X.P.); (F.H.); (H.J.)
| | - Xiaoqin Pi
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; (H.G.); (S.C.); (X.P.); (F.H.); (H.J.)
| | - Fang Hua
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; (H.G.); (S.C.); (X.P.); (F.H.); (H.J.)
- Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Han Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; (H.G.); (S.C.); (X.P.); (F.H.); (H.J.)
| | - Chang Liu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; (H.G.); (S.C.); (X.P.); (F.H.); (H.J.)
- Correspondence: (C.L.); (M.D.); Tel.: +86-027-8768-6227 (C.L.)
| | - Minquan Du
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; (H.G.); (S.C.); (X.P.); (F.H.); (H.J.)
- Correspondence: (C.L.); (M.D.); Tel.: +86-027-8768-6227 (C.L.)
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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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17
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Luo H, Tan C, Adhikari S, Plassman B, Kamer A, Sloan F, Schwartz M, Qi X, Wu B. Effects of the Co-occurrence of Diabetes Mellitus and Tooth Loss on Cognitive Function. Curr Alzheimer Res 2021; 18:1023-1031. [PMID: 34951384 PMCID: PMC8810293 DOI: 10.2174/1567205019666211223093057] [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: 08/18/2021] [Revised: 10/06/2021] [Accepted: 11/05/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Both diabetes mellitus (DM) and poor oral health are common chronic conditions and risk factors of Alzheimer's disease and related dementia among older adults. This study assessed the effects of DM and complete tooth loss (TL) on cognitive function, accounting for their interactions. METHODS Longitudinal data were obtained from the 2006, 2012, and 2018 waves of the Health and Retirement Study. This cohort study included 7,805 respondents aged 65 years or older with 18,331 person-year observations. DM and complete TL were self-reported. Cognitive function was measured by the Telephone Interview for Cognitive Status. Random-effect regressions were used to test the associations, overall and stratified by sex. RESULTS Compared with older adults without neither DM nor complete TL, those with both conditions (b = -1.35, 95% confidence interval [CI]: -1.68, -1.02), with complete TL alone (b = -0.67, 95% CI: -0.88, -0.45), or with DM alone (b = -0.40, 95% CI: -0.59, -0.22), had lower cognitive scores. The impact of having both conditions was significantly greater than that of having DM alone (p < .001) or complete TL alone (p = 0.001). Sex-stratified analyses showed the effects were similar in males and females, except having DM alone was not significant in males. CONCLUSION The co-occurrence of DM and complete TL poses an additive risk for cognition. Healthcare and family-care providers should pay attention to the cognitive health of patients with both DM and complete TL. Continued efforts are needed to improve older adults' access to dental care, especially for individuals with DM.
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Affiliation(s)
- Huabin Luo
- East Carolina University, Brody School of Medicine, Greenville, USA
| | - Chenxin Tan
- New York University, Rory Meyers College of Nursing New York, USA
| | | | | | - Angela Kamer
- New York University College of Dentistry, New York, USA
| | - Frank Sloan
- Duke University School of Medicine, Durham, USA
| | - Mark Schwartz
- New York University Grossman School of Medicine, New York, USA
| | - Xiang Qi
- New York University, Rory Meyers College of Nursing New York, USA
| | - Bei Wu
- New York University, Rory Meyers College of Nursing New York, USA
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18
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Hasegawa Y, Sakuramoto-Sadakane A, Nagai K, Tamaoka J, Oshitani M, Ono T, Sawada T, Shinmura K, Kishimoto H. Does Oral Hypofunction Promote Social Withdrawal in the Older Adults? A Longitudinal Survey of Elderly Subjects in Rural Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8904. [PMID: 33266111 PMCID: PMC7731335 DOI: 10.3390/ijerph17238904] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/19/2020] [Accepted: 11/25/2020] [Indexed: 12/14/2022]
Abstract
It is often assumed that oral hypofunction is associated with social withdrawal in older adults because decreased motor function is related to decreased oral function. However, few studies have examined the relationship between social withdrawal in older adults and oral function. This longitudinal study aimed to clarify the relationship between changes in the level of social withdrawal and oral function in independent older adults. Participants were 427 older adults aged 65 years or older who took part in a self-administered questionnaire from 2016 to 2017 (baseline), and again two years later (follow-up). At baseline, 17 items related to oral function and confounding factors related to withdrawal, physical condition, physical function, and cognitive function were evaluated. A Cox proportional hazard model was used to examine the oral functions that negatively impact social withdrawal. The following factors were significantly associated with the worsening of social withdrawal: the number of remaining teeth, gingival condition, occlusal force, masticatory efficiency, and items related to swallowing and dry mouth. Older adults with cognitive issues who walk slowly and have a weak knee extension muscle were also significantly more likely to have oral frailty. Those who were found to have oral frailty at baseline were 1.8 times more likely to develop withdrawal compared to those with robust oral function. The results indicated that the worsening of withdrawal was associated with oral hypofunction at baseline. Since oral hypofunction was associated with the worsening of social withdrawal in older adults, it is important to maintain older adults' oral function.
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Affiliation(s)
- Yoko Hasegawa
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan; (A.S.-S.); (J.T.); (M.O.); (H.K.)
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan;
| | - Ayumi Sakuramoto-Sadakane
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan; (A.S.-S.); (J.T.); (M.O.); (H.K.)
| | - Koutatsu Nagai
- Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo 650-8530, Japan;
| | - Joji Tamaoka
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan; (A.S.-S.); (J.T.); (M.O.); (H.K.)
| | - Masayuki Oshitani
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan; (A.S.-S.); (J.T.); (M.O.); (H.K.)
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan;
| | - Takashi Sawada
- Hyogo Dental Association, 5-7-18 Yamamoto-dori, Chuo-ku, Kobe, Hyogo 650-0003, Japan;
| | - Ken Shinmura
- Department of General Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan;
| | - Hiromitsu Kishimoto
- Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan; (A.S.-S.); (J.T.); (M.O.); (H.K.)
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19
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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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20
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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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21
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Saikia UP, Chander NG, Balasubramanian M. Effect of fixed dental prosthesis on the brain functions of partially edentulous patients - pilot study with power spectrum density analysis. Eur Oral Res 2020; 54:114-118. [PMID: 33543115 PMCID: PMC7837703 DOI: 10.26650/eor.20200032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: This study was done to analyse the influence of fixed dental prosthesis (FDP) on
brain function by analysing power spectral density of partially edentulous patients. Materials and methods: The study included unilateral missing mandibular molar replacement patients. The
patients were restored with three-unit metal ceramic FDP restorations. The cognitive
function was analysed with a mental state questionnaire. Power spectral density
(PSD) analysis of EEG alpha waves was made pre- treatment, post treatment and 3
months after FDP treatment to analyse the brain function. The data in various phases
were obtained before and after chewing. The results were statistically analysed. Results: The mean pre and post treatment PSD was 0.0175 (SD ±0.0132) and 0.0178 (SD
±0.0135). The mean post treatment PSD after three months was 0.024 (SD± 0.019).
The results were analysed with repeated ANOVA and were statistically significant.
(p<0.01). Conclusion: The study displayed improvement in brain function of partially edentulous patients
with FDP rehabilitation.
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Affiliation(s)
| | - N Gopi Chander
- Department of Prosthodontics, SRM Dental College, Ramapuram, Chennai, Tamilnadu,India
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22
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Abstract
Currently, a few of studies revealed that there is an association between mastication and cognitive impairment. There is no study of Korean adult representative samples in relation to mastication and cognitive decline. This study was to investigate the relationship between mastication and mild cognitive impairment in Korean adults.A population-based cross-sectional study was conducted in which a total of 7029 subjects (2987 men and 4042 women) over 45 years old were surveyed from the Korea Longitudinal Study on Aging (KLoSA), Round 5th survey. Logistic regression analysis was performed for the study data controlling for confounding factors such as age, gender, education, income, smoking, drinking, exercise, wearing denture, and the number of chronic diseases.Decreased chewing function is associated with mild cognitive impairment (odds ratio [OR] = 3.24, 95% confidence interval [CI] = 2.67-3.93) after controlling for confounding variables. In the participants who did not wear dentures, the reduction of chewing function was strongly correlated with mild cognitive impairment (OR = 3.97, 95% CI = 3.11-5.08).Mastication was associated with mild cognitive impairment. To prevent cognitive decline, health specialists should pay more attention to the decline of the mastication in people without dentures.
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Affiliation(s)
- Mi-Sun Kim
- Department of Dental Hygiene, Kyungdong University, Wonju, South Korea
| | - Bumjo Oh
- Department of Family Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Ji Won Yoo
- Department of Internal Medicine, School of Medicine, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University, Seoul, South Korea
- Dental Research Institute, Seoul National University, Seoul, South Korea
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23
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Effect of an implant-retained complete overdenture on the hearing ability of edentulous patients: A clinical pilot study. J Prosthet Dent 2020; 125:628-635. [PMID: 32345511 DOI: 10.1016/j.prosdent.2020.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 11/23/2022]
Abstract
STATEMENT OF PROBLEM Edentulism has been associated with sensoneurinal hearing reduction, but whether hearing is improved by the provision of an implant-retained overdenture is unclear. PURPOSE The purpose of this pilot clinical study was to provide completely edentulous participants with implant-retained complete overdentures and to evaluate the effect on their hearing ability by pure tone audiometry (PTA). MATERIAL AND METHODS Fifteen completely edentulous first-time denture wearers were enrolled, and their hearing was evaluated with PTA for air conduction and bone conduction at 6 time intervals: before denture insertion (R1), after denture insertion (R2), 1 month after denture insertion (R3), on the day of suture removal after implant surgery (R4), 3 months later, at the time of loading (R5), and 1 month after implant loading (R6). The Friedman test was performed to find significant differences in the measurements from the completely edentulous state to rehabilitation with a complete denture and an implant-retained complete overdenture. The post hoc Tukey test was used for multiple comparisons (α=.05). RESULTS Significant differences were found between R1 and R6, between R2 and R6, between R3 and R6, and between R4 and R6 in PTA in multiple comparisons (P<.05). The post hoc test revealed significant difference in the R1and R6 and R3 and R6 pairs (P<.05) at 500 Hz, 1 kHz, and 8 kHz, whereas only between R1 and R6 (P<.05) at 2 kHz for the air conduction test. In the bone conduction test, a significant difference was observed between the R1 and R6 and the R3 and R6 pairs (P<.05) at 500 Hz and 4 kHz, but only between R3 and R6 (P<.05) at 1 kHz and 2 kHz. CONCLUSIONS The study showed that the placement of dental implants improved hearing acuity via the acoustic pathway through air and bone conduction.
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Rodríguez-Rabassa M, López P, Sánchez R, Hernández C, Rodríguez C, Rodríguez-Santiago RE, Orengo JC, Green V, Yamamura Y, Rivera-Amill V. Inflammatory Biomarkers, Microbiome, Depression, and Executive Dysfunction in Alcohol Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030689. [PMID: 31973090 PMCID: PMC7037324 DOI: 10.3390/ijerph17030689] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/11/2020] [Accepted: 01/13/2020] [Indexed: 02/07/2023]
Abstract
Alcohol-related disorders (ARD) are highly prevalent among Latin American-Caribbean countries. Mental disorders are common comorbidities in individuals with ARD. However, the etiology of the association between ARD and mental disorders remains unclear. We examined the association of inflammatory cytokines, microbiome, and other biomakers with measures of depression, social anxiety, and executive functions. We observed a significant increase in cytokine and chemokine expression levels in saliva and plasma in the alcohol group (AG) samples. Also, the salivary bacterial composition in the AG revealed an abundance of Prevotella. Depression symptomatology was markedly higher in the AG, but social anxiety levels were negligible. AG also exhibited executive dysfunctions, which negatively correlated with increased plasma levels of pro-inflammatory cytokines and increased salivary concentrations of Prevotella bacteria. Our study suggests that chronic alcohol use correlates with executive dysfunction, immune system dysregulation, and dysbiosis of the salivary microbiota. Additional studies are needed to understand the role of the microbiome and inflammation in alcohol use and mental comorbidities.
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Affiliation(s)
- Mary Rodríguez-Rabassa
- Center for Research Resources, Ponce Health Sciences University-Ponce Research Institute, Ponce, PR 00716-2348, USA; (M.R.-R.); (P.L.); (R.S.); (R.E.R.-S.); (Y.Y.)
- Clinical Psychology Program, Ponce Health Sciences University-Ponce Research Institute, Ponce, PR 00716-2348, USA; (C.H.); (C.R.)
| | - Pablo López
- Center for Research Resources, Ponce Health Sciences University-Ponce Research Institute, Ponce, PR 00716-2348, USA; (M.R.-R.); (P.L.); (R.S.); (R.E.R.-S.); (Y.Y.)
| | - Raphael Sánchez
- Center for Research Resources, Ponce Health Sciences University-Ponce Research Institute, Ponce, PR 00716-2348, USA; (M.R.-R.); (P.L.); (R.S.); (R.E.R.-S.); (Y.Y.)
| | - Cyanela Hernández
- Clinical Psychology Program, Ponce Health Sciences University-Ponce Research Institute, Ponce, PR 00716-2348, USA; (C.H.); (C.R.)
| | - Cesarly Rodríguez
- Clinical Psychology Program, Ponce Health Sciences University-Ponce Research Institute, Ponce, PR 00716-2348, USA; (C.H.); (C.R.)
| | - Ronald E. Rodríguez-Santiago
- Center for Research Resources, Ponce Health Sciences University-Ponce Research Institute, Ponce, PR 00716-2348, USA; (M.R.-R.); (P.L.); (R.S.); (R.E.R.-S.); (Y.Y.)
| | - Juan C. Orengo
- Public Health Program, Ponce Health Sciences University-Ponce Research Institute, Ponce, PR 00716-2348, USA; (J.C.O.); (V.G.)
| | - Vivian Green
- Public Health Program, Ponce Health Sciences University-Ponce Research Institute, Ponce, PR 00716-2348, USA; (J.C.O.); (V.G.)
| | - Yasuhiro Yamamura
- Center for Research Resources, Ponce Health Sciences University-Ponce Research Institute, Ponce, PR 00716-2348, USA; (M.R.-R.); (P.L.); (R.S.); (R.E.R.-S.); (Y.Y.)
| | - Vanessa Rivera-Amill
- Center for Research Resources, Ponce Health Sciences University-Ponce Research Institute, Ponce, PR 00716-2348, USA; (M.R.-R.); (P.L.); (R.S.); (R.E.R.-S.); (Y.Y.)
- Correspondence: ; Tel.: +1-(787)-841-5150; Fax: +1-(787)-841-5159
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Han JH, Lee HJ, Han JW, Suh SW, Lee JR, Byun S, Kim KS, Kim SY, Lee JT, Yoo E, Chang NH, Kim TH, Kim KW. Loss of Functional Dentition is Associated with Cognitive Impairment. J Alzheimers Dis 2020; 73:1313-1320. [PMID: 31929161 DOI: 10.3233/jad-190971] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although tooth loss is known to increase the risk of cognitive impairment and dementia, few studies have investigated the association between functional teeth including rehabilitated lost teeth and cognitive functionObjective:We investigated the associations of the numbers of functional teeth and functional occlusal units with cognitive impairment and cognitive function in late life. METHODS The current study was conducted as a part of the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD), a community-based elderly cohort study. We analyzed 411 participants who have agreed with the additional dental exam. Geriatric psychiatrists and neuropsychologists administered the Consortium to Establish a Registry for Alzheimer's disease Assessment Packet Clinical and Neuropsychological Assessment Battery to all participants, and dentists examined their dental status. RESULTS Higher number of functional teeth (OR = 0.955, 95% CI = 0.914-0.997, p = 0.037) and higher number of functional occlusal units (OR = 0.900, 95% CI = 0.813-0.996, p = 0.042) were associated with lower odds of cognitive impairment. When we analyzed these relationships separated by the location of teeth, only the numbers of functional teeth (OR = 0.566, 95% CI = 0.373-0.857, p = 0.007) and functional occlusal units (OR = 0.399, 95% CI = 0.213-0.748, p = 0.004) in the premolar area were associated with lower odds of cognitive impairment. CONCLUSION Loss of functional teeth and functional occlusal units (especially in the premolar region) were associated with increased cognitive impairment.
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Affiliation(s)
- Ji Hyun Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seung Wan Suh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | | | - Seonjeong Byun
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Keun Suh Kim
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Yeol Kim
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung-Tae Lee
- Department of Periodontics, Dankook University College of Dentistry Jukjeon Dental Hospital, Yongin, Korea
| | - Eunha Yoo
- Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Na-Hee Chang
- Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea.,National Institute of Dementia, Seongnam, Korea
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Kim DH, Jeong SN, Lee JH. Severe periodontitis with tooth loss as a modifiable risk factor for the development of Alzheimer, vascular, and mixed dementia: National Health Insurance Service-National Health Screening Retrospective Cohort 2002-2015. J Periodontal Implant Sci 2020; 50:303-312. [PMID: 33124208 PMCID: PMC7606895 DOI: 10.5051/jpis.2000600030] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/14/2020] [Accepted: 05/08/2020] [Indexed: 01/15/2023] Open
Abstract
Purpose The purpose of this study was to evaluate severe periodontitis with tooth loss as a modifiable risk factor for Alzheimer dementia (AD), vascular dementia (VaD), and mixed dementia (MD) using the National Health Insurance Service-National Health Screening Retrospective Cohort database with long-term follow-up over 14 years. Methods Multivariate Cox hazards regression analysis was applied to a longitudinal retrospective database, which was updated in 2018, to evaluate the association between severe periodontitis with few remaining teeth and dementia after adjusting for potential risk factors, including sociodemographic factors and comorbid diseases. Results Among 514,866 individuals in South Korea, 237,940 (46.2%) participants satisfying the inclusion criteria were selected. A total of 10,115 age- and sex-matched participants with severe periodontitis and 10,115 periodontally healthy participants were randomly selected and evenly assigned. The results showed that the risks of AD (hazard ratio [HR], 1.08), VaD (HR, 1.24), and MD (HR, 1.16) were significantly higher in patients with severe periodontitis with 1–9 remaining teeth after adjustment for sociodemographic factors, anthropomorphic measurements, lifestyle factors, and comorbidities. Conclusions Severe periodontitis with few remaining teeth (1–9) may be considered a modifiable risk factor for the development of AD, VaD, and MD in Korean adults.
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Affiliation(s)
- Do Hyung Kim
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Jae Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea.
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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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Lee KH, Choi YY. Association between oral health and dementia in the elderly: a population-based study in Korea. Sci Rep 2019; 9:14407. [PMID: 31594986 PMCID: PMC6783535 DOI: 10.1038/s41598-019-50863-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 09/20/2019] [Indexed: 11/17/2022] Open
Abstract
We have investigated the association of oral health with development of dementia in elderly Koreans. Data for subjects aged ≥65 years who underwent regular National Health Insurance Service check-ups and received dental care in 2017 were analysed. Those treated for dementia in 2017 served as the dementia group and those with no record of dementia in 2002-2017 as the control group. Explanatory variables were sex, age, household income, place of residence, smoking status, alcohol consumption, and presence of diabetes mellitus and hypertension, periodontitis, and removable dentures. Regression analysis showed that dementia was significantly more common in women than in men and in those aged ≥81 years than in those aged 65-70 years. The risk of dementia was highest in the 'upper-middle' income group and in the rural population. Smokers and those who consumed alcohol were less likely to develop dementia. Subjects with diabetes were more likely to have dementia than those without it, as were those with hypertension. Dementia was less likely in subjects with periodontitis and more likely in those with removable dentures. Therefore, loss of teeth may contribute to development of dementia.
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Affiliation(s)
- Kyeong Hee Lee
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu, 11644, Republic of Korea
| | - Yoon Young Choi
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu, 11644, Republic of Korea.
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Systemic inflammation linking chronic periodontitis to cognitive decline. Brain Behav Immun 2019; 81:63-73. [PMID: 31279681 DOI: 10.1016/j.bbi.2019.07.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 12/25/2022] Open
Abstract
Persistent inflammation in the systemic immune system can impose detrimental effects on the central nervous system (CNS). Neuroinflammation might be a result of this to accelerate the progressive deterioration of neuronal functions during aging. In this regard, controlling inflammation through delaying and/or preventing chronic inflammatory diseases may be a potential strategy to prevent or modify the progression of Alzheimer's Disease (AD). Periodontitis is a chronic inflammatory disease of the oral cavity that is common among the elderly, especially for those who have decline in cognitive functions. While epidemiological findings support the association of chronic periodontitis and cognitive decline, whether they have causal relationship remains unclear. Nonetheless, the possibility that periodontopathogens, systemic immune cells and inflammatory cytokines could reach the CNS should not be overlooked. The impacts of periodontitis on CNS homeostasis and inflammation as a pathophysiological factor concerning the association between periodontitis and AD will be discussed in this review. Future work should elucidate the pathological pathways involved in periodontitis-induced cerebral infections and inflammation, and define the role of the latter in AD progression.
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Mikami Y, Watanabe Y, Motokawa K, Shirobe M, Motohashi Y, Edahiro A, Nakajima J, Osuka Y, Inagaki H, Fujiwara Y, Shinkai S, Awata S. Association between decrease in frequency of going out and oral function in older adults living in major urban areas. Geriatr Gerontol Int 2019; 19:792-797. [DOI: 10.1111/ggi.13715] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 04/27/2019] [Accepted: 05/11/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Yurie Mikami
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Yutaka Watanabe
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
- Gerodontology, Department of Oral Health Science, Faculty of Dental MedicineHokkaido University Sapporo Japan
| | - Keiko Motokawa
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Maki Shirobe
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Yoshiko Motohashi
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Ayako Edahiro
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Junko Nakajima
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Yosuke Osuka
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Hiroki Inagaki
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Yoshinori Fujiwara
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Shoji Shinkai
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Shuichi Awata
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology Tokyo Japan
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Okamoto N, Amano N, Nakamura T, Yanagi M. Relationship between tooth loss, low masticatory ability, and nutritional indices in the elderly: a cross-sectional study. BMC Oral Health 2019; 19:110. [PMID: 31196057 PMCID: PMC6567659 DOI: 10.1186/s12903-019-0778-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/29/2019] [Indexed: 11/29/2022] Open
Abstract
Background Low masticatory ability and the resulting decrease in intake of masticable foods can result in undernutrition. The present study investigated the relationship between tooth loss, low masticatory ability, and nutritional indices in the elderly. Methods The data analyzed in this study were retrieved from the baseline data of the 2007 Fujiwara-kyo study, a prospective cohort study of community-dwelling elderly individuals. Subjects included 1591 men and 1543 women, both with a median age of 71 years. The maximum occlusal force was measured as an objective index of masticatory ability. Foods were divided into five groups based on hardness: Group 1 (bananas, etc.), 0.53 kg; Group 2 (boiled rice, etc.), 1.22 kg; Group 3 (raisins, etc.), 2.93 kg; Group 4 (raw carrots, etc.), 4.38 kg; and Group 5 (beef jerky), 6.56 kg. To obtain a subjective index of masticatory ability, a questionnaire-based survey was conducted to determine whether subjects could masticate foods within each group. As nutritional indices, serum albumin levels and body mass index (BMI) data were used. Results The median number of teeth was 21. The proportion of subjects for whom all five food groups were masticable showed a significant decrease in the number of teeth in both males and females. Logistic regression analysis showed that, after adjustment for confounders, no significant relationships were observed between the number of teeth and the masticatory ability with nutritional indices in males. In females, a maximum occlusal force of 100 to 300 N (OR = 1.65; 95% CI = 1.06–2.55) or less than 100 N (OR = 1.95; 95% CI = 1.15–3.31) showed a significant correlation with serum albumin levels below 4.4 g/dL (reference: 500 N or more). In addition, the masticability of all five food groups showed a significant correlation with BMI < 21.0 kg/m2 (OR = 0.62; 95% CI = 0.46–0.85) in females. Conclusions A low number of teeth was associated with low masticatory ability in both males and females. Low masticatory ability was associated with low plasma albumin levels and low BMI in females. Not smoking, maintaining grip strength, preventing cancer, and masticatory ability are important for preventing undernutrition.
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Affiliation(s)
- Nozomi Okamoto
- Department of School Psychology, Developmental Science and Health Education, Hyogo University of Teacher Education, Simokume 942-1, Kato City, Hyogo, Japan.
| | - Nobuko Amano
- Department of Clinical Nutrition and Dietetics, Konan Women's University, Morikita-cho 6-2-23, Higashinadaku, Kobe City, Hyogo, Japan.,Department of Epidemiology, Nara Medical University, 840 Shijo-cho, Kashihara City, Nara, Japan
| | - Tomiyo Nakamura
- Department of Food Science and Human Nutrition, Ryukoku University, Yokotani1-5, Setaoe-cho, Otsu City, Shiga, Japan
| | - Motokazu Yanagi
- Department of Food and Nutrition, Tezukayama University, Gakuenmaeminami 3-1-3, Nara City, Nara, Japan
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Yoo JJ, Yoon JH, Kang MJ, Kim M, Oh N. The effect of missing teeth on dementia in older people: a nationwide population-based cohort study in South Korea. BMC Oral Health 2019; 19:61. [PMID: 31023356 PMCID: PMC6485168 DOI: 10.1186/s12903-019-0750-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 03/31/2019] [Indexed: 01/25/2023] Open
Abstract
Background To determine the effect of missing teeth on the risk of dementia onset among individuals who received tooth extractions and those who did not, based on the number of missing teeth. Methods We selected individuals who had not been diagnosed or treated for dementia between 2002 to 2011 from the National Health Insurance Service-Elderly Cohort Database (NHIS-ECD). We divided participants into two cohorts, a tooth extraction and non-extraction cohort, based on tooth loss from 2002 to 2011. After propensity score matching, there were 104,903 individuals in each cohort, and we included a total of 209,806 individuals in this study. Each cohort was grouped by sex, age, residential area, health insurance eligibility, income level, history of dental caries, history of periodontal treatment, and number of extracted teeth. We analyzed the relationship between dementia onset and these variables using logistic regression analysis. Results Individuals with tooth loss had a higher risk for dementia than those without tooth loss (odds ratio [OR] = 1.18; 95% confidence interval [CI]: 1.146–1.215). Regarding the incidence of dementia, the OR increased as the number of missing teeth and age increased, and the OR was higher for women (OR = 1.33; 95% CI: 1.286–1.367) than for men, and this difference was statistically significant (P < 0.01). The incidence of dementia decreased with periodontal treatment (OR = 0.96; 95% CI: 0.932–0.992) and increased with dental caries (OR = 1.07; 95% CI: 1.035–1.101). Conclusions These results suggest that it is important to delay tooth loss and preserve the stable remaining teeth to help prevent dementia. Electronic supplementary material The online version of this article (10.1186/s12903-019-0750-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jin-Joo Yoo
- Department of Prosthodontics, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10444, Republic of Korea
| | - Joon-Ho Yoon
- Department of Prosthodontics, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10444, Republic of Korea
| | - Min-Jin Kang
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10444, Republic of Korea
| | - Manyong Kim
- Department of Prosthodontics, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10444, Republic of Korea
| | - Namsik Oh
- Department of Dentistry, College of Medicine, Inha University, 27, Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea.
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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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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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Jou YT. Dental deafferentation and brain damage: A review and a hypothesis. Kaohsiung J Med Sci 2018; 34:231-237. [PMID: 29655412 DOI: 10.1016/j.kjms.2018.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/07/2017] [Accepted: 01/12/2018] [Indexed: 01/04/2023] Open
Abstract
In the last few decades, neurobiological and human brain imaging research have greatly advanced our understanding of brain mechanisms that support perception and memory, as well as their function in daily activities. Knowledge of the neurobiological mechanisms behind the deafferentation of stomatognathic systems has also expanded greatly in recent decades. In particular, current studies reveal that the peripheral deafferentations of stomatognathic systems may be projected globally into the central nervous system (CNS) and become an associated critical factor in triggering and aggravating neurodegenerative diseases. This review explores basic neurobiological mechanisms associated with the deafferentation of stomatognathic systems. Further included is a discussion on tooth loss and other dental deafferentation (DD) mechanisms, with a focus on dental and masticatory apparatuses associated with brain functions and which may underlie the changes observed in the aging brain. A new hypothesis is presented where DD and changes in the functionality of teeth and the masticatory apparatus may cause brain damage as a result of altered cerebral circulation and dysfunctional homeostasis. Furthermore, multiple recurrent reorganizations of the brain may be a triggering or contributing risk factor in the onset and progression of neurodegenerative conditions such as Alzheimer's disease (AD). A growing understanding of the association between DD and brain aging may lead to solutions in treating and preventing cognitive decline and neurodegenerative diseases.
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Affiliation(s)
- Yi-Tai Jou
- Department of Endodontics School of Dental Medicine University of Pennsylvania Philadelphia, Pennsylvania, USA.
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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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Gusman DJR, Mello-Neto JM, Alves BES, Matheus HR, Ervolino E, Theodoro LH, de Almeida JM. Periodontal disease severity in subjects with dementia: A systematic review and meta-analysis. Arch Gerontol Geriatr 2018. [PMID: 29518672 DOI: 10.1016/j.archger.2018.02.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Despite clinical trials and reviews attempt to assess a possible relationship between dementia and periodontal disease, no meta-analysis has been performed and this issue remains undetermined. The aim of this study is to conduct a systematic review and meta-analysis to assess severity of periodontitis in subjects with dementia. METHODS The search was conducted in Pubmed, Embase/MEDLINE. Two independent reviewers extracted data and assessed the risk bias (Newcastle-Ottawa scale). Meta-analyses were performed using the means of probing depth (PD) and clinical attachment loss (CAL) in patients with or without dementia. The mean difference were analyzed (P ≤ 0.05). RESULTS Fourteen studies were included in the systematic review. In the qualitative analysis, most studies reported higher prevalence of periodontal disease in dementia patients. The studies had low risk of bias and two meta-analyses were performed for each parameter, including or not a cross-sectional study. The meta-analyses including the cross-sectional study demonstrated significant association between dementia and periodontal disease (mean difference: PD = 1.41; CAL = 1.40, P < 0.05), however, it wasn't confirmed when the cross-sectional study was removed (1.25 mm, P < 0.22) and CAL (1.20 mm, P < 0.22). CONCLUSION Although the qualitative analysis have suggested worse periodontal conditions in dementia patients, due to different study types and the high heterogeneity among them, the meta-analysis does not support the association between dementia and severity of periodontal disease.
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Affiliation(s)
- David Jonathan R Gusman
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - João M Mello-Neto
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Breno Edson S Alves
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Henrique R Matheus
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil.
| | - Letícia H Theodoro
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil.
| | - Juliano M de Almeida
- Department of Surgery and Integrated Clinic, Division of Periodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil.
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Okamoto N, Morikawa M, Amano N, Yanagi M, Takasawa S, Kurumatani N. Effects of Tooth Loss and the Apolipoprotein E ɛ4 Allele on Mild Memory Impairment in the Fujiwara-kyo Study of Japan: A Nested Case-Control Study. J Alzheimers Dis 2018; 55:575-583. [PMID: 27716671 PMCID: PMC5147497 DOI: 10.3233/jad-160638] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background: Several studies have suggested that periodontal disease can exacerbate the pro-inflammatory status of the brain. Tooth loss is one of the alternative evaluation indices of periodontal disease. There are few data on the relationship between tooth loss and memory impairment, depending on the apolipoprotein E (APOE) ɛ4 genotype. Objective: To determine if tooth loss is associated with mild memory impairment (MMI) and if this association is modified by the presence of the APOEɛ4 allele. Methods: A nested case-control study was conducted from 2007 to 2012 in Japan. Five hundred and thirty-seven Japanese subjects aged 65 years and over who were cognitively intact at baseline were analyzed. MMI at follow-up was evaluated. Results: The median number of teeth at baseline was significantly lower in MMI participants (n = 179) than in controls (n = 358) (MMI: median 21.0, interquartile range 10.0–25.0 versus controls: 24.0, 14.0–27.0). After adjustment for demographics, vascular risk factors, and APOEɛ4 allele, the multivariate adjusted odds ratio (OR) of ≤8 teeth was 1.97 (95% confidence interval [CI], 1.13–3.44) compared to 25–32 teeth. Participants with both the presence of at least 1 APOEɛ4 allele and ≤8 teeth had a higher risk of MMI compared with those with neither (OR, 2.82; 95% CI, 1.15–6.91). Those with either risk factor alone did not have a higher risk of MMI. Conclusions: A lower number of teeth is related to risk of MMI. This may be primarily true for those individuals with an APOEɛ4 allele.
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Affiliation(s)
- Nozomi Okamoto
- Department of Community Health and Epidemiology, Nara Medical University, Nara, Japan
| | - Masayuki Morikawa
- Mie Prefectural Mental Medical Center, Mie, Japan.,Department of Psychiatry, Nara Medical University, Nara, Japan
| | | | - Motokazu Yanagi
- Department of Food and Nutrition, Tezukayama University, Nara, Japan
| | - Shin Takasawa
- Department of Biochemistry, Nara Medical University, Nara, Japan
| | - Norio Kurumatani
- Department of Community Health and Epidemiology, Nara Medical University, Nara, Japan
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Scannapieco FA, Cantos A. Oral inflammation and infection, and chronic medical diseases: implications for the elderly. Periodontol 2000 2018; 72:153-75. [PMID: 27501498 DOI: 10.1111/prd.12129] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2015] [Indexed: 12/12/2022]
Abstract
Oral diseases, such as caries and periodontitis, not only have local effects on the dentition and on tooth-supporting tissues but also may impact a number of systemic conditions. Emerging evidence suggests that poor oral health influences the initiation and/or progression of diseases such as atherosclerosis (with sequelae including myocardial infarction and stoke), diabetes mellitus and neurodegenerative diseases (such as Alzheimer's disease, rheumatoid arthritis and others). Aspiration of oropharyngeal (including periodontal) bacteria causes pneumonia, especially in hospitalized patients and the elderly, and may influence the course of chronic obstructive pulmonary disease. This article addresses several pertinent aspects related to the medical implications of periodontal disease in the elderly. There is moderate evidence that improved oral hygiene may help prevent aspiration pneumonia in high-risk patients. For other medical conditions, because of the absence of well-designed randomized clinical trials in elderly patients, no specific guidance can be provided regarding oral hygiene or periodontal interventions that enhance the medical management of older adults.
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The Effect of Number of Teeth and Chewing Ability on Cognitive Function of Elderly in UAE: A Pilot Study. Int J Dent 2017; 2017:5732748. [PMID: 29348749 PMCID: PMC5734010 DOI: 10.1155/2017/5732748] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/16/2017] [Accepted: 09/24/2017] [Indexed: 12/31/2022] Open
Abstract
Cognitive decline is one of the major causes of disability among the aging population. The aim of this study was to explore the relationship between oral health parameters (number of teeth, chewing ability, and presence of a denture) and cognitive function in the elderly across the UAE. Fifty persons (age ≥ 60; 71.26 ± 10.23) were enrolled in the study. Cognitive status was assessed using the standardized mini-mental state examination (SMMSE) and accordingly, cognitively normal subjects scoring ≥24 were considered as the control group and cognitively impaired individuals scoring ≤23 were considered as the low scoring group. Chewing ability was examined, number of teeth was noted, and demographical data was collected. The results of this pilot study showed that individuals with low SMMSE scores were significantly less educated (P < 0.01) and had fewer number of remaining teeth (P < 0.05) and impaired chewing ability (P < 0.05). These results demonstrate a significant link between the number of teeth, chewing ability, and cognitive function. However, this pilot study had its limitations and was the first of its kind in the UAE and Gulf region; therefore, future research addressing the limitations is needed to further explore this association.
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41
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Cestari JAF, Fabri GMC, Kalil J, Nitrini R, Jacob-Filho W, de Siqueira JTT, Siqueira SRDT. Oral Infections and Cytokine Levels in Patients with Alzheimer's Disease and Mild Cognitive Impairment Compared with Controls. J Alzheimers Dis 2017; 52:1479-85. [PMID: 27104907 DOI: 10.3233/jad-160212] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Oral infections are prevalent in the adult population. Their impact includes the implication as a risk factor for Alzheimer's disease (AD), altering its progression. One of the potential mechanisms involves immune mediators such as circulating cytokines. OBJECTIVE The goal of the present study was to investigate the prevalence of oral infections and blood levels of IL-1β, TNF-α, and IL-6 in patients with AD, mild cognitive impairment (MCI), and controls. METHODS Sixty-five elderly were evaluated (25 AD, 19 MCI, and 21 controls) by the following methods: Mini Mental State Exam, Questionnaire of Functional Activities, periodontal and oral evaluation, and blood concentrations of IL-1β, TNF-α and IL-6. RESULTS Patients with AD had high serum IL-6 levels (p = 0.029), and patients with periodontitis had high serum TNF-α levels (p = 0.005). There was an association between IL-6 and TNF-α in patients with AD/MCI and periodontitis (p = 0.023). CONCLUSION The increased levels of TNF-α and IL-6 in this study suggests their implication in the overlapping mechanisms between oral infections and AD. Longitudinal studies are necessary for further investigation.
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Affiliation(s)
| | - Gisele Maria Campos Fabri
- Orofacial Pain Team, Dentistry Division, Hospital das Clinicas, School of Medicine of the University of São Paulo, Brazil.,Federal University of Juiz de Fora, Brazil
| | - Jorge Kalil
- Laboratory of Medical Investigation in Immunology, School of Medicine of the University of São Paulo, Brazil
| | - Ricardo Nitrini
- Neurology Department, School of Medicine of the University of São Paulo, Brazil
| | - Wilson Jacob-Filho
- Geriatric Clinic, Clinical Medicine Department, School of Medicine of the University of São Paulo, Brazil
| | | | - Silvia Regina D T Siqueira
- Neurology Department, School of Medicine of the University of São Paulo, Brazil.,Orofacial Pain Team, Dentistry Division, Hospital das Clinicas, School of Medicine of the University of São Paulo, Brazil.,Gerontology, School of Arts, Science and Medicine, University of São Paulo, Brazil
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Kitamura K, Watanabe Y, Nakamura K, Takahashi A, Takachi R, Oshiki R, Kobayashi R, Saito T, Tsugane S, Sasaki A. Weight loss from 20 years of age is associated with cognitive impairment in middle-aged and elderly individuals. PLoS One 2017; 12:e0185960. [PMID: 28982190 PMCID: PMC5628924 DOI: 10.1371/journal.pone.0185960] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/24/2017] [Indexed: 12/21/2022] Open
Abstract
Background Few empirical studies have been conducted to identify modifiable factors that may affect cognitive impairment in Japanese individuals. The present study aimed to clarify whether body mass and lifestyle are associated with cognitive impairment in Japanese middle-aged and elderly individuals. Methods Subjects were 1814 community-dwelling individuals aged 44–79 years, all of whom were participants of the Murakami Cohort Study baseline survey conducted in 2011–2013. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) in 2014–2016, and cognitive impairment, the outcome measure, was defined as an MMSE score <24. Predictor variables were body mass index (BMI), long-term weight changes from 20 years of age, and lifestyle factors, such as smoking, drinking, and physical activity levels, which were obtained from a self-administered questionnaire in the baseline survey. Covariates were sex, age, education level, and histories of stroke and diabetes. Multiple logistic regression analysis was used to calculate the adjusted odds ratios (ORs). Results The prevalence of overall cognitive impairment was 6.2%. The adjusted ORs of cognitive impairment in the lowest (<[-4]kg) (OR = 2.70, 95%CI, 1.18–6.20) and second ([-4]-[0]kg) (OR = 2.37, 95%CI, 1.04–5.37) quintiles for long-term weight change were significantly higher than the reference 4th quintile ([+4]-[+7]kg). The adjusted OR in the highest quintile (≥[+8]kg) was 2.24 (95%CI, 0.99–5.04). Current BMI was not associated with cognitive impairment. Conclusions Long-term weight loss is associated with cognitive impairment in Japanese middle-aged and elderly individuals. Because the present study was retrospective in nature, prospective studies should also be conducted for further characterization of this association.
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Affiliation(s)
- Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- * E-mail:
| | - Akemi Takahashi
- Department of Physical Therapy, Niigata University of Rehabilitation, Murakami, Niigata, Japan
| | - Ribeka Takachi
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Food Science and Nutrition, Nara Women’s University Graduate School of Humanities and Sciences, Nara, Japan
| | - Rieko Oshiki
- Department of Physical Therapy, Niigata University of Rehabilitation, Murakami, Niigata, Japan
| | - Ryosaku Kobayashi
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Toshiko Saito
- Department of Health and Nutrition, Niigata University of Health and Welfare, Niigata, Japan
| | - Shoichiro Tsugane
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Ayako Sasaki
- Murakami Public Health Center, Murakami, Niigata, Japan
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Tramonti Fantozzi MP, De Cicco V, Barresi M, Cataldo E, Faraguna U, Bruschini L, Manzoni D. Short-Term Effects of Chewing on Task Performance and Task-Induced Mydriasis: Trigeminal Influence on the Arousal Systems. Front Neuroanat 2017; 11:68. [PMID: 28848404 PMCID: PMC5550729 DOI: 10.3389/fnana.2017.00068] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/24/2017] [Indexed: 12/19/2022] Open
Abstract
Trigeminal input to the ascending activating system is important for the maintenance of arousal and may affect the discharge of the noradrenergic neurons of the locus coeruleus (LC), whose activity influences both vigilance state and pupil size, inducing mydriasis. For this reason, pupil size evaluation is now considered an indicator of LC activity. Since mastication activates trigeminal afferent neurons, the aims of the present study, conducted on healthy adult participants, were to investigate whether chewing a bolus of different hardness may: (1) differentially affect the performance on a cognitive task (consisting in the retrieval of specific target numbers within numerical matrices) and (2) increase the dilatation of the pupil (mydriasis) induced by a haptic task, suggesting a change in LC activation. Results show that chewing significantly increased both the velocity of number retrieval (without affecting the number of errors) and the mydriasis associated with the haptic task, whereas simple task repetition did not modify either retrieval or mydriasis. Handgrip exercise, instead, significantly decreased both parameters. Effects were significantly stronger and longer lasting when subjects chewed hard pellets. Finally, chewing-induced improvements in performance and changes in mydriasis were positively correlated, which suggests that trigeminal signals enhanced by chewing may boost the cognitive performance by increasing LC activity.
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Affiliation(s)
| | - Vincenzo De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of PisaPisa, Italy
| | - Massimo Barresi
- Institut des Maladies Neurodégénératives, University of BordeauxBordeaux, France
| | | | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of PisaPisa, Italy.,Department of Developmental Neuroscience, IRCCS Foundation Stella MarisPisa, Italy
| | - Luca Bruschini
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of PisaPisa, Italy
| | - Diego Manzoni
- Department of Translational Research and of New Surgical and Medical Technologies, University of PisaPisa, Italy
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Yoshikawa M, Yamamoto Y, Tomoda K, Fujita Y, Yamauchi M, Osa T, Uyama H, Okamoto N, Kurumatani N, Kimura H. Prevalence of chronic obstructive pulmonary disease in independent community-dwelling older adults: The Fujiwara-kyo study. Geriatr Gerontol Int 2017. [PMID: 28620960 DOI: 10.1111/ggi.13091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM As the Japanese population ages, the number of older patients with chronic obstructive pulmonary disease (COPD) is expected to increase, but the prevalence of COPD in patients aged ≥80 years remains unclear. The purpose of the present study was to determine the prevalence of COPD in independent community-dwelling older adults aged ≥80 years. METHODS We investigated the prevalence of COPD in 2862 independent community-dwelling older adults (1504 men, 1358 women, mean age 77.7 ± 7.0 years) who underwent spirometry in the Fujiwara-kyo study, a study of successful aging in older adults. Those participants with airflow limitation (forced expiratory volume in 1 s/forced vital capacity <0.7) who indicated on a self-administered questionnaire that they had a history of smoking and did not have bronchial asthma were considered to have COPD. RESULTS The prevalence of COPD was 16.9% among all participants and 37.4% among smokers. The prevalence among individuals aged ≥80 years (19.7%) was significantly higher than that among those aged <80 years (16.0%; P < 0.05). When forced expiratory volume in 1 s/forced vital capacity lower limit of normal was used as the criterion for airflow limitation, the prevalence fell to 11.0%. Patients with mild-to-moderate airflow limitation (stage I/stage II) accounted for the great majority (91.2%) of COPD patients aged ≥80 years. CONCLUSIONS A high prevalence of mild-to-moderate COPD was observed even in the independent community-dwelling older adults aged ≥80 years. However, the benefits of the spirometric screening and treatment for these patients needs to be determined. Geriatr Gerontol Int 2017; 17: 2421-2426.
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Affiliation(s)
- Masanori Yoshikawa
- Second Department of Internal Medicine, Nara Medical University, Nara, Japan
| | - Yoshifumi Yamamoto
- Second Department of Internal Medicine, Nara Medical University, Nara, Japan
| | - Koichi Tomoda
- Second Department of Internal Medicine, Nara Medical University, Nara, Japan
| | - Yukio Fujita
- Second Department of Internal Medicine, Nara Medical University, Nara, Japan
| | - Motoo Yamauchi
- Second Department of Internal Medicine, Nara Medical University, Nara, Japan
| | - Takao Osa
- Second Department of Internal Medicine, Nara Medical University, Nara, Japan
| | - Hiroki Uyama
- Second Department of Internal Medicine, Nara Medical University, Nara, Japan
| | - Nozomi Okamoto
- Department of Community Health and Epidemiology, Nara Medical University, Nara, Japan
| | - Norio Kurumatani
- Department of Community Health and Epidemiology, Nara Medical University, Nara, Japan
| | - Hiroshi Kimura
- Second Department of Internal Medicine, Nara Medical University, Nara, Japan
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Ziebolz D, Werner C, Schmalz G, Nitschke I, Haak R, Mausberg RF, Chenot JF. Oral Health and nutritional status in nursing home residents-results of an explorative cross-sectional pilot study. BMC Geriatr 2017; 17:39. [PMID: 28143415 PMCID: PMC5282867 DOI: 10.1186/s12877-017-0429-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 01/21/2017] [Indexed: 01/06/2023] Open
Abstract
Background This study was performed to assess oral and nutritional status of nursing home residents in a region of Lower Saxony, Germany. The aim was to show potential associations between oral status (dentate or edentulous), further anamnestic factors (dementia, age, smoking) and the risk for malnutrition in this population. Methods In this observational cross-sectional pilot study of residents from four nursing homes Mini Nutritional Assessment (MNA), Body-Mass-Index (BMI), dental status (DMF-T) and periodontal situation (PSR®/PSI) were recorded. Associations of recorded factors with oral health and nutritional status were examined in univariate and multivariate analysis. Results Eighty-seven residents participated in the study (mean age: 84.1 years; female: 72%, demented: 47%). Average BMI was 26.2 kg/m2; according MNA 52% were at risk for malnutrition. 48% of the residents were edentulous, and the average DMF-T of dentulous was 25.0 (3.7) (D-T: 2.0 [3.1], M-T: 15.0 [8.3], F-T: 8.0 [7.4]); PSR®/PSI 3 and 4 (need for periodontal treatment) showed 79% of residents. In univariate analysis dementia (OR 2.5 CI95 1.1–5.6) but not being edentulous (OR 2.0 CI95 0.8–5.8) were associated with being at risk for malnutrition. Dementia remained associated in multivariate analysis adjusting for age and sex, (OR 3.1 CI95 1.2–8.2) and additionally being edentulous (OR 2.8 CI95 1.1–7.3) became associated significantly. Furthermore, nursing home residents with dementia had more remaining teeth (OR 2.5 CI95 1.1–5.9). Conclusion Dementia was a stronger predictor for risk of malnutrition in nursing home residents than being edentulous. Further studies to elucidate the possible role of oral health as cofactor for malnutrition in dementia are needed.
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Affiliation(s)
- Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany.
| | | | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
| | - Ina Nitschke
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany.,Clinic of Geriatric and Special Care Dentistry, Center of Dentistry, University of Zurich, Zurich, Switzerland
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
| | - Rainer F Mausberg
- Deptartment of Preventive Dentistry, Periodontology and Cariology, University University Medical Center, Goettingen, Germany
| | - Jean-François Chenot
- Department of General Practice, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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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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Ehrenthal JC, Graetz C, Plaumann A, Dörfer CE, Herzog W. Number of teeth predict depressive symptoms in a longitudinal study on patients with periodontal disease. J Psychosom Res 2016; 89:16-9. [PMID: 27663105 DOI: 10.1016/j.jpsychores.2016.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/19/2016] [Accepted: 08/04/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Periodontal disease is associated with a wide range of psychosocial risk-factors. Disease-related tooth-loss has been associated with an increase in depressive symptoms in cross-sectional studies. However, while depression is a known risk-factor for the outcome of chronic diseases, it remains unclear if tooth loss can also predict depressive symptoms over the course of treatment. Aim of the current pilot study was to test, to what extend the number of teeth predict depressive symptoms several years later. METHODS Tooth status of 310 patients with chronic and aggressive periodontitis was evaluated at the beginning of a specialized, university based outpatient treatment. We assessed depressive symptoms with the Patient Heath Questionnaire (PHQ) on average 13years later. Regression analyses were used to relate initial number of teeth to self-reported depression scores. RESULTS Fewer teeth at the beginning of the treatment were related to higher scores of depressive symptoms, even when controlling for several covariates. CONCLUSIONS Tooth loss is a potential risk-factor for the development of depression in periodontal disease. Further longitudinal studies that control for initial depressive symptoms are needed to identify disease mechanisms.
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Affiliation(s)
- Johannes C Ehrenthal
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Germany; Department of Psychology, University of Kassel, Germany.
| | - Christian Graetz
- Department of Conservative Dentistry and Periodontology, University of Kiel, Germany.
| | - Anna Plaumann
- Department of Conservative Dentistry and Periodontology, University of Kiel, Germany.
| | - Christof E Dörfer
- Department of Conservative Dentistry and Periodontology, University of Kiel, Germany.
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Germany.
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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: 65] [Impact Index Per Article: 8.1] [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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49
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Gao W, Wang X, Wang X, Cai Y, Luan Q. Association of cognitive function with tooth loss and mitochondrial variation in adult subjects: a community-based study in Beijing, China. Oral Dis 2016; 22:697-702. [PMID: 27353124 DOI: 10.1111/odi.12529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/12/2016] [Accepted: 06/21/2016] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Cognitive impairment is a common neurological problem in elderly people. In this study, we investigated whether tooth loss, periodontal parameters, and gene variations in the mitochondrial DNA displacement loop region are potential influencing factors on cognitive function. DESIGN We employed a linear regression model to estimate cross-sectional association between number of teeth lost, periodontal parameters and Mini-mental State Examination score, adjusting for demographic factors, socioeconomic factors, general health status, smoking, drinking, and life habits. PARTICIPANTS A total of 905 Han Chinese people, ≥50 years of age, with complete data, were enrolled. Blood samples of 567 of the subjects were analyzed for correlation between mitochondrial DNA variants and Mini-mental State Examination score. RESULTS The number of teeth lost (β = -0.042, 95% CI: -0.061, -0.024, P < 0.001), two single nucleotide polymorphism (SNP) points: A189G (β = -1.540, 95% CI: -2.818, -0.263, P = 0.018) and A16164G (β = -1.053, 95% CI: -2.054, -0.052, P = 0.039) in the mitochondrial DNA displacement loop region, and haplogroup Y (β = -2.152, 95% CI: -4.062, -0.242, P = 0.027) were found to be negatively associated with Mini-mental State Examination scores in the fully adjusted model. No correlation was found between periodontal parameters and Mini-mental State Examination scores. CONCLUSION Number of teeth lost, mitochondrial SNPs, and haplogroup Y were correlated with cognitive function in this study population.
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Affiliation(s)
- W Gao
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - X Wang
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - X Wang
- Department of Genetics, Beijing Hypertension League Institute, Beijing, China
| | - Y Cai
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Q Luan
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.
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Kamiya K, Narita N, Iwaki S. Improved Prefrontal Activity and Chewing Performance as Function of Wearing Denture in Partially Edentulous Elderly Individuals: Functional Near-Infrared Spectroscopy Study. PLoS One 2016; 11:e0158070. [PMID: 27362255 PMCID: PMC4928845 DOI: 10.1371/journal.pone.0158070] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 06/09/2016] [Indexed: 01/29/2023] Open
Abstract
The purpose of this study was to elucidate the effects of wearing a denture on prefrontal activity during chewing performance. We specifically examined that activity in 12 elderly edentulous subjects [63.1±6.1 years old (mean ± SD)] and 12 young healthy controls (22.1±2.3 years old) using functional near-infrared spectroscopy (fNIRS) in order to evaluate the quality of prefrontal functionality during chewing performance under the conditions of wearing a denture and tooth loss, and then compared the findings with those of young healthy controls. fNIRS and electromyography were used simultaneously to detect prefrontal and masticatory muscle activities during chewing, while occlusal force and masticatory score were also examined by use of a food intake questionnaire. A significant increase in prefrontal activity was observed during chewing while wearing a denture, which was accompanied by increased masticatory muscle activity, occlusal force, and masticatory score, as compared with the tooth loss condition. Prefrontal activation during chewing while wearing a denture in the elderly subjects was not much different from that in the young controls. In contrast, tooth loss in the elderly group resulted in marked prefrontal deactivation, accompanied by decreased masticatory muscle activity, occlusal force, and masticatory score, as compared with the young controls. We concluded that intrinsic prefrontal activation during chewing with a denture may prevent prefrontal depression induced by tooth loss in elderly edentulous patients.
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Affiliation(s)
- Kazunobu Kamiya
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | - Noriyuki Narita
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | - Sunao Iwaki
- Automotive Human Factors Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba Central 6, Ibaraki, Japan
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