Associations of Oral Health Status and Swallowing Function with Cognitive Impairment in the Aging Population: a Cross-sectional Study

Overview

Journal BMC Oral Health

Publisher Biomed Central

Specialty Dentistry

Date 2023 Nov 23

PMID 37993856

Authors

Yong Chen

Canyang Li

Yongmei Fan

Lili Jiao

Matthew Silverman

Masashi Ishimaru

Jing Wang

Alice J Van Pelt

Rumi Wang

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to investigate the relationships of oral health status and swallowing function with cognitive impairment in community-dwelling older adults from Changsha, Hunan Province, China.

Methods: In this cross-sectional study, we analyzed the data of 215 participants aged ≥ 50 years which were retrieved from the Xiangya and Panasonic mild cognitive impairment (MCI) Study, a community-based study conducted among the residents of the urban areas of Hunan province in China. Demographic information of all participants was collected. We determined oral function by evaluating oral hygiene, oral dryness, occlusal force, tongue pressure, chewing function, swallowing function, remaining teeth number, and other indicators. The mini-mental state examination (MMSE) was used to screen for cognitive function. The relationship between each oral function evaluation item and cognitive function was investigated using correlation analysis. The associations between oral health status and swallowing function with cognitive impairment were inferred using multiple regression analysis.

Results: The general characteristics of participants showed statistically significant correlation coefficients in number of teeth remaining (p = 0.003) and number of teeth lost (p < 0.0001). Almost half of the 25 participants (48%) were aged from 70-80 years. Only 25 older adults (11.6% of the participants) were determined to have cognitive impairment by MMSE sores less than 24. Tongue pressure in male participants was the only significant independent variable that was associated with cognitive impairment (p = 0.01971). The results indicate that male participants with lower MMSE scores had a relative deficiency in tongue pressure.

Conclusions: In this cross-sectional study, the oral health status and swallowing function of participants were in relatively good condition and showed low correlations with cognitive impairment. However, lower tongue pressures were associated with lower MMSE scores in males, indicating it could serve as a novel oral function index for evaluating cognitive impairment.

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References

Goto T, Kishimoto T, Iwawaki Y, Fujimoto K, Ishida Y, Watanabe M . Reliability of Screening Methods to Diagnose Oral Dryness and Evaluate Saliva Secretion. Dent J (Basel). 2020; 8(3). PMC: 7558334. DOI: 10.3390/dj8030102. View

Ikebe K, Matsuda K, Morii K, Wada M, Hazeyama T, Nokubi T . Impact of dry mouth and hyposalivation on oral health-related quality of life of elderly Japanese. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103(2):216-22. DOI: 10.1016/j.tripleo.2005.12.001. View

Delwel S, Scherder E, de Baat C, Binnekade T, van der Wouden J, Hertogh C . Orofacial pain and its potential oral causes in older people with mild cognitive impairment or dementia. J Oral Rehabil. 2018; 46(1):23-32. PMC: 7380060. DOI: 10.1111/joor.12724. View

Delwel S, Scherder E, Perez R, Hertogh C, Maier A, Lobbezoo F . Oral function of older people with mild cognitive impairment or dementia. J Oral Rehabil. 2018; 45(12):990-997. DOI: 10.1111/joor.12708. View

Gunne H . Masticatory efficiency and dental state. A comparison between two methods. Acta Odontol Scand. 1985; 43(3):139-46. DOI: 10.3109/00016358509064144. View

Mizutani S, Egashira R, Yamaguchi M, Tamai K, Yoshida M, Kato T . Changes in oral and cognitive functions among older Japanese dental outpatients: A 2-year follow-up study. J Oral Rehabil. 2021; 48(10):1150-1159. DOI: 10.1111/joor.13224. View

Kuroki A, Sugita N, Komatsu S, Wakasugi M, Yokoseki A, Yoshihara A . The number of remaining teeth as a risk indicator of cognitive impairment: A cross-sectional clinical study in Sado Island. Clin Exp Dent Res. 2019; 4(6):291-296. PMC: 6305911. DOI: 10.1002/cre2.147. View

Gil-Montoya J, Sanchez-Lara I, Carnero-Pardo C, Fornieles-Rubio F, Montes J, Barrios R . Oral Hygiene in the Elderly with Different Degrees of Cognitive Impairment and Dementia. J Am Geriatr Soc. 2016; 65(3):642-647. DOI: 10.1111/jgs.14697. View

Goncalves T, Schimmel M, van der Bilt A, Chen J, van der Glas H, Kohyama K . Consensus on the terminologies and methodologies for masticatory assessment. J Oral Rehabil. 2021; 48(6):745-761. PMC: 8252777. DOI: 10.1111/joor.13161. View

10.

Nakamori M, Imamura E, Fukuta M, Tachiyama K, Kamimura T, Hayashi Y . Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly. PLoS One. 2020; 15(8):e0230224. PMC: 7413413. DOI: 10.1371/journal.pone.0230224. View

11.

Kaufman L, Setiono T, Doros G, Andersen S, Silliman R, Friedman P . An oral health study of centenarians and children of centenarians. J Am Geriatr Soc. 2014; 62(6):1168-73. PMC: 4057979. DOI: 10.1111/jgs.12842. View

12.

Hagglund P, Koistinen S, Olai L, Stahlnacke K, Wester P, Levring Jaghagen E . Older people with swallowing dysfunction and poor oral health are at greater risk of early death. Community Dent Oral Epidemiol. 2019; 47(6):494-501. PMC: 6899490. DOI: 10.1111/cdoe.12491. View

13.

Takehara S, Clive Wright F, Waite L, Naganathan V, Hirani V, Blyth F . Oral health and cognitive status in the Concord Health and Ageing in Men Project: A cross-sectional study in community-dwelling older Australian men. Gerodontology. 2020; 37(4):353-360. DOI: 10.1111/ger.12469. View

14.

Shimizu T, Ueda T, Sakurai K . New method for evaluation of tongue-coating status. J Oral Rehabil. 2007; 34(6):442-7. DOI: 10.1111/j.1365-2842.2007.01733.x. View

15.

Petersen R, Lopez O, Armstrong M, Getchius T, Ganguli M, Gloss D . Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2017; 90(3):126-135. PMC: 5772157. DOI: 10.1212/WNL.0000000000004826. View

16.

Fang W, Jiang M, Gu B, Wei Y, Fan S, Liao W . Tooth loss as a risk factor for dementia: systematic review and meta-analysis of 21 observational studies. BMC Psychiatry. 2018; 18(1):345. PMC: 6195976. DOI: 10.1186/s12888-018-1927-0. View

17.

Nagayoshi M, Higashi M, Takamura N, Tamai M, Koyamatsu J, Yamanashi H . Social networks, leisure activities and maximum tongue pressure: cross-sectional associations in the Nagasaki Islands Study. BMJ Open. 2017; 7(12):e014878. PMC: 5728263. DOI: 10.1136/bmjopen-2016-014878. View

18.

Ziebolz D, Werner C, Schmalz G, Nitschke I, Haak R, Mausberg R . Oral Health and nutritional status in nursing home residents-results of an explorative cross-sectional pilot study. BMC Geriatr. 2017; 17(1):39. PMC: 5282867. DOI: 10.1186/s12877-017-0429-0. View

19.

Yasui M, Ryu M, Sakurai K, Ishihara K . Colonisation of the oral cavity by periodontopathic bacteria in complete denture wearers. Gerodontology. 2011; 29(2):e494-502. DOI: 10.1111/j.1741-2358.2011.00506.x. View

20.

Iwasaki M, Kimura Y, Ogawa H, Yamaga T, Ansai T, Wada T . Periodontitis, periodontal inflammation, and mild cognitive impairment: A 5-year cohort study. J Periodontal Res. 2018; 54(3):233-240. DOI: 10.1111/jre.12623. View