Longitudinal association of oral functions and dementia in Japanese older adults

Iwai, Komei; Azuma, Tetsuji; Yonenaga, Takatoshi; Sasai, Yasuyuki; Nomura, Taketsugu; Sugiura, Iwane; Inagawa, Yujo; Matsumoto, Yusuke; Nakashima, Seiji; Abe, Yoshikazu; Tomofuji, Takaaki

doi:10.1038/s41598-024-56628-8

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…However, well-fitting dentures, especially two implant-assisted overdentures (2-IODs), are associated with higher cognitive function 5 . Despite this, a study indicates that edentulous patients with dentures still face a greater risk of MCI, suggesting the need for ongoing research into the cognitive benefits of implant overdentures (IODs) 6 . The Montreal Cognitive Assessment (MoCA) is more effective than the Mini-Mental State Examination (MMSE) for detecting mild cognitive impairment (MCI) 7 , with studies indicating its heightened sensitivity in patients with diabetes and heart failure 8 .…”

Section: Commentarymentioning

confidence: 99%

Short-term data suggests cognitive benefits in the elderly with single-implant overdentures

Afrashtehfar,

Jurado,

Abu Fanas

et al. 2024

Evid Based Dent

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Design This study was an extension of a randomized crossover clinical trial approved by the institutional ethics committee (approval number: D2014–148) and adhered to the CONSORT guidelines. The original study juxtaposed patient contentment with single-implant overdentures (1-IODs) against conventional complete dentures (CCDs), with patient satisfaction being the primary focus. In this follow-up study, the cognitive function of edentulous patients receiving 1-IODs was assessed, specifically monitoring for the emergence of mild cognitive impairment (MCI) throughout a three-year period. Patient outcomes were systematically recorded at predetermined intervals: initially, two months post-1-IOD placement, after one year (with groups alternated between denture types at eight-month marks), then after two and three years. A prosthodontist with a decade of expertise performed all denture-related procedures. This follow-up emphasized the cognitive outcomes using the Montreal Cognitive Assessment (MoCA-J), considering it alongside previously documented results on masticatory function, bone resorption, survival rates, and patient-reported outcomes. Case selection Between 2015 and 2016, a follow-up study enrolled edentulous patients over 50 years of age who were proficient in Japanese, had sufficient mandibular bone for implants, and were free of systemic health issues and habits that could impact oral health. The participants were randomly divided into two groups after receiving a central mandibular implant. Group 1 initially used 1-IODs, and Group 2 used unloaded CCDs. After two months and subsequent periods, they swapped denture types. Eventually, all patients chose 1-IODs for continued use. Implant success was monitored over three years. The design featured block randomization and accounted for a sample size of 22, determined to be sufficient for evaluating the primary outcome of patient satisfaction. All patients underwent careful allocation and received customized dental interventions, with detailed radiographic planning and surgical precision guiding the implantation process. Data analysis Multivariable linear mixed models were used to assess within-group changes in both overall and specific cognitive function scores across five timepoints. Age, assessment interval, and upper jaw denture status were incorporated as consistent variables, while individual participants were considered variable elements in the analysis. SPSS software version 22.0 was utilized to conduct the statistical tests, and a p value threshold of 0.05 was predetermined to establish statistical significance. Results Twenty-two patients with edentulous mandibles received 1-IODs. Memory and executive functions saw significant score increases at multiple timepoints over the three-year period, with statistical significance. Though one participant dropped out and another passed away, and two did not complete the 3-year follow-up, the remaining 18 participants provided comprehensive data. Age and type of maxillary denture were significant factors, influencing MoCA-J scores with older participants and those with fixed dentures showing lower scores in certain domains. Overall, the findings illustrated the positive correlation between 1-IODs and cognitive function in older adults. Conclusions Older adults with no natural teeth left in their mandible showed improved cognitive function after one and three years of using 1-IODs, as reflected by their total and specific cognitive domain scores. The study suggests that such implant therapy may offer protective benefits against cognitive decline, demonstrating clinical relevance for patient care, regardless of the maxillary arch (antagonist) condition.

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Section: Commentarymentioning

confidence: 99%

Short-term data suggests cognitive benefits in the elderly with single-implant overdentures

Afrashtehfar,

Jurado,

Abu Fanas

et al. 2024

Evid Based Dent

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“…Dental checkups in Gifu, Japan ( Gifu sawayaka koku kenshin ) are conducted once a year for Japanese older people aged ≥ 75 years [ 13 , 14 ]. This checkup also includes content related to swallowing function.…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors Associated with Future Decline in Swallowing Function among Japanese Older People Aged ≥ 75 Years

Iwai,

Azuma,

Yonenaga

et al. 2024

IJERPH

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Predictive factors associated with a decline in swallowing function after 2 years were examined in 3409 Japanese older people aged ≥ 75 years who had undergone a dental checkup in Gifu Prefecture, Japan. Participants with normal swallowing function in a baseline survey in April 2018 were followed for 2 years. Swallowing function was assessed using a repetitive saliva swallowing test. In our study, 429 participants (13%) who were swallowing less than three times in 30 s based on a repetitive saliva swallowing test after 2 years were diagnosed as those with decline in swallowing function. Multivariate logistic regression analyses showed the decline in swallowing function after 2 years was associated with the male gender (odds ratio [ORs]: 0.772; 95% confidence interval [CIs]: 0.615–0.969), age ≥ 81 years (presence; ORs: 1.523; 95% CIs: 1.224–1.895), support/care-need certification (presence; ORs: 1.815; 95% CIs: 1.361–2.394), periodontal pocket depth (PPD) ≥ 4 mm (presence; ORs: 1.469; 95% CIs: 1.163–1.856), difficulty in biting hard food (yes; ORs: 1.439; 95% CIs: 1.145–1.808), choking on tea and water (yes; ORs: 2.543; 95% CIs: 2.025–3.193), and dry mouth (yes; ORs: 1.316; 95% CIs: 1.052–1.646) at baseline. Therefore, the dental checkup items associated with a decline in swallowing function after 2 years were a PPD ≥ 4 mm, difficulty in biting hard food, choking on tea and water, and dry mouth. PPD status and confirming to the self-administered questionnaire about biting, choking, and dry mouth may be useful in predicting future decline in swallowing function.

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Loss of dental pulp potentially increased the risk of Alzheimer's dementia

Son,

Lee,

Chung

2024

Journal of Dental Sciences

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Longitudinal association of oral functions and dementia in Japanese older adults

Cited by 4 publications

References 33 publications

Short-term data suggests cognitive benefits in the elderly with single-implant overdentures

Short-term data suggests cognitive benefits in the elderly with single-implant overdentures

Predictive Factors Associated with Future Decline in Swallowing Function among Japanese Older People Aged ≥ 75 Years

Loss of dental pulp potentially increased the risk of Alzheimer's dementia

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