Posterior Teeth Occlusion Associated with Cognitive Function in Nursing Home Older Residents: A Cross-Sectional Observational Study

Takeuchi, Kenji; Izumi, Maya; Furuta, Michiko; Takeshita, Toru; Shibata, Yukie; Kageyama, Shinya; Ganaha, Seijun; Yamashita, Yoshihisa

doi:10.1371/journal.pone.0141737

Cited by 41 publications

(68 citation statements)

References 46 publications

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“…The authors concluded that a poor chewing ability was significantly associated with cognitive impairment and dementia. The design of the present study partially reproduces that of a study published by Takeuchi et al in 2015, who studied the relationship between the number of FMUs and cognitive function (measured with the MMSE) in 279 residents of a geriatric centre in the Japanese city of Aso. The most substantial methodological differences between this study and our study were that the participants were of Asian origin and that only posterior FMUs were quantified (corresponding to premolars and molars).…”

Section: Discussionmentioning

confidence: 84%

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Relationship between functional masticatory units and cognitive impairment in elderly persons

Cardoso

Diniz‐Freitas

Vázquez

et al. 2019

J of Oral Rehabilitation

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Summary Background Studies on the elderly have reported that the risk of cognitive impairment is affected by chewing difficulty. Objective To determine whether there is a relationship between the number of pairs of antagonist teeth that come into contact when the mouth is closed (functional masticatory units [FMUs]) and the level of cognitive impairment. Methods We conducted a cross‐sectional observational study with 502 institutionalised White individuals older than 65 years, living in the northwest of Spain and Portugal. Through a direct visual inspection, we recorded the number of FMUs. Cognitive impairment was assessed by applying the Mini‐Cognitive Examination (MCE), a test derived from the Mini‐Mental State Examination. To describe the statistical relationship between the FMUs and the MCE values, a generalised linear model (GLM) was applied. We assessed the GLM predictive capacity for detecting cognitive impairment (MCE ≤23) in a new study group consisting of 156 elderly individuals. Results A large number of FMUs was significantly associated with a lower probability of cognitive impairment, regardless of the nature of the contact and its location (explained deviance, 30.1%). The model's discriminatory capacity for cognitive impairment based on the FMUs was “good” (0.820). The model's predictive capacity for cognitive impairment was “acceptable” (sensitivity, 0.786; positive predictive value, 0.900; accuracy, 0.729). Conclusion In White, elderly institutionalised individuals, the absolute number of FMUs is significantly related to their MCE scores.

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Section: Discussionmentioning

confidence: 84%

“…The reliability of MCE is debatable for individuals with moderate to severe levels of disability or with difficulties reading and writing . Lastly, we did not record a number of factors that could play a relevant role in cognitive impairment, such as socio‐economic level and malnutrition …”

Section: Discussionmentioning

confidence: 99%

Relationship between functional masticatory units and cognitive impairment in elderly persons

Cardoso

Diniz‐Freitas

Vázquez

et al. 2019

J of Oral Rehabilitation

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“…This prospective cohort study of an elderly Japanese population demonstrated an inverse association between number of remaining teeth and risk of development of all‐cause dementia and AD, indicating that subjects with greater tooth loss were at greater risk of onset of dementia. Tooth loss was estimated using data from clinical oral examinations performed by dentists, and dementia subtypes were determined on the basis of brain morphological data (neuroimaging and neuropathology), unlike previous studies . The present prospective cohort study investigated the association between tooth loss evaluated through a professional oral examination and risk of dementia and its subtypes in an elderly general population.…”

Section: Discussionmentioning

confidence: 99%

Tooth Loss and Risk of Dementia in the Community: the Hisayama Study

Takeuchi

Ohara

Furuta

et al. 2017

J American Geriatrics Society

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131

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OBJECTIVES:To clarify the effect of tooth loss on development of all-cause dementia and its subtypes in an elderly Japanese population. DESIGN: Prospective cohort study. SETTING: The Hisayama Study, Japan. PARTICIPANTS: Community-dwelling Japanese adults without dementia aged 60 and older (N = 1,566) were followed for 5 years (2007)(2008)(2009)(2010)(2011)(2012). MEASUREMENTS: Participants were classified into four categories according to baseline number of remaining teeth (≥20, 10-19, 1-9, 0). The risk estimates of the effect of tooth loss on the development of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) were computed using a Cox proportional hazards model. RESULTS: During follow-up, 180 (11.5%) subjects developed all-cause dementia; 127 (8.1%) had AD, and 42 (2.7%) had VaD. After adjusting for potential confounders, there was a tendency for the multivariableadjusted hazard ratio of all-cause dementia to increase with decrease in number of remaining teeth (P for trend = .04). The risk of all-cause dementia was 1.62 times as great in subjects with 10 to 19 teeth, 1.81 times as great in those with one to nine teeth, and 1.63 times as great in those with no teeth as in those with 20 teeth or more. An inverse association was observed between number of remaining teeth and risk of AD (P for trend = .08), but no such association was observed with risk of VaD (P for trend = .20).CONCLUSION: Tooth loss is associated with an increased risk of all-cause dementia and AD in the Japanese population. J Am Geriatr Soc 65:e95-e100, 2017.Key words: Alzheimer's disease; epidemiology; oral health; prospective cohort study; vascular dementia T he increase in the incidence of dementia is a substantial public health concern in aging societies. Approximately 46.8 million people worldwide have dementia, and the incidence is 9.9 million per year.1 The number of people living with dementia will nearly double every 20 years, but the causes of dementia, especially Alzheimer's disease (AD), are unclear, and there is a lack of treatments and health service settings for this disorder.2,3 Therefore, intensified research studies are needed to identify factors that have the potential to decrease the risk of dementia and thereby decrease the burden of this disease on health systems.A growing number of research studies have focused on the link between oral health and cognitive status. In particular, many research studies have assessed the association between number of teeth and cognitive function, [4][5][6][7][8][9][10][11][12][13][14][15] but the results of observational longitudinal studies on the effect of tooth loss on cognitive function are inconsistent. A recent systematic review of the literature suggested that tooth loss was associated with greater risk of cognitive impairment and dementia, 16 whereas another reported that tooth loss was not consistently associated with those outcomes. 17 The inconsistency might be due to methodological deficiencies in this field, such as the lack of representativeness of the ...

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“…All measurements were performed by a single dental hygienist (M.I.). This procedure has been described elsewhere (19,20). As measurement of peak flow rate during induced coughing was challenging with the study participants, an alternative to PCF measurement was needed.…”

Section: Coughing Ability Measurement and Questionnairesmentioning

confidence: 99%

Effects of oral care with tongue cleaning on coughing ability in geriatric care facilities: a randomised controlled trial

Izumi

Takeuchi

Ganaha

et al. 2016

J of Oral Rehabilitation

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Methods for preventing aspiration pneumonia are needed soon in order to reduce mortality from aspiration pneumonia and promote the health of the elderly. The aim of this randomised controlled trial was to examine whether oral care with tongue cleaning improves coughing ability in elderly individuals living in geriatric care facilities. Participants comprised of 114 residents of 11 group homes and private nursing homes in Aso City in Kumamoto Prefecture. Participants were randomly assigned to either (i) a group that underwent routine oral care with tongue cleaning (intervention group; n = 58) or (ii) a group that underwent routine oral care alone (control group; n = 56). Coughing ability was evaluated by measuring peak expiratory flow (PEF) before and after 4 weeks of intervention. Before the intervention, PEF did not differ significantly between the intervention group (1·65 ± 1·11 L s ) and control group (1·59 ± 1·05 L s ; P = 0·658). However, on termination of the intervention, PEF was significantly higher in the intervention group (2·54 ± 1·42 L s ) than in the control group (1·90 ± 1·20 L s ; P = 0·014). After the intervention, PEF had increased significantly in both groups; however, this increase was significantly greater in the intervention group (0·90 ± 0·95 L s ) than in the control group (0·31 ± 0·99 L s ; P < 0·001). Oral care with tongue cleaning led to increased PEF, suggesting improved coughing ability. Oral care incorporating tongue cleaning appears to be important for preventing aspiration pneumonia.

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Posterior Teeth Occlusion Associated with Cognitive Function in Nursing Home Older Residents: A Cross-Sectional Observational Study

Cited by 41 publications

References 46 publications

Relationship between functional masticatory units and cognitive impairment in elderly persons

Relationship between functional masticatory units and cognitive impairment in elderly persons

Tooth Loss and Risk of Dementia in the Community: the Hisayama Study

Effects of oral care with tongue cleaning on coughing ability in geriatric care facilities: a randomised controlled trial

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