Abstract
Background: An amount of cognition decline is normal with aging; however, intrinsic and extrinsic risk factors may exacerbate it, affecting social and occupational tasks. Masticatory dysfunction (MD), as a general term, refers to an impairment in the masticatory function triggered by a structural factor, such as tooth loss; functional factors, such as weaker bite force or a poorer masticatory performance; or both factors. MD acting as a source of chronic stress, promotes functional and morphological changes on the hippocampus, a brain area crucial for learning and memory abilities. This study aimed to synthesize evidence on the association between MD and cognitive deficit (CD), and demonstrate whether might be adequately considered as a risk factor.Methods: Observational studies were screened in seven online databases; the search strategy (PECO) was focused in observational studies with humans as a population (P), presenting groups exposed (E), and non-exposed (C) to tooth loss, in which cognition parameters were measured and compared between groups (O). The final selection included only those studies comparing the effect in cognition between subjects having ≥20 remaining teeth and <20 remaining teeth, considering the latter as a structural factor triggering MD by the literature. Searching and data extraction were conducted following PRISMA guidelines. Qualitative and risk of bias evaluations were performed. The meta-analysis (MA) was constructed including the odds ratio (OR) and its 95% confidence interval (CI) comparing two groups—with/without MD. The level of evidence was rated by Grading Recommendations Assessment, Development and Evaluation (GRADE) approach.Results: In total, 5,666 citations were identified, 14 accomplished our eligibility criteria, and nine were include in the MA. The MA demonstrates that individuals with MD had 46% higher chance to presented CD (OR 2.24 [1.73, 2.90], p < 0.00001, I2 = 46%). The level of evidence was rated as low by GRADE.Conclusion: Despite the low certainty in evidence, according to our MA, MD is positively associated with increased risk of CD. However, more studies including other factors underlying MD and similar measurements should be conducted to obtain a strong estimate of the risk.
Highlights
An optimal cognition status is essential to lead a quality of life (QoL) in young and old people
The MA demonstrates that individuals with Masticatory dysfunction (MD) had 46% higher chance to presented cognitive deficit (CD)
In order to reduce heterogeneity, the aim of this study was synthesizing only those studies that made a comparison between subjects with presence/absence of tooth loss as a structural factor triggering MD and its association with CD; and demonstrate, through a quantitative analysis, whether MD might be adequately considered as a risk factor for CD, measuring its impact
Summary
An optimal cognition status is essential to lead a quality of life (QoL) in young and old people. Changes in cognition occur with normal aging (Harada et al, 2013), but they can be maximized by intrinsic and extrinsic risk factors (Marchesi, 2011), triggering severe cognition impairment that affect social and occupational tasks (Hugo and Ganguli, 2014). Cognitive changes are mostly related to declines of learning, memory, thinking, reasoning, and judgment abilities, such cases of dementia, among others neurocognitive disorders (Murman, 2015). All the factors related to cognitive changes are still unknown and subject to study. An amount of cognition decline is normal with aging; intrinsic and extrinsic risk factors may exacerbate it, affecting social and occupational tasks. This study aimed to synthesize evidence on the association between MD and cognitive deficit (CD), and demonstrate whether might be adequately considered as a risk factor
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