Abstract
BackgroundPrevious research indicates that patients with mild cognitive impairment (MCI) are more likely to have poor oral health and impairments in oral functions, which may be due to few remaining teeth and impaired tongue and lip motor function. However, the oral health of those patients following comprehensive cognitive assessment by a dementia specialist has not been sufficiently investigated. Therefore, this study aimed to clarify the oral function of patients with MCI and the association between oral health and lower cognitive function.MethodsThis cross-sectional study included 96 participants (men: 35; women: 61; mean age: 73.3 ± 8.5 years) who visited a dementia clinic between December 2017 and January 2020. Participants’ cognitive function was assessed by a dementia specialist using neuropsychological and hematological tests and neuroimaging immediately after enrollment. The participants were divided into the healthy and MCI groups according to comprehensive cognitive assessment. Participants’ age, sex, body mass index, primary disease, education level, drinking habits, smoking habits, living environment, employment status, and exercise habits were evaluated. Moreover, oral outcomes, including the number of existing teeth, number of functional teeth (natural and prosthetic teeth which were occluded with antagonists), denture use, oral dryness, tongue and lip motor function, tongue pressure, occlusal force, masticatory ability, and swallowing ability were recorded. The Mann–Whitney U test, χ2, and Fisher’s exact tests were used for between-group comparisons. Furthermore, logistic regression analysis using MCI diagnosis as the target variable was performed.ResultsA comprehensive evaluation of the cognitive function of the study participants by the dementia specialist revealed that 48 participants (mean age: 69.8 ± 8.8 years) were healthy and 48 (mean age: 76.9 ± 6.7 years) had MCI. MCI participants were significantly older (p < 0.001) and had significantly fewer existing teeth (p = 0.031) and lower maximum occlusal force (p = 0.019) than healthy participants. Age (odds ratio: 1.126, p = 0.002) and maximum occlusal force (odds ratio: 0.978, p = 0.048) were significantly associated with lower cognitive function.ConclusionsPatients with MCI had poorer oral health than healthy individuals. Decreased maximum occlusal force was independently associated with lower cognitive function, even when adjusted for age and sex.
Highlights
Previous research indicates that patients with mild cognitive impairment (MCI) are more likely to have poor oral health and impairments in oral functions, which may be due to few remaining teeth and impaired tongue and lip motor function
The exclusion criteria were as follows: patients who were living in long-term care facilities, patients aged < 50 years, patients who had been diagnosed with dementia, and patients who were unable to undergo an oral function test
Participants’ characteristics A comprehensive evaluation of the cognitive function of the study participants by the dementia specialist revealed that 48 participants were healthy and 48 participants had MCI
Summary
Previous research indicates that patients with mild cognitive impairment (MCI) are more likely to have poor oral health and impairments in oral functions, which may be due to few remaining teeth and impaired tongue and lip motor function. Older adults with dementia are known to have poor oral health, including poor oral hygiene due to inadequate cleaning of teeth and dentures [4, 5], tooth loss due to caries and periodontal disease [6, 7], decreased masticatory ability, difficulties in using dentures [8], and impaired swallowing function [9]. This poor oral health leads to loss of pleasure from eating and impaired quality of life, which increases the risk of undernutrition [10] and aspiration pneumonia [11] along with reduced diversity of meals. Oral health should be adequately managed before the onset of dementia
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