Delwel Suzanne, Maier Andrea B, Parvaneh Donya, Meijers Jesse, Scherder Erik J A, Lobbezoo Frank
Department of Clinical Neuropsychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Front Aging Neurosci. 2020 Sep 9;12:225. doi: 10.3389/fnagi.2020.00225. eCollection 2020.
: Previous studies suggest an association between poor mastication and cognitive impairment. The role of chewing efficiency and dentition in this relation is unclear. The aim was to examine global cognitive functioning and dentition as predictors for chewing efficiency, in older people with mild cognitive impairment (MCI) or dementia. : In this observational cross-sectional study, 136 people with MCI or dementia were included. The chewing efficiency was assessed with a two-colored chewing gum and analyzed with the Chewing Efficiency Analysis software. The level of global cognitive functioning was measured with the Mini Mental State Examination (MMSE) by trained clinical staff. An oral examination was performed by a dentist and included the number of present teeth, the number of occluding pairs, and the presence of prostheses. Age, gender, and educational years were derived from the medical records. Univariate and multivariate backward stepwise linear regression analyses were used to evaluate global cognitive functioning and dentition as predictors for chewing efficiency. : The mean age of the participants was 82.1 (SD 5.8) years, and 74 (54.4%) were female. The participants had a median MMSE score of 22.4 (IQR 18.0-26.0) and a median Chewing Efficiency Analysis score of 0.46 (IQR 0.14-0.59). The median number of teeth was 13.0 (IQR 0.0-23.0), and the median number of occluding pairs was 0.0 (IQR 0.0-7.0). Sixty-four (47.4%) of the participants wore full prosthesis in the upper jaw. In univariate linear regression analyses, predictive factors for the Chewing Efficiency Analysis score were age, MMSE score, full prosthesis in the upper jaw, number of present teeth, and number of occluding pairs. In the multivariate model, full prosthesis in the upper jaw and number of occluding pairs were significant predictors for the Chewing Efficiency Analysis score. Participants with full prosthesis in the upper jaw had a lower Chewing Efficiency Analysis score than participants with natural dentition in the upper jaw. : Better mastication is associated with a higher number of occluding pairs. Full prosthesis in the upper jaw is related to a lower chewing efficiency. Global cognitive functioning is not associated with mastication in older people with MCI or mild-to-moderate dementia. This might be explained by sufficient capacity for compensation of reduced mastication in this group.
以往研究表明咀嚼功能差与认知障碍之间存在关联。咀嚼效率和牙列在这种关系中的作用尚不清楚。本研究旨在探讨在患有轻度认知障碍（MCI）或痴呆症的老年人中，整体认知功能和牙列作为咀嚼效率预测指标的情况。
在这项观察性横断面研究中，纳入了136名患有MCI或痴呆症的患者。使用双色口香糖评估咀嚼效率，并通过咀嚼效率分析软件进行分析。由经过培训的临床工作人员使用简易精神状态检查表（MMSE）测量整体认知功能水平。由一名牙医进行口腔检查，包括现存牙齿数量、咬合对数量以及假牙的佩戴情况。年龄、性别和受教育年限来自病历记录。采用单因素和多因素向后逐步线性回归分析来评估整体认知功能和牙列作为咀嚼效率预测指标的情况。
参与者的平均年龄为82.1（标准差5.8）岁，74名（54.4%）为女性。参与者的MMSE评分中位数为22.4（四分位间距18.0 - 26.0），咀嚼效率分析评分中位数为0.46（四分位间距0.14 - 0.59）。牙齿数量中位数为13.0（四分位间距0.0 - 23.0），咬合对数量中位数为0.0（四分位间距0.0 - 7.0）。64名（47.4%）参与者上颌佩戴全口假牙。在单因素线性回归分析中，咀嚼效率分析评分的预测因素包括年龄、MMSE评分、上颌全口假牙、现存牙齿数量和咬合对数量。在多因素模型中，上颌全口假牙和咬合对数量是咀嚼效率分析评分的显著预测因素。上颌佩戴全口假牙的参与者的咀嚼效率分析评分低于上颌为天然牙列的参与者。
更好的咀嚼功能与更多的咬合对数量相关。上颌全口假牙与较低的咀嚼效率有关。在患有MCI或轻度至中度痴呆症的老年人中，整体认知功能与咀嚼功能无关。这可能是因为该组中存在足够的能力来补偿咀嚼功能的下降。
