Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan.
Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan.
Exp Gerontol. 2021 Feb;144:111189. doi: 10.1016/j.exger.2020.111189. Epub 2020 Dec 4.
Recent shifts in the distribution of Japan's population towards older ages, have meant that the chance of encountering patients with dementia in dental clinics is increasing. Many studies have shown that the brain volume decreases along with the progression of dementia. Although previous studies have reported a relationship between tooth loss or periodontitis and the onset of dementia, the pathological mechanisms underlying this association have not been elucidated. In this study, we aimed to examine the relationship between the oral condition and brain atrophy and to discuss how to adequately deal with patients with dementia.
This cross-sectional study included 15 participants who underwent brain magnetic resonance imaging (MRI). The participants were 60 years or older and presented with cognitive decline, including Alzheimer's disease (AD) and mild cognitive impairment (MCI), diagnosed by a neurologist. We obtained information on the oral condition, lifestyle, cognitive function, and brain atrophy. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). MR images of each patient were analyzed using the voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) to provide a quantitative measure of the degree of brain atrophy.
The study population included 4 male and 11 female patients. The mean age and mean number of present teeth were 75.9 years (SD 6.7) and 15.0 (SD 11.1), respectively. The median MMSE score was 25.6 (SD 3.7). The degree of atrophy of the whole brain was significantly correlated with the number of present teeth (ρ = -0.72, p < 0.05) and the presence of a daily exercise habit (ρ = -0.66, p < 0.05).
This study demonstrated that the number of present teeth could be an indicator of the progress of dementia. Preserving the teeth as well as the acquisition of a regular exercise habit might be important for preventing progression of dementia. Further research examining a larger study population and analyzing a greater number of factors is warranted.
随着日本人口老龄化分布的变化，在牙科诊所遇到痴呆症患者的机会越来越多。许多研究表明，大脑体积随着痴呆症的发展而减小。尽管以前的研究报告了牙齿缺失或牙周炎与痴呆症发病之间的关系，但尚未阐明这种关联的病理机制。在这项研究中，我们旨在研究口腔状况与脑萎缩之间的关系，并讨论如何妥善处理痴呆症患者。
本横断面研究纳入了 15 名接受脑部磁共振成像（MRI）检查的参与者。参与者年龄在 60 岁及以上，存在认知能力下降，包括由神经科医生诊断的阿尔茨海默病（AD）和轻度认知障碍（MCI）。我们获得了口腔状况、生活方式、认知功能和脑萎缩的信息。认知功能使用简易精神状态检查（MMSE）进行评估。使用基于体素的阿尔茨海默病特定区域分析系统（VSRAD）对每位患者的 MRI 图像进行分析，以提供脑萎缩程度的定量测量。
研究人群包括 4 名男性和 11 名女性患者。平均年龄和平均现齿数分别为 75.9 岁（标准差 6.7）和 15.0（标准差 11.1）。中位数 MMSE 得分为 25.6（标准差 3.7）。全脑萎缩程度与现齿数（ρ=-0.72，p<0.05）和每日运动习惯（ρ=-0.66，p<0.05）显著相关。
本研究表明，现齿数可能是痴呆症进展的一个指标。保留牙齿和养成定期运动习惯可能对预防痴呆症进展很重要。需要进一步研究更大的研究人群并分析更多的因素。
