Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
Department of Geriatric Dentistry, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo, 145-8515, Japan.
BMC Oral Health. 2021 Dec 27;21(1):665. doi: 10.1186/s12903-021-02027-8.
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. 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.
This 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, χ, and Fisher's exact tests were used for between-group comparisons. Furthermore, logistic regression analysis using MCI diagnosis as the target variable was performed.
A 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.
Patients 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.
先前的研究表明，轻度认知障碍 (MCI) 患者的口腔健康状况较差，口腔功能受损，这可能是由于牙齿缺失、舌和唇运动功能受损所致。然而，经过痴呆专家全面认知评估的此类患者的口腔健康状况尚未得到充分研究。因此，本研究旨在阐明 MCI 患者的口腔功能以及口腔健康与较低认知功能之间的关系。
本横断面研究纳入了 2017 年 12 月至 2020 年 1 月期间在痴呆诊所就诊的 96 名参与者（男性 35 名，女性 61 名，平均年龄 73.3±8.5 岁）。参与者的认知功能由痴呆专家通过神经心理学和血液学测试以及神经影像学检查进行评估。参与者在入组后立即接受评估。根据全面的认知评估，将参与者分为健康组和 MCI 组。评估了参与者的年龄、性别、体重指数、主要疾病、教育水平、饮酒习惯、吸烟习惯、生活环境、就业状况和运动习惯。此外，还记录了口腔结局，包括现存牙齿数量、功能牙数量（与对颌牙咬合的天然牙和义齿）、义齿使用情况、口腔干燥情况、舌和唇运动功能、舌压、咬合力量、咀嚼能力和吞咽能力。采用 Mann-Whitney U 检验、χ²检验和 Fisher 确切概率法进行组间比较。此外，还使用 MCI 诊断作为目标变量进行了逻辑回归分析。
痴呆专家对研究参与者的认知功能进行了全面评估，结果显示 48 名参与者（平均年龄 69.8±8.8 岁）认知健康，48 名参与者（平均年龄 76.9±6.7 岁）患有 MCI。MCI 组参与者年龄明显较大（p<0.001），现存牙齿数量明显较少（p=0.031），最大咬合力量明显较低（p=0.019）。年龄（比值比：1.126，p=0.002）和最大咬合力量（比值比：0.978，p=0.048）与较低的认知功能显著相关。
与健康个体相比，MCI 患者的口腔健康状况较差。即使调整了年龄和性别因素，最大咬合力量的降低仍与认知功能降低独立相关。
