改善口腔卫生以促进更好的认知健康：老年人口腔卫生习惯、口腔健康状况与认知功能的相互关系。

Improving oral hygiene for better cognitive health: Interrelationships of oral hygiene habits, oral health status, and cognitive function in older adults.

作者信息

Yang Yajie, Liang Lizhu, Cai Jinfen, You Jie, Liao Xiaoyan

机构信息

Nursing Department, Nanfang Hospital, Southern Medical University, Guangzhou, China.

School of Nursing, Southern Medical University, Guangzhou, China.

出版信息

J Adv Nurs. 2024 Jan;80(1):275-286. doi: 10.1111/jan.15769. Epub 2023 Jul 4.

DOI:10.1111/jan.15769

PMID:37403198

Abstract

OBJECTIVES

To explore the interrelationships between oral hygiene habits, oral health status and cognitive function in older adults.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

A total of 371 participants (age 76.79 [7.99] years) were enrolled from June 2020 to November 2021 in an aged care facility.

METHODS

Cognitive function was screened using the mini-mental state examination (MMSE) with adjusted cut-off points for age and education. Periodontal status (Biofilm-Gingival Interface index based on periodontal probing depth and bleeding on probing), dental status (plaque, calculus, and caries), and tooth loss were assessed through full-mouth examination. Oral hygiene habits were based on self- or informant-reporting.

RESULTS

Poor periodontal status was an associated factor for MCI (OR = 2.89, 95% CI = 1.20-6.95), while multiple tooth loss (OR = 4.90, 95% CI = 1.06 ~ 22.59), brushing teeth less than once a day (OR = 2.88, 95% CI = 1.12 ~ 7.45) and delayed dental visits (OR = 2.45, 95% CI = 1.05 ~ 5.68) were associated factors for cognitive impairment. An indirect effect of brushing teeth ≥2 daily on MMSE score through periodontal status was observed only in older adults without cognitive impairment (Bootstrap-corrected B = 0.17, 95%CI = 0.03 ~ 0.36, SE = 0.08, β = 0.08).

CONCLUSIONS AND IMPLICATIONS

Adequate toothbrushing might prevent cognitive decline indirectly by improving periodontal health only in older adults without cognitive impairment. Multiple tooth loss, infrequent toothbrushing, and delayed dental visits were associated factors for cognitive impairment. Nursing professionals and health care policymakers should advocate for the improvement of basic oral hygiene in older adults, and provide regular professional oral hygiene care for older adults with cognitive impairment.

PATIENT OR PUBLIC CONTRIBUTION

The information on oral health habits of this study was based on an interview with the participants or their caregivers during the study period.

摘要

目的

探讨老年人的口腔卫生习惯、口腔健康状况与认知功能之间的相互关系。

设计

一项横断面研究。

设置与参与者

2020年6月至2021年11月，共有371名参与者（年龄76.79[7.99]岁）被纳入一家老年护理机构。

方法

使用简易精神状态检查表（MMSE）对认知功能进行筛查，并根据年龄和教育程度调整了临界值。通过全口检查评估牙周状况（基于牙周探诊深度和探诊出血的生物膜-牙龈界面指数）、牙齿状况（牙菌斑、牙结石和龋齿）以及牙齿缺失情况。口腔卫生习惯基于自我报告或他人报告。

结果

牙周状况不佳是轻度认知障碍的相关因素（OR = 2.89，95%CI = 1.20 - 6.95），而牙齿多处缺失（OR = 4.90，95%CI = 1.06 - 22.59）、每天刷牙少于一次（OR = 2.88，95%CI = 1.12 - 7.45）以及延迟看牙（OR = 2.45，95%CI = 1.05 - 5.68）是认知障碍的相关因素。仅在无认知障碍的老年人中观察到每日刷牙≥2次通过牙周状况对MMSE评分产生的间接影响（经Bootstrap校正的B = 0.17，95%CI = 0.03 - 0.36，SE = 0.08,β = 0.08）。