Ishihara Yuichi, Taguchi Akira, Yunoue Shiho, Mugiyama Misaki, Hosokubo Kazumi, Ido Minami, Nohara Kaori, Shinmei Momo, Oniki Takayuki, Uchiyama Akira, Furukawa Masae, Wang Jingshu, Saji Naoki, Takeda Akinori, Sakurai Takashi, Matsushita Kenji
Lion Foundation for Dental Health, Tokyo, Japan.
Department of Oral and Maxillofacial Radiology School of Dentistry, Matsumoto Dental University, Nagano, Japan.
BMC Oral Health. 2025 Jun 3;25(1):891. doi: 10.1186/s12903-025-06289-4.
Oral dysfunctions that affect masticatory function, such as tooth loss, reportedly lead to malnutrition, which contributes to cognitive decline and the onset and progression of dementia. Previous studies on oral dysfunction have focused on older people already in need of nursing care. Therefore, we conducted a study of older people able to travel independently or with minor assistance to examine the relationship between oral and cognitive function in memory clinic study participants classified as cognitively normal, with mild cognitive impairment, or with dementia.
Participants were 178 study participants (median age: 79.0 years, 49.4% female) attending the memory clinic at the National Center for Geriatrics and Gerontology, Japan. Following provision of informed consent, cognitive function was assessed using clinical dementia ratings and oral function assessed using number of present teeth, occlusal force, oral diadochokinesis, repetitive salivary swallowing test, and tongue pressure. The relationships between cognitive and oral function were evaluated using multivariable logistic regression analyses.
Of the participants, 25, 92, and 61 were classified as cognitively normal, with mild cognitive impairment, and with dementia, respectively. Oral diadochokinesis /ka/ was associated with a high risk of mild cognitive impairment: adjusted odds ratio, 6.930 (95% confidence interval: 1.284-37.402, P = 0.024). Repetitive salivary swallowing test score was associated with a high-risk tendency for dementia: adjusted odds ratio, 4.171 (95% confidence interval: 0.981-17.736, P for trend = 0.053). Number of present teeth, occlusal force, and tongue pressure were not associated with mild cognitive impairment or dementia.
Oral diadochokinesis /ka/ was independently associated with mild cognitive impairment. A well-designed cohort study is needed to clarify the causal relationships between cognitive decline and oral diadochokinesis. The ability to identify study participants with possible mild cognitive impairment through regular dental examinations would help to prevent dementia.
This study was registered to UMIN Clinical Trials Registry (UMIN000048126) at 2022-06-21.
据报道，影响咀嚼功能的口腔功能障碍，如牙齿缺失，会导致营养不良，进而导致认知能力下降以及痴呆症的发生和发展。以往关于口腔功能障碍的研究主要集中在已经需要护理的老年人身上。因此，我们对能够独立出行或在少量协助下出行的老年人进行了一项研究，以探讨在记忆门诊研究参与者中，认知功能正常、轻度认知障碍或患有痴呆症的老年人的口腔功能与认知功能之间的关系。
研究对象为178名在日本国立老年医学和老年学中心记忆门诊就诊的参与者（中位年龄：79.0岁，女性占49.4%）。在获得知情同意后，使用临床痴呆评定量表评估认知功能，使用现存牙齿数量、咬合力、口腔轮替运动速率、重复性唾液吞咽试验和舌压评估口腔功能。使用多变量逻辑回归分析评估认知功能与口腔功能之间的关系。
参与者中，分别有25人、92人和61人被分类为认知功能正常、轻度认知障碍和患有痴呆症。口腔轮替运动速率/ka/与轻度认知障碍的高风险相关：调整后的优势比为6.930（95%置信区间：1.284 - 37.402，P = 0.024）。重复性唾液吞咽试验得分与痴呆症的高风险倾向相关：调整后的优势比为4.171（95%置信区间：0.981 - 17.736，趋势P值 = 0.053）。现存牙齿数量、咬合力和舌压与轻度认知障碍或痴呆症无关。
口腔轮替运动速率/ka/与轻度认知障碍独立相关。需要进行精心设计的队列研究以阐明认知能力下降与口腔轮替运动速率之间的因果关系。通过定期牙科检查识别可能患有轻度认知障碍的研究参与者的能力将有助于预防痴呆症。
本研究于2022年6月21日在UMIN临床试验注册中心（UMIN000048126）注册。
