Journal of dental hygiene science (치위생과학회지)

The Korean Society of Dental Hygiene Science (한국치위생과학회)
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Impact of Masticatory Discomfort on Daily Living Difficulties in Korean Elderly with Cognitive Decline

  • Kyung-Yi Do (Department of Preventive Medicine, Yonsei University Wonju College of Medicine) ;
  • Chun-Bae Kim (Department of Preventive Medicine, Yonsei University Wonju College of Medicine) ;
  • Yeon-Soon Ahn (Department of Preventive Medicine, Yonsei University Wonju College of Medicine)
  • Received : 2023.05.30
  • Accepted : 2023.06.13
  • Published : 2023.06.30
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Abstract

Background: Cognitive impairment has been reported to be closely associated with poor oral health, and the relationship is bidirectional, as older adults with poor oral health and chewing function are at a higher risk of cognitive decline (CD). This cross-sectional study aimed to determine whether masticatory discomfort in Korean elderly increases the risk of daily living difficulty (DLD) related to CD and whether there is a difference in risk according to gender and age. Methods: The data used were obtained from the Korean Community Health Survey (2019). The final analysis included 22,154 people aged 65 years and older who completed the survey and responded to all items on the variables used in the study. Chi-square test, trend test, and complex sample logistic regression were performed for statistical analysis, to clarify the purpose of this study. Results: As masticatory discomfort increased, the elderly's DLD tended to increase (p-for trend, p<0.001). For logistic regression, adjusting for all covariates, participants who reported masticatory discomfort as "discomfort" (adjusted odds ratio [AOR]=2.45, 95% confidence interval [CI]=2.11~3.50) and "severe discomfort" (AOR=2.95, 95% CI=2.49~3.50) had a more than a two-fold increased risk of CD-related DLD compared to participants who reported "no discomfort at all." In age-stratified analyses, elderly men aged 75~84 years and elderly women aged 65~74 years had the highest risk of developing CD-related DLD. Conclusion: Oral care interventions to improve masticatory function in older adults may slow CD and improve CD-related DLD. We hope that this study will raise awareness among caregivers and clinical professionals regarding the importance of oral care for older adults with CD.

Keywords

References

  1. Lee JH, Yi SK, Kim SY, et al.: Factors related to the number of existing teeth among Korean adults aged 55-79 years. Int J Environ Res Public Health 16: 3927, 2019. https://doi.org/10.3390/ijerph16203927
  2. Bakker MH, Vissink A, Spoorenberg SLW, Jager-Wittenaar H, Wynia K, Visser A: Are edentulousness, oral health problems and poor health-related quality of life associated with malnutrition in community-dwelling elderly (aged 75 years and over)? A cross-sectional study. Nutrients 10: 1965, 2018. https://doi.org/10.3390/nu10121965
  3. Park T, Jung YS, Son K, et al.: More teeth and posterior balanced occlusion are a key determinant for cognitive function in the elderly. Int J Environ Res Public Health 18: 1996, 2021. https://doi.org/10.3390/ijerph18041996
  4. Ju YJ, Lee JE, Lee SY: Associations between chewing difficulty, subjective cognitive decline, and related functional difficulties among older people without dementia: focus on body mass index. J Nutr Health Aging 25: 347-355, 2021. https://doi.org/10.1007/s12603-020-1521-2
  5. Kaye EK, Valencia A, Baba N, Spiro A 3rd, Dietrich T, Garcia RI: Tooth loss and periodontal disease predict poor cognitive function in older men. J Am Geriatr Soc 58: 713-718, 2010. https://doi.org/10.1111/j.1532-5415.2010.02788.x
  6. Lee KH, Jung ES, Choi YY: Association of oral health and activities of daily living with cognitive impairment. Gerodontology 37: 38-45, 2020. https://doi.org/10.1111/ger.12442
  7. Nilsson H, Berglund J, Renvert S: Tooth loss and cognitive functions among older adults. Acta Odontol Scand 72: 639-644, 2014. https://doi.org/10.3109/00016357.2014.882983
  8. Park H, Suk SH, Cheong JS, et al.: Tooth loss may predict poor cognitive function in community-dwelling adults without dementia or stroke: the PRESENT project. J Korean Med Sci 28: 1518-1521, 2013. https://doi.org/10.3346/jkms.2013.28.10.1518
  9. Li A, Chen Y, Visser A, Marks LAM, Tjakkes GE: Combined association of cognitive impairment and poor oral health on mortality risk in older adults: results from the NHANES with 15 years of follow-up. J Periodontol 93: 888-900, 2022. https://doi.org/10.1002/JPER.21-0292
  10. Weijenberg RAF, Delwel S, Ho BV, van der Maarel-Wierink CD, Lobbezoo F: Mind your teeth- the relationship between mastication and cognition. Gerodontology 36: 2-7, 2019. https://doi.org/10.1111/ger.12380
  11. Cho MJ, Kim EK: Subjective chewing ability and health-related quality of life among the elderly. Gerodontology 36: 99-106, 2019. https://doi.org/10.1111/ger.12385
  12. Kim YJ, Kim CB, Ahn YH, Chung WG, Kim NH: Gender differences in chewing discomfort in older South Koreans. Int J Dent Hyg 13: 273-282, 2015. https://doi.org/10.1111/idh.12146
  13. Gerritsen AE, Allen PF, Witter DJ, Bronkhorst EM, Creugers NH: Tooth loss and oral health-related quality of life: a systematic review and meta-analysis. Health Qual Life Outcomes 8: 126, 2010. https://doi.org/10.1186/1477-7525-8-126
  14. Kononen E, Gursoy M, Gursoy UK: Periodontitis: a multifaceted disease of tooth-supporting tissues. J Clin Med 8: 1135, 2019. https://doi.org/10.3390/jcm8081135
  15. Zenthofer A, Baumgart D, Cabrera T, et al.: Poor dental hygiene and periodontal health in nursing home residents with dementia: an observational study. Odontology 105: 208-213, 2017. https://doi.org/10.1007/s10266-016-0246-5
  16. Lee YL, Hu HY, Huang LY, Chou P, Chu D: Periodontal disease associated with higher risk of dementia: population-based cohort study in Taiwan. J Am Geriatr Soc 65: 1975-1980, 2017. https://doi.org/10.1111/jgs.14944
  17. Lee YT, Lee HC, Hu CJ, et al.: Periodontitis as a modifiable risk factor for dementia: a nationwide population-based cohort study. J Am Geriatr Soc 65: 301-305, 2017. https://doi.org/10.1111/jgs.14449
  18. Syrjala AM, Ylostalo P, Sulkava R, Knuuttila M: Relationship between cognitive impairment and oral health: results of the Health 2000 Health Examination Survey in Finland. Acta Odontol Scand 65: 103-108, 2007. https://doi.org/10.1080/00016350601083521
  19. Hansson P, Eriksson Sorman D, et al.: Dental status is unrelated to risk of dementia: a 20-year prospective study. J Am Geriatr Soc 62: 979-981, 2014. https://doi.org/10.1111/jgs.12814
  20. Stewart R, Stenman U, Hakeberg M, Hagglin C, Gustafson D, Skoog I: Associations between oral health and risk of dementia in a 37-year follow-up study: the prospective population study of women in Gothenburg. J Am Geriatr Soc 63: 100-105, 2015. https://doi.org/10.1111/jgs.13194
  21. Bonfiglio V, Umegaki H, Kuzuya M: Quality of life in cognitively impaired older adults. Geriatr Gerontol Int 19: 999-1005, 2019. https://doi.org/10.1111/ggi.13759
  22. Ishimiya M, Nakamura H, Kobayashi Y, et al.: Tooth loss-related dietary patterns and cognitive impairment in an elderly Japanese population: the Nakajima study. PLoS One 13: e0194504, 2018. https://doi.org/10.1371/journal.pone.0194504
  23. Lexomboon D, Trulsson M, Wardh I, Parker MG: Chewing ability and tooth loss: association with cognitive impairment in an elderly population study. J Am Geriatr Soc 60: 1951-1956, 2012. https://doi.org/10.1111/j.1532-5415.2012.04154.x
  24. Thomson WM, Barak Y: Tooth loss and dementia: a critical examination. J Dent Res 100: 226-231, 2021. https://doi.org/10.1177/0022034520957233
  25. Korea Centers for Disease Control and Prevention: 2019 Korea community health survey. Retrieved 2023 Apr 1, from: https://chs.kdca.go.kr/chs/stats/statsMain.do (2020, Oct 26).
  26. Park KY: Reliability, validity and clinical usefulness of the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Glob Health Nurs 7: 71-78, 2017. https://doi.org/10.35144/ghn.2017.7.2.71
  27. Miranda Lde P, Silveira MF, Oliveira TL, et al.: Cognitive impairment, the Mini-Mental State Examination and sociodemographic and dental variables in the elderly in Brazil. Gerodontology 29: e34-e40, 2012. https://doi.org/10.1111/j.1741-2358.2011.00541.x
  28. Uppoor AS, Lohi HS, Nayak D: Periodontitis and Alzheimer's disease: oral systemic link still on the rise? Gerodontology 30: 239-242, 2013. https://doi.org/10.1111/j.1741-2358.2012.00660.x
  29. Do KY, Moon S: Relationship between subjective oral discomfort and health-related quality of life in the South Korean elderly population. Int J Environ Res Public Health 17: 1906, 2020. https://doi.org/10.3390/ijerph17061906
  30. Li J, Xu H, Pan W, Wu B: Association between tooth loss and cognitive decline: a 13-year longitudinal study of Chinese older adults. PLoS One 12: e0171404, 2017. https://doi.org/10.1371/journal.pone.0171404
  31. Saito S, Ohi T, Murakami T, et al.: Association between tooth loss and cognitive impairment in community-dwelling older Japanese adults: a 4-year prospective cohort study from the Ohasama study. BMC Oral Health 18: 142, 2018. https://doi.org/10.1186/s12903-018-0602-7
  32. Campos CH, Ribeiro GR, Rodrigues Garcia RCM: Mastication and oral health-related quality of life in removable denture wearers with Alzheimer disease. J Prosthet Dent 119: 764-768, 2018. https://doi.org/10.1016/j.prosdent.2017.07.010
  33. Daly B, Thompsell A, Sharpling J, et al.: Evidence summary: the relationship between oral health and dementia. Br Dent J 223: 846-853, 2018. https://doi.org/10.1038/sj.bdj.2017.992
  34. Dioguardi M, Gioia GD, Caloro GA, et al.: The association between tooth loss and Alzheimer's disease: a systematic review with meta-analysis of case control studies. Dent J (Basel) 7: 49, 2019. https://doi.org/10.3390/dj7020049
  35. Elsig F, Schimmel M, Duvernay E, et al.: Tooth loss, chewing efficiency and cognitive impairment in geriatric patients. Gerodontology 32: 149-156, 2015. https://doi.org/10.1111/ger.12079
  36. Cho MJ, Jung EK, Jung YS, et al.: Relationship between the activities of daily living, oral health-related quality of life and dementia. Geriatr Gerontol Int 18: 943-949, 2018. https://doi.org/10.1111/ggi.13305
  37. Listl S: Oral health conditions and cognitive functioning in middle and later adulthood. BMC Oral Health 14: 70, 2014. https://doi.org/10.1186/1472-6831-14-70
  38. Kato H, Takahashi Y, Iseki C, et al.: Tooth loss-associated cognitive impairment in the elderly: a community-based study in Japan. Intern Med 58: 1411-1416, 2019. https://doi.org/10.2169/internalmedicine.1896-18
  39. Teixeira FB, Pereira Fernandes Lde M, Noronha PA, et al.: Masticatory deficiency as a risk factor for cognitive dysfunction. Int J Med Sci 11: 209-214, 2014. https://doi.org/10.7150/ijms.6801
  40. Song IS, Ki EY, Han K, Ryu JJ, Park JB: Evaluation of the association between menstrual cycle irregularity and dental pain or chewing discomfort in women before menopause. J Clin Med 8: 454, 2019. https://doi.org/10.3390/jcm8040454
  41. Batisse C, Bonnet G, Veyrune JL, Nicolas E, Bessadet M: Predictive parameters of oral health quality of life in complete mandibular denture wearers stabilized by mini-implants: a two-year follow-up study. Materials (Basel) 10: 1197, 2017. https://doi.org/10.3390/ma10101197
  42. Yi Mohammadi JJ, Franks K, Hines S: Effectiveness of professional oral health care intervention on the oral health of residents with dementia in residential aged care facilities: a systematic review protocol. JBI Database System Rev Implement Rep 13: 110-122, 2015. https://doi.org/10.11124/jbisrir-2015-2330