Association Between Cognitive Decline and Oral Health Status in the Aging Population

Abstract. Background: To date, no longitudinal prospective study has investigated the association between oral health status and cognitive decline in the geriatric Indian population, possibly because past studies differed in their target groups and methodologies. We investigated the association between tooth loss, as evaluated through clinical oral examinations, and the development of cognitive decline in older adults while considering baseline cognitive function. Objectives: This study served to find an association between oral health status and the subsequent development of cognitive decline in older adults of Maharashtra state while considering baseline cognitive function. Material and Methods: This 5-year prospective cohort study followed 140 participants without cognitive impairment aged ≥ 65 years (mean age: 70.9 ± 4.3 years) living in the Dhule region of Maharashtra, India. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) in baseline and follow-up surveys, while oral health examination was carried out using Oral Hygiene Index. To investigate the association between oral health status and cognitive decline, we applied a multiple logistic regression analysis adjusted for age, sex, hypertension, diabetes, cerebrovascular/cardiovascular disease, hypercholesterolemia, depressive symptoms, body mass index, smoking status, drinking status, duration of education, and baseline MMSE score. Results: In the 5 years after the baseline survey, we obtained an overall incidence of 20.71% in the population that developed cognitive decline (i.e., MMSE scores of ≤ 24). A multivariable logistic regression analysis indicated that participants with compromised oral health were more likely to develop cognitive decline than those with mild to moderate oral health were (odds ratio: 3.31; 95% confidence interval: 1.07–10.2). Age, male sex, and baseline MMSE scores were also significantly associated with cognitive decline. Conclusion: Among the geriatric population of India, poor oral health status was independently associated with the development of cognitive decline within 5 years. This finding corroborates the hypothesis that oral health may be a predictor or risk factor for cognitive decline.

Download Full-text

Association between Cognitive Decline and Oral Health Status in the Aging Population – A 5- year prospective cohort study (Preprint)

10.2196/preprints.15221 ◽

2019 ◽

Author(s):

Swapnil Bumb ◽

Charu Chitra Govindan ◽

Safalya Kadtane ◽

Rukmini JN ◽

Roshani Chawla ◽

...

Keyword(s):

Older Adults ◽

Regression Analysis ◽

Cohort Study ◽

Health Status ◽

Oral Health ◽

Cognitive Function ◽

Cognitive Decline ◽

Tooth Loss ◽

Oral Health Status ◽

Oral Examinations

BACKGROUND Till date no longitudinal prospective study have investigated the association between the oral health status and cognitive decline in the geriatric Indian population, possibly due to past studies differing in target groups and methodologies. We aimed to investigate the association between tooth loss, as evaluated through clinical oral examinations, and the development of cognitive decline in the older adults while considering baseline cognitive function. OBJECTIVE to investigate the association between tooth loss, as evaluated through clinical oral examinations, and the development of cognitive decline in the older adults while considering baseline cognitive function. METHODS This 5-year prospective cohort study followed 140 participants (mean age: 72.5 ± 4.3 years) without cognitive impairment aged ≥65 years (mean age: 70.9 ± 4.3 years) living in the Dhule Region of Maharashtra , India. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) in baseline and follow-up surveys,while oral health examination was carried out using Oral Hygiene Index To investigate the association between oral health status and cognitive decline, we applied a multiple logistic regression analysis adjusted for age, gender, hypertension, diabetes, cerebrovascular/cardiovascular disease, hypercholesterolemia, depressive symptoms, body mass index, smoking status, drinking status, duration of education, and baseline MMSE score. RESULTS In the 5 years after the baseline survey, we have obtained an overall incidence of 20.71%. population who developed cognitive decline (i.e., MMSE scores of ≤24). Multivariable logistic regression analysis indicated that participants with compromised oral health were more likely to develop cognitive decline than those with mild to moderate oral health were (odds ratio: 3.31; 95% confidence interval: 1.07–10.2). Age, male gender, and baseline MMSE scores were also significantly associated with cognitive decline. CONCLUSIONS Poor Oral health status was independently associated with the development of cognitive decline within 5 years among the geriatric population of India . This finding corroborates the hypothesis that oral health may be a predictor or risk factor for cognitive decline. CLINICALTRIAL Not applied

Download Full-text

Oral health and caries/gingivitis-associated factors of adolescents aged 12–15 in Shandong province, China: a cross-sectional Oral Health Survey

BMC Oral Health ◽

10.1186/s12903-021-01640-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Meng Zhang ◽

Jing Lan ◽

Tiantian Zhang ◽

Wenshuang Sun ◽

Panpan Liu ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Health Status ◽

Oral Health ◽

Associated Factors ◽

Multivariate Logistic Regression Analysis ◽

Oral Health Status ◽

Shandong Province ◽

Multivariate Logistic Regression ◽

Dental Visits

Abstract Background We aimed to analyse the oral health status of adolescents in Shandong province, including dental caries and gingivitis, and their associated factors. Methods Adolescents aged 12–15-years in Shandong province were recruited. Caries and gingival status were assessed following the World Health Organisation diagnostic criteria. Information including the sociodemographic, oral hygiene knowledge, attitudes and practices were collected through the questionnaire. Chi-square test and multivariate logistic regression analysis were used to investigate the oral diseases associated factors. Results In total, 3868 students (50.2% males) were enrolled. Of these, 39.9% of the participants experienced caries, and 81.7% and 31.3% had calculus and bleeding gingival, respectively. Multivariate logistic regression analysis revealed that there was an association between dental caries and toothaches, dental visits and sleeping troubles caused by oral problems (P < 0.024). A low-frequency of brushing, high sugar consumption and no flossing were more associated with calculus formation and gingival bleeding (P < 0.008). Conclusion Compared to caries, worse gingival condition was more prevalent among adolescents in Shandong province. Brushing behaviour is associated with gingivitis, while dental visits and toothaches are associated with caries. Hence, prevention-oriented dental visits and oral hygiene training are strongly recommended to improve oral health status.

Download Full-text

Evaluation of Variables to Characterize Respiratory Periodicity during Sleep in Older Adults

Biological Research For Nursing ◽

10.1177/10900402003004003 ◽

2002 ◽

Vol 3 (4) ◽

pp. 176-188 ◽

Cited By ~ 2

Author(s):

Barbara Waag Carlson ◽

Virginia J. Neelon

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Regression Analysis ◽

Standard Deviation ◽

Cognitive Decline ◽

Logistic Regression Analysis ◽

Breathing Cycle ◽

Body Movements ◽

Central Apneas ◽

Band Signal

Reliable markers of early neurological decline might guide interventions to prevent or reverse cognitive decline in older adults. Because cognitive decline is associated with hypoxemia during sleep, the authors examined 3 respiratory periodicity variables in 5 older adults. Subjects were monitored overnight using standard polysomnography. From the inductance band signal, the authors calculated the variability in duration of breathing cycles measured by standard deviation of interbreath intervals (sdIBI), frequency of breathing cycles measured by standard deviation of interbreath frequencies (sdIBF), and amplitude of breathing cycles measured by standard deviation of breathing cycle amplitudes (sdAMP). Logistic regression analysis and kappa coefficients identified variables that reliably detected 5-minute segments having central or obstructive apneas or body movements. An sdIBF 4.5 cpm identified body movements (sensitivity= 0.96, specificity = 0.96, kappa = 0.90). An sdIBI > 1.2 seconds identified central apneas (sensitivity = 0.86, specificity = 0.99, kappa= 0.86), and an sdIBI 1.68 seconds identified segments with 3 central apneas (sensitivity = 0.90, specificity = 0.89, kappa = 0.89). An sdAMP 0.1 V and an sdIBF 1.5 cpm identified obstructive apneas (kappa = 0.91). Data support the potential of these variables to identify central and obstructive apneas and to classify individuals according to different patterns of respiratory periodicity.

Download Full-text

Oral Health and Risk Indicators of Early Adolescents in Shandong Province, China: A Cross-sectional Oral Health Survey

10.21203/rs.3.rs-145470/v1 ◽

2021 ◽

Author(s):

Meng Zhang ◽

Jing Lan ◽

Tiantian Zhang ◽

Wenshuang Sun ◽

Panpan Liu ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Health Status ◽

Oral Health ◽

Multivariate Logistic Regression Analysis ◽

Oral Health Status ◽

Shandong Province ◽

Risk Indicators ◽

Multivariate Logistic Regression ◽

Dental Visits

Abstract Objective: We aimed to analyse the oral health status of adolescents in Shandong province, including dental caries and gingivitis, and the relevant risk indicators.Methods: Adolescents aged 12-15-years in Shandong province were recruited. Caries and gingival status were assessed following the World Health Organisation diagnostic criteria. Information including the sociodemographic, oral hygiene knowledge, attitudes and practices were collected through the questionnaire. Chi-square test and multivariate logistic regression analysis were used to investigate the independent risk indicators.Results: In total, 3,868 students (50.2% males) were enrolled. Of these, 39.9% of the participants experienced caries, and 81.7% and 31.3% had calculus and bleeding gums, respectively. Multivariate logistic regression analysis revealed that there was an association between an increased risk of caries with toothaches, dental visits and sleeping troubles caused by oral problems (P < 0.024). A low-frequency of brushing, high sugar consumption and no flossing increased the risk of calculus formation and gum bleeding (P < 0.008).Conclusion: Compared to caries, worse gingival condition was more prevalent among adolescents in Shandong province and was not taken seriously. Brushing behaviour is associated with gingivitis, while dental visits and toothaches are associated with caries. Hence, prevention-oriented dental visits and oral hygiene training are strongly recommended to improve oral health status.Trial registration: Not applicable.

Download Full-text

Cross-Sectional Examination of Homocysteine Levels with Sarcopenia and Its Components in Memory Clinic Outpatients

Journal of Alzheimer s Disease ◽

10.3233/jad-210083 ◽

2021 ◽

pp. 1-10

Author(s):

Yosuke Yamada ◽

Hiroyuki Umegaki ◽

Fumie Kinoshita ◽

Chi Hsien Huang ◽

Taiki Sugimoto ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Linear Regression ◽

Logistic Regression Analysis ◽

Linear Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Memory Clinic ◽

Cross Sectional

Background: Homocysteine is a common risk factor for cognitive impairment and sarcopenia. However, very few studies have shown an association between sarcopenia and serum homocysteine levels after adjustment for cognitive function. Objective: The purpose of this study was to investigate the relationship between homocysteine and sarcopenia in memory clinic patients. Methods: This cross-sectional study investigated outpatients in a memory clinic. We enrolled 1,774 participants (≥65 years old) with measured skeletal muscle mass index (SMI), hand grip strength (HGS), and homocysteine. All participants had undergone cognitive assessments and were diagnosed with dementia, mild cognitive impairment, or normal cognition. Patient characteristics were compared according to sarcopenia presence, SMI level, or HGS. Multivariate logistic regression analysis was performed to determine the association of homocysteine with sarcopenia, low SMI, or low HGS. Next, linear regression analysis was performed using HGS as a continuous variable. Results: Logistic regression analysis showed that low HGS was significantly associated with homocysteine levels (p = 0.002), but sarcopenia and low SMI were not. In linear regression analysis, HGS was negatively associated with homocysteine levels after adjustment for Mini-Mental State Examination score (β= –2.790, p < 0.001) or clinical diagnosis of dementia (β= –3.145, p < 0.001). These results were similar for men and women. Conclusion: Our results showed a negative association between homocysteine and HGS after adjustment for cognitive function. Our findings strengthen the assumed association between homocysteine and HGS. Further research is needed to determine whether lower homocysteine levels lead to prevent muscle weakness.

Download Full-text

Impact of Oral Health Status on Perceived Dental Problems Among Japan Maritime Self-Defense Force Personnel

Military Medicine ◽

10.1093/milmed/usab216 ◽

2021 ◽

Author(s):

Chikanobu Sonoda ◽

Yutaka Sakurai ◽

Manabu Okoda ◽

Masato Ebisawa ◽

Hiroshi Nakashima ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multiple Logistic Regression Analysis ◽

Oral Health Status ◽

Oral Disease ◽

Multiple Logistic Regression ◽

Self Defense ◽

Military Mission ◽

Stepwise Procedure

ABSTRACT Introduction Dental problems may have a great impact on military mission effectiveness, as such, evidence-based dental classification guidelines are required for minimizing the occurrence of dental problems. The aim of this study is to elucidate the independent contribution of each oral disease to the perception of dental problems among Japan Maritime Self-Defense Force (JMSDF) personnel in order to make the dental classification guidelines more precise for the prediction of future dental problems. Materials and Methods Japan Maritime Self-Defense Force personnel who were examined during the annual dental checkup in 2013 answered questions about the experience of dental problems within the last 12 months in 2014. The associations between the items of a dental checkup and the perception of dental problems were examined using multiple logistic regression analysis with a stepwise procedure to calculate odds ratios (ORs) and 95% CIs. Results The data of a total of 22,441 subjects were included in the analysis. Those who declared to have perceived dental problems within the last 12 months were 5,088 (22.7%). The multiple logistic regression analysis showed that personnel who had decayed teeth had a higher chance of experiencing dental problems than those who had no dental caries. Personnel whose periodontal disease was judged to be more severe in a dental examination had a greater OR for the perception of dental problems. Conclusion These results may become recommendations for operations in the JMSDF dental classification system.

Download Full-text

Analysis of cognitive characteristics and influencing factors of mass sports rehabilitation in Taiyuan

10.21203/rs.2.15690/v1 ◽

2019 ◽

Author(s):

Yaye He ◽

Jiangong Wang ◽

Liangyuan Zhao

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Health Status ◽

Influencing Factors ◽

Logistic Regression Analysis ◽

Education Level ◽

Factors Affecting ◽

Exercise Rehabilitation ◽

And Gender ◽

Socio Economic Factors

Abstract Background: To assess the awareness regarding sports rehabilitation among residents of Taiyuan. Method: From September 27, 2018 to March 29, 2019, 1200 residents who met the inclusion/ criteria were selected using convenient sampling method. The population was surveyed by self-designed questionnaires, and single factor and two-category logistic regression analysis (stepwise forward method) was used to identify the factors influencing awareness of mass sports rehabilitation in Taiyuan. Results: A total of 1200 questionnaires were issued, of which 1167 were collected and 1101 were valid. The corresponding recovery and effective recovery rates were 97.25% and 94.34% respectively. The overall rate of awareness of exercise rehabilitation was 80.7%, and education level, occupation, income and health status were significant influencing factors (R<0.05). The results of two-class logistic regression analysis showed that age, occupation, education level, income level and health status were the influencing factors affecting the public's perception of the sports rehabilitation concept (R<0.05), whereas gender, occupation, education level and health status influenced understanding of the establishment of the rehabilitation department in Taiyuan (R<0.05), and gender, age, education level and health status affected understanding of the types of patients receiving rehabilitation (R<0.05). Conclusion: There is a high general awareness regarding sports rehabilitation, and is influenced by various socio-economic factors.

Download Full-text

PS01.058: OLDER AGE AND DEMENTIA MIGHT BE CONSIDERED BACKGROUND FACTORS OF BLEEDING FROM EROSIVE REFLUX ESOPHAGITIS WITH ESOPHAGEAL ULCER

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.058 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 66-66

Author(s):

Tomohiro Kato ◽

Yukari Uno ◽

Hironao Ichikawa ◽

Yuhei Iwasa ◽

Chiemi Nakayama ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cognitive Decline ◽

Hiatal Hernia ◽

Logistic Regression Analysis ◽

Reflux Esophagitis ◽

Older Age ◽

Esophageal Ulcer ◽

Background Factors ◽

Esophageal Hiatal Hernia

Abstract Background Hematemesis is one of the most eventful complications in patients with reflux esophagitis (RE). But bleeding is not observed in all patients who have RE with esophageal ulcer. We retrospectively studied the association of bleeding with background factors in patients with RE with esophageal ulcer. Methods Between January 2013 and January 2018, 30 patients were endoscopically diagnosed as RE with Los Angeles classification D (LA-D). These 30 patients were enrolled in our study. Fifteen of them were suddenly admitted to our hospital because the RE exhibited bleeding (B-group). Patients with Mallory-Weiss syndrome, peptic ulcers, and any malignancies were excluded as possible sources of the bleeding. Bleeding was not observed in the remaining 15 RE patients (NB-group). In these 30 patients, we retrospectively studied the relations between the bleeding and the following background factors: age, gender, body mass index (BMI), esophageal hiatal hernia, endoscopical atrophy of the gastric mucosa which is related to the secretion of gastric juice, cognitive decline (so called dementia), diabetes mellitus, and drugs (NSAIDs, PPI). Results The B-group included 5 males and 10 females. The NB-group also included 5 males and 10 females. The mean age of the B-group was 81.7 ± 8.2 (M ± SD) yrs, which was statistically (P < 0.05) greater than that of the NB-group, which was 71.5 ± 11.0 yrs. Older age, larger esophageal hiatal hernia, and cognitive decline (so-called dementia) were significantly (P < 0.05) associated with bleeding on logistic regression analysis. Multiple logistic regression analysis showed that older age and dementia were significantly (P < 0.05) associated with bleeding. Conclusion It is well known that esophageal hiatal hernia is a major factor in erosive RE, such as RE with LA-D. On the other hand, it was speculated that older RE patients and those with cognitive decline could not easily explain their RE complaints, and their condition might be left unattended for long periods. This lack of attention may result in sudden bleeding in patients with non-treated RE. Further studies are needed. Disclosure All authors have declared no conflicts of interest.

Download Full-text

352. Characteristics Associated with Pre-Frailty in Older People Living with HIV

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.425 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S186-S186

Author(s):

Peter Mazonson ◽

Theoren Loo ◽

Jeff Berko ◽

Sarah-Marie Chan ◽

Ryan Westergaard ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cognitive Function ◽

Older People ◽

Logistic Regression Analysis ◽

The United States ◽

People Living With Hiv ◽

Factors Associated ◽

Increased Risk ◽

Living With Hiv

Abstract Background Frailty is a concern among older people living with HIV (PLHIV). There is a paucity of research characterizing PLHIV who are at risk of becoming frail (pre-frailty). To investigate how HIV impacts older PLHIV in the United States, a new study called Aging with Dignity, Health, Optimism and Community (ADHOC) was launched at ten sites to collect self-reported data. This analysis uses data from ADHOC to identify factors associated with pre-frailty. Methods Pre-frailty was assessed using the Frailty Index for Elders (FIFE), where a score of zero indicated no frailty, 1–3 indicated pre-frailty, and 4–10 indicated frailty. A cross-sectional analysis was performed on 262 PLHIV (age 50+) to determine the association between pre-frailty and self-reported sociodemographic, health, and clinical indicators using bivariate analyses. Factors associated with pre-frailty were then included in a logistic regression analysis using backward selection. Results The average age of ADHOC participants was 59 years. Eighty-two percent were male, 66% were gay or lesbian, and 56% were white. Forty-seven percent were classified with pre-frailty, 26% with frailty, and 27% with no frailty. In bivariate analyses, pre-frailty was associated with depression, low cognitive function, depression, multiple comorbidities, low income, low social support and unemployment (Table 1). In the multiple logistic regression analysis, pre-frailty was associated with having low cognitive function (Odds Ratio [OR] 8.56, 95% Confidence Interval [CI]: 3.24–22.63), 4 or more comorbid conditions (OR 4.00, 95% CI: 2.23–7.06), and an income less than $50,000 (OR 2.70, 95% CI: 1.56–4.68) (Table 2). Conclusion This study shows that commonly collected clinical and sociodemographic metrics can help identify PLWH who are more likely to have pre-frailty. Early recognition of factors associated with pre-frailty among PLHIV may help to prevent progression to frailty. Understanding markers of increased risk for pre-frailty may help clinicians and health systems better target multi-modal interventions to prevent negative health outcomes associated with frailty. Disclosures All authors: No reported disclosures.

Download Full-text