Oral health status in relation to cognitive function among older Japanese

Masanori Iwasaki; Yumi Kimura; Akihiro Yoshihara; Hiroshi Ogawa; Takayuki Yamaga; Misuzu Sato; Taizo Wada; Ryota Sakamoto; Yasuko Ishimoto; Eriko Fukutomi; Wenling Chen; Hissei Imai; Michiko Fujisawa; Kiyohito Okumiya; George W Taylor; Toshihiro Ansai; Hideo Miyazaki; Kozo Matsubayashi

doi:10.1002/cre2.2

Oral health status in relation to cognitive function among older Japanese

Clin Exp Dent Res. 2015 Jun 7;1(1):3-9. doi: 10.1002/cre2.2. eCollection 2015 Oct.

Authors

Masanori Iwasaki^{1

2}, Yumi Kimura³, Akihiro Yoshihara⁴, Hiroshi Ogawa¹, Takayuki Yamaga¹, Misuzu Sato¹, Taizo Wada³, Ryota Sakamoto³, Yasuko Ishimoto³, Eriko Fukutomi³, Wenling Chen⁵, Hissei Imai⁵, Michiko Fujisawa³, Kiyohito Okumiya³, George W Taylor⁶, Toshihiro Ansai², Hideo Miyazaki¹, Kozo Matsubayashi^{3

5}

Affiliations

¹ Division of Preventive Dentistry, Department of Oral Health Science Niigata University Graduate School of Medical and Dental Sciences Niigata Japan.
² Division of Community Oral Health Development Kyushu Dental University Kitakyushu Japan.
³ Center for Southeast Asian Studies Kyoto University Kyoto Japan.
⁴ Division of Oral Science for Health Promotion, Department of Oral Health and Welfare Niigata University Graduate School of Medical and Dental Sciences Niigata Japan.
⁵ Department of Field Medicine, School of Public Health Kyoto University Kyoto Japan.
⁶ Department of Preventive and Restorative Dental Sciences University of California San Francisco San Francisco California USA.

PMID: 29744134
PMCID: PMC5839238
DOI: 10.1002/cre2.2

Abstract

Epidemiologic data examining the relationship between oral health status and cognitive status are sparse, especially in Asian populations. This study aimed to assess whether periodontal disease and tooth loss were related to cognitive impairment among older Japanese. Study participants were 291 Japanese (101 men and 190 women, average age: 80.9 years), classified into three groups based on a clinical examination of oral health status: no periodontal disease, periodontal disease, and edentulous. Periodontal disease was defined using criteria recommended in the consensus report of the European Workshop in Periodontology with a modification. Cognitive impairment was defined using the results of the Mini-mental State Examination (MMSE) and Hasegawa Dementia Scale-Revised (HDS-R) scores. Multivariable logistic regression analyses assessed the relationship of the three-category oral health status variable (reference category = no periodontal disease) with low MMSE score (≤23) and low HDS-R score (≤20). Age, gender, years of education, body mass index, smoking status, drinking behavior, and history of cardiovascular disease were tested as potential confounders in the multivariable models. Periodontal disease and edentulous were significantly associated with greater odds of low cognitive performance after controlling for potential confounders. The multivariable adjusted odds ratios (ORs) (95% confidence intervals [CIs]) for low MMSE score associated with periodontal disease and edentulous were 2.21 (1.01-4.84) and 2.28 (1.06-4.90), respectively. The multivariable adjusted ORs (95% CIs) for low HDS-R score associated with periodontal disease and edentulous were 4.85 (1.29-18.15) and 3.86 (1.05-14.20), respectively. Poor oral health status was significantly associated with cognitive impairment among community-dwelling older Japanese. Additional well-controlled longitudinal studies are needed to elucidate whether there may be a possible cause-and-effect relationship between oral health status and cognitive function.

Keywords: Cognitive disorders; cross‐sectional; elderly; epidemiology.