Abstract
Introduction: Previous studies suggest an association between poor mastication and cognitive impairment. The role of chewing efficiency and dentition in this relation is unclear. The aim was to examine global cognitive functioning and dentition as predictors for chewing efficiency, in older people with mild cognitive impairment (MCI) or dementia. Methods: In this observational cross-sectional study, 136 people with MCI or dementia were included. The chewing efficiency was assessed with a two-colored chewing gum and analyzed with the Chewing Efficiency Analysis software. The level of global cognitive functioning was measured with the Mini Mental State Examination (MMSE) by trained clinical staff. An oral examination was performed by a dentist and included the number of present teeth, the number of occluding pairs, and the presence of prostheses. Age, gender, and educational years were derived from the medical records. Univariate and multivariate backward stepwise linear regression analyses were used to evaluate global cognitive functioning and dentition as predictors for chewing efficiency. Results: The mean age of the participants was 82.1 (SD 5.8) years, and 74 (54.4%) were female. The participants had a median MMSE score of 22.4 (IQR 18.0–26.0) and a median Chewing Efficiency Analysis score of 0.46 (IQR 0.14–0.59). The median number of teeth was 13.0 (IQR 0.0–23.0), and the median number of occluding pairs was 0.0 (IQR 0.0–7.0). Sixty-four (47.4%) of the participants wore full prosthesis in the upper jaw. In univariate linear regression analyses, predictive factors for the Chewing Efficiency Analysis score were age, MMSE score, full prosthesis in the upper jaw, number of present teeth, and number of occluding pairs. In the multivariate model, full prosthesis in the upper jaw and number of occluding pairs were significant predictors for the Chewing Efficiency Analysis score. Participants with full prosthesis in the upper jaw had a lower Chewing Efficiency Analysis score than participants with natural dentition in the upper jaw. Conclusion: Better mastication is associated with a higher number of occluding pairs. Full prosthesis in the upper jaw is related to a lower chewing efficiency. Global cognitive functioning is not associated with mastication in older people with MCI or mild-to-moderate dementia. This might be explained by sufficient capacity for compensation of reduced mastication in this group.
| Original language | English |
|---|---|
| Article number | 225 |
| Pages (from-to) | 1-10 |
| Number of pages | 10 |
| Journal | Frontiers in Aging Neuroscience |
| Volume | 12 |
| Issue number | September |
| Early online date | 9 Sept 2020 |
| DOIs | |
| Publication status | Published - Sept 2020 |
Funding
We thank the participants and their care providers for their cooperation with the study. Furthermore, we thank the staff of the outpatient clinics at the VU Medical Center and the Amstelland Hospital, the staff at the 10 participating nursing homes of Amstelring, Cordaan, and Zonnehuisgroep Amstelland for their cooperation. Moreover, we thank Tarik Binnekade of the Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, and Janine van Kooten of the Department of General Practice and Elderly Care Medicine, VU University Medical Center, for their help with the acquisition of the participants and the demographic and neuropsychological data collection. Furthermore, we thank the students of the Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, and the Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), for their assistance. In addition, we thank Irene Aartman of the Department of Social Dentistry and Maurits van Selms of the Department for Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), for their statistical support. Funding. This study was supported by grants from Alzheimer Nederland (WE.09-2012-02), Amstelring (RVB U-9107-2013/HM/wb), Arnold Oosterbaan Hersenstichting, Fonds NutsOhra (1130-046), Roomsch Catholijk Oude Armen Kantoor (U-9128-2012 HM/lw), Stichting Beroepsopleiding Huisartsen (SBOH), and Stichting Henri?tte Hofje. FL reports grants from Sunstar Suisse, SomnoMed, Goedegebuure, and Airway Management, outside the submitted work.
| Funders | Funder number |
|---|---|
| Academic Centre for Dentistry Amsterdam | |
| Amstelland Hospital | |
| Arnold Oosterbaan Hersenstichting | |
| Department of Social Dentistry | |
| Stichting Henriëtte Hofje | |
| VU University Medical Center | |
| Veterans Administration Medical Center | |
| Fonds NutsOhra | 1130-046 |
| Stichting Beroepsopleiding Huisarts | |
| Alzheimer Nederland | RVB U-9107-2013/HM/wb, WE.09-2012-02 |
| Stichting RCOAK | U-9128-2012 HM/lw |
Keywords
- aged
- chewing
- cognitive dysfunction
- cognitive impairment
- dementia
- geriatric dentistry
- gerodontology
- mastication