Oral function of older people with mild cognitive impairment or dementia

Suzanne Delwel; Erik J.A. Scherder; Roberto S.G.M. Perez; Cees M.P.M. Hertogh; Andrea B. Maier; Frank Lobbezoo

doi:10.1111/joor.12708

Oral function of older people with mild cognitive impairment or dementia

Suzanne Delwel^*, Erik J.A. Scherder, Roberto S.G.M. Perez, Cees M.P.M. Hertogh, Andrea B. Maier, Frank Lobbezoo

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Objectives: The aim of this study was to examine and compare the oral function of older people with mild cognitive impairment (MCI) or dementia. Methods: This cross-sectional observational study included participants with MCI or dementia aged 60 years or older. Global cognitive functioning was evaluated with the Mini Mental State Examination (MMSE) and the oral function was evaluated with subjective and objective assessments, including the perceived quality of chewing and swallowing, the function of the prostheses, the number of occluding pairs (OP), the degree of tooth wear and the active and passive maximum mouth opening. Results: The quality of chewing and swallowing was perceived as good in, respectively, 86.0% and 90.9% of the participants. Full or partial prostheses were worn by 63.8% of the participants, and the retention was good in 58.4% of the upper and 50.0% of the lower prostheses. Participants with MCI had a median of 3.0 (Inter Quartile Range [IQR] 0.0-7.5) occluding pairs, while participants with dementia had a median of 0.0 (IQR 0.0-1.0) occluding pairs, U = 3838.50, P < 0.001. There was a weak positive correlation between the number of occluding pairs and the MMSE score, r = 0.267, also when adjusted for age, r = 0.230. The median tooth wear score was 2.0 (IQR 2.0-2.0) in participants with MCI or dementia. The active maximum mouth opening was 45.8 (SD 9.3) mm in participants with dementia, while it was 49.8 (SD 8.1) mm in those with MCI, t(253) = 2.67, P = 0.008. Conclusion: For most participants with MCI or dementia, the swallowing ability and chewing ability were perceived as good. In addition, more than half of the prostheses had good retention and occlusion. Participants with more severe cognitive impairment had fewer occluding pairs and a smaller active mouth opening. The degree of tooth wear was less than one-third of the clinical crown in most participants with MCI or dementia.

Original language	English
Pages (from-to)	990-997
Number of pages	8
Journal	Journal of Oral Rehabilitation
Volume	45
Issue number	12
Early online date	12 Aug 2018
DOIs	https://doi.org/10.1111/joor.12708
Publication status	Published - Dec 2018

Funding

This study was supported by grants from the following: 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 Henriëtte Hofje. R. Perez reported grants from STW outside the submitted work. F. Lobbezoo reports grants from Sunstar Suisse and SomnoMed Ltd, outside the submitted work. Funding information This study was supported by grants from the following: 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. R. Perez reported grants from STW outside the submitted work. F. Lobbezoo reports grants from Sunstar Suisse and SomnoMed Ltd, outside the submitted work. The authors thank the participants and their care providers for their cooperation with the study. Furthermore, they thank the staff of the outpatient clinics at the VU Medical Center and the Amstelland hospital, and the staff at the ten participating nursing homes of Amstelring, Cordaan and Zonnehuisgroep Amstelland for their cooperation. Moreover, they thank the students of the Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, and the Department of Oral Kinesiology, Academic Center for Dentistry Amsterdam (ACTA), for their assistance. Furthermore, they thank Tarik Binnekade, MSc of the Department of Neuropsychology, Vrije Universiteit Amsterdam, for the cognitive screening of the participants and Drs. Janine van Kooten of the Department of General Practice and Elderly Care Medicine, VU University Medical Center, for her help with the acquisition of part of the participants and the collection of the demographic data at the nursing homes. In addition, they thank Johannes van der Wouden of the Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, for his methodological support.

Funders	Funder number
Academic Center for Dentistry Amsterdam
Arnold Oosterbaan Hersenstichting
Department of Oral Kinesiology
Roomsch Catholijk Oude Armen Kantoor	U-9128-2012 HM/lw
Stichting Henri?tte Hofje
Stichting Henriëtte Hofje
VU Medical Center
VU University Medical Center
Fonds NutsOhra	1130-046
Stichting voor de Technische Wetenschappen
Stichting Beroepsopleiding Huisarts

Keywords

aged
cognitive dysfunction
deglutition
dental prosthesis
dentures
geriatric dentistry
mastication
neurocognitive disorder
oral health
temporomandibular joint
tooth wear

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@article{9cd63a3ac9fe44f7a8b71a33d26cfa3a,

title = "Oral function of older people with mild cognitive impairment or dementia",

abstract = "Objectives: The aim of this study was to examine and compare the oral function of older people with mild cognitive impairment (MCI) or dementia. Methods: This cross-sectional observational study included participants with MCI or dementia aged 60 years or older. Global cognitive functioning was evaluated with the Mini Mental State Examination (MMSE) and the oral function was evaluated with subjective and objective assessments, including the perceived quality of chewing and swallowing, the function of the prostheses, the number of occluding pairs (OP), the degree of tooth wear and the active and passive maximum mouth opening. Results: The quality of chewing and swallowing was perceived as good in, respectively, 86.0% and 90.9% of the participants. Full or partial prostheses were worn by 63.8% of the participants, and the retention was good in 58.4% of the upper and 50.0% of the lower prostheses. Participants with MCI had a median of 3.0 (Inter Quartile Range [IQR] 0.0-7.5) occluding pairs, while participants with dementia had a median of 0.0 (IQR 0.0-1.0) occluding pairs, U = 3838.50, P < 0.001. There was a weak positive correlation between the number of occluding pairs and the MMSE score, r = 0.267, also when adjusted for age, r = 0.230. The median tooth wear score was 2.0 (IQR 2.0-2.0) in participants with MCI or dementia. The active maximum mouth opening was 45.8 (SD 9.3) mm in participants with dementia, while it was 49.8 (SD 8.1) mm in those with MCI, t(253) = 2.67, P = 0.008. Conclusion: For most participants with MCI or dementia, the swallowing ability and chewing ability were perceived as good. In addition, more than half of the prostheses had good retention and occlusion. Participants with more severe cognitive impairment had fewer occluding pairs and a smaller active mouth opening. The degree of tooth wear was less than one-third of the clinical crown in most participants with MCI or dementia.",

keywords = "aged, cognitive dysfunction, deglutition, dental prosthesis, dentures, geriatric dentistry, mastication, neurocognitive disorder, oral health, temporomandibular joint, tooth wear",

author = "Suzanne Delwel and Scherder, {Erik J.A.} and Perez, {Roberto S.G.M.} and Hertogh, {Cees M.P.M.} and Maier, {Andrea B.} and Frank Lobbezoo",

year = "2018",

month = dec,

doi = "10.1111/joor.12708",

language = "English",

volume = "45",

pages = "990--997",

journal = "Journal of Oral Rehabilitation",

issn = "0305-182X",

publisher = "Wiley-Blackwell",

number = "12",

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T1 - Oral function of older people with mild cognitive impairment or dementia

AU - Delwel, Suzanne

AU - Scherder, Erik J.A.

AU - Perez, Roberto S.G.M.

AU - Hertogh, Cees M.P.M.

AU - Maier, Andrea B.

AU - Lobbezoo, Frank

PY - 2018/12

Y1 - 2018/12

N2 - Objectives: The aim of this study was to examine and compare the oral function of older people with mild cognitive impairment (MCI) or dementia. Methods: This cross-sectional observational study included participants with MCI or dementia aged 60 years or older. Global cognitive functioning was evaluated with the Mini Mental State Examination (MMSE) and the oral function was evaluated with subjective and objective assessments, including the perceived quality of chewing and swallowing, the function of the prostheses, the number of occluding pairs (OP), the degree of tooth wear and the active and passive maximum mouth opening. Results: The quality of chewing and swallowing was perceived as good in, respectively, 86.0% and 90.9% of the participants. Full or partial prostheses were worn by 63.8% of the participants, and the retention was good in 58.4% of the upper and 50.0% of the lower prostheses. Participants with MCI had a median of 3.0 (Inter Quartile Range [IQR] 0.0-7.5) occluding pairs, while participants with dementia had a median of 0.0 (IQR 0.0-1.0) occluding pairs, U = 3838.50, P < 0.001. There was a weak positive correlation between the number of occluding pairs and the MMSE score, r = 0.267, also when adjusted for age, r = 0.230. The median tooth wear score was 2.0 (IQR 2.0-2.0) in participants with MCI or dementia. The active maximum mouth opening was 45.8 (SD 9.3) mm in participants with dementia, while it was 49.8 (SD 8.1) mm in those with MCI, t(253) = 2.67, P = 0.008. Conclusion: For most participants with MCI or dementia, the swallowing ability and chewing ability were perceived as good. In addition, more than half of the prostheses had good retention and occlusion. Participants with more severe cognitive impairment had fewer occluding pairs and a smaller active mouth opening. The degree of tooth wear was less than one-third of the clinical crown in most participants with MCI or dementia.

AB - Objectives: The aim of this study was to examine and compare the oral function of older people with mild cognitive impairment (MCI) or dementia. Methods: This cross-sectional observational study included participants with MCI or dementia aged 60 years or older. Global cognitive functioning was evaluated with the Mini Mental State Examination (MMSE) and the oral function was evaluated with subjective and objective assessments, including the perceived quality of chewing and swallowing, the function of the prostheses, the number of occluding pairs (OP), the degree of tooth wear and the active and passive maximum mouth opening. Results: The quality of chewing and swallowing was perceived as good in, respectively, 86.0% and 90.9% of the participants. Full or partial prostheses were worn by 63.8% of the participants, and the retention was good in 58.4% of the upper and 50.0% of the lower prostheses. Participants with MCI had a median of 3.0 (Inter Quartile Range [IQR] 0.0-7.5) occluding pairs, while participants with dementia had a median of 0.0 (IQR 0.0-1.0) occluding pairs, U = 3838.50, P < 0.001. There was a weak positive correlation between the number of occluding pairs and the MMSE score, r = 0.267, also when adjusted for age, r = 0.230. The median tooth wear score was 2.0 (IQR 2.0-2.0) in participants with MCI or dementia. The active maximum mouth opening was 45.8 (SD 9.3) mm in participants with dementia, while it was 49.8 (SD 8.1) mm in those with MCI, t(253) = 2.67, P = 0.008. Conclusion: For most participants with MCI or dementia, the swallowing ability and chewing ability were perceived as good. In addition, more than half of the prostheses had good retention and occlusion. Participants with more severe cognitive impairment had fewer occluding pairs and a smaller active mouth opening. The degree of tooth wear was less than one-third of the clinical crown in most participants with MCI or dementia.

KW - aged

KW - cognitive dysfunction

KW - deglutition

KW - dental prosthesis

KW - dentures

KW - geriatric dentistry

KW - mastication

KW - neurocognitive disorder

KW - oral health

KW - temporomandibular joint

KW - tooth wear

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Oral function of older people with mild cognitive impairment or dementia

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