• Journal of Korean society of Dental Hygiene
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• v.19 no.1
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• pp.65-78
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• 2019

Objectives: This study was conducted to characterize the impact of cognitive function and oral health status on mastication in senior citizens, ${\geq}65$ years of age, using senior centers in the city of Wonju, South Korea. Methods: A cross-sectional study consisting of a simple oral examination and survey questionnaires was performed in 154 individuals. General characteristics, subjective masticatory function, objective masticatory function, cognitive function, and oral health status were collected as variables. Correlation and multiple linear regression analyses were conducted. A p-value of <0.05 was considered to be statistically significant. Results: The subjective masticatory function was scored using the 5-point Likert scale. When subjective masticatory function was analyzed in groups according to cognitive function, the mean subjective masticatory function scores were 4.31, 4.09, and 3.29 in the normal group (cognitive score of ${\geq}16$), suspected dementia group (cognitive score of 1215), and mild dementia group (cognitive score of ${\leq}11$), respectively. Thus, subjective masticatory function decreased along with decreasing cognitive function. When cognitive function, subjective masticatory function, and objective masticatory function were compared with indicators of oral health status (number of functional teeth, oral dryness), subjective masticatory function exhibited a significant positive correlation with objective masticatory function (r=0.635, p<0.01), cognitive function (r=0.292, p<0.01), and total number of functional teeth, including prosthetic appliances (dentures) (r=0.305, p<0.01). According to the regression analysis, age, sex, number of functional teeth, and cognitive function affected subjective masticatory function. Conclusions: The results of this study revealed that age, sex, number of functional teeth, and cognitive function affected subjective masticatory function, whereas oral dryness did not. Therefore, dental professionals must consider subjective masticatory function when providing oral care in senior patients with low cognitive function.

• Journal of Korean society of Dental Hygiene
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• v.15 no.2
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• pp.217-223
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• 2015

Objectives: The purpose of this study is to investigate cognitive function, performance of activities of daily living, and recognition on oral health with the cognitive function testto dementia or dementia-suspected patients in the outpatients. Methods: The subjects were 94 dementia or dementia-suspected patients visiting C University hospital for the dementia test. Study instruments included Korea Mini-Mental State Examination KMMS, The Bayer-Activities of Daily Living Scale; B-ADL, Seoul-Instrumental Activities of Daily Living; S-IADL, Global Deterioration Scale; GDS, Korean Dementia Screening Questionnaire; KDSQ, and underlying diseases. Results: Dementia or dementia-suspected patients were 42 by KMMSE test, 25 patients had impaired functioning of daily living by B-ADL test, 27 patients showed the presence of depression by GDS test, and 45 patients showed impaired functioning of daily living. There was a statistically significant difference in the subjective recognition on oral health conditions. There was a statistically significant difference in the subjective recognition on oral health conditions by ADL. There was a positive correlation between the cognitive function and ADL performance. Higher cognitive function is proportional to ADL performance. Conclusions: The cognitive function was closely associated with ADL and subjective oral health conditions.

• Journal of dental hygiene science
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• v.22 no.2
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• pp.67-74
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• 2022

Background: Depression and cognitive function have a positive effect on the improvement of quality of life and extension of lifespan in the elderly. In addition, it appears as a major factor influencing oral health status. Therefore, this study looked at the relationship between the Geriatric Oral Health Assessment Index (GOHAI), depression, and cognitive function in the elderly using the Korea Longitudinal Study of Aging. Methods: In this study, 4,535 elderly people aged 65 years and over were targeted using the 7th data of the 2018 Korea Longitudinal Study of Aging. A t-test and ANOVA analysis were performed to compare GOHAI, depression, and cognitive function by group. In addition, hierarchical multiple linear regression was performed to understand the effect of the elderly's perceived depression scale and cognitive ability on GOHAI. Results: As a result of adding the depression scale and cognitive function variables to Model 2, the explanatory power was 22%. Educational level, marital status, private health insurance subscription, average monthly allowance, subjective health status, use of dentures, smoking status, economic activity, depression scale, and cognitive function were found to have significant influence (p<0.05). In addition, when controlled and viewed with all factors, depression and cognitive function were found to have an effect on oral health-related quality of life. Conclusion: The findings indicate that depression and cognitive function are associated with oral health-related quality of life in the Korean elderly. As the age increases, the quality of life declines due to depression and cognitive function problems, in addition to oral discomfort, eating disorders, and physical discomfort.

• The Journal of the Korean dental association
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• v.56 no.4
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• pp.218-230
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• 2018

According to the burst of aged people, researchers have focused on aging-related diseases. Cognitive impairment including Alzheimer's disease (AD), one of the representative diseases related to aging, has no treatment option until now. Recently, it has been revealed that systemic inflammation plays a fundamental role in the pathogenesis of AD. Previous studies have suggested the association between poor oral health and cognitive impairment. Poor oral health can cause dental caries, chronic periodontitis, multiple tooth loss, and poor chewing ability, etc. Especially, periodontitis is a well-known chronic inflammatory disease and affects cognitive impairment directly and indirectly by inflammatory products mediators. Therefore, reduction of pathogenic microbial burden and inflammatory products by treating periodontitis can be a therapeutic modality to prevent cognitive impairment or to slow down the progression of it. Future studies are necessary to elucidate the causal relations and plausible mechanisms between poor oral health and cognitive impairment.

• Journal of Korean society of Dental Hygiene
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• v.22 no.5
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• pp.333-340
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• 2022

Objectives: This study aimed to confirm the association between cognitive function and oral health status in the elderly. Methods: In this study, 5,794 respondents, aged 55 or older, who had participated in the 7th aging research panel survey were used. Statistical analyses were performed using a complex samples cross-tabulation analysis, complex samples general linear model, and a complex sample multinomial logistic regression analysis. Results: After analyzing the cognitive function of the elderly according to their oral health conditions, it was found that suspicions of dementia (19.6%) and cognitive function decline (25.9%) were more common for those who wore dentures than for those who did not wear dentures (p<0.001). Compared to those who did not wear dentures, those who wore dentures were linked to a 1.665 times higher suspicion of dementia (p<0.001). In comparison, cognitive decline was 0.964 times lower when the number of natural teeth increased by 1, and it was 0.941 times lower when the oral health evaluation index for the elderly increased by 1 point (p<0.001). Conclusions: As a result of this study, it was confirmed that cognitive function and oral health status are related in the elderly. Therefore, systematic measures for oral health management and oral health promotion should be prepared in tandem with awareness of possible cognitive decline in the elderly.

• Journal of Korean society of Dental Hygiene
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• v.23 no.1
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• pp.43-53
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• 2023

Objectives: We developed an integrated cognitive function improvement program comprising cognitive, emotional, and physical domains, and remotely applied it to middle-aged adults to investigate its effects on oral health, cognitive function, and mental health improvement. Methods: The experimental group underwent the program remotely, using the Zoom platform. A total of 24 participants were recruited and divided into 12 experimental and 12 control groups. The program comprised cognitive, emotional, and physical activities. The sessions lasted 90 min and were performed twice a week for 6 weeks from April to May 2022. Results: Cognitive function, arousal, physical, and mental stress were significantly improved in the experimental group after the intervention than at the baseline (p<0.05). Regarding oral health, tongue plaque decreased 1.34-fold (p<0.01) and saliva increased 1.04-fold (p<0.05) in the experimental group after the intervention than at the baseline. Moreover, the experimental group showed significant improvements in tongue plaque and saliva than the control group (p<0.05 for tongue plaque and p<0.01 for saliva). Regarding mental health, social support significantly increased 11.67-fold (p<0.05) in the experimental group than at the baseline. The experimental group also showed significantly improved social support than the control group (p<0.01). Conclusions: The non-face-to-face integrated cognitive function improvement program for middle-aged adults improved their cognitive function and oral and mental health. Based on these findings, this program may be a useful health program tool for middle-aged individuals.

• Journal of Preventive Medicine and Public Health
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• v.55 no.1
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• pp.106-113
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• 2022

Objectives: Previous studies have found that the oral health of seniors can affect their physical nutrition and quality of life (QoL). Additionally, poor oral health can lead to the development of dementia, which is associated with decreased cognitive function. This study aimed to examine the impact of geriatric oral health (GOH) on the QoL of Korean seniors and the mediating effects of cognitive function. Methods: We used data from the seventh Korean Longitudinal Study of Aging conducted in 2018. In total, 4049 seniors were included in our study. We analyzed the impact of GOH on QoL according to 5 mediating domains of cognitive function and control variables. To examine each path of mediating effects, bootstrapping with 5000 iterations was performed with 95% confidence intervals. Results: Our findings revealed that good GOH had a positive effect on the QoL of seniors. Also, better GOH corresponded to a higher degree of cognitive function within all 5 domains: orientation, memory registration, attention/calculation, memory recall, and language and visuospatial ability. In addition, 3 domains of the 5 domains (attention/calculation, memory recall, and language and visuospatial ability) had significant mediating effects on the relationship between GOH and QoL. Conclusions: This study suggests that adequate management of GOH is crucial for promoting a better QoL and a high degree of cognitive function among seniors. To prevent cognitive impairment, such as dementia, future studies should take a more targeted approach by examining data according to each cognitive domain and various socio-demographic factors.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.1
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• pp.11-14
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• 2011

Individuals with cognitive disabilities face many barriers to oral care, often suffering from partial or complete edentulism. While the use of implant reconstruction is becoming more common in general population, such care is still being used infrequently in individuals with intellectual impairment. Because of the patients'oral hygiene practice is poor, special need is required for prosthetic design. These two cases were restored by prostheses using implants. Prosthetic modalities were different but the implants were fully osseointegrated, presenting satisfactory functional and esthetic conditions without clinical or radiographic signs of alterations or pathologies. We report that it is good for cognitive disabilities to give prosthetic treatment using implants.

• Journal of Korean Academy of Oral Health
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• v.42 no.4
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• pp.159-166
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• 2018

Objectives: The aim of this study was to investigate the association between masticatory ability, oral health-related quality of life, and cognitive function in an elderly population using structural equation modeling. Methods: A total of 308 subjects, aged 65 years and over, were recruited from the senior citizen center in Daegu, South Korea and provided consent for inclusion in the study. The Korean version of the Mini-Mental State Examination (K-MMSE) was used to assess the level of cognitive function. Masticatory ability was evaluated through chewing tests, patient-perceived masticatory function and, measurement of relative occlusal forces on molar teeth using the T-Scan $III^{(R)}$ system. All data were analyzed using ${\chi}^2$ tests, t-tests, and one-way ANOVA in SPSS version 23.0 for windows. Structural equation modeling was performed using SPSS AMOS version 22.0. Results: There was a significant association between cognitive function and molar teeth occlusal force. Ability of food chewing score and patient-perceived masticatory function could affect oral health-related quality of life (P>0.05). Higher occlusal forces on molar teeth, compared to anterior teeth, positively correlated with higher cognitive function. Conclusions: These results suggest that an individual's oral health condition could affect molar teeth occlusal forces and may be related to a risk of developing dementia. Therefore, there is a need for implementing nation-wide policies to improve oral health, such as masticatory function, in the elderly population.

• Journal of dental hygiene science
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• v.19 no.4
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• pp.245-253
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• 2019

Background: This study aimed to analyze correlations between depression, cognitive function, oral health state, ability to perform activities of daily living, oral dryness symptoms, and oral health-related quality of life, and determine factors influencing the latter. Methods: This was a cross-sectional study based on questionnaires completed by 260 participants with suspected dementia, residing in South Korea. Psychiatrists, psychiatric nurses, and dental hygienists visited clinics in the participating regions for examination and questionnaire administration. General characteristics, the geriatric depression scale, ability to perform activities of daily living, cognitive function, oral health state, and oral health-related quality of life were analyzed. Independent t-tests, one-way analysis of variance (ANOVA), correlation analysis and multiple regression analysis were conducted, identifying factors affecting oral health-related quality of life. Data analysis was performed using SPSS ver. 20.0 (IBM Corp., USA), and the significance was set at p<0.05. Results: Approximately 65.0% of participants were female, 63.5% were in their 70s, and 90.0% had health insurance. About 21.5%, 42.0%, and 36.5% were normal, slightly impaired, and had dementia, respectively. High cognitive impairment was associated with poor oral health. Sex, education levels, marital status, and living arrangements influenced oral health-related quality of life. According to the regression analysis, geriatric depression and oral dryness affected the Geriatric Oral Health Assessment Index scores. Conclusion: In conclusion, oral dryness and depression levels among elders influenced oral health-related quality of life. The results showed that to enhance elders' oral health-related quality of life, it is essential to not only improve their oral health state, but also relieve oral health problems, especially oral dryness, and take into consideration their psychological aspects.