Journal of Preventive Medicine and Public Health

Original Articles

Mediating Effect of Cognitive Function on the Relationship Between Geriatric Oral Health and Quality of Life Among Korean Seniors: Eun Jee Chang, Hyun-Jae Woo, Kyu-Hyoung Jeong; J Prev Med Public Health. 2022;55(1):106-113. Published online January 12, 2022; DOI: https://doi.org/10.3961/jpmph.21.536

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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.

Summary

Korean summary
본 연구는 2018년도 7차 한국고령화연구패널조사(KLoSA) 자료를 이용하여 65세 이상 노인4,049명을 대상으로 노인 구강건강 수준(GOHAI, Geriatric Oral Health Assessment Index)이 삶의 질에 미치는 영향을 확인하였다. 또한 K-MMSE(Korean Mini-Mental State Examination) 점수를 매개변수로 활용하여 인지기능을 시간 및 장소 지남력, 기억등록, 주의집중 및 계산력, 기억회상, 언어 및 시공간 구성력의 5가지 하위영역의 다중매개효과를 분석하였다. 그 결과, 노인의 구강건강은 삶의 질과 인지기능의 모든 하위영역에 영향을 미치는 것으로 나타났으며, 특히 인지기능 하위영역 중 주의집중 및 계산력, 기억회상, 언어 및 시공간 구성력이 구강건강과 삶의 질의 관계에서 유의한 매개효과를 보였다. 향후 노인의 삶의 질을 악화하는 주요 질환인 치주질환 및 구강건조증 등을 예방할 수 있도록 국가 차원의 구강보건사업을 확대하고, 인지기능 하위영역별 저하 양상에 따라 세분화된 약물적/비약물적 중재를 시행해야 한다.

Citations

Citations to this article as recorded by

Association of Denture Use and Chewing Ability with Cognitive Function Analysed Using Panel Data from Korea Longitudinal Study of Aging (2006–2018)
Nu-Ri Jun, Jae-Hyun Kim, Jong-Hwa Jang
Healthcare.2023; 11(18): 2505. CrossRef

Association Between Dental Implants and Cognitive Function in Community-dwelling Older Adults in Korea: Seungkook Ki, Jihye Yun, Jinhee Kim, Yunhwan Lee; J Prev Med Public Health. 2019;52(5):333-343. Published online September 20, 2019; DOI: https://doi.org/10.3961/jpmph.19.163

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to evaluate the association between dental implants and cognitive function in community-dwelling older adults.
Methods
Data were collected from the baseline survey (2016-2017) of the Korean Frailty and Aging Cohort Study. The study sample comprised 1115 community-dwelling people aged 70 years to 84 years who had 0-19 natural teeth. Dental implants and natural teeth were identified by panoramic radiography, while the cognitive function was assessed by the Korean version of the Mini-Mental State Examination (MMSE-KC). The association between dental implants and cognitive function was analyzed by multiple linear regression. Sensitivity analysis was performed to test for potential bias.
Results
The mean number of natural teeth in the study population was 9.50 (standard deviation [SD], 6.42), and the mean MMSE-KC score was 24.93 (SD, 3.55). In the simple univariate analysis, tooth replacement, age, sex, smoking status, alcohol consumption, body mass index, osteoporosis, number of natural teeth, periodontitis, chewing discomfort, tooth-brushing frequency, education level, monthly household income, participation in economic activity, living alone, and marital status had a significant impact on the association. After adjusting for confounders, the association between dental implants and cognitive function remained significant (B, 0.85; standard error, 0.40; p<0.05). Age, body mass index, periodontitis, tooth-brushing frequency, and education level were also significantly associated with cognitive function. The results of the sensitivity analyses were consistent with those of the primary analysis.
Conclusions
Dental implants were associated with cognitive function in older adults living in the community. Dental implants as tooth replacements may play a role in preserving cognitive function.

Summary

Korean summary
임플란트 내지 임플란터블 디바이스는 생활 양식에 미치는 영향이 적고 직접적인 행동이나 복잡한 기술을 덜 필요로 하므로 임플란트는 라이프스타일 변경보다 더 수정성이 있는 효과적인 개입이 될 수 있다. 이 연구에서는 임플란터블 디바이스의 일종인 치아 임플란트와 인지 기능 사이의 관계를 조사하였다. 연구 결과 70세 이상의 지역사회 거주 노인에 있어 치아 탈락의 치료로서 치아 임플란트가 인지 기능과 연관성이 있음을 보여주었다. 치아 임플란트는 인지 예비능력의 보존에 기여하는 것으로 생각되며, 지역 사회 거주 노인에서 인지 저하의 예방으로서 치아 임플란트 치료를 충분히 고려해볼 수 있을 것이다.

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Dental implant considerations in patients with systemic diseases: An updated comprehensive review
Seyed Ali Mosaddad, Sahar Talebi, Seied Omid Keyhan, Hamid Reza Fallahi, Mohammad Darvishi, Seyedeh Sara Aghili, Narges Tavahodi, Reza Abdollahi Namanloo, Artak Heboyan, Amirhossein Fathi
Journal of Oral Rehabilitation.2024;[Epub] CrossRef
Oral health and risk of cognitive disorders in older adults: A biannual longitudinal follow‐up cohort
Keun‐Suh Kim, Soyeon Ahn, Ji Won Han, Sang Hyun Cho, Jung‐Tae Lee, Hyo‐Jung Lee, Ki Woong Kim
Journal of Oral Rehabilitation.2023; 50(9): 792. CrossRef
Assessment and Improvement of Masticatory Performance in Frail Older People: A Narrative Review
Martin Schimmel, Noemi Anliker, Gabriela Panca Sabatini, Marcella Silva De Paula, Adrian Roman Weber, Pedro Molinero-Mourelle
Journal of Clinical Medicine.2023; 12(11): 3760. CrossRef
Impact of Denture Prostheses on Cognitive Functioning in Completely Edentulous Patients: A Pilot Study
Syed Ershad Ahmed, Ramesh Raju, Anjana Kurien, Kanaha M, Sidra Bano, Hemcle Shalma
Cureus.2023;[Epub] CrossRef
Tooth Loss-Associated Mechanisms That Negatively Affect Cognitive Function: A Systematic Review of Animal Experiments Based on Occlusal Support Loss and Cognitive Impairment
Xiaoyu Wang, Jiangqi Hu, Qingsong Jiang
Frontiers in Neuroscience.2022;[Epub] CrossRef
Selenium attenuates the association of co-exposure to arsenic, cadmium, and lead with cognitive function among Chinese community-dwelling older adults
Bei-Jing Cheng, Jie Sheng, Hong-Li Wang, Yuan Wang, Hong-Juan Cao, Xiu-De Li, Ting-Ting Zhou, Xiang-Long Meng, Huan-Huan Nie, Su-Fang Wang, Dong-Mei Zhang, Gui-Mei Chen, Fang-Biao Tao, Lin-Sheng Yang
Environmental Science and Pollution Research.2022; 30(13): 36377. CrossRef
The association of marital status with cognitive function and the role of gender in Chinese community-dwelling older adults: a cross-sectional study
Pei-ru Xu, Rong Wei, Bei-jing Cheng, A-jun Wang, Xiu-de Li, Huai-biao Li, Liang Sun, Jing Du, Jie Sheng, Kai-yong Liu, Fang-biao Tao, Lin-sheng Yang
Aging Clinical and Experimental Research.2021; 33(8): 2273. CrossRef
Osteoimmunology drives dental implant osseointegration: A new paradigm for implant dentistry
Luis Amengual-Peñafiel, Luis A. Córdova, M. Constanza Jara-Sepúlveda, Manuel Brañes-Aroca, Francisco Marchesani-Carrasco, Ricardo Cartes-Velásquez
Japanese Dental Science Review.2021; 57: 12. CrossRef
Influence of Dental Prostheses on Cognitive Functioning in Elderly Population: A Systematic Review
Syed Ershad Ahmed, Jayashree Mohan, Parithimar Kalaignan, Saravanan Kandasamy, Ramesh Raju, Bharath Champakesan
Journal of Pharmacy and Bioallied Sciences.2021; 13(Suppl 1): S788. CrossRef

English Abstracts

Apolipoprotein E Polymorphism and Cognitive Function Change of the Elderly in a Rural Area, Korea.: Sang Kyu Kim, Tae Yoon Hwang, Kyeong Soo Lee, Pock Soo Kang, Hee Soon Cho, Young Kyung Bae; J Prev Med Public Health. 2009;42(4):261-266.; DOI: https://doi.org/10.3961/jpmph.2009.42.4.261

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Abstract PDF

OBJECTIVES
The aim of this study is to examine the cognitive function change related to aging, the incidence of cognitive impairment, and the association between apolipoprotein E polymorphism and cognitive impairment through a follow-up of the elderly with normal cognitive ability at baseline. METHODS: Two hundred and fifteen subjects aged 65 and over were surveyed in February, 1998 (baseline survey), and their cognitive function was assessed again in 2003 (1st follow-up) and the once again in 2006 (2nd follow-up). Ninety one subjects completed all surveys up through the 2nd follow-up and their cognitive function scores using MMSE-K (Korean Version of the Mini-Mental State Examination) and the distribution of apolipoprotein E allele were analyzed. RESULTS: The cognitive function scores decreased with aging and the difference between baseline and the 2nd follow-up scores of the study increased with the age group. The incidence rate of cognitive impairment through an 8-year follow-up was 38.5% and higher in older age groups. Age was the only significant factor for incidence of cognitive impairment, but there was no significant association between apolipoprotein E genotype and incidence of cognitive impairment. CONCLUSIONS: The cognition of the elderly decreased with aging and the association of apolipoprotein E genotype with incidence of cognitive impairment was not significant in this study. To confirm the association between apolipoprotein E polymorphism and incidence of cognitive impairment further studies will be needed.

Summary

Citations

Citations to this article as recorded by

ApoE Type 4 Allele Affects Cognitive Function of Aged Population in Tianjin City, China
Shoudan Sun, Jingming Fu, Jun Chen, Wei Pang, Ruomei Hu, Haiqiang Li, Long Tan, Yugang Jiang
American Journal of Alzheimer's Disease & Other Dementiasr.2015; 30(5): 503. CrossRef

Change of Cognitive Function and Associated Factors among the Rural Elderly: A 5-Year Follow-up Study.: Sang Kyu Kim, Pock Soo Kang, Tae Yoon Hwang, Joon Sakong, Kyeong Soo Lee; J Prev Med Public Health. 2007;40(2):162-168.; DOI: https://doi.org/10.3961/jpmph.2007.40.2.162

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Abstract PDF

OBJECTIVES
This prospective population-based cohort study was conducted to evaluate the risk factors of cognitive impairment and the degree of cognitive function change through a 5-year follow-up. METHODS: The baseline and follow-up surveys were conducted in 1998 and 2003, respectively. Among 176 subjects who had normal cognitive function in the baseline study, 136 were followed up for 5 years. The cognitive function was investigated using the Korean version of the Mini-Mental State Examination (MMSE-K). The collected data were analyzed using SPSS and Stata. RESULTS: Of the 136 subjects analyzed, 25 (18.4%) were cognitively impaired. Old age and low social support in the baseline survey were risk factors for cognitive impairment after 5 years. In the generalized estimating equation for 128 subjects except severe cognitive impairment about the contributing factors of cognitive function change, the interval of 5 years decreased MMSE-K score by 1.02 and the cognitive function was adversely affected with increasing age, decreasing education and decreasing social support. CONCLUSIONS: Although the study population was small, it was considered that the study results can be used to develop a community-based prevention system for cognitive impairment.

Summary

Citations

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Status of Physical and Mental Function and, Its Related Factors Among the Elderly People Using from Long-Term Care Insurance Service
Nam-Kyou Bae, Young-Soo Song, Eun-Sook Shin, Young-Chae Cho
Journal of the Korea Academia-Industrial cooperation Society.2012; 13(12): 5976. CrossRef
Toxicities and functional consequences of systemic chemotherapy in elderly Korean patients with cancer: A prospective cohort study using Comprehensive Geriatric Assessment
Dong-Yeop Shin, Jeong-Ok Lee, Yu Jung Kim, Myung-Sook Park, Keun-Wook Lee, Kwang-Il Kim, Soo-Mee Bang, Jong Seok Lee, Cheol-Ho Kim, Jee Hyun Kim
Journal of Geriatric Oncology.2012; 3(4): 359. CrossRef
Apolipoprotein E Polymorphism and Cognitive Function Change of the Elderly in a Rural Area, Korea
Sang-Kyu Kim, Tae-Yoon Hwang, Kyeong-Soo Lee, Pock-Soo Kang, Hee-Soon Cho, Young-Kyung Bae
Journal of Preventive Medicine and Public Health.2009; 42(4): 261. CrossRef

Original Articles

Prevalence Rate of Cognitive Impairment and Dementia Among the Elderly in Busan.: Jung Soon Kim, Su Ill Lee, Ihn Sook Jeong, Young In Chung, In Kyung Hwang, Bong Sook Yih, Min Jeong Kim, Eu Soo Cho, Jin Ho Chun; Korean J Prev Med. 2003;36(1):63-70.

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Abstract PDF: OBJECTIVES
To investigate the prevalence of cognitive impairment and dementia in elderly people, aged 65 or above, residing in Busan Metropolitan City. METHODS: Total of 1, 101 old people, aged 65 or above, living in Busan as of December 31, 2001 were selected using stratified three-stage cluster sampling. Cognitive impairment was determined from the MMSE-K score, and dementia confirmed from five psychometric measures and the Barthel index. The crude prevalence, sex-age adjusted for the Korean population, were obtained. RESULTS: With the cut-off point for cognitive impairment was set at 24 points, or below, on the MMSE-K scale, the crude rate of cognitive impairment was 29.3% (15.7% for men and 37.5% for women), and the sex-age adjusted prevalence was 30.5% (17.5% for men and 37.0% for women). When the cut-off point for cognitive impairment was set at 20 points, or below, on the MMSE-K scale, the crude rate of cognitive impairments were 10.0% (4.1% for men and 13.5% for women), and 10.6% (4.7% for men and 13.1% for women), respectively. The crude dementia, and the sex-age adjusted rates were 7.4% (2.4% for men and 10.5% for women), and 8.0% (2.7% for men and 10.0% for women), respectively. CONCLUSIONS: The prevalence of dementia in this study was somewhat lower than that reported by other domestic and foreign studies. Our results related to the difference in time and space, diagnostic tools, response rates, and distribution of male and female subjects, etc.; Summary

Coal Miners' Recognition and Attitude toward Pneumoconiosis in Kangneung Area.: Ho Keun Chung, Kyung Yong Rhee; Korean J Prev Med. 1988;21(2):251-266.

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Abstract PDF: This study was planned in order to investigate coal miners' recognition and attitude toward pneumoconiosis, and its relationship with related behavior for prevention of pneumoconiosis. Study object was coal miners in Kangneung area, sampled by multistage random proportional sampling, Sample size was 13% of total coal miners in Kangneung area. The results were divided into three parts: (1) descriptive results presented percent distribution, (2) reclassification of knowledge, experiences, and attitude by factor analysis, (3) prediction of health behavior for prevention of pneumoconiosis by discriminant analysis. Knowledge, experiences, and attitude toward pneumoconiosis were classified into nine factors. Knowledge about pneumoconiosis were broken down to two factors and attitude to four factors, and valence, perceived severity were classified into each one factor. According to demographic, socioeconomic characteristics, and factors of knowledge, experiences, attitude about pneumoconiosis, about 62% of behavior of wearing respiratory protector was correctly discriminated. And by the same methods, about 81% of behavior of hospital visit at respiratory symptoms; cough, sputum, chest pain etc. was discriminated correctly.; Summary

Association of Dietary Factors with Cognitive Impairment in Older Women.: Jin Hee Kim, Yunhwan Lee, Geunshik Han; J Prev Med Public Health. 2004;37(2):174-181.

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Abstract PDF: OBJECTIVE
To examine the association between dietary factors and cognitive impairment in older Korean women living in the community. METHODS: Wave 2 data, from the Suwon Longitudinal Aging Study (SLAS), of 365 women aged 65 years or over, were used. The Korean version of the 30-point Mini-Mental State Examination (MMSE-K) was used to assess cognitive impairment (score< = or19). Dietary habits and frequencies of food group consumption were also examined. RESULTS: A total of 67 women (18.4%) were found to be cognitively impaired. In bivariate analyses, nondietary factors, such as age, marital status, education, income, self-rated health, depression, emotional support, social activity, exercise, and dietary factors, such as self-rated nutritional status, frequency of beans and bean products and milk and dairy products consumption were associated with cognitive impairment. In the multivariate analysis, a higher frequency ( > = or 1 vs. < 1 time/day) of beans and bean products (OR=0.48, 95% CI: 0.23-0.99) and milk and dairy products (OR=0.25, 95% CI: 0.10-0.61) consumption was inversely associated with cognitive impairment, after adjustment for non-dietary factors. CONCLUSION: These results suggest that dietary factors may play a significant role in cognitive impairment of older Korean women.; Summary

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