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Cognitive Function and Oral Health Status in Stroke Patients
Int J Clin Prev Dent 2018;14(1):35-40
Published online March 31, 2018;  https://doi.org/10.15236/ijcpd.2018.14.1.35
© 2018 International Journal of Clinical Preventive Dentistry.

Ja-Young Moon1, Seon-Ju Sim2

1Department of Rehabilitation Medicine, College of Medicine, Konyang University, Daejeon, 2Department of Dental Hygiene, Baekseok University, Cheonan, Korea
Correspondence to: Seon-Ju Sim
Department of Dental Hygiene, Baekseok University, 76 Munam-ro, Dongnam-gu, Cheonan 31065, Korea. 
Tel: +82-41-550-2311, Fax: +82-41-550-2829, E-mail: vision1991@bu.ac.kr
Received February 12, 2018; Revised March 22, 2018; Accepted March 23, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objective: Some evidences suggest that tooth loss may be associated with stroke, at the same time, with cognitive impairment. So, we investigated the association between tooth loss and cognitive impairment in stroke patients.Methods: In a cross-sectional study, 251 stroke patients attacked within the latest 1 year, were surveyed for oral health status including the periodontitis and the number of remaining tooth. Subjects aged between 40 and 79 years. 41.8% of the participants were female, mean age was 58.9±9.5 years. Questionnaires were focused on education, income, vascular risk factors (hypertension, diabetes mellitus, cardiac disease, hyperlipidemia), smoking and drinking habit, previous and present medication, and BMI (body mass index). All subjects were examined the number of teeth, and the presence of periodontitis. The Korean Mini-mental state examination (K-MMSE) was tested as a screening test for cognitive impairment by medical doctor.Results: Tooth loss was significantly associated with MMSE in multivariate analyses. The odds ratio (OR) was 1.75 (1.75- 3.13) with adjustment for age, sex, income, education, smoking, drinking, hypertension, diabetes mellitus (DM), heart disease, hyperlipidemia, BMI, family hypertension history, family DM history, family heart disease (p<0.05).Conclusion: Tooth loss was significantly associated with cognitive function in stroke patients. 
Keywords : tooth loss, oral health, stroke, cognition
References
  1. Gorelick PB. Stroke prevention therapy beyond antithrombotics: unifying mechanisms in ischemic stroke pathogenesis and implications for therapy: an invited review. Stroke 2002;33:862- 75.
    Pubmed CrossRef
  2. Hong KS, Bang OY, Kang DW, Yu KH, Bae HJ, Lee JS, et al. Stroke statistics in Korea: part I. Epidemiology and risk factors: a report from the Korean stroke society and clinical research center for stroke. J Stroke 2013;15:2-20.
    Pubmed CrossRef
  3. DeLisa JA, Gans BM, Walsh NE. Physical medicine and rehabilitation medicine: principles and practice. 4th ed. Philadelphia: Lippincott-Raven Publishers; 2004:1655-7.
  4. Joshipura KJ, Hung HC, Rimm EB, Willett WC, Ascherio A. Periodontal disease, tooth loss, and incidence of ischemic stroke. Stroke 2003;34:47-52.
    Pubmed CrossRef
  5. Dörfer CE, Becher H, Ziegler CM, Kaiser C, Lutz R, Jörss D, et al. The association of gingivitis and periodontitis with ischemic stroke. J Clin Periodontol 2004;31:396-401.
    Pubmed CrossRef
  6. Sim SJ, Jin BH, Kim HD, Paik DI. Association between oral health status and stroke. Int J Clin Prev Dent 2006;2:169-77.
  7. Stein PS, Scheff S, Dawson D III. Alzheimer’s disease and periodontal disease: mechanisms underlying a potential bi-directional relationship. Grand Rounds Oral-Sys Med 2006;1:14-24.
  8. Chalmers JM, Carter KD, Spencer AJ. Oral diseases and conditions in community-living older adults with and without dementia. Spec Care Dentist 2003;23:7-17.
    Pubmed CrossRef
  9. Kusdhany LS, Rahardjo TB, Agustin D, Masulili C, Lelyati S, Hogervorst E. Oral hygiene status and cognitive function in Indonesian elderly. Int J Clin Prev Dent 2015;11:261-4.
    CrossRef
  10. Slowik J, Wnuk MA, Grzech K, Golenia A, Turaj W, Ferens A, et al. Periodontitis affects neurological deficit in acute stroke. J Neurol Sci 2010;297:82-4.
    Pubmed CrossRef
  11. Kim JB, Choi YJ, Moon HS, Kim JB, Kim DK, Lee HS. Public oral health. 5th ed. Seoul: Komoonsa; 2015:1-5.
  12. Luchsinger JA, Mayeux R. Dietary factors and Alzheimer’s disease. Lancet Neurol 2004;3:579-87.
    CrossRef
  13. Kaye EK, Valencia A, Baba N, Spiro A 3rd, Dietrich T, Garcia RI. Tooth loss and periodontal disease predict poor cognitive function in older men. J Am Geriatr Soc 2010;58:713-8.
    Pubmed CrossRef
  14. Park H, Suk SH, Cheong JS, Lee HS, Chang H, Do SY, et al. Tooth loss may predict poor cognitive function in community-dwelling adults without dementia or stroke: the PRESENT project. J Korean Med Sci 2013;28:1518-21.
    Pubmed CrossRef
  15. Ballard C, Rowan E, Stephens S, Kalaria R, Kenny RA. Prospective follow-up study between 3 and 15 months after stroke: improvements and decline in cognitive function among dementia-free stroke survivors >75 years of age. Stroke 2003; 34:2440-4.
    Pubmed CrossRef
  16. Mok VC, Wong A, Lam WW, Fan YH, Tang WK, Kwok T, et al. Cognitive impairment and functional outcome after stroke associated with small vessel disease. J Neurol Neurosurg Psychiatry 2004;75:560-6.
    Pubmed CrossRef
  17. Zinn S, Dudley TK, Bosworth HB, Hoenig HM, Duncan PW, Horner RD. The effect of poststroke cognitive impairment on rehabilitation process and functional outcome. Arch Phys Med Rehabil 2004;85:1084-90.
    Pubmed CrossRef
  18. Donovan NJ, Kendall DL, Heaton SC, Kwon S, Velozo CA, Duncan PW. Conceptualizing functional cognition in stroke. Neurorehabil Neural Repair 2008;22:122-35.
    Pubmed CrossRef
  19. Nelson A, Fogel BS, Faust D. Bedside cognitive screening instruments. A critical assessment. J Nerv Ment Dis 1986;174: 73-83.
    Pubmed CrossRef
  20. Grace J, Nadler JD, White DA, Guilmette TJ, Giuliano AJ, Monsch AU, et al. Folstein vs modified Mini-Mental State Examination in geriatric stroke. Stability, validity, and screening utility. Arch Neurol 1995;52:477-84.
    Pubmed CrossRef
  21. Folstein MF, Folstein SE, Fanjiang G. MMSE, Mini-Mental State Examination. Lutz: Psychologyical Assessment Resources; 2001.
  22. Burt BA, Ismail AI, Morrison EC, Beltran ED. Risk factors for tooth loss over a 28-year period. J Dent Res 1990;69:1126-30.
    Pubmed CrossRef
  23. Kim KW, Park JH, Kim MH, Kim MD, Kim BJ, Kim SK, et al. A nationwide survey on the prevalence of dementia and mild cognitive impairment in South Korea. J Alzheimers Dis 2011; 23:281-91.
    Pubmed
  24. Noble JM, Borrell LN, Papapanou PN, Elkind MS, Scarmeas N, Wright CB. Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III. J Neurol Neurosurg Psychiatry 2009;80:1206-11.
    Pubmed CrossRef
  25. Batty GD, Li Q, Huxley R, Zoungas S, Taylor BA, Neal B, et al. Oral disease in relation to future risk of dementia and cognitive decline: prospective cohort study based on the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation (ADVANCE) trial. Eur Psychiatry 2013;28:49-52.
    Pubmed CrossRef


September 2018, 14 (3)