社区老年人口腔功能不全与轻度认知障碍的相关性

A study of the correlation between oral insufficiency and mild cognitive impairment in community-dwelling older adults

目的应用口腔功能不全的评估指标探讨口腔功能与轻度认知障碍(MCI)的关联。方法采用横断面调查设计,于2021年7月采用方便抽样法选取居住在3个不同社区(长沙市芙蓉区识字岭社区、文艺新村社区、窑岭社区)的受试者作为研究对象,采用简易精神状态量表(MMSE)-2与口腔功能不全的7项评估指标(口腔清洁度、口腔干燥度、咬合力、口唇舌运动能力、舌压、咀嚼能力和吞咽功能)对受试者的认知功能与口腔功能进行测定。结果本研究共纳入144例受试者,其中男性72例(50.00%)。除教育程度外,MCI组与认知正常组在人口学信息、自我报告与测定的口腔功能等指标上的差异均无统计学意义(均P>0.05)。受试者自我报告的口腔功能与实际测定的口腔功能具有一定的相关性。多元线性回归分析结果显示,MMSE得分与上述7项评估指标测量值的关联均不具有统计学意义(均P>0.05)。女性组MMSE得分与咀嚼能力呈负相关(β=-0.003,P=0.043),小学文化水平受试者的MMSE得分与咀嚼能力呈负相关(β=-0.022,P=0.016),中学文化水平受试者的MMSE得分与残齿数量呈正相关(β=0.090,P=0.030)。结论受试者自我报告的口腔功能可用于粗略评估口腔功能状态,在口腔功能未显著减退的老年人群中,口腔功能与MCI未呈现出明显相关,需进行大样本试验与更细致的亚组分析来进行MCI的筛查指标研究。

Objective To investigate the relationship between oral health and mild cognitive impairment(MCI)by using indicators that evaluate oral hypofunction.Methods The study was conducted using a cross-sectional design.Participants were recruited from three communities(Shizi Ling,Wenyi Xincun,and Yaoling in Furong District)in Changsha in July 2021,using convenience sampling.Cognitive and oral functions were evaluated using the simple mental state examination,version 2(MMSE-2)and seven indicators of oral hypofunction,which included oral hygiene,oral dryness,occlusal force,tongue and lip movement,tongue pressure,mastication,and swallowing function.Results A total of 144 subjects were included in this study,with 72 males.Except for education level,there were no statistically significant differences between the MCI group and the normal cognitive group in terms of demographic information and self-reported and measured oral functions(all P>0.05).There was a correlation between the subjects'self-reported oral function and the actual measured oral function.Multiple linear regression analysis revealed no significant correlation between the MMSE score and the seven indicators used to measure oral hypofunction(all P>0.05).The MMSE score of the female group showed a negative correlation with mastication(β=-0.003,P=0.043),while the MMSE score of subjects with elementary school education also showed a negative correlation with mastication(β=-0.022,P=0.016).Additionally,the MMSE score of subjects with middle school education showed a positive correlation with the number of residual teeth(β=0.090,P=0.030).Conclusions The self-reported oral function can serve as an initial assessment of overall oral function.However,among elderly individuals who do not show significant decline in oral function,there was no significant correlation between oral function and MCI.To accurately identify individuals with MCI,a more detailed sub-analysis with a larger sample size is required.