title: Tooth loss, chewing efficiency and cognitive impairment in geriatric patients.
abstract: BACKGROUND
  Patients with dementia have poorer oral health and fewer teeth than their peers without cognitive impairment.
  
  
  OBJECTIVE
  The hypothesis of this study is that the number of natural teeth and the chewing efficiency are associated with cognitive functioning.
  
  
  METHODS
  This cross-sectional study included 29 patients diagnosed with dementia aged 75 years or older and 22 controls who were either cognitively normal (n = 19) or with mild cognitive impairment (n = 3). Neuropsychological, nutritional and dental assessments were performed. The chewing efficiency was evaluated with a two-colour mixing test.
  
  
  RESULTS
  Demented patients and controls presented with a mean of 4.9 and 6.5 teeth, respectively (n.s.). The number of natural teeth was not associated with dementia (p = 0.553). Same results were found for age (p = 0.746) and sex (p = 0.901). The chewing efficiency by visual inspection proved worse in participants with dementia than in the controls (p < 0.011) and explained 9.3% of the variance in the diagnosis of dementia. Neither dental state nor chewing efficiency was related to the nutritional state.
  
  
  CONCLUSIONS
  Chewing efficiency seems stronger associated with cognitive impairment than the number of teeth. Hence, in a more holistic approach for the geriatric assessment, the dental examination may be complemented by a chewing efficiency test.
authors.affiliation: Division of Gerodontology and Removable Prosthodontics, University of Geneva Dental School, Geneva, Switzerland.
authors.forename: Fanny
authors.initials: F
authors.lastname: Elsig
authors.affiliation: Division of Gerodontology and Removable Prosthodontics, University of Geneva Dental School, Geneva, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Schimmel
authors.affiliation: Division of Gerodontology and Removable Prosthodontics, University of Geneva Dental School, Geneva, Switzerland.
authors.forename: Elena
authors.initials: E
authors.lastname: Duvernay
authors.affiliation: Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals Geneva, Thônex, Switzerland.
authors.forename: Sandra V
authors.initials: SV
authors.lastname: Giannelli
authors.affiliation: Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals Geneva, Thônex, Switzerland.
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Graf
authors.affiliation: Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals Geneva, Thônex, Switzerland.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Carlier
authors.affiliation: Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals Geneva, Thônex, Switzerland.
authors.forename: François R
authors.initials: FR
authors.lastname: Herrmann
authors.affiliation: Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals Geneva, Thônex, Switzerland.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Michel
authors.affiliation: Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals Geneva, Thônex, Switzerland.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gold
authors.affiliation: Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals Geneva, Thônex, Switzerland.
authors.forename: Dina
authors.initials: D
authors.lastname: Zekry
authors.affiliation: Division of Gerodontology and Removable Prosthodontics, University of Geneva Dental School, Geneva, Switzerland.|Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals Geneva, Thônex, Switzerland.
authors.forename: Frauke
authors.initials: F
authors.lastname: Müller
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008409:Mastication / Q000502:physiology*; D009909:Oral Health; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D016388:Tooth Loss / Q000503:physiopathology*
keywords: chewing; dementia; elderly; geriatrics; mild cognitive impairment; risk factor