title: Relationship between chewing ability and cognitive impairment in the rural elderly.
abstract: OBJECTIVE
  Relationship between masticatory function and cognitive impairment had been suggested but still understudied. We investigated the association between chewing ability and cognitive impairment among the elderly living in a rural region.
  
  
  METHODS
  A total of 295 elderly individuals aged ≥70 years in a rural city of Korea participated in a cross-sectional study. Trained nurses conducted interviews and assessed chewing ability using gum that changed color based on chewing performance. Cognitive impairment was assessed using the Mini-Mental State Examination for Dementia Screening (MMSE-DS) of Korean vesrsion. Socio-demographic characteristics, activities of daily living (ADL), Mini-Nutritional Assessment (MNA) were also assessed using questionnaires as potential confounders.
  
  
  RESULTS
  The mean age of the participants was 81.4 (ranged 70-102) years and 67.8% of them were female. Participants with low chewing ability were significantly older, dependent, and had lower MNA and MMSE-DS scores. The elderly with middle or low chewing ability had significantly higher risk for having cognitive impairment than those with higher chewing ability.
  
  
  CONCLUSIONS
  Our findings suggest that poor chewing ability is associated with cognitive impairment or dementia in the elderly living in rural area.
authors.affiliation: Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, Republic of Korea.
authors.forename: Eun-Kyong
authors.initials: EK
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
authors.forename: Sung Kook
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea; Department of Preventive Dentistry, Osaka University Graduate School of Dentistry Suita, Japan. Electronic address: cyh1001@knu.ac.kr.
authors.forename: Youn-Hee
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Faculty of Nursing and Human Nutrition, Yamaguchi Prefectural University, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Faculty of Nursing and Human Nutrition, Yamaguchi Prefectural University, Japan.
authors.forename: Kimiko
authors.initials: K
authors.lastname: Hirotsu
authors.affiliation: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyeon Chang
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Department of Dentistry, Yeungnam University College of Medicine, Daegu, Republic of Korea.
authors.forename: Hee-Kyung
authors.initials: HK
authors.lastname: Lee
authors.affiliation: Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea.
authors.forename: Yun-Sook
authors.initials: YS
authors.lastname: Jung
authors.affiliation: Department of Preventive Dentistry, Osaka University Graduate School of Dentistry Suita, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Amano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008409:Mastication / Q000502:physiology*; D009483:Neuropsychological Tests; D056910:Republic of Korea; D012424:Rural Population
keywords: Chewing ability; Cognitive impairment; Elderly