RSUSSH 2020

IN20-195 Oral health status of Thai older adults with Mild Cognitive Impairment (MCI)

Presenter: Panatcha Weerapol
Chulalongkorn University, Thailand

Abstract

          Background: Mild Cognitive Impairment (MCI) is a transitional stage between normal cognitive decline and dementia. Cognitively impaired elders tend to have higher risk of oral health problems with poorer oral hygiene than elders with normal cognition. The better we know about oral health status and bio-psycho-social factors in this preventable stage, the more we can early prevent and prepare for dependency in late life. Objective: To assess oral health status among Thai older adults with MCI Methods: Cross-sectional study conducted on Thai older adults at Faculty of Dentistry, Chulalongkorn University. Dementia or depression individuals were excluded. Cognitive function was assessed by Montreal Cognitive Assessment Thai version (MoCA-T). Any participants with MoCA score below 25 were referred to a psychiatrist for final diagnosis. Bio-psycho-social data of 60 MCI participants were obtained by self-reported interview. Oral examination was evaluated by a dentist. Results: Average age of participants was 72.18 years with 76.7% female. From total 60 MCI participants, there were 60.0% had periodontal disease, and 40.0% had active caries. The mean number of natural teeth (NT) was 16.80 ± 9.1, and by 43.3% had at least 20 NT. The mean number of posterior opposing pairs (POPs) was 2.78 ± 3.0 and by 33.3% had at least 4 POPs. Only 33.3% had at least 20 NT with 4 POPs. Conclusion: Oral health status of Thai older adults with MCI in this study was poorer than general Thai elders in the national data, but considerably better than dementia Thais.

Keywords: Oral health status; Thai; Mild Cognitive Impairment (MCI); Geriatric; Elders; Older adults

Citation format:

Weerapol, P., Tangwongchai, S., & Komin, O.. (2020). Oral health status of Thai older adults with Mild Cognitive Impairment (MCI). Proceeding in RSU International Research Conference, May 1, 2020. Pathum Thani, Thailand.

QUESTIONS & ANSWERS

อ.ทญ.ณัฐชาภรณ์ สงวนสิน (Chairperson)

- Dentition classified into 7 dentition types : มีการ classified อย่างไรบ้างคะ

- ใน table 2 ที่มีการแสดงผล medical and behavioral characteristics พบ 3.3% had history of cerebrovascular disease, and 1.7% had history of depression โรค cerebrovascular disease & depression ไม่ได้มีการ exclude ไปตั้งแต่ exclusion criteria แล้วหรือคะ--> (Any individuals with history of dementia, depression, psychiatric disorders, cerebrovascular diseases, cancer, major head trauma or any brain diseases were excluded ที่เขียนไว้ในส่วน materials and methods)

- ในส่วน discussion ที่เปรียบเทียบ Periodontal disease และ active caries ของ 8th national survey among general Thai population และ Srisilapanan & Jai-Ua, 2013 ใช้เกณฑ์การวินิจฉัยเหมือนกันไหมคะ เหมือนหรือแตกต่างกันอย่างไรบ้างคะ

 

ขอบคุณค่ะ

Panatcha Weerapol (Presenter)

Thank you for your questions and kind attention of my study.


- Dentiton types were classified by types of present functional teeth for mastication; 1) All natural teeth, 2) Natural teeth with fixed prostheses, 3) Natural teeth with fixed and removable protheses, 4) Natural teeth with removable prostheses, 5) Complete denture, 6) Partial edentulism without prosthesis, and 7) Completed edentulism without prosthesis. In this study, there were no participants having completed edentulism without prosthesis. So, it was only 6 dentitions showed in the table 3 of my proceeding paper.

- These results happened by limitations in self-reported interview of participants. Some participants rejected all exclusion criteria because they did not get any treatments or hospitalizations from specific medical problems. Anyway, after participation, they reported their related symptoms or experienes in their lifetime during interview but it was not clearly confirmed by doctors, for example by CT scan or MRI for cerebrovascular disease. Therefore, we decided to keep this important information. This conflict was also a result of unclear exclusion criteria which can be improved by adding severity levels to all exclusion criteria.

- This study showed that 60.0% had periodontal disease and 40.0% had active caries. In the full proceeding paper, we discussed that these two factors were incomparable to other studies and the national data, as well. It was because of different criteria, methodology, and definition. Our study was designed and focused on methodology of oral health-related cognitive impairment studies. For example, three or more millimeters of Clinical Attachment Loss (CAL) were used to defined the presence of periodontal disease as following to the study of Kamer, A. R., Pirraglia, et al (2015). Therefore, our data about active dental caries and periodontal disease, which implied chronic inflammatory process; one of oral health-related Alzheimer's disease plausible theories, can be used for furthur studies in this area. The conclusion of our study was only based on number of remaining natural teeth (์NT) and posterior opposing pairs (POPs).  It was in the first rank of major oral health problems among Thai elderly population: 'Tooth loss'.

Piyanuch Karnasuta (Visitor)

Thank you for your nice presentation 

Did the economical status of the family might effect to the result of the study?

 

 

Panatcha Weerapol (Presenter)

Unfortunately, this study collected only individual income per month of participants.
Approximately half of MCI participants in this study (48.3%) had monthly income lower than 10,000 THB.
However, this proceeding paper described only characteristics of the MCIs without comparing to other groups.

It is better to know the economical status of 'the family' due to the economical changes of participant's family/working generation after retirement.
The family income seems to be more valid than individual income.
Thank you for your thoughtful point.