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Strategies for Managing Dementia Patients through Improving Oral Health and Occlusal Rehabilitation: A Review and Meta-analysis

  • Yeon-Hee Lee;Sung-Woo Lee;Hak Young Rhee;Min Kyu Sim;Su-Jin Jeong;Chang Won Won
    • Journal of Korean Dental Science
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    • v.16 no.2
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    • pp.128-148
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    • 2023
  • Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.

A Studyof Psychiatric Treatment Compliance in Referred Patients at a General Hospital (자문의뢰된 입원환자의 특성과 정신과 치료 순응도에 대한 연구)

  • Shim, In-Bo;Ko, Young-Hoon;Lee, Moon-Soo;Kim, Yong-Ku;Han, Chang-Su
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.2
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    • pp.66-73
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    • 2011
  • Objectives:The present study investigates the status of inpatient psychiatric consultations at a general hospital in order to find factors that contribute to treatment compliance related to psychiatric consultations. Methods:The subjects were 333 patients who were hospitalized at Korea University Medical Center Ansan Hospital from 1 September 2009 to 31 July 2010.The patients were referred for psychiatric consultation during hospitalization. This study investigates demographic data, request department, referral causes, requestor, psychiatric history and diagnosis, andpsychiatric treatment compliance. Treatment compliance was defined as whether or not the patient had accepted psychiatric treatment during hospitalization or outpatient department(OPD) follow-up. This study ascertains the factors that have impact on compliance, by taking binary logistic regression with compliance and other variables. Results:Among the patients that were offered psychiatric treatment during hospitalization(N=310), treatment compliance was 82.9%. Among the patients that were offered OPD treatment(N=111), compliance was 55.8%. Elderly group(>65 years) showed better compliance to treatment during hospitalization than the younger patient group(OR=4.838, p=0.004). Patients with secondary psychiatric disorders showed better OPD follow-up compliance than patients with secondary psychiatric disorders(OR=8.520, p=.008). Conclusion:Elderly patients showed better compliance for psychiatric treatment during hospitalization. However they commonly have disorders such as delirium and mood disorders that have impact on the patient's physical state, hence further active measures should be carried out. Patients referred due to primary psychiatric disorders showed poor OPD compliance. Therefore clinicians have to suggest multidisciplinary interventions that will improve treatment compliance of such patients.

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Effects on senior fitness, cognitive function and daily living activity of female elderly with light dementia by continuous and intermittent exercises (연속적.간헐적 운동이 경증치매 여성고령자의 기능적 체력, 인지기능 및 일상생활수행능력에 미치는 영향)

  • Kang, Joo-Seong;Jeang, Il-Hong;Yang, Jum-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.11
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    • pp.4234-4243
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    • 2010
  • Dementia such as poor concentration, anxiety and tension makes it hard to continue exercise in reality. For this, intermediate exercise is suggested in this study. And the study investigates the effects on senior fitness, cognitive function(MMSE-K) and daily living activity(ADL) by continuous exercise and intermittent exercise, which helps to provide proper exercise treatment to them. For this, female elderly patients at A dementia hospital in B Metropolitan city are selected and they have been diagnosed with possible Alzheimer's disease according to DSM-IV. Among them, six(6) are grouped for continuous exercise and five(5) for intermediate exercise, total 11 people are finally tested. They are given hand&foot exercise, Korean folk dance and band exercise three times a week for the total 12 weeks. The continuous exercise group does their exercise one time of 30 minutes a day while the intermediate exercise group for three times of each 10 minute a day. For the result, SPSS Ver. 18.0 is used to get mean value(M) and standard deviation(SD) and in order to verify the interaction effect between exercise group and time, two-way repeated ANOVA is applied and statistical significance level is set at .05. The result shows that there is significant difference in time between senior fitness and cognitive function. But there is no significant difference in group and time${\times}$group. And there is no significant difference in time, group and time${\times}$group for daily living activity. Continuous exercise group and intermediate exercise group both have the similar effects. That does not mean that intermediate exercise is the best for all people with dementia, but in terms of exercise time, intermittent exercise may be effective for patients of light dementia.

Nutritional Risks Analysis Based on the Food Intake Frequency and Health-related Behaviors of the Older Residents (50 Years and Over) in Andong Area (1) (안동주변 농촌지역 50세 이상 주민의 식품섭취빈도 및 건강행위에 따른 영양위험 분석 (1))

  • Lee, Hye-Sang;Kwun, In-Sook;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.8
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    • pp.998-1008
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    • 2008
  • This study aimed to assess the nutritional status and the nutritional risks based on the food intake frequency and health-related behaviors of middle-aged and elderly people living in Andong area. Interviews were conducted with 1,384 subjects (532 males, 852 females) aged 50 years and over. Nutrient intakes, food intake frequency, and health-related behaviors including smoking, drinking, and exercise were investigated. The average energy intakes were 1410.5 kcal for males and 1279.2 kcal for females, and the percentages of the subjects consuming below the estimated energy requirement (EER) were 92.5% and 88.4%, respectively. The least consumed nutrients compared to the estimated average requirement (EAR) were riboflavin (92.5% for males, 89.6% for females), folic acid (89.7%, 88.5%), and calcium (78.9%, 85.8%), in order. According to the food intake frequency survey, the intakes of meat, fish and vegetable (except kimchi) were very poor, and this low intakes of meat and fish showed as poor status of protein, niacin, vitamin $B_6$, and zinc intakes. Health-related behaviors data showed that the ratio of cigarette smokers, especially male, was higher, while the ratio of the person exercising regularly was lower than that of the nationwide statistics, respectively. Cigarette smoking and drinking were not significantly related to the poor nutrition intake, while regular exercise positively influenced nutrient intakes in female subjects. These results showed that the nutritional status of the subjects was likely to be severely deficient and the low intakes of meat and fish to be highly related to the increase of nutritional risk. Therefore, in order to prevent the occurrence of the secondary disease related to the food intake and health-related behaviors of the subjects, the proper educational program on balanced dietary intake and the correction of health-related behaviors should be developed and applied to this area.

Health-Related Quality of Life by Socioeconomic Factors and Health-related Behaviors of the Elderly in Rural Area (농촌지역 노인들의 사회경제적인 요인 및 건강습관에 따른 건강관련 삶의 질)

  • Choe, Jeong-Sook;Kwon, Sung-Ok;Paik, Hee-Young
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.29-41
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    • 2004
  • Objectives: This study was to identify socioeconomic factors and health-related behaviors influencing on HRQOL(health-related quality of life) for the older adults in rural area. Methods: 483 subjects aged over 65 years responded a direct interview, which covered HRQOL, BMI, socioeconomic characteristics, and health-related behaviors including smoking, drinking, and exercise. Results: Overall, the mean number of healthy days were 15.1 days and not significantly different by sex. Men didn't show a significant difference in HRQOL by age group. But women reported lower levels of healthy days and higher levels of activity limitation and physical unhealthy days with increasing age. Results from ANCOVA showed HRQOL to be significantly associated with education, job, and family type. Men presented no significant difference in HRQOL by health-related behaviors, but women who have been drinking, or have less number of chronic diseases reported higher mean healthy days and lower activity limitation days, physical unhealthy days, and mental unhealthy days. Older adults who reported good to excellent self-rated health were higher healthy days and lower activity limitation, physical unhealthy days, and mental unhealthy days than those who reported fair to poor health status. Conclusions: The HRQOL for the older adults in rural area was related to socioeconomic characteristics, health-related behaviors and self-rated health status. A better understanding of factors related to HRQOL would help to improve the older adults' quality of life.

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Utilization Pattern and Percept ion and Attitude of Rural Residents towards Primary Health Post (관할지역 주민의 보건진료소에 대한 태도와 이용양상)

  • Park, Chun-Na;Park, Jae-Yong;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.79-96
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    • 2001
  • In order to ascertain the utilization patterns and Perception and attitudes of Primary Health Post(PHP) by rural residents in farm areas, a survey was conducted of 753 households(1,803 persons) in 24 PHPs in Sangju-si, Gyeongsangbuk- do, from December 10, 2000 to January 15, 2001. The morbidly rate of acute illnesses for last two weeks for all households was 29.6%, and the rate of use of medical facilities to treat acute illness was 98.3%. The morbidly rate was highest between the ages of 60 and 69, with a rate of 35.4%. The higher their ages and the lower their educational levels were, the higher the morbidly rate was. The morbidly rate of chronic illnesses for one year for all households was 19.2%, and the rate of use of medical facilities to treat chronic illness was 92.8%. The elderly over 70 years old had the highest morbidly rate of 37.2%. The higher their ages and the lower their educational levels were, the higher the chronic illnesses rate was. For the rate of use of medical facilities to treat acute diseases, the use of PHPs was 89.5%, accounting for the majority of the time. However, for chronic diseases, hospitals and clinics were used more often, with a rate of 48.9%, compared to the use of PHPs, 40.2%. Their previous experiences on the use of PHPs one year before the survey showed that 94.8% used PHPs, 72.2% just visited them, not for the purpose of getting any medical assistance, and 73.3% received health education from PHPs. 98.5% remembered the locations of PHPs, 98.6% thought that PHPs were helpful for their health management, and 84.3% said that PHPs were playing great roles in development of their communities. 97.4% said that they found PHPs necessary. They understood the main job of PHPs as in the order of disease treatment, vaccination and health counseling. The work that they mostly wanted PHPs to do was health counseling and health management, which 31.6% answered. 88.9% said the examination fee was not expensive, 98.4% said CHPs were kind, and 97.0% said they were satisfied with the services at PHPs. Complaints about PHPs included a lack of a variety of medications, said by 42.9%, and poor facilities, by 15.8%. According to the above results, it is concluded that local residents on survey were frequently using PHPs due to their geographical and economical conditions. Also, the residents appeared to be satisfied with the services at PHPs, and they had a high demand for public health service as well as disease treatment. Considering the complaints about medications and medical facilities and equipment, active supports are required to manage PHPs in a way it can provide desirable services to the residents in remote villages through the readjustment of PHPs' functions, reinforcement of facilities and equipment and enhancement of CHPs ' training.

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Effects of Exercise Program by Type on Balance Ability and Muscle Activity In A Standing Posture (유형별 운동프로그램이 선 자세에서의 균형능력과 근활성도에 미치는 영향)

  • Kang, Jeong-Il;Park, Jun-Su;Park, Seung-Kyu;Yang, Dae-Jung;Choi, Hyun;Jeong, Dae-Keun;Kwon, Hye-Min;Moon, Young-Jun
    • Journal of Digital Convergence
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    • v.12 no.7
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    • pp.411-418
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    • 2014
  • This study, in order to establish the effect of three exercise groups on the static and dynamic balancing abilities and the muscular activity, targeting adult males aged 20-29, assigned 15 men to each aquatic exercise group, trunk stabilization exercise group, and balance exercise group. The study was conducted from June, 2013 to August, 2013, and measured and compared the balancing ability and the muscle activity(tibialis anterior and gastrocnemius muscle) of the participants after performing intervention for 30 minutes a day, 3 days a week, for 6 weeks. As a result, on the comparison between before and after the intervention, there were significant differences in changes of the surface area and the whole path length in all the three groups(p<.05)(p<.01), and also on the dynamic balance, there was a significant difference in change of limited of stability(p<.05)(p<.01). On change of the muscle activity of tibialis anterior, both left and right sides showed statistically significant differences in all the three groups(p<.05)(p<.01), and gastrocnemius muscle showed a statistically significant difference in all the three groups except for the left side of the trunk stabilization exercise group(p<.05)(p<.01). It could be established that aquatic exercise is effective for improvement of the balancing ability and increase of the muscular activity, and we intend to propose specific aquatic exercise program development by conducting a study to determine the objective effect of aquatic exercise on the elderly or patients who have a poor balancing ability.

Analysis of Relationship Between Dental Health Condition and Eating Habit (치아건강상태와 식습관과의 상관관계 분석)

  • kim, Jeong-Sook;Lee, Jong-Do;Jung, Hyo-Kyung
    • Journal of Technologic Dentistry
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    • v.29 no.1
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    • pp.103-119
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    • 2007
  • The survey on dental health condition and eating habit of local residents in Daegu and Kyungbuk had been conducted. Through the analysis of influence of dental health condition on eating habit I could get the following result. The number of subjects of survey is 630. The period of survey is from June 2006 to September 2006. 1. General quality of subjects is that forty-four point four percent of subjects are male and fiftyfive pointsix percent are female. The age of thirty point one percent of subjects is between 20 and 29. Fifty-six point two percent of subjects are married. Fifty-one point four percent of subjects have above bachelor degree. Monthly income of forty-four point eight percent of subjects is less than one million won. Twenty-four point four percent of subjects are students. Fifty-five point seven percent of subjects are living in big cities. 2. Forty-seven point seven percent of male and fifty-one point eight percent of female answered their subjective dental health condition is bad. Marital status, age and academic background have relationship with answer. Forty-three point nine percent of married subjects and forty-one point five percent of divorced or bereaved subjects said they have bad dental health condition. The older he is or the lower academic background he has subjects think they have bad dental health condition. Forty-seven point four percent of non-educated subjects answered their dental health condition is bad. Forty-six percent of self-employed subjects and subjects who live in the country have tendency to think their dental health condition is bad. 3. About eating habit knowledge, male's knowledge of 2.03$\pm$0.20 is lower than female's of 2.08$\pm$0.21. This shows there is statistically significant difference(p<0.01). 4. There is significant relationship between subjective dental health condition and health condition of subjective. This means subject who has better health condition has also better dental health condition(37.5%). About subjective dental health condition, subject who eats restoratives has worse dental health condition. This shows there is a relationship between dental health condition and eating restoratives(p=0.004) and subject who works out steadily has better dental condition. 5. About relation between dental health condition and eating habit, subject who eats vegetables has worse dental health condition by fifty point seven percent. As cross tabulation result, p-value is 0.002. In level of significance of 0.05, there is statistically significant difference in eating habit. 6. It seems that eating habit has an effect on marital status, age, academic background, income and also on dental prosthetic treatment situation. Many subjects think their dental health condition is bad. About eating habit, subjects who eat meat have better dental health condition. Subjects who drink green tea and fruit juice has better dental health condition than who drink coffee and Balanced diet is good for dental health condition. As eating habit is important for developing dental health, government should make a proper program. Dental health education program especially for elderly, low-eduacted, residents in the country and poor people should be developed. Government, dental health organization, dental health specialist, associated research institution and people work in the press should be concerned and devote to improve quality of life. Primary prevention education will help for dental health.

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A Study on the Fallow of Depopulation Area in Rural Korea - The Case Study of Deoggali, Sangju Gun - (과소농촌지역(過疎農村地域)의 휴경요인(休耕要因)과 유형(類型) - 경북 상주시 사벌면 덕기리의 사례연구 -)

  • Lee, Han-Bang
    • Journal of the Korean association of regional geographers
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    • v.7 no.3
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    • pp.74-90
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    • 2001
  • Serious depopulation has occurred since the rapid economic growth after $1965{\sim}1995$. As a result, nowadays most of mountain villages face difficulty in maintaining and managing their settlement, because of the elderly population and the extremely small size of the settlement. Population change is understood as the origin of depopulation problems and the criterion for the depopulation. This study aims to identify the problems of over-depopulation in rural Korea and to classify the patterns and process of follow and to provide policy alternatives. It consists with the three parts : identifying the problems of over- depopulation, classifying the socio-economic factors of fallow land, analyzing a detailed case study of follow land in over-depopulation rural area-Sangju Gun and to provide policy alternatives. The results are summarizes as follows: 1) In the study area, the amount of fallow and abandoned cultivated land has increased since 1975. With the increased urbanization, the cause of the increase in fallow and abandoned cultivated-land is the labor shortage of quantity and quality. The underlying reasons for the abandonment of farmland are poor field conditions and the lack of rented farmland. 2) The secondary cause is a relative labor shortage through specialization into intensive horticulture. In the study area, specialization into pear requires intensive labor input. It has caused a relative labor shortage. 3) The third causes are landowner and the lack of rented farmland due to labor shortage. The declining of agriculture and forestry have caused out-migration and increased non-residents' landowner. 4) The fallow patterns are devided into two types the less favored farmland fallow type, non-residents' landowner(out-migrator) fallow type. The significant causes of the increase in fallow and abandoned cultivated land are the labor shortage, intensive farming, less favored farmland conditions, non-residents' landowner. The factors which caused the follow processes in Korea are socio-economic factors (labor shortage, intensive farming, less favored farmland conditions) and cultural factor(non-residents' landowner, psychological ties between rural areas and urban areas).

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Analysis of Physical Status on COVID-19: Based on Impacts of Physical Activity (COVID-19에 대한 운동중재효과 분석)

  • Kim, Kwi-Baek;Kwak, Yi Sub
    • Journal of Life Science
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    • v.31 no.6
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    • pp.603-608
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    • 2021
  • The purpose of this perspective research is to discuss the potential role of exercise-interventions in COVID-19, terms of prevention and prognosis in the periods of the COVID-19 vaccine. SARCO-CoV-2. COVID-19 was detected as a new virus causing severe cardiovascular and respiratory complications. It emerged as a global public health emergency and national pandemic. It caused more than 1 million deaths in the first 6 months of the pandemic and resulted in huge social and economic fluctuations internationally. Unprecedented stressful situations, such as COVID-19 blue and COVID-19 red impact on many health problems. In healthy individuals, COVID-19 infection may induced no symptoms (i.e., asymptomatic), whereas others may experience flu-like symptoms, such as ARDS, pneumonia, and death. Poor health status, such as obesity and cardiovascular and respiratory complications, are high risk factors for COVID-19 prevention, occurrence, and prognosis. Several COVID-19 vaccines are currently in human trials. However, the efficacy and safety of COVID-19 vaccines, including potential side effects, such as anaphylaxis (a life-threatening allergic reaction) and rare blood clots, still need to be investigated. On the basis of direct and indirect evidence, it seems that regular and moderate physical exercise can be recommended as a nonpharmacological, efficient, and safe way to cope with COVID-19. Physical inactivity and metabolic abnormalities are directly associated with reduced immune responses, including reduced innate, CMI, and AMI responses. Due to prolonged viral shedding, quarantine in inactive, obese and disease people should likely be longer than physical active people. Multicomponent and systemic exercise should be considered for the obese, disease, and elderly people. More mechanism research is needed in this area.