Skip to main content
Top
Published in: Clinical Oral Investigations 7/2018

01-09-2018 | Original Article

Relationship of aspiration pneumonia to cognitive impairment and oral condition: a cross-sectional study

Authors: Koji Naruishi, Yasufumi Nishikawa, Jun-ichi Kido, Akihiro Fukunaga, Toshihiko Nagata

Published in: Clinical Oral Investigations | Issue 7/2018

Login to get access

Abstract

Objectives

The objective of this study was to investigate the relationship of the incidence of aspiration pneumonia to cognitive impairment and the oral condition.

Materials and methods

A total of 1174 elderly patients were analyzed in a cross-sectional study. Cognitive function was evaluated by the Clinical Dementia Rating scale and the oral condition was evaluated by inspection and palpation. Swallowing was examined in 196 patients by video-endoscopic evaluation. The Mann-Whitney U test or chi-square test was used for statistical analysis. Conditional logistic regression analysis was performed to compute the odds ratio (OR) and 95% confidence interval (CI).

Results

Loss of posterior occlusion, impaired tongue movements, and impaired cognition were factors significantly related to aspiration pneumonia. The incidence of aspiration pneumonia was higher in patients with both cognitive impairment and loss of posterior occlusion compared with those having either factor alone (OR: 5.16). There was no statistical association between impaired swallowing and the incidence of aspiration pneumonia in elderly patients with normal cognitive function (cognitive impairment, OR: 3.45; normal function, OR: 0.94).

Conclusion

Co-existence of cognitive impairment and oral frailty significantly enhances the risk of aspiration pneumonia.

Clinical relevance

Early and simple evaluation of the oral condition and cognitive function can predict the risk of aspiration pneumonia.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hickling KG, Howard R (1988) A retrospective survey of treatment and mortality in aspiration pneumonia. Intensive Care Med 14(6):617–622CrossRefPubMed Hickling KG, Howard R (1988) A retrospective survey of treatment and mortality in aspiration pneumonia. Intensive Care Med 14(6):617–622CrossRefPubMed
2.
go back to reference Wada H, Nakajoh K, Satoh-Nakagawa T, Suzuki T, Ohrui T, Arai H, Sasaki H (2001) Risk factors of aspiration pneumonia in Alzheimer's disease patients. Gerontology 47:271–276CrossRefPubMed Wada H, Nakajoh K, Satoh-Nakagawa T, Suzuki T, Ohrui T, Arai H, Sasaki H (2001) Risk factors of aspiration pneumonia in Alzheimer's disease patients. Gerontology 47:271–276CrossRefPubMed
7.
go back to reference van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JM, de Baat C (2011) Risk factors for aspiration pneumonia in frail older people: a systematic literature review. J Am Med Dir Assoc 12:44–354CrossRef van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JM, de Baat C (2011) Risk factors for aspiration pneumonia in frail older people: a systematic literature review. J Am Med Dir Assoc 12:44–354CrossRef
9.
go back to reference García-Ptacek S, Faxén-Irving G, Cermáková P, Eriksdotter M, Religa D (2014) Body mass index in dementia. Eur J Clin Nutr 68:1204–1209CrossRefPubMed García-Ptacek S, Faxén-Irving G, Cermáková P, Eriksdotter M, Religa D (2014) Body mass index in dementia. Eur J Clin Nutr 68:1204–1209CrossRefPubMed
13.
go back to reference Camina Martín MA, de Mateo Silleras B, Redondo del Río MP (2014) Body composition analysis in older adults with dementia. Anthropometry and bioelectrical impedance analysis: a critical review. Eur J Clin Nutr 68:1228–1233CrossRefPubMed Camina Martín MA, de Mateo Silleras B, Redondo del Río MP (2014) Body composition analysis in older adults with dementia. Anthropometry and bioelectrical impedance analysis: a critical review. Eur J Clin Nutr 68:1228–1233CrossRefPubMed
18.
go back to reference van der Putten GJ, de Baat C, De Visschere L, Schols J (2014) Poor oral health, a potential new geriatric syndrome. Gerodontol Suppl 1:17–24CrossRef van der Putten GJ, de Baat C, De Visschere L, Schols J (2014) Poor oral health, a potential new geriatric syndrome. Gerodontol Suppl 1:17–24CrossRef
19.
go back to reference van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JM, de Baat C (2011) Meta-analysis of dysphagia and aspiration pneumonia in frail elders. J Dent Res 90:1398–1404CrossRefPubMed van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JM, de Baat C (2011) Meta-analysis of dysphagia and aspiration pneumonia in frail elders. J Dent Res 90:1398–1404CrossRefPubMed
21.
go back to reference Bours GJ, Speyer R, Lemmens J, Limburg M, de Wit R (2009) Bedside screening tests vs. videofluoroscopy or fibreoptic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: systematic review. J Adv Nurs 65:477–493CrossRefPubMed Bours GJ, Speyer R, Lemmens J, Limburg M, de Wit R (2009) Bedside screening tests vs. videofluoroscopy or fibreoptic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: systematic review. J Adv Nurs 65:477–493CrossRefPubMed
Metadata
Title
Relationship of aspiration pneumonia to cognitive impairment and oral condition: a cross-sectional study
Authors
Koji Naruishi
Yasufumi Nishikawa
Jun-ichi Kido
Akihiro Fukunaga
Toshihiko Nagata
Publication date
01-09-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 7/2018
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-018-2356-7

Other articles of this Issue 7/2018

Clinical Oral Investigations 7/2018 Go to the issue