Objective
To assess caregiver‐reported dementia as a risk factor for retained roots, an indicator of poor oral hygiene, among patients receiving home‐visit dental treatment in Japan.
Methods
The medical records of 231 dentate patients who received home‐visit dental treatment (covered by public medical insurance) for more than 2 years were retrospectively analyzed. The number of teeth and retained roots at the initial and final examinations were obtained from the dental charts, and the “change in the number of retained roots from initial to final examination” was determined. The presence or absence of caregiver‐reported dementia, diabetes, and osteoporosis, as well as the level of long‐term care needed, were used as indicators of general health condition at the initial interview. Multiple regression analyses were conducted in five models that tested the association of independent variables (age, gender, observation period, general health, presence or absence of caregiver‐reported dementia at the initial interview) with changes in the number of retained roots.
Results
In all models, the presence of caregiver‐reported dementia at the initial interview was significantly associated with the change in the number of retained roots (p < .05). The adjusted coefficient of determination (R2) of model 5, which included all the predetermined independent factors, was .168.
Conclusions
Caregiver‐reported dementia may be a risk factor for an increase in the number of retained roots among patients who receive home‐visit dental treatment and may serve as an indicator of the need for regular and proactive oral hygiene management.
Background
A significant clinicopathological and genetic overlap has been suggested between amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD).
Aim
To determine the overlap, we assessed the cerebral atrophy as a surrogate indicator of FTLD in ALS inpatients with post‐tracheostomy positive pressure ventilation by CT imaging analysis.
Methods
The extent of cerebral atrophy was quantitatively evaluated in 92 ALS patients (age: 68.3 ± 11.0 years and disease duration: 7.6 ± 4.8 years) and 42 age‐matched healthy controls (age: 60.4 ± 13.6 years) by computer‐mediated assessments of sizes of the following four areas [anterior temporal (TL), frontal lobes (FL), and inferior horn (IH) and anterior horn (AH) of the lateral ventricle] and of the corresponding intracranial fossae, to minimize individual head‐size differences.
Results
More than half of the ALS patients clearly exhibited the parenchymal atrophy in TL and FL regions and the ventricular dilatation in IH and AH areas, both of which exceed the age‐associated physiological changes. By clustering analysis using degrees of TL and FL atrophy and of IH and AH dilatation the ALS patients examined were grouped into five clusters resulting in the following characteristics: (i) normal to mild frontotemporal cortical atrophy (51%); (ii) mild frontotemporal lobar atrophy (FTLA) (26%); (iii) moderate FTLA (15%); (iv) severe FTLA (4%); and (v) severe temporal lobar atrophy (3%).
Conclusion
Half of the ALS patients after ventilation had apparent frontotemporal lobar atrophy by CT imaging, and such patients would develop FTLD.
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