Relationship between the Necessary Support Level for Oral Hygiene and Performance of Physical, Daily Activity, and Cognitive Functions

Abstract

To maintain good oral hygiene on their own, elderly adults need comprehensive abilities, such as physical, daily activity, and cognitive functions. In the long-term care certification, care support specialists conduct surveys that include a total of 74 items about physical function, daily activity function, living functions, cognitive function, mental/behavioral disorders, and adaption to social life. The data of the long-term care certification survey contain three items related to oral health: the necessary support level for oral hygiene, ability to swallow, and assistance with food intake. The aims of this study were to identify which functions are absent in elderly individuals who cannot maintain proper oral hygiene and to clarify at which stage it is necessary to assist elderly individuals with their oral hygiene and provide professional oral care. In this study, an analysis was conducted to identify the relationship between the necessary support level for oral hygiene and the performance of physical, daily activity, and cognitive functions. The results of the long-term care certification surveys were analyzed for 23,423 cases that involved 9,571 individuals who submitted a claim using long-term care statements between January 2009 and March 2018. The results of a multivariable logistic regression analysis showed that the following items had high odds ratios: “walk” and “stand up” in the physical and daily activity functions and the ability to “understand the everyday routine” and “make daily decisions” in the cognitive functions. The results of a decision tree analysis revealed that in order for elderly individuals to maintain good oral hygiene on their own, they must have adequate physical functioning as well as adequate performance of cognitive functions. Our study's findings suggest that comprehensive ability in both physical and cognitive functions is required for elderly adults to maintain their oral hygiene.

Low Tongue Strength and the Number of Teeth Present Are Associated with Cognitive Decline in Older Japanese Dental Outpatients: A Cross-Sectional Study

“…Previous epidemiological studies have explored the relationship between dementia and oral health. Lee et al [ 7 ] reported that periodontitis is associated with a high risk of developing dementia, whereas Tamaki et al [ 8 ] indicated that oral hygiene is associated with cognitive function. Furthermore, certain studies showed that tooth loss is associated with the onset of dementia, particularly in the Japanese population [ 9 , 10 ].…”

Risk Factors for Dementia Incidence Based on Previous Results of the Specific Health Checkups in Japan

“…In the certification process for long-term care in Japan, the Needs Certification Committee conducts a survey of a total of 74 items, including physical function, cognitive function, life function, daily activity function, behavioral disorder, and adjustment to social life. The required level of care is classified into a total of 7 levels (support needs levels 1–2 and care needs levels 1–5) [ 22 ]. The data from the care certification survey include items associated with dementia.…”

Evaluation of the Influence of Clinical History on the Occurrence of Dementia Using the Database of National Health Insurance in Japan

“…Furthermore, Japanese individuals with long-term care needs are provided care services at home and in institutions [22] by municipalities [23]. The Municipal Needs Certification Committee is responsible for evaluating the requests for long-term nursing care by residents based on more than 70 functions, such as activities of daily living, cognitive function, physical function, living function, adaptation to society, and behavioral disorder [4,24]. The Municipal Care Certification Survey collects data related to the cognitive ability and dementia.…”