노인의 구강건강 관련 지표와 MMSE의 관련성 = Associations between oral health-related index and MMSE of the elderly

다국어 초록 (Multilingual Abstract)

Objectives: All over the world the elderly population is increasing, therefore, countries are developing policies to solve the related problems. Additionally, there is an increasing interest in developing measures to improve the quality of life of the elderly. Senile dementia, which appears with increasing age, is becoming a serious problem not only for the patient himself but also for the family and society. Additional, the oral health of the elderly is very important because it is directly related to their the eating. Therefore, there is also a growing interest in oral health-related quality of life (OHRQoL) among the elderly. The present study examined the associations between dementia and oral health-related index, and specifically investigated associations of dementia with number of remaining teeth, masticatory level, and OHRQoL. These associations were investigated using the Korean version of Mini-Mental State Examination (MMSE), oral examination, and a self-reported questionnaire.
Methods: A total of 456 elderly aged over 65 years, who visited a public health center, senior center, and sanatorium in a community dwelling in Daegu city, were assessed for dementia using the MMSE, and their oral health was assessed based on denture use, remaining teeth, and tooth mobility. A questionnaire was used to assess subjective, objective mastication levels, and the Oral Health Impact Profile (OHIP-14) and Geriatric Oral Health Assessment Index (GOHAI) were used to assess oral health-related quality of life using a 5-point Likert scales. All the collected data were analyzed by the chi-square test, t-test, one way ANOVA, and logistic regression using SPSS 23.0 version. Logistic regression was used to analyzed the association between dementia and number of remaining teeth, and OHIP-14, and GOHAI scores.
Results: There was a significant association between dementia and number of remaining teeth. For those with 0-10 remaining teeth, the risk of dementia was 3.00 (95% CI: 1.610―5.590). After adjusting for age, gender, residence, education, and denture usage, the odds ratio was 5.02 (95% CI: 1.885―13.367) and there was statistically significant difference (P<0.05). Mastication level could affect dementia in the elderly, but there was no statistically significant difference (P>0.05). For those elderly who reported poor OHRQoL on the GOHAI, the risk of dementia was 1.81 times higher (95% CI: 1.071―3.050). After adjusting for age, gender, residence, education, and denture usage, the odds ratio was 1.80 (95% CI: 1.018―3.192), and there was statistically significant difference (P<0.05). For those elderly who reported poor OHRQoL on the OHIP-14, the risk of dementia was 1.38 times higher (95% CI: 1.071―3.050), and there was no statistically significant difference (P>0.05).
Conclusions: This study showed a significant relationship between dementia and oral health-related indexes such as number of remaining tooth, masticatory level, and lower OHRQoL. Future follow up longitudinal studies will be helpful in improving the quality of life of the elderly by maintaining their oral health.

목차 (Table of Contents)

• Ⅰ. 서론 1
• 1.1. 연구배경 1
• 1.2. 연구목적 5
• Ⅱ. 문헌고찰 7
• 2.1. 잔존 치아 수와 치매 8
• 2.2. 구강건강 관련 삶의 질 9
• 2.3. 저작능력과 삶의 질 10
• Ⅲ. 연구대상 및 방법 12
• 3.1. 연구대상 12
• 3.2. 연구방법 14
• 3.2.1. 잔존 치아 수 14
• 3.2.2. 저작정도 15
• 3.2.3. 구강건강 관련 삶의 질 16
• 3.2.3.1. 구강건강영향지수(OHIP-14) 16
• 3.2.3.2. 노인구강건강관련평가지수(GOHAI) 18
• 3.2.4 인지기능 20
• 3.3 통계분석 21
• Ⅳ. 연구결과 22
• 4.1. 연구 대상자 노인들의 일반적 특성 22
• 4.2. 잔존 치아 수에 따른 노인들의 일반적 특성 24
• 4.3. 잔존 치아 수에 따른 주관적 및 객관적 저작정도 25
• 4.4. 잔존 치아 수에 따른 구강건강 관련 삶의 질 26
• 4.5. MMSE 점수에 따른 노인들의 일반적 특성 28
• 4.6. MMSE 점수에 따른 노인들의 저작정도 29
• 4.7. MMSE 점수에 따른 노인들의 구강건강 관련 삶의 질 30
• 4.8. OHIP-14와 GOHAI 점수에 대한 노인들의 삶의 질 비교 31
• 4.9. 잔존 치아 수와 치매와의 관련성 34
• 4.10. 객관적인 저작정도와 치매와의 관련성 35
• 4.11. 주관적인 저작정도와 치매와의 관련성 37
• 4.12. 구강건강 관련 삶의 질과 치매와의 관련성 38
• Ⅴ. 고찰 41
• Ⅵ. 결론 47
• 참고문헌 49
• 영문초록 62
• (부 록) 65