[Research agenda oral care for older people in the Netherlands and Flanders (Belgium)]. / Wetenschapsagenda 'Mondzorg voor ouderen' in Nederland en Vlaanderen.

Oral care for older people is an underexposed topic in dentistry as well as in general healthcare, while oral care professionals are increasingly confronted with frail and multimorbid older people with complex care needs. The research agenda 'Oral care for the elderly' was developed to encourage the collaboration of researchers in the Netherlands and Flanders (Belgium) to do more research in this area and in this way, to achieve an expansion and implementation of knowledge. This will make possible the provision of a socially responsible and robust basis for sustainable oral care for frail older people. The focus of the agenda is on 3 themes, namely oral health and oral function for older people; multi/interdisciplinary collaboration within primary care and the costs, benefits and long-term effect(s) of oral care throughout the entire course of life. This article provides an overview of this research agenda and the way in which it has been established.

[Mind your teeth - the relationship between mastication and cognition]. / Denk aan je tanden - de relatie tussen kauwen en cognitie.

Elderly persons, especially those suffering from dementia, are at great risk of suffering from oral health problems such as orofacial pain and loss of natural teeth. A possible explanation could be that the cognitive and motor impairments resulting from dementia cause a decrease in self-care and as such, a worsening of oral health. An alternative explanation is that cognition and oral health influence each other. Animal studies show that a decrease in masticatory activity, for example due to a soft diet or loss of teeth, causes memory loss and neuronal degeneration. The relationship between mastication and cognition has also been researched in human studies, but a cause-effect relationship is not yet evident. It is likely that multiple factors play a role in this relationship, such as self-care, nutrition, stress and pain.

Oral mixing ability and cognition in elderly persons with dementia: a cross-sectional study.

Masticatory performance has been positively associated with cognitive ability in both animals and healthy humans. We hypothesised that there would also be a positive correlation between masticatory performance and cognition in older persons suffering from dementia. Older persons suffering from dementia (n = 114) and receiving institutionalised care were studied in a cross-sectional design. The assessments included masticatory performance, which was measured objectively with a two-colour gum mixing ability test, and cognition, which was assessed with a multidomain neuropsychological test battery. Significant relationships were observed between masticatory performance and general cognition and between masticatory performance and verbal fluency. Hierarchical regression analysis revealed that the correlation with general cognition was influenced by the scores for dependency in activities of daily living. The association between verbal fluency and masticatory performance was not significantly affected by secondary variables. An unexpected limitation of this study was the high dropout rate for the mixing ability test. The clinical implications of these findings are profound; care professionals should endeavour to maintain and stimulate mastication in older persons with dementia in an attempt to preserve cognition.

Two-colour chewing gum mixing ability: digitalisation and spatial heterogeneity analysis.

Many techniques are available to assess masticatory performance, but not all are appropriate for every population. A proxy suitable for elderly persons suffering from dementia was lacking, and a two-colour chewing gum mixing ability test was investigated for this purpose. A fully automated digital analysis algorithm was applied to a mixing ability test using two-coloured gum samples in a stepwise increased number of chewing cycles protocol (Experiment 1: n = 14; seven men, 19-63 years), a test-retest assessment (Experiment 2: n = 10; four men, 20-49 years) and compared to an established wax cubes mixing ability test (Experiment 3: n = 13; 0 men, 21-31 years). Data were analysed with repeated measures anova (Experiment 1), the calculation of the intraclass correlation coefficient (ICC; Experiment 2) and Spearman's rho correlation coefficient (Experiment 3). The method was sensitive to increasing numbers of chewing cycles (F5,65 = 57·270, P = 0·000) and reliable in the test-retest (ICC value of 0·714, P = 0·004). There was no significant correlation between the two-coloured gum test and the wax cubes test. The two-coloured gum mixing ability test was able to adequately assess masticatory function and is recommended for use in a population of elderly persons with dementia.

Mastication for the mind--the relationship between mastication and cognition in ageing and dementia.

The goal of this literature review has been to investigate the relationship between mastication and cognition, with a special focus on ageing and dementia, and its possible underlying mechanisms. Since the relationship between mastication and cognition is not yet firmly established, and is investigated in the context of a number of different disciplines, a comprehensive overview will contribute to our knowledge. The results of animal and human experimental studies suggest a causal relationship between mastication and cognition. Furthermore, correlations exist between mastication and activities of daily living and nutritional status. These findings have compelling implications for the development of prevention strategies by which medical and nursing staff may optimize their care for the frail and elderly, suffering from dementia.