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

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

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).

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).

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

Early and simple evaluation of the oral condition and cognitive function can predict the risk of aspiration pneumonia.