Assessment of subjective and objective masticatory function among elderly individuals with mild cognitive impairment

Aging Clin Exp Res. 2023 Jan;35(1):107-115. doi: 10.1007/s40520-022-02290-x. Epub 2022 Nov 11.


Background: Masticatory function is known to be related to cognitive ability; therefore, factors for improving masticatory function should be identified.

Aims: This study aimed to identify factors influencing masticatory function associated with mild cognitive impairment (MCI) in elderly individuals.

Methods: A total of 123 elderly participants [mean age: 76.5 ± 6.5 years; 82 females (66.7%), 41 males (33.3%)] were included. Cognitive function was evaluated by the Korean version of the Mini-Mental State Examination (KMMSE). Questionnaires for subjective evaluation were administered, and dynamic objective masticatory function evaluations, including chewing tests and bite force measurements, were performed. Intergroup differences were evaluated by the Wilcoxon rank-sum and chi-square test, and correlations between cognitive ability and masticatory function were evaluated by multilinear logistic regression.

Results: The number of teeth, number of posterior teeth, bite force, masticatory ability index (MAI) and posterior support status showed significant differences between the normal (KMMSE > 23) and MCI (KMMSE ≤ 23) groups. However, only the MAI, representing dynamic masticatory performance, was significantly associated with MCI regardless of age, sex and removable prostheses. The number of teeth and posterior teeth, bite force, subjective masticatory ability and posterior occlusal support showed no significant association with MCI.

Discussion: These results suggested the importance of chewing function for preventing the progression of cognitive impairment.

Conclusions: Considering that only the MAI was significantly associated with MCI, it is more important to improve chewing efficiency by harmonizing therapeutic prosthetics with the surrounding masticatory system than simply increasing the number of teeth to prevent or delay cognitive impairment in elderly individuals.

Keywords: KMMSE; Masticatory ability index (MAI); Masticatory function; Mild cognitive impairment (MCI).

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bite Force
  • Cognition
  • Cognitive Dysfunction*
  • Female
  • Humans
  • Male
  • Mastication*
  • Surveys and Questionnaires