Subgingival microbiome at different levels of cognition.

Oral health and declining cognition may have a bi-directional association. We characterized the subgingival microbiota composition of subjects from normal cognition to severe cognitive decline in two cohorts. Memory and Periodontitis (MINOPAR) include 202 home-living participants (50-80 years) in Sweden. Finnish Oral Health Studies in Older Adults (FINORAL) include 174 participants (≥65 years) living in long-term care in Finland. We performed oral examination and assessed the cognitive level with Mini Mental State Examination (MMSE). We sequenced the 16S-rRNA gene (V3-V4 regions) to analyse the subgingival bacterial compositions. The microbial diversities only tended to differ between the MMSE categories, and the strongest determinants were increased probing pocket depth (PPD) and presence of caries. However, abundances of 101 taxa were associated with the MMSE score. After adjusting for age, sex, medications, PPD, and caries, only eight taxa retained the significance in the meta-analyses of the two cohorts. Especially Lachnospiraceae [XIV] at the family, genus, and species level increased with decreasing MMSE. Cognitive decline is associated with obvious changes in the composition of the oral microbiota. Impaired cognition is accompanied with poor oral health status and the appearance of major taxa of the gut microbiota in the oral cavity. Good oral health-care practices require special deliberations among older adults.

Survey of health care personnel's attitudes toward oral hygiene in long-term care facilities in Finland.

AIM: To survey long-term residences' health care personnel's opinions and attitudes toward maintenance of older adults' daily oral hygiene. METHODS AND RESULTS: The survey was directed to the health care personnel of three long-term care facilities in Helsinki, Finland. We analyzed the survey responses focusing on opinions and attitudes toward older adults' daily oral hygiene. To measure this aspect, a scoring system was developed. When the analysis was based on two specific statements, 60% of responding members of health care personnel had a negative attitude toward older adults' oral hygiene. They tended to experience more refusals when assisting oral hygiene measures, more often experienced a lack of time, and were willing to get more training related to the task. CONCLUSION: The health care personnel of long-term care facilities considered older adults' oral health important. Members of the health care personnel who showed a negative attitude with our scoring system toward older adults' daily oral hygiene indicated in their questionnaire responses the need for additional training and additional time for the task.