Associations Between Chewing Difficulty, Subjective Cognitive Decline, and Related Functional Difficulties Among Older People Without Dementia: Focus on Body Mass Index

Abstract

Objective This study aimed to determine whether chewing difficulty is associated with subjective cognitive decline (SCD) and related functional difficulties by body mass index. Design A population-based cross-sectional study. Setting and Participants A nationwide sample of 54,004 individuals aged >= 65 years from the 2018 Korea Community Health Survey. Measurements SCD and SCD-related functional difficulties were measured using the cognitive decline module of the Behavioral Risk Factor Surveillance System. Chewing difficulty was assessed based on a self-report questionnaire from an oral health-related behaviors interview survey. BMI was calculated from objective values by measuring height and weight through a physical meter. Results Among the 54,004 individuals, the prevalence of SCD in underweight, overweight, and obesity group was 33.6% (n = 806), 30.3% (n = 9,691), and 28.7% (n=5,632) respectively. Chewing difficulty was associated with SCD and SCD-related functional difficulties. This association was more pronounced in underweight (BMI: <18.5 kg/m2) people [underweight: (odds ratio [OR] = 1.68, 95% confidence interval [CI] 1.48-1.92); normal weight: OR = 1.13, 95% CI 1.04-1.22; obese: OR = 1.15, 95% CI 1.05-1.27]. Similar trends were demonstrated for SCD-related functional difficulties (underweight: OR = 1.53, 95% CI 1.17-2.01; normal weight: OR = 1.36, 95% CI 1.15-1.63; obese: OR = 1.50, 95% CI 1.22-1.86). Conclusions Chewing difficulty was associated with SCD and SCD-related functional difficulties in older people. Our results suggest that underweight status may play roles in the associations between chewing difficulty and SCD and SCD-related functional difficulties.