Physical and Cognitive Function

Chapter

Abstract

Progress in medical and dental clinical practice fosters treating even very old geriatric patients with implants. Very few absolute contraindications remain nowadays, and the long-term performance of endosseous implants has largely exceeded initial expectations. In contrast to the environment in which they are placed, implants do not change. In view of the aging population, a paradigm shift in implant dentistry seems inevitable.

Physiological aging is featured by deterioration in vision, tactile sensitivity, and dexterity, rendering denture handling and oral hygiene difficult. In addition, old people often present with frailty and multimorbidity, often requiring assistance with the activities of daily living and a shift in life priorities.

When additional tooth loss occurs, a new restorative treatment is required. Although it is well accepted that age alone is not a contraindication for successful implant therapy, it is increasingly necessary to consider its implications in a geriatric treatment planning.

Monitoring the use and management of fixed and removable implant prostheses in geriatric patients seems mandatory. When functional decline and frailty render denture management difficult, “backing off” to a simplified and less complex restoration with or without the present implants may become necessary.

Notes

Acknowledgments

The text of this chapter is largely based on the International Team of Implantology Treatment Guide 9, Implant therapy in the Geriatric Patient (Quintessence, Berlin, 2016).

References

  1. 1.
    Takiguchi T, Yoshihara A, Takano N, Miyazaki H. Oral health and depression in older Japanese people. Gerodontology. 2015;33(4):439–46.  https://doi.org/10.1111/ger.12177.CrossRefPubMedGoogle Scholar
  2. 2.
    Newton J, Yemm R, Abel R, Menhinick S. Changes in human jaw muscles with age and dental state. Gerodontology. 1993;10(1):16–22.CrossRefPubMedGoogle Scholar
  3. 3.
    Tokmakidis SP, Kalapotharakos VI, Smilios I, Parlavantzas A. Effects of detraining on muscle strength and mass after high or moderate intensity of resistance training in older adults. Clin Physiol Funct Imaging. 2009;29(4):316–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Schimmel M, Loup A, Duvernay E, Gaydarov N, Müller F. The effect of lower denture abstention on masseter muscle thickness in a 97 year-old patient: a case report. Int J Prosthodont. 2010;23:418–20.PubMedGoogle Scholar
  5. 5.
    Müller F, Duvernay E, Loup A, Vazquez L, Herrmann FR, Schimmel M. Implant-supported mandibular overdentures in very old adults: a randomized controlled trial. J Dent Res. 2013;92(12 Suppl):154S–60S.  https://doi.org/10.1177/0022034513509630.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Scott J, Valentine JA, St Hill CA, Balasooriya BA. A quantitative histological analysis of the effects of age and sex on human lingual epithelium. J Biol Buccale. 1983;11(4):303–15.PubMedGoogle Scholar
  7. 7.
    Müller F, Link I, Fuhr K, Utz KH. Studies on adaptation to complete dentures. Part II: oral stereognosis and tactile sensibility. J Oral Rehabil. 1995;22(10):759–67.CrossRefPubMedGoogle Scholar
  8. 8.
    Fried LP, Walston J. Frailty and failure to thrive. In: Hazzard WR, Blass JP, Jr EW, editors. Principles of geriatric medicine and gerontology. 4th ed. New York, NY: McGraw Hill; 1998. p. 1387–402.Google Scholar
  9. 9.
    Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. The Gerontologist. 1970;10(1):20–30.CrossRefPubMedGoogle Scholar
  10. 10.
    Fillenbaum GG. Screening the elderly. A brief instrumental activities of daily living measure. J Am Geriatr Soc. 1985;33(10):698–706.CrossRefPubMedGoogle Scholar
  11. 11.
    Mahoney FI, Barthel DW. Functional evaluation: the barthel index. Md State Med J. 1965;14:61–5.PubMedGoogle Scholar
  12. 12.
    Guigoz Y, Vellas B, Garry PJ. Mini nutritional assessment: a practical assessment tool for grading the nutritional state of elderly patients. In:The mini nutritional assessment, facts and research in gerontology, vol. Suppl I. Paris: Serdi; 1994.Google Scholar
  13. 13.
    Sheikh J, Yesavange J. Geriatric depression scale (GDS): recent evidence and development of a shorter version. In: Bring T, editor. Clinical gerontology: a guide to assessment and interventions. New York: Haworth Press; 1986. p. 165–73.Google Scholar
  14. 14.
    Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRefPubMedGoogle Scholar
  15. 15.
    Shulman KI. Clock-drawing: is it the ideal cognitive screening test? Int J Geriatr Psychiatry. 2000;15(6):548–61.CrossRefPubMedGoogle Scholar
  16. 16.
    Moore KL, Boscardin WJ, Steinman MA, Schwartz JB. Age and sex variation in prevalence of chronic medical conditions in older residents of U.S. Nursing Homes. J Am Geriatr Soc. 2012;60(4):756–64.  https://doi.org/10.1111/j.1532-5415.2012.03909.x.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Moore KL, Boscardin WJ, Steinman MA, Schwartz JB. Patterns of chronic co-morbid medical conditions in older residents of U.S. Nursing Homes: differences between the sexes and across the agespan. J Nutr Health Aging. 2014;18(4):429–36.  https://doi.org/10.1007/s12603-014-0001-y.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    BFS. Medizinische Statistik der Krankenhäuser 2009—Standardtabellen. Neuchâtel: Bundesamt für Statistik; 2011.Google Scholar
  19. 19.
    Stone AA, Schwartz JE, Broderick JE, Deaton A. A snapshot of the age distribution of psychological well-being in the United States. Proc Natl Acad Sci U S A. 2010;107(22):9985–90.  https://doi.org/10.1073/pnas.1003744107.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Locker D, Jokovic A. Using subjective oral health status indicators to screen for dental care needs in older adults. Community Dent Oral Epidemiol. 1996;24(6):398–402.CrossRefPubMedGoogle Scholar
  21. 21.
    Müller F, Salem K, Barbezat C, Herrmann FR, Schimmel M. Knowledge and attitude of elderly persons towards dental implants. Gerodontology. 2012;29(2):e914–23.CrossRefPubMedGoogle Scholar
  22. 22.
    Graves AB, Larson EB, Edland SD, Bowen JD, McCormick WC, McCurry SM, Rice MM, Wenzlow A, Uomoto JM. Prevalence of dementia and its subtypes in the Japanese American population of King County, Washington state. The Kame Project. Am J Epidemiol. 1996;144(8):760–71.CrossRefPubMedGoogle Scholar
  23. 23.
    American Psychiatry Association. Diagnostic and statistical manual of mental disorders 4th edn. Washington, DC: APA; 1994.Google Scholar
  24. 24.
    Syrjala AM, Ylostalo P, Ruoppi P, Komulainen K, Hartikainen S, Sulkava R, Knuuttila M. Dementia and oral health among subjects aged 75 years or older. Gerodontology. 2012;29(1):36–42.  https://doi.org/10.1111/j.1741-2358.2010.00396.x.CrossRefPubMedGoogle Scholar
  25. 25.
    Faxen-Irving G, Basun H, Cederholm T. Nutritional and cognitive relationships and long-term mortality in patients with various dementia disorders. Age Ageing. 2005;34(2):136–41.  https://doi.org/10.1093/ageing/afi023.CrossRefPubMedGoogle Scholar
  26. 26.
    White H. Weight change in Alzheimer’s disease. J Nutr Health Aging. 1998;2(2):110–2.PubMedGoogle Scholar
  27. 27.
    Taji T, Yoshida M, Hiasa K, Abe Y, Tsuga K, Akagawa Y. Influence of mental status on removable prosthesis compliance in institutionalized elderly persons. Int J Prosthodont. 2005;18(2):146–9.PubMedGoogle Scholar
  28. 28.
    Wilding L, Eagles D, Molnar F, O'Brien JA, Dalziel WB, Moors J, Stiell I. Prospective validation of the Ottawa 3DY Scale by Geriatric Emergency Management Nurses to Identify Impaired Cognition in Older Emergency Department Patients. Ann Emerg Med. 2016;67(2):157–63.  https://doi.org/10.1016/j.annemergmed.2015.09.008.CrossRefPubMedGoogle Scholar
  29. 29.
    Zhang Y, Niu J, Kelly-Hayes M, Chaisson CE, Aliabadi P, Felson DT. Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly: the Framingham Study. Am J Epidemiol. 2002;156(11):1021–7.CrossRefPubMedGoogle Scholar
  30. 30.
    Müller F, Rentsch A. Les prothèses de recouvrement supraradiculaires. Titane. 2010;7(4):249–57.Google Scholar
  31. 31.
    Müller F, Schimmel M. GUEST EDITORIAL: revised success criteria: a vision to meet frailty and dependency in implant patients. JOMI. 2016;31(1):15.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Gerodontology and Removable Prosthodontics, Department of Oral Rehabilitation, Medical FacultyUniversity Clinics of Dental Medicine—CUMD, University of GenevaGenevaSwitzerland
  2. 2.Division of Gerodontology, Department of Reconstructive Dentistry and Gerodontology, Medical Faculty, School of Dental Medicine—ZMK BernUniversity of BernBernSwitzerland

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