Clinical Oral Investigations

, Volume 22, Issue 7, pp 2575–2580 | Cite as

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

  • Koji NaruishiEmail author
  • Yasufumi Nishikawa
  • Jun-ichi Kido
  • Akihiro Fukunaga
  • Toshihiko Nagata
Original Article



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

Materials and methods

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.

Clinical relevance

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


Aspiration pneumonia Cognitive impairment Oral frailty Elderly patients 



The authors thank the medical staff of Tottori Municipal Hospital and Naruto Seagull Hospital for their assistance.


This study was supported by a Grant-in-Aid for Scientific Research (B) (No. 15H05054) from the Japan Society for the Promotion of Science.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the ethics committee of Tottori Municipal Hospital (No. 1153) and Naruto Seagull Hospital (No. 16-0001).

Informed consent

For this type of study, formal consent is not required.

Supplementary material

784_2018_2356_MOESM1_ESM.ppt (348 kb)
ESM 1 (PPT 347 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Periodontology and Endodontology, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaJapan
  2. 2.Social Welfare Corporation KouzukaiNaruto Seagull HospitalNarutoJapan

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