Salivary Antimicrobial Peptide in Patients With Dementia Before and After Clinical Oral Rehabilitation Programme: A Randomised Controlled Trial

• Published in: Journal of oral rehabilitation Vol. 52; no. 1; pp. 1 - 8
• Main Authors: Chen, Ming‐An, Yang, Yuan‐Han, Liu, Ching‐Kuan, Matsuo, Koichiro, Hsu, Chih‐Cheng, Lin, Ying‐Chu, Huang, Hsiao‐Ling
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.01.2025
• Subjects: Aged; Aged, 80 and over; Antimicrobial Peptides; cognitive ageing; Defensins; Dementia; Dementia - physiopathology; Dementia - rehabilitation; Dementia disorders; Female; hospitals; Humans; Male; Middle Aged; Oral Health; Oral Hygiene; Quality of Life; Rehabilitation; Saliva; Saliva - chemistry; Saliva - metabolism; Treatment Outcome; saliva; hospitals; oral health; rehabilitation; quality of life; cognitive ageing
• ISSN: 0305-182X; 1365-2842; 1365-2842
• DOI: 10.1111/joor.13867

ABSTRACT Background Emerging evidence suggests a link between salivary metabolite changes and neurodegenerative dementia, with antimicrobial peptides (AMPs) implicated in its pathogenesis. Objective We investigated the effects of a clinical oral rehabilitation programme tailored for dementia patients on salivary flow rate, AMP levels and oral health‐related quality of life (OHRQoL). Methods Eligible patients were randomly assigned to either the experimental group (EG; n = 28) or the control group (CG; n = 27). Both groups received a leaflet on oral health. In addition, the EG received an oral care intervention that included individual lessons on oral muscle exercises and oral self‐care practices. Saliva samples and OHRQoL data were collected at baseline and follow‐up visits. Generalised estimating equation models were used to analyse the changes over time. Results At the 3‐month follow‐up, EG showed significantly lower histatin 5 (HTN‐5) levels (β = −0.08; effect size [ES] = 0.72) than CG. At 6 months, EG exhibited improved salivary flow rate (β = 0.89; ES = 0.89) and OHRQoL (β = 6.99; ES = 1.31) compared to CG. Changes in salivary flow rate (β = 4.03), HTN‐5 level (β = −0.78) and beta‐defensin 2 level (BD‐2) (β = −0.91) at 3 months predicted improved OHRQoL at 6 months (all p < 0.05). Conclusions Our clinical oral rehabilitation programme reduced the level of salivary HTN‐5, increased salivary flow rate and enhanced OHRQoL in dementia patients. Furthermore, changes in salivary flow rate, HTN‐5 level and BD‐2 level were associated with improvements in patients' OHRQoL. Our clinical oral rehabilitation programme reduced the level of salivary histatin‐5, increased salivary flow rate, and enhanced oral health‐related quality of life (OHRQoL) in dementia patients. Furthermore, changes in salivary flow rate, histatin‐5 level, and beta‐defensin‐2 level were associated with improvements in patients' OHRQoL.