Cognitive Decline and Oral Health in Middle-aged Adults in the ARIC Study

Li²,

J of Periodontal Research

et al. 2014

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Multiple tooth loss is associated with vascular cognitive impairment in subjects with acute ischemic stroke

Li²,

J of Periodontal Research

et al. 2014

Journal of Medicinal Food

“…Similar combined scores have been calculated and used in other studies for analysis of cognitive function. 30,31 The change in the test score for the digit symbol was positively associated with increased total flavonol intake (P-values < .001). Change in word fluency was only marginally associated with flavonol intake (P = .027 for the unadjusted model and not significantly correlated for the adjusted models).…”

Section: Discussionmentioning

confidence: 97%

Flavonol Intake and Cognitive Decline in Middle-Aged Adults

Root

Ravine

Harper

2015

Cognitive decline occurs with age and may be slowed by dietary measures, including increased intake of dietary phytochemicals. However, evidence from large and long-term studies of flavonol intake is limited. Dietary intakes of flavonols were assessed from a large biracial study of 10,041 subjects, aged 45-64, by analysis of a food frequency questionnaire administered at visit 1 of triennial visits. Cognitive function was assessed at visits 2 and 4 with the following three cognitive performance tests: the delayed word recall test, the revised Wechsler Adult Intelligence Scale digit symbol subtest, and the word fluency test of the Multilingual Aphasia Examination. The change in each score over 6 years was calculated, and a combined standardized change score was calculated. Generalized linear models controlled for age, ethnicity, gender, education level, energy intake, current smoking, physical activity, body mass index, diabetes, and vitamin C intake. Total flavonols across quintiles of intake were positively associated with preserved combined cognitive function (P<.001). This pattern with preserved combined cognitive function was consistent for the three major individual flavonols in the diet, myricetin, kaempferol, and quercetin (each P<.001). The positive association with total flavonols was strongest for the digit symbol subtest (P<.001). In this cohort, flavonol intake was correlated with protected cognitive function over time.

“…Our study may have been underpowered to detect an association between BGI and cognitive function because the mean differences between the two extreme BGI groups were relatively small, and cognitive change during the eight-year follow-up was modest (Supplemental material). However, it is also possible that subtle changes in cognitive function occurring prior to study baseline resulted in poor oral hygiene care, thereby increasing plaque level and the extent of bleeding on probing at baseline (35). …”

Section: Discussionmentioning

confidence: 99%

Tooth loss, periodontal disease, and cognitive decline in the Atherosclerosis Risk in Communities (ARIC) study

Naorungroj

Schoenbach

Wruck

et al. 2014

Comm Dent Oral Epid

105

Objective The purpose of this prospective study was to investigate whether poor oral health predicted eight-year cognitive function change in predominantly late middle adults in the Atherosclerosis Risk in Communities (ARIC) study. Methods Participants included a subset of ARIC participants aged 52–75 years at 1996–1998 from two study sites: Forsyth County NC and Jackson MS. All subjects completed cognitive function assessments both in 1996–1998 and 2004–2006, and the same subjects received a dental examination at the initial visit. Cognitive assessment consisted of Delayed Word Recall (DWR), Digit Symbol Substitution (DSS), and Word Fluency (WF) tests. In the analysis, cognitive function for 911 dentally screened participants was evaluated, and 558 of 785 dentate participants received comprehensive oral examinations, including periodontal probing. Measures of oral health included dental status, number of teeth, and periodontal disease classified by the Biofilm-Gingival Interface (BGI) index. The generalized estimating equations (GEE) method was used to analyze repeated measures of cognitive scores with adjustment for socio-demographic characteristics and cardiovascular risk factors. Results Of 911 study participants, 13.8% were edentulous. About 13 % of dentally examined participants had periodontal pockets (≥4 mm) with severe bleeding. At the follow-up visit, DWR and WF scores were lower in edentulous compared to dentate people, whereas other oral health measures were not associated with cognitive function. Mean values declined over time for all three cognitive measures, although poor oral health conditions were not associated with greater degree of decline in cognitive function. Conclusions In these late-middle aged adults, complete tooth loss was significantly associated with lower cognitive performance. However, neither edentulism, number of teeth, nor periodontal disease predicted greater subsequent cognitive decline.