Edentulism and Trajectories of Cognitive Functioning Among Older Adults: The Role of Dental Care Service Utilization

Han, Sae Hwang; Wu, Bei; Burr, Jeffrey A.

doi:10.1177/0898264319851654

Cited by 13 publications

(33 citation statements)

References 31 publications

(49 reference statements)

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“…In this study we did not find any mediation effect from an inflammatory factor CRP, but people with regular dental visits showed better cognitive function at the later stages. This is consistent to the findings from a recent longitudinal study, which demonstrated that dental care service utilization was independently associated with cognitive decline among older adults in the U.S. [22] Diet and nutrition may also explain the association. Poor quality diet has been linked to cognitive decline in elderly people.…”

Section: Discussionsupporting

confidence: 91%

Bidirectional relations between cognitive function and oral health in ageing persons: a longitudinal cohort study

Kang

Bunce

et al. 2020

Age and Ageing

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Background evidence suggests a reciprocal relationship between cognitive function (CF) and oral health (OH), but no study has demonstrated this inter-relationship in a longitudinal population. Objective to investigate the bidirectional relationship between CF and OH in an ageing cohort. Design cohort study. Setting general community. Subjects participants from the English Longitudinal Study of Ageing. Methods OH, measured by teeth status, self-reported OH and OH-related quality of life (OHRQoL), and CFs were collected at three time points in 2006/07, 2010/11 and 2014/15. Cross-lagged structural equation models were used to investigate the association between CF and OH, adjusted for potential confounding factors. Results 5477 individuals (56.4% women) were included (mean age = 63.1 years at 2006/07, 67.2 at 2010/11 and 70.4 at 2014/15, SD = 8.9) in analyses. The average CF score was 46.5(SD = 12.3) at baseline and 41.2 (SD = 13.4) at follow-up. 3350 (61.2%) participants had natural teeth only and 622 (11.2%) were edentulous. In the fully adjusted model, better cognition at baseline was associated with better OH at follow-up (beta coefficient = 0.02, 95% CI: 0.01–0.03); conversely better OH at baseline predicted better cognition (beta coefficient = 0.12, 95% CI: 0.06–0.18). Similar magnitude and direction of the reciprocal association was evident between cognition and OHRQoL. Conclusions This is the first longitudinal study to demonstrate the positive reciprocal association between CF and OH. The findings suggest the importance of maintaining both good CF and OH in old age.

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Section: Discussionsupporting

confidence: 91%

Bidirectional relations between cognitive function and oral health in ageing persons: a longitudinal cohort study

Kang

Bunce

et al. 2020

Age and Ageing

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“…Forty seven studies were included in this review: 24 for cognitive decline 8 , 9 , 15 , 16 , 17 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 and 23 for dementia 10 , 11 , 12 , 13 , 14 , 47 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 (Figure 1 ). Characteristics of included studies are summarized in Table S1 .…”

Section: Resultsmentioning

confidence: 99%

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Asher

Stephen

Mäntylä

et al. 2022

J American Geriatrics Society

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Background Emerging evidence indicates that poor periodontal health adversely impacts cognition. This review examined the available longitudinal evidence concerning the effect of poor periodontal health on cognitive decline and dementia. Methods Comprehensive literature search was conducted on five electronic databases for relevant studies published until April 2022. Longitudinal studies having periodontal health as exposure and cognitive decline and/or dementia as outcomes were considered. Random effects pooled estimates and 95% confidence intervals were generated (pooled odds ratio for cognitive decline and hazards ratio for dementia) to assess whether poor periodontal health increases the risk of cognitive decline and dementia. Heterogeneity between studies was estimated by I2 and the quality of available evidence was assessed through quality assessment criteria. Results Adopted search strategy produced 2132 studies for cognitive decline and 2023 for dementia, from which 47 studies (24 for cognitive decline and 23 for dementia) were included in this review. Poor periodontal health (reflected by having periodontitis, tooth loss, deep periodontal pockets, or alveolar bone loss) was associated with both cognitive decline (OR = 1.23; 1.05–1.44) and dementia (HR = 1.21; 1.07–1.38). Further analysis, based on measures of periodontal assessment, found tooth loss to independently increase the risk of both cognitive decline (OR = 1.23; 1.09–1.39) and dementia (HR = 1.13; 1.04–1.23). Stratified analysis based on the extent of tooth loss indicated partial tooth loss to be important for cognitive decline (OR = 1.50; 1.02–2.23) and complete tooth loss for dementia (HR = 1.23; 1.05–1.45). However, the overall quality of evidence was low, and associations were at least partly due to reverse causality. Conclusions Poor periodontal health and tooth loss appear to increase the risk of both cognitive decline and dementia. However, the available evidence is limited (e.g., highly heterogenous, lacking robust methodology) to draw firm conclusions. Further well‐designed studies involving standardized periodontal and cognitive health assessment and addressing reverse causality are highly warranted.

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“…Oral health is increasingly considered as an essential element of healthy aging as it is closely related to one’s general health status and health-related quality of life (Shuman et al, 2017). Regular dental checkups can prevent oral diseases, maintain good oral health (Griffin, Jones, Brunson, Griffin, & Bailey, 2012), and promote cognitive functioning in late life (Han, Wu, & Burr, 2019). However, regularly utilizing dental services is often a challenge for many Americans, especially for older adults, racial/ethnic minorities, and immigrant populations (Wilson, Wang, Borrell, Bae, & Stimpson, 2018; Zhang, 2016).…”

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confidence: 99%

Racial/Ethnic Disparities in Dental Service Utilization for Foreign-Born and U.S.-Born Middle-Aged and Older Adults

Zhang

2019

Res Aging

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This study examines racial/ethnic disparities of dental service utilization for foreign-born and U.S.-born dentate residents aged 50 years and older. Generalized linear mixed-effects models (GLMM) were used to perform longitudinal analyses of five-wave data of dental service utilization from the Health and Retirement Study (HRS). We used stratified analyses for the foreign-born and U.S.-born and assessed the nonlinear trend in rates of dental service utilization for different racial/ethnic groups. Findings indicate that Whites had higher rates of service utilization than Blacks and Hispanics regardless of birthplace. For all groups, the rates of service utilization decreased around age 80, and the rates of decline for Whites were slower than others. The U.S.-born showed the trend of higher rates of service utilization than the foreign-born for all racial/ethnic groups. These findings suggest the importance of developing culturally competent programs to meet the dental needs of the increasingly diverse populations in the United States.

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Edentulism and Trajectories of Cognitive Functioning Among Older Adults: The Role of Dental Care Service Utilization

Cited by 13 publications

References 31 publications

Bidirectional relations between cognitive function and oral health in ageing persons: a longitudinal cohort study

Bidirectional relations between cognitive function and oral health in ageing persons: a longitudinal cohort study

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Racial/Ethnic Disparities in Dental Service Utilization for Foreign-Born and U.S.-Born Middle-Aged and Older Adults

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