scholarly journals THE IMPACT OF DIABETES AND POOR ORAL HEALTH ON COGNITION: IMPLICATIONS TO IMPROVE DENTAL CARE ACCESS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S607-S607
Author(s):  
Bei Wu ◽  
Huabin Luo

Abstract This study examined the joint effects of diabetes and poor oral health on cognitive function among older adults aged 60 years or older in the U.S. We analyzed data of 2,937 participants from the National Health and Nutrition Examination Survey (2011-2014). We investigated the interaction effects between diabetes and significant tooth loss, i.e. differences among the following four groups: 1=neither of the two conditions, 2=non-diabetic but with tooth loss, 3=diabetic but no tooth loss, and 4=both conditions. Significant interaction effects were found in our study. Having either diabetes or significant tooth loss was associated with lower cognitive function. When the two conditions were both present, the negative effects were much stronger than the total effects from either one of the two conditions. The additional loss of cognitive function resulting from multiple health conditions illustrates the importance of improving access to dental care for older adults in the U.S.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 799-800
Author(s):  
Bei Wu ◽  
Stephen Shuman ◽  
Elisa Ghezzi

Abstract Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the impact of early childhood disadvantages on oral health in later life among adults age 51 and above in the U.S. The second paper used large-scale epidemiological data that addressed the relationship between acculturation and subsequent oral health problems. It also tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The third paper demonstrated the importance of examining different pathways among foreign-born and native-born Chinese older adults with regard to offspring’s support on their oral health outcomes. While increasing evidence shows that cognitive function is associated with oral health, limited studies have been conducted to examine the impact of cognitive impairment, e.g., Alzheimer’s Disease (AD) and related dementias (RD), on dental care utilization and costs in older adults. The fourth paper aimed to address this knowledge gap. Results showed that AD and RD had different impacts on different types of dental care utilization and costs. The fifth paper further displayed that individuals with cognitive impairment face a significant challenge in handling dental-related medications. This symposium provides policy and clinical implications on improving oral health and dental care utilization among older adults in the U.S. Oral Health Interest Group Sponsored Symposium.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 206-206
Author(s):  
Bei Wu ◽  
Susie Keepper ◽  
Michèle Saunders

Abstract Poor oral health, diabetes mellitus (DM), and cognitive impairment are common problems in older adults. Using national surveys, this symposium aims to present new findings regarding the impact of the co-occurrence of DM and poor oral health on cognitive function, cognitive decline, and mortality. This symposium will also cover the topic of dental care use among adult populations in the U.S. Using data from the Health and Retirement Study (HRS) (2006- 2018), the first study shows that adults with both DM and edentulism had the worst cognitive function, followed by those with edentulism alone, and those with DM alone. Using the same HRS data, the second study found that co-occurrence of DM and edentulism had a higher risk of more rapid cognitive decline with advancing age than the presence of each condition alone. The third study used data from the 2006-2016 HRS linked with mortality files, and revealed that the risk of diabetes and edentulism on mortality may vary across racial/ethnic groups. Using the Behavioral Risk Factor Surveillance System survey (2002-2018), the fourth study examined disparities of dental service utilization among racial/ethnic groups (Whites, Hispanics, Blacks, Asians, American Indians or Alaska Natives, and Native Hawaiian or other Pacific Islanders). Age differences in dental services were also compared between older adults and other younger and middle-aged populations. This symposium highlights the role of oral health in improving cognitive health. Policies and programs are needed to increase dental care access, a critical way to help maintain good oral health.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S606-S606
Author(s):  
Yanyan Wu ◽  
Wei Zhang ◽  
Bei Wu

Abstract Oral health is an essential part of staying healthy. Neglect of dental care may lead to tooth decay/ loss, poor nutrition, and affects individuals’ quality of life. Over the past decades, dental care utilization has risen considerably, however, racial/ethnic and socioeconomic disparities still persist in the U.S. Additionally, poor oral health is a contributing factor to, and a consequence of chronic diseases such as cognitive impairment, diabetes and cardiovascular disease. Faced with the complex and intertwined health and social challenges, it’s imperative to understand the disparities of dental care utilization and the relationships among oral health and chronic diseases so that effective policies and preventions can be implemented to improve quality of care. In this symposium, we present findings for older adults from diverse racial/ethnic populations in the U.S. We begin with results from two national-wide trend analyses: a 15-year review of dental care utilization and the evaluation of dental care performance over a 16-year period in nursing homes. The next study presents the barriers of dental care utilization in Hawaii. Finally, we present results of the negative effects of diabetes and poor oral health on cognitive function. Our studies address the disparities of dental care utilization among minority and under-represented ethnic groups as well as the connections between oral health and chronic conditions. Our results are helpful in educating policy makers and health practitioners about how to improve dental care and how dental care can be effectively integrated into chronic disease prevention and health promotion activities.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S349-S349
Author(s):  
Bei Wu ◽  
Stephen K Shuman ◽  
Michele Saunders

Abstract There is an increasing awareness of the importance of oral health and its associated risk factors among older adults. This symposium includes four papers that address cognitive function, social support and oral health problems and symptoms among older adults in the U.S. and China. Lu and his colleagues examined the reciprocal relationship between cognitive function and complete tooth loss Chinese adults age 50+ using the China Health and Retirement Longitudinal study. The results show that there is a reciprocal relationship between these two indicators. The second paper used the Population Study of Chinese Elderly in Chicago (PINE) and examined the associations between tooth/gums symptoms and changes in cognitive function in Chinese older immigrants. The results reveal that having teeth symptoms was associated with a decline in cognitive function. Using the same PINE data, the third paper examined the association between different characteristics of social relationships and the number of oral health problems among U.S. older Chinese adults. Wu and her colleagues conducted a partner-assisted pilot intervention to improve oral health for community-dwelling older adults with either mild cognitive impairment or mild dementia. The results of this 6-month intervention show that persons in the treatment group had more improvement in oral hygiene than those in the control group. Findings from these four papers illustrate that cognitive function, social support, and oral health are interrelated. This symposium highlights the importance of improving cognitive health, social support, and oral health for middle-aged and older adults.


2019 ◽  
Author(s):  
Swapnil Bumb ◽  
Charu Chitra Govindan ◽  
Safalya Kadtane ◽  
Rukmini JN ◽  
Roshani Chawla ◽  
...  

BACKGROUND Till date no longitudinal prospective study have investigated the association between the oral health status and cognitive decline in the geriatric Indian population, possibly due to past studies differing in target groups and methodologies. We aimed to investigate the association between tooth loss, as evaluated through clinical oral examinations, and the development of cognitive decline in the older adults while considering baseline cognitive function. OBJECTIVE to investigate the association between tooth loss, as evaluated through clinical oral examinations, and the development of cognitive decline in the older adults while considering baseline cognitive function. METHODS This 5-year prospective cohort study followed 140 participants (mean age: 72.5 ± 4.3 years) without cognitive impairment aged ≥65 years (mean age: 70.9 ± 4.3 years) living in the Dhule Region of Maharashtra , India. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) in baseline and follow-up surveys,while oral health examination was carried out using Oral Hygiene Index To investigate the association between oral health status and cognitive decline, we applied a multiple logistic regression analysis adjusted for age, gender, hypertension, diabetes, cerebrovascular/cardiovascular disease, hypercholesterolemia, depressive symptoms, body mass index, smoking status, drinking status, duration of education, and baseline MMSE score. RESULTS In the 5 years after the baseline survey, we have obtained an overall incidence of 20.71%. population who developed cognitive decline (i.e., MMSE scores of ≤24). Multivariable logistic regression analysis indicated that participants with compromised oral health were more likely to develop cognitive decline than those with mild to moderate oral health were (odds ratio: 3.31; 95% confidence interval: 1.07–10.2). Age, male gender, and baseline MMSE scores were also significantly associated with cognitive decline. CONCLUSIONS Poor Oral health status was independently associated with the development of cognitive decline within 5 years among the geriatric population of India . This finding corroborates the hypothesis that oral health may be a predictor or risk factor for cognitive decline. CLINICALTRIAL Not applied


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S350-S350
Author(s):  
Nan Lu ◽  
Bei Wu ◽  
Yaolin Pei

Abstract While empirical evidence shows that cognitive function affects oral health and vice versa, there is a lack of empirical evidence to test the reciprocal relationship between these two indicators. This study aimed to examine this relationship among middle-aged and older adults in China. Data were derived from the 2011 and 2015 waves of the China Health and Retirement Longitudinal study. A two-wave cross-lag analysis was adopted to test the hypothesized model. Cognitive function in 2011 was found to be a significant predictor of complete tooth loss in 2015. Furthermore, complete tooth loss in 2011 was found to be a significant predictor of cognitive cognition in 2015. This finding demonstrates the reciprocal relationship between cognitive function and oral health. This study highlights the importance of improving both cognitive health and oral health for middle-aged and older adults. Policy and intervention implications are discussed.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 414-415
Author(s):  
Xi Chen ◽  
Bei Wu ◽  
Stephen Shuman

Abstract Older adults face a unique challenge in maintaining their oral health due to an increased disease burden, polypharmacy, functional impairment and other reasons. The five papers in this symposium describe the oral health issues in various groups of older adults and discuss different approaches to improve oral health for older adults. Using data from the Population Study of Chinese Elderly in Chicago, the first paper examined the relationship between self-reported discrimination and oral health related quality of life and investigated how resilience mediated such a relationship among foreign-born older Chinese Americans. The second paper described the oral health concerns and related treatment needs in older adults receiving palliative care using a mixed method design. The third paper demonstrated how to use behavior change techniques to improve oral self-care skills of individuals with mild dementia and support their family caregivers. The fourth paper described a project that integrates the age-friendly health system's principles into specialty dental care to address healthy aging and oral health. This initiative helped prevent and change the false belief that aging inevitably involves deterioration in oral health. The fifth paper described the impact of COVID-19 on the management of oral health problems and access to dental care in older adults. Transformative changes in care delivery and the impact of vaccination on access to care was also explored. This symposium helps better understand the oral health needs in older adults and provides new evidence to improve oral health for these individuals.


2021 ◽  
Vol 19 ◽  
Author(s):  
Huabin Luo ◽  
Chenxin Tan ◽  
Samrachana Adhikari ◽  
Brenda L. Plassman ◽  
Angela R. Kamer ◽  
...  

Objective: Both diabetes mellitus (DM) and poor oral health are common chronic conditions and risk factors of Alzheimer’s disease and related dementia among older adults. This study assessed the effects of DM and complete tooth loss (TL) on cognitive function, accounting for their interactions. Methods: Longitudinal data were obtained from the 2006, 2012, and 2018 waves of the Health and Retirement Study. This cohort study included 7,805 respondents aged 65 years or older with 18,331 person-year observations. DM and complete TL were self-reported. Cognitive function was measured by the Telephone Interview for Cognitive Status. Random-effect regressions were used to test the associations, overall and stratified by sex. Results: Compared with older adults without neither DM nor complete TL, those with both conditions (b = -1.35, 95% confidence interval [CI]: -1.68, -1.02), with complete TL alone (b = -0.67, 95% CI: -0.88, -0.45), or with DM alone (b = -0.40, 95% CI: -0.59, -0.22), had lower cognitive scores. The impact of having both conditions was significantly greater than that of having DM alone (p < .001) or complete TL alone (p = 0.001). Sex-stratified analyses showed the effects were similar in males and females, except having DM alone was not significant in males. Conclusion: The co-occurrence of DM and complete TL poses an additive risk for cognition. Healthcare and family-care providers should pay attention to the cognitive health of patients with both DM and complete TL. Continued efforts are needed to improve older adults’ access to dental care, especially for individuals with DM.


Author(s):  
Dinorah Munira Hernandez-Santos ◽  
Irma Fabiola Diaz-Garcia

This paper presents the results of a case study about the perceptions of oral health care, factors that influenced current oral health, and barriers to dental attention of two older adults; the study was conducted by researchers from a hospital-school of dentistry at a public university in Mexico. Two adults aged 64 and 70 years participated in this study. First, the oral health status was clinically evaluated using the Decayed/Missing/Filled/Teeth (DMFT) Index. A semi-structured interview was then conducted to learn about the perceptions of oral health care. Thematic content analysis was used to explore the data obtained using the ATLAS.ti software 7.0 version. Four main themes and their subthemes were developed. The main finding of the case study was that oral health was directly and strongly associated with the impact that it has on a participant's life, especially in the functional field of chewing. Also, the participants recognized the importance of having good oral health and see it as a necessity for living. Aspects that influenced the current status of oral health were mainly the care received during their childhood, as well as the previous dental beliefs and treatments. Finally, some of the perceived barriers to dental care treatment were lack of time, finances, and education. These findings challenge professionals to be more sensitive to past and current experiences of older adults at the time of receiving dental care. Knowing their perceptions can support health professionals to strengthen patients’ commitment to prioritizing oral health care needs.


Sign in / Sign up

Export Citation Format

Share Document