Is there a link between Oral Health & Cognitive Decline?

Regular visits to the dentist may help you to keep thinking clearly during later life, suggests new research published in the Journal of the American Geriatrics Society.  The study links oral health with cognitive well-being. However, the researchers do caution that more studies are needed.

Oral Health & Disease

Oral health problems are starting to be linked to disease elsewhere in the body.
According to the Mayo Clinic, poor oral health could contribute to heart disease which may be due to the spread of bacteria. Also, diabetes could exacerbate oral health problems by reducing resistance to infection in the body.

As the older population expands in North America, both oral health and cognition have become increasingly important areas of study. Researchers are speculating that a common inflammatory pathway could hold the key to a link, if it exists.

The authors include the statistic that around 36% of people in the US who are 70+ years are living with some degree of cognitive decline. According to the Alzheimer's Association, in the US around 5.4 million people now have Alzheimer's disease. The most common form of dementia.

The likelihood and severity of both cognitive impairment and dementia tend to increase with one's age. In the US population numbers are expected to double by the year 2050.

Similarly, evidence suggests a higher rate of oral disease among older adults. And significantly so amongst those who are experiencing cognitive impairments and particularly those with dementia.

Senior at the Dentist

Correlation or Causation? Some evidence of a link with dementia?

A group of researchers led by Dr. Bei Wu (Duke University's School of Nursing based in Durham, NC) wanted to know whether there was indeed a link between oral health and cognitive status in older adults. In that order.

The team delved into analyzing studies published between 1993-2013. They used cross-sectional data, i.e. collected at a specific point in time. Plus longitudinal data, i.e. gathered over an extended period of time.

Their results suggest that certain oral health measures, e.g number of teeth, number of cavities, along with the presence of periodontal disease (gum disease) may reflect and predict the risk of cognitive decline or dementia itself.

However, some studies did not seem to reveal any association. Plus there are conflicting findings if based on the number of teeth or cavities. So there is limited solid evidence of a link between periodontal conditions like gingivitis and poor or declining cognition.

The team also concluded that there is insufficient hard evidence to infer a common underlying cause in inflammation. Or a causative relationship between oral health and cognition.

Dr. Wu said:

"Clinical evidence suggests that the frequency of oral health problems increases significantly in cognitively impaired older people, particularly those with dementia. In addition, many of the factors associated with poor oral health, such as poor nutrition and systemic diseases like diabetes and cardiovascular disease, are also associated with poor cognitive function."

The team suggested for future studies, gathering data from much larger and more representative population samples. And using standard cognitive assessments as well as oral health measures along with more sophisticated methods of data analysis.

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