Researchers at New York University Rory Meyers College of Nursing, the University of Nevada and Rutgers University found that older Chinese adults in the U.S. who reported teeth symptoms experienced faster cognitive decline than those who reported gum symptoms.
This finding underscores the importance of dental care and the need to include oral healthcare services when developing culturally-tailored interventions aimed at mitigating cognitive decline and improving quality of life among the elderly.
Teeth problems linked to cognitive decline
For their study, the researchers drew data from the Population Study of Chinese Elderly or PINE, an epidemiological study that examined the health and quality of life of the Chinese elderly in the greater Chicago area.
The PINE researchers interviewed more than 3,000 participants between 2011 and 2013 and inquired about their health issues. Among the questions asked was whether the participants experienced teeth and gum symptoms.
In the follow-up interview conducted in 2015, only 2,713 out of the 3,157 baseline respondents agreed to participate. Those who did not complete the follow-up interview were older participants who also had worse cognitive performance, according to the researchers.
During the initial as well as the follow-up interview, the PINE researchers asked the participants to take five cognitive tests. Four of the tests covered three cognitive domains: executive function, episodic memory and working memory.
Using data from these tests as well as the participants' self-reported oral symptoms, the current study examined the link between teeth and gum symptoms and changes in cognitive function.
The researchers found that 47.8 percent of the more than 2,700 participants reported having teeth symptoms, while 18.9 percent reported having gum symptoms. After adjusting for sociodemographic and health?related characteristics, they noted that participants who had teeth symptoms at baseline experienced a decrease in global cognition and episodic memory.
The same participants also displayed a faster rate of decline in global cognition for each additional year. In contrast, the researchers did not find a significant relationship between gum symptoms and changes in cognitive function. (Related: “Exergaming” improves cognitive function of older patients.)
According to XinQi Dong, the study's senior author, racial and ethnic minorities in the U.S., particularly older Chinese Americans, are vulnerable to the negative effects of poor oral health. Besides having less access to dental care, language barriers and a low socioeconomic status further exacerbate this problem.
"Our research raises critical awareness for dental and healthcare providers," said Dong. "Working collaboratively, dental and healthcare providers can better identify oral health symptoms as risk factors of cognitive decline in this fast-growing vulnerable population. The primary focus should include promoting optimal oral health and improving the quality of life."
Poor social conditions can contribute to stress, dry mouth
In another study, Dong and some of his colleagues examined the role of psychosocial factors in oral health problems by looking at how perceived stress is linked to dry mouth, a common complaint among older adults. They used baseline information from the PINE study for their analysis.
The researchers found that higher levels of perceived stress correlated to a higher likelihood of reporting dry mouth. They also noted that the effect of perceived stress on the risk of dry mouth was dependent on the amount of support the older participants received from their family and friends.
Taken together, the two studies highlight the importance of adequate dental care services and social support for maintaining the well-being of the elderly.
"Efforts must be made to increase social support to alleviate stress and the resulting dry mouth issues reported by our study participants," said Dong. "These efforts can help preserve older adults' health and well-being and limit cognitive decline."
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