A new research conducted on various groups of elderly people indicates a connection between levels of cognitive deterioration and diabetes combined with tooth loss, stressing the need for dental care, especially in the ageing population.
The connection between diabetes, oral health, and dementia highlights the need for dental care and diabetes management as people age. A new study, published in a special issue of the Journal of Dental Research that focuses on ageing and oral health, reveals that older adults who have both diabetes and tooth loss experience worse cognitive functioning and faster cognitive decline.
According to the lead author, Bei Wu, who is the vice dean for research at NYU Rory Meyers College of Nursing and co-director of the NYU Aging Incubator, "Our findings emphasise the importance of dental care and diabetes management for older adults, in order to reduce the personal and societal costs of Alzheimer's disease and related dementias."
Diabetes is a well-established risk factor for cognitive decline and dementia. Several features of diabetes, such as high blood sugar, insulin resistance, inflammation, and related heart disease, are believed to contribute to brain changes.
A growing body of research suggests that poor oral health, specifically gum disease and tooth loss, is also linked to cognitive impairment and dementia, much like diabetes. Inflammation is a significant factor in gum disease, and these inflammatory processes can contribute to cognitive decline. Furthermore, sore gums and missing teeth can cause chewing difficulties, leading to dietary changes that may result in nutritional deficiencies. Nutritional deficiency, which can be worsened by impaired glucose tolerance and insulin sensitivity in diabetes, is another risk factor for cognitive impairment and dementia.
“Poor oral health, diabetes, and cognitive decline are all connected, and we’re beginning to understand how they may influence and exacerbate one another,” says Wu.
Although diabetes and tooth loss are both risk factors for dementia, little research has been conducted on the effects of having both conditions during cognitive decline. To address this gap, Wu and her colleagues utilized data from the University of Michigan’s Health and Retirement Study, analyzing 12 years of data (2006-2018) to observe cognitive changes over time.
The researchers examined 9,948 older adults who were categorized by age (65 to 74, 75 to 84, and 85 and older) in their analysis. The Health and Retirement Study provided memory and cognitive function measures that were assessed every two years, along with questions about tooth loss, diabetes, and other health and demographic factors. The researchers focused particularly on older adults who had lost all of their teeth.
The findings showed that older adults aged 65 to 84, with both diabetes and complete tooth loss, had worse cognitive function than their counterparts who had neither condition. Over time, older adults aged 65 to 74 with diabetes alone experienced accelerated cognitive decline, and those aged 65 to 84 without any teeth also experienced accelerated cognitive decline. However, older adults aged 65 to 74, with both diabetes and complete tooth loss, had the fastest rate of cognitive decline.
The relationship among diabetes, tooth loss, and cognitive decline was unclear for adults aged 85 and older. This could be due to this group having greater overall cognitive impairment, being healthier (as less healthy individuals may be less likely to survive into their late 80s), or perhaps having more experience in managing their diabetes.
For older adults who suffer from both poor oral health and diabetes, experts recommend regular dental check-ups, compliance with diabetes treatment, maintaining self-care to manage blood sugar levels, and undergoing cognitive assessments in primary care facilities. Bei Wu emphasized the significance of dental care access for elderly individuals, particularly those with diabetes, and called on healthcare professionals to educate their patients on the correlation between oral health and cognitive function.