Diabetes and Edentulism in Older Adults Can Accelerate Cognitive Decline

Older adults with diabetes and edentulism have accelerated rates of cognitive decline, according to study findings published in the Journal of Dental Research.

Previous research has identified diabetes as a risk factor for cognitive decline. Additionally, there is increasing research regarding the bidirectional influence of diabetes and poor oral health.

For the study, researchers sought to determine the joint association of diabetes and edentulism on long-term cognition.

The researchers took data that was taken from the 2006 to 2018 Health and Retirement Study (HRS). The HRS collected data regarding patient demographics, lifestyle, and health information every 2 years, with a response rate of 82% to 90%.

The researchers identified 11,395 older adults aged 65 years and older and 9948 participants remained after exclusion. There were 5440 participants aged 65 to 74 years, 3300 were aged 75 to 84 years, and 1208 were aged 85 years and older.

The primary outcome was cognitive function, which was assessed using the modified HRS Telephone Interview for Cognitive Status (TICS-m). The HRS TICS-m score was rated on a scale from 0-35, with a higher score indicating better cognition.

Adults aged 85 years and older scored the lowest on the HTS TICS-m (mean±standard deviation [SD], 18.53±0.17), while adults aged 65 to 74 years scored highest (23.07±0.07).

Rates of participants with both diabetes and edentulism were 6.0%, 6.7%, and 5.0% for participants aged 65 to 74 years, 75 to 84 years, and 85 years and older, respectively (P <.001).

When compared with patients without diabetes or edentulism in the same age group, participants aged 65 to 74 years with diabetes only (0.28 points; 95% CI, 0.03-0.53), edentulism only (0.61 points; 95% CI, 0.29-0.92), and both conditions (1.12 points; 95% CI, 0.65-1.56) had decreased average cognition scores.

Compared with their counterparts without diabetes or edentulism, adults aged 75 to 84 years with diabetes only scored lower on the cognitive test (0.53 points; 95% CI, 0.14-0.92), while those with both conditions in this age group scored 1.35 points (95% CI, 0.61-2.09) lower.

Participants aged 65 to 74 years with diabetes only, with edentulism only, or with both conditions, scored an additional 0.09 (95% CI, 0.05-0.13), 0.13 (95% CI, 0.08-0.17), and 0.15 (95% CI, -0.10-0.20) points lower each year in cognitive decline, respectively, compared with the average decline of 0.29 (95% CI, 0.25–0.33) from their counterparts with neither conditions in the same age group.

Overall, having diabetes was associated with worsened cognitive function in adults aged 65 to 74 years and 75 to 84 years. The only age group where having both diabetes and edentulism accelerated cognitive decline were patients aged 65 to 74 years.

“From a public health perspective, our study demonstrates the importance of improving access to dental health care and integrating primary dental and medical care in older adults,” the researchers noted.

Study limitations are the lack of diagnostic criteria used for diabetes or edentulism, the exclusion of participants with changing diabetes or edentulism status, and the lack of oral health data.

This article originally appeared on Neurology Advisor