title: Cognitive decline and oral health in middle-aged adults in the ARIC study.
abstract: Even before dementia becomes apparent, cognitive decline may contribute to deterioration in oral health. This cohort study of middle-aged adults evaluated associations of six-year change in cognitive function with oral health behaviors and conditions in the Atherosclerosis Risk in Communities (ARIC) study. Cognitive function was measured at study visits in 1990-1992 and 1996-1998 with three tests: (a) Delayed Word Recall (DWR), (b) Digit Symbol Substitution (DSS), and (c) Word Fluency (WF). Cognitive decline scores were computed as 'studentized' residuals of 1996-1998 scores regressed against 1990-1992 scores. In 1996-1998, 10,050 participants answered dental screening questions, and 5,878 of 8,782 dentate participants received a comprehensive oral examination. Multiple regression models used cognitive change to predict oral health behaviors and conditions with adjustment for covariates. In the fully adjusted models, greater decline in all three measures of cognitive function was associated with increased odds of complete tooth loss. Greater decline in DSS and WF scores was associated with infrequent toothbrushing. Decline in WF scores was also associated with higher plaque levels. In these middle-aged adults, six-year cognitive decline was modestly associated with less frequent toothbrushing, plaque deposit, and greater odds of edentulism, but not with other oral behaviors or diseases.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA. naorungr@ad.unc.edu
authors.forename: S
authors.initials: S
authors.lastname: Naorungroj
authors.forename: G D
authors.initials: GD
authors.lastname: Slade
authors.forename: J D
authors.initials: JD
authors.lastname: Beck
authors.forename: T H
authors.initials: TH
authors.lastname: Mosley
authors.forename: R F
authors.initials: RF
authors.lastname: Gottesman
authors.forename: A
authors.initials: A
authors.lastname: Alonso
authors.forename: G
authors.initials: G
authors.lastname: Heiss
mesh_terms: D001741:Black or African American; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000503:physiopathology*; D015331:Cohort Studies; D003729:Dental Care / Q000706:statistics & numerical data; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000145:classification; D004522:Educational Status; D056344:Executive Function / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005891:Gingivitis / Q000145:classification; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D007802:Language; D008297:Male; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000145:classification; D009909:Oral Health; D010518:Periodontitis / Q000145:classification; D011446:Prospective Studies; D012923:Social Class; D013997:Time Factors; D016388:Tooth Loss / Q000145:classification; D014099:Toothbrushing; D014706:Verbal Learning / Q000502:physiology; D044465:White People
keywords: cognition; executive function; memory; oral hygiene; periodontitis; tooth loss