Diabetes, tooth loss can be a double problem for an aging brain

By Cara Murez Health Day Reporter

(Health Day)

WEDNESDAY, March 15, 2023 (HealthDay News) — Diabetes is a known risk factor for mental decline and dementia. When combined with total tooth loss, the potential damage to the brain is even greater, new research shows.

The findings highlight the importance of good dental care and diabetes control in aging adults, said Bei Wu, lead author of a new study of nearly 10,000 adults.

“Access to dental care for older adults, especially those with diabetes, is very important,” said Wu, vice dean for research at New York University Rory Meyers College of Nursing and co-director of the NYU Aging Incubator in New York City.

The American Diabetes Association recommends regular dental checkups for anyone with diabetes – “but how many people follow that and how many clinicians recommend this?” Wu said.

In itself, poor oral health, especially gum disease and tooth loss, has also been linked to cognitive impairment and dementia.

Wu notes that researchers are now beginning to understand how oral health, diabetes and cognitive decline can exacerbate each other.

“We need to bring this to the attention,” she said.

Inflammation plays a role in both diabetes and gum disease, the study notes. These inflammatory processes can contribute to a decline in reasoning and thinking skills – so-called cognitive decline.

Poor nutrition is another way. Sore gums and missing teeth can make it difficult to chew healthy food. This can lead to nutritional deficiencies. The decreased blood sugar and insulin sensitivity found in diabetes may also exacerbate nutritional deficiencies, according to the study.

And certain bacteria linked to chronic periodontitis or gum disease may also affect cognitive function, Wu said.

To study this in combination, the researchers divided older adults into age groups: 65 to 74, 75 to 84, and 85 and older.

The researchers used data from the University of Michigan Health and Retirement Study for 2006 to 2018, which measured memory and cognition every two years. This included 9,948 older adults.

In adults ages 65 to 84, those with diabetes and complete tooth loss combined had the highest rates of accelerated mental decline compared to those without either condition.

Those with diabetes alone between the ages of 65 and 74 or just complete tooth loss between the ages of 65 and 84 also had faster cognitive decline.

But mental decline was fastest between the ages of 65 and 74 with both diabetes and total tooth loss.

Researchers found no conclusive evidence for a link between mental decline and toothlessness and diabetes in adults aged 85 and older.

They theorized that perhaps the less healthy among this group had already died before their late 80s. Or it is possible that this age group already had a greater cognitive impairment.

Wu noted that the study is observational and cannot prove cause and effect.

Dr. Cyprien Rivier, a postdoctoral researcher in neurology at Yale School of Medicine, cautioned that he is not a diabetes expert, saying the links between diabetes and periodontitis make sense. River was not involved in the investigation.

Experts are aware that inflammation leads to changes in the microarchitecture of the brain.

“We know that when there are high levels of systemic inflammation, the white matter gets a little more disorganized,” Rivier said.

This leads to poorer brain health and cognitive outcomes, he said.

Oral health is very important for other parts of the body, including heart health, Rivier noted. For example, the American Heart Association says patients with heart valve problems should take antibiotics before certain dental procedures because of bacteria that can travel through the bloodstream.

“The effects of oral health on the whole body are now really well defined,” Rivier said.

More studies are needed to assess these connections, but good dental health is an easy and important target for improving health, Rivier said.

“It’s quite cheap. It’s quite easy to improve oral health at a population level,” Rivier said.

The study authors say that older adults with poor dental health and diabetes would benefit from cognitive screenings by their primary care providers.

SOURCES: Bei Wu, PhD, vice dean for research, New York University Rory Meyers College of Nursing and co-director, NYU Aging Incubator, New York City; Cyprien Rivier, MD, MSc, postdoctoral researcher, neurology, Yale School of Medicine, New Haven, Connecticut; Journal of dental researchMarch 12, 2023

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Diabetes, tooth loss can be a double problem for an aging brain

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