How Oral Health Affects Cognitive Health

Good oral health impacts various aspects of overall health in older adults, including psychological well-being. Similarly, poor oral health is associated with decreased quality of life, depression, and decline of cognitive health in older adults, researchers report. Led by Bei Wu, PhD, Dean’s Professor in Global Health at New York University (NYU) Rory Meyers College of Nursing, and codirector of NYU Aging Incubator, the studies indicate oral health is an important part of healthy aging.

Researchers from NYU and Rutgers University explored the relationship between poor oral health and cognitive decline in the first study, while the second study examined the effects of perceived stress and social support on xerostomia among older Chinese Americans. Findings from “Oral Health Symptoms and Cognitive Function Among U.S. Community—Dwelling Chinese Older Adults” have been published in the Journal of the American Geriatrics Society.

Of the more than 2,700 Chinese Americans aged 60 and older interviewed for the longitudinal survey, nearly 50% reported experiencing tooth and periodontal symptoms, and 25.5% reported xerostomia. In the first study, participants who reported tooth symptoms experienced declines in cognition and episodic memory. In the second study, researchers found that perceived stress was associated with increased risk for xerostomia.

“Older adults are susceptible to stress because they face a higher risk of loss of functions, mobility, and independence; loss of significant others; and limited income and social support compared to general populations,” says Wu. “Older immigrants are particularly vulnerable to stress due to interrupted or lost social ties and acculturation challenges after immigration.”

In addition to dentists, dental hygienists are well positioned to identify xerostomia in patients. Once detected, oral health professionals can provide in-office treatment for managing the symptoms of xerostomia, as well as offering preventive treatment.

Oral health professionals should also make sure patients understand the treatment options proposed. Wu explains, “Often, they may not fully understand the treatment option, but are reluctant to speak up. It would be helpful to talk to both the patient and someone who accompanies the patient to the clinic. Also, many older Chinese Americans may lack knowledge about effective self-care and the importance of regular dental check-ups.”

Several intervention strategies are recommended to improve oral health in Chinese American older adults:

1. Ensuring access to dental care by expanding Medicare coverage to include dental services
2. Training culturally competent dental care providers to serve this population
3. Developing outreach programs that target older adults to improve the awareness of these problems

“We need to work with staff at community organizations to deliver effective oral health education messages to this population,” says Wu. “It will be important to integrate oral health programs into the regular activities provided by community agencies, providing workshops on oral health in senior centers and churches, or distributing bilingual brochures on oral health in these sites and at community health fairs.”