Objective:
Both diabetes mellitus (DM) and poor oral health are common chronic conditions and risk factors of Alzheimer’s disease and related dementia among older adults. This study
assessed the effects of DM and complete tooth loss (TL) on cognitive function, accounting for their
interactions.
Methods:
Longitudinal data were obtained from the 2006, 2012, and 2018 waves of the Health and
Retirement Study. This cohort study included 7,805 respondents aged 65 years or older with
18,331 person-year observations. DM and complete TL were self-reported. Cognitive function was
measured by the Telephone Interview for Cognitive Status. Random-effect regressions were used
to test the associations, overall and stratified by sex.
Results:
Compared with older adults without neither DM nor complete TL, those with both conditions (b = -1.35, 95% confidence interval [CI]: -1.68, -1.02), with complete TL alone (b = -0.67,
95% CI: -0.88, -0.45), or with DM alone (b = -0.40, 95% CI: -0.59, -0.22), had lower cognitive
scores. The impact of having both conditions was significantly greater than that of having DM
alone (p < .001) or complete TL alone (p = 0.001). Sex-stratified analyses showed the effects were
similar in males and females, except having DM alone was not significant in males.
Conclusion:
The co-occurrence of DM and complete TL poses an additive risk for cognition.
Healthcare and family-care providers should pay attention to the cognitive health of patients with
both DM and complete TL. Continued efforts are needed to improve older adults’ access to dental
care, especially for individuals with DM.
Objective
Social isolation and loneliness have been linked to numerous determinants of health and well‐being. However, the effects of social isolation and loneliness on oral health remain unclear. The purpose of this study was to examine the effects of social isolation and loneliness on the number of remaining teeth and the rate of tooth loss over time among Chinese older adults.
Methods
We used three waves of data (2011/2012, 2014 and 2018) from the Chinese Longitudinal Healthy Longevity Survey with 4268 older adults aged 65 and older who were interviewed in at least two waves. The number of remaining teeth was first evaluated at baseline and then subsequently at follow‐up visits. Mixed‐effects Poisson regression was used to examine the associations between social isolation, loneliness, and both the number of remaining teeth and the rate of tooth loss.
Results
Social isolation was associated with fewer remaining teeth (β = −.06, 95% CI = −0.13 to 0.00, p < .05) and accelerated tooth loss (β = −.02, 95% CI = −0.02 to −0.01, p < .01) after adjusting for sociodemographic covariates, lifestyle and oral hygiene behaviours, physical and cognitive health, and loneliness. Loneliness was neither associated with the number of remaining teeth (β = .15, 95% CI = −0.01 to 0.30, p = .06) nor with the rate of tooth loss (β = −.01, 95% CI = −0.02 to 0.00, p = .16) after adjusting for all other factors.
Conclusions
This study provides strong evidence that social isolation was associated with fewer remaining teeth and accelerated tooth loss among Chinese older adults. These findings expand our knowledge about the impact of social disconnection on tooth loss. More future studies are needed to further examine the associations between social connections and oral conditions using longitudinal cohort studies and intervention studies.
The aims of the study were to present the prevalence of dental service utilization among adults (age between 18 and 65) in Chinese megacities and to examine the associations of health insurance and city of residence with dental visits. This study was a cross-sectional analysis of the 2019 New Era and Living Conditions in Megacities Survey data with a sample of 4835 participants aged 18–65 from 10 different megacities in China. The data including gross domestic product (GDP) per capita of each megacity obtained from the National Bureau of Statistics of China as a city-level characteristic. After adjusting sampling weights, approximately 24.28% of the participants had at least one dental visit per year. Findings from multilevel mixed-effects linear models showed that participants residing in megacities with higher GDP per capita (β = 0.07, p < 0.001) who had Urban Employee Basic Medical Insurance (β = 0.25, p < 0.001) or Urban Resident Basic Medical Insurance (β = 0.19, p < 0.01) had more frequent dental visits after adjusting demographic characteristics, socioeconomic status, health status, health behavior and attitude, and oral health indicators. Margins post-estimation model results demonstrated disparities in the predicted probability of having never visited a dentist by types of health insurance and city of residence. In conclusion, the prevalence of dental visits in China was found to be low. This study highlights socioeconomic inequalities in dental service utilization. There is a great need to develop more dental care programs and services and expand health insurance to cover dental care in China.
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