P3‐114: The association of executive function with limitations in instrumental activities of daily living among older adults in the United States: The aging, demographics, and memory study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152613/1/alzjjalz2010051611.pd

Edentulism trends among middle‐aged and older adults in the United States: comparison of five racial/ethnic groups

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90571/1/j.1600-0528.2011.00640.x.pd

Oral health among white, black, and Mexican‐American elders: an examination of edentulism and dental caries

Objectives: To examine racial/ethnic disparities in oral health among older Americans. Methods: Differences in frequency of edentulism and number of decayed, missing, and filled teeth were assessed in 2,679 non‐Hispanic white, 742 non‐Hispanic black, and 934 Mexican‐American individuals aged 60 and older from the National Health and Nutrition Examination Survey (1999‐2004). Results: Controlling for potential confounding variables, blacks and Mexican‐Americans had significantly higher numbers of decayed teeth but fewer numbers of filled teeth than whites. Although blacks had a lower likelihood of being edentulous than whites, dentate blacks had a higher number of missing teeth. Compared with whites, Mexican‐Americans were less likely to be edentulous, and dentate Mexican‐Americans had fewer missing teeth. Our study also showed that blacks and Mexican‐Americans had less frequent dental checkups than whites. Conclusions: Oral health disparities are persistent across racial/ethnic groups for older Americans despite the fact that the differences between groups typically diminish when socioeconomic, health‐related, and behavioral factors are considered in the models. Our study suggests that reducing racial/ethnic oral health disparities requires multiple clinical approaches.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/88103/1/j.1752-7325.2011.00273.x.pd

Risk and Protective Factors of Dementia Among Adults With Post-Traumatic Stress Disorder: A Systematic Review Protocol

INTRODUCTION: Post-traumatic stress disorder (PTSD) is associated with an increased risk of dementia. Individual epidemiological studies have controlled for several confounders of the relationship between PTSD and increased dementia risk, yet particular risk factors underlying this relationship have not been determined. This systematic review protocol aims to identify risk and protective factors of dementia among adults with PTSD. METHODS AND ANALYSIS: We will conduct an electronic search of the databases: PubMed, CINAHL, PsychINFO, The Cochrane Library, Scopus and ProQuest Dissertation and Theses Global. After screening the studies, quantitative synthesis will be performed, if possible. Otherwise, a narrative synthesis will be performed. We will include randomised controlled trials and other types of research evidence including longitudinal cohort studies. Strength of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations method. Examples of variables that will be extracted are: year of PTSD diagnosis, comorbid conditions, health behaviours, pharmacological treatments and year of mild cognitive impairment or dementia diagnosis. We developed this systematic review protocol according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 statement. ETHICS AND DISSEMINATION: The proposed study will not collect individual-level data and, therefore, does not require ethical approval. Results of this study will provide current evidence on risk and protective factors of dementia in adults with PTSD. Findings will be disseminated in peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER: CRD42019128553

Trends in decayed teeth among middle‐aged and older adults in the United States: socioeconomic disparities persist over time

ObjectivesWhile trends in tooth loss among older adults have been well documented and show a decline over the last few decades, little is known about trends in tooth decay which may lead to tooth loss. The study aim was to examine trends in tooth decay among adults ages 50 years and older in the United States and determine whether these trends were consistent across demographic and socioeconomic subgroups of middle‐aged and older adults.MethodsSecondary analysis of data collected through detailed oral health examinations in the National Health and Nutrition Examination (NHANES) surveys 1988–1994 and 1999–2004. Tooth decay was measured as active caries. Multivariable associations were estimated using negative binomial regression models.ResultsAveraged over time, the mean number of decayed teeth was 0.54. Rates of decay remained stable over time. Males, non‐Hispanic Blacks, Mexican‐Americans, and those of other race/ethnicity as well as those with fewer years of education and lower levels of income had more decayed teeth. The increased number of decayed teeth for Mexican‐Americans and those of other race/ethnicity was due in part to differing levels of education and income. Trends over time did not vary by any of these demographic and socioeconomic characteristics. Trends in the number of decayed teeth did not meaningfully change when the numbers of missing and filled teeth were controlled.ConclusionsAlthough studies have shown the number of middle‐aged and older Americans experiencing tooth loss has decreased over time, trends in tooth decay have remained relatively stable, with socioeconomic disparities persisting over time.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135439/1/jphd12153_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135439/2/jphd12153.pd

Oral health, diabetes, and inflammation: Effects of oral hygiene behavior

The aim of this research was to assess the association between inflammation and oral health and diabetes, as well as the mediating role of oral hygiene practice in this association. Data were from the 2009–2010 National Health and Nutrition Examination Survey. The analytical sample consisted of 2,191 respondents aged 50 and older. Poor oral health was clinically defined by significant tooth loss (STL) and periodontal disease (PD). Diabetes mellitus (DM) was determined by glycemic levels. The outcome variable was serum C-reactive protein (CRP) level, dichotomised as ?1 mg/dL (elevated CRP) vs <1 mg/dL (not elevated CRP). Two path models, one using STL and DM as the independent variable, the other using PD and DM as the independent variable, were estimated to assess the direct effects of having poor oral health and DM on elevated CRP and the mediating effects of dental flossing. In path model 1, individuals having both STL and DM (adjusted odds ratio [AOR], 1.92; 95% confidence interval [CI], 1.30–2.82) or having STL alone (AOR, 2.30; 95% CI, 1.68–3.15) were more likely to have elevated CRP than those with neither STL nor DM; dental flossing (AOR, 0.92, 95% CI, 0.88–0.96) was associated with lower risk of elevated CRP. In path model 2, no significant association was found between having both PD and DM and elevated CRP; dental flossing (AOR, 0.91; 95% CI:, 0.86–0.94) was associated with lower risk of elevated CRP. Findings from this study highlight the importance of improving oral health and oral hygiene practice to mitigate inflammation. Further research is needed to assess the longer-term effects of reducing inflammation.ECU Open Access Publishing Support Fun

Caring for Individuals with Dementia and Cognitive Impairment, Not Dementia: Findings from the Aging, Demographics, and Memory Study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106975/1/j.1532-5415.2010.03304.x.pd

P1‐504: Influence Of Patient Mci On Physician Conception Of Risk And Decision‐Making For Cardiovascular Treatments

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153216/1/alzjjalz2019061109.pd

High throughput DNA sequencing to detect differences in the subgingival plaque microbiome in elderly subjects with and without dementia

BACKGROUND: To investigate the potential association between oral health and cognitive function, a pilot study was conducted to evaluate high throughput DNA sequencing of the V3 region of the 16S ribosomal RNA gene for determining the relative abundance of bacterial taxa in subgingival plaque from older adults with or without dementia. METHODS: Subgingival plaque samples were obtained from ten individuals at least 70 years old who participated in a study to assess oral health and cognitive function. DNA was isolated from the samples and a gene segment from the V3 portion of the 16S bacterial ribosomal RNA gene was amplified and sequenced using an Illumina HiSeq1000 DNA sequencer. Bacterial populations found in the subgingival plaque were identified and assessed with respect to the cognitive status and oral health of the participants who provided the samples. RESULTS: More than two million high quality DNA sequences were obtained from each sample. Individuals differed greatly in the mix of phylotypes, but different sites from different subgingival depths in the same subject were usually similar. No consistent differences were observed in this small sample between subjects separated by levels of oral health, sex, or age; however a consistently higher level of Fusobacteriaceae and a generally lower level of Prevotellaceae was seen in subjects without dementia, although the difference did not reach statistical significance, possibly because of the small sample size. CONCLUSIONS: The results from this pilot study provide suggestive evidence that alterations in the subgingival microbiome are associated with changes in cognitive function, and provide support for an expanded analysis of the role of the oral microbiome in dementia