Cognitive decline and oral health in middle-aged adults in the ARIC study

S. Naorungroj, G. D. Slade, J. D. Beck, T. H. Mosley, R. F. Gottesman, A. Alonso, G. Heiss

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)795-801
Number of pages7
JournalJournal of dental research
Issue number9
StatePublished - Sep 2013

Bibliographical note

Funding Information:
The ARIC study was carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts ( HHSN268201100005C , HHSN268201100006C , HHSN26820 1100007C , HHSN268201100008C , HHSN268201100009C , HHSN2682011000010C , HHSN2682011000011C , and HHSN 2682011000012C ). The Dental ARIC study was supported by the National Institute of Dental and Craniofacial Research ( DE13807-01A1 and DE 11551 ).


  • cognition
  • executive function
  • memory
  • oral hygiene
  • periodontitis
  • tooth loss


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