Periodontitis May Raise the Risk for Developing Dementia

Journal of the American Geriatrics Society Research Summary

Gum disease (gingivitis) that goes untreated can become periodontitis. When this happens, the infection that affected your gums causes loss in the bone that supports your teeth. Periodontitis is the main cause of tooth loss in adults.Interestingly, periodontitis is also a risk factor for developing dementia, one of the leading causes for disability in older adults. A United Nations forecast estimates that 1 in 85 individuals will be diagnosed with Alzheimer’s disease, a form of dementia, by the year 2050. Reducing the risk factors that lead to dementia and Alzheimer’s disease could potentially lower older adults’ chances of developing those conditions.

Recently, researchers in South Korea studied the connection between chronic periodontitis and dementia. They published their findings in the Journal of the American Geriatrics Society.

The research team examined information from the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS). In South Korea, the NHIS provides mandatory health insurance covering nearly all forms of health care for all Korean citizens. The agency also provides health screening examinations twice a year for all enrollees aged 40 years or older and maintains detailed health records for all enrollees.

The researchers looked at health information from 262,349 people aged 50 or older. All of the participants were grouped either as being healthy (meaning they had no chronic periodontitis) or as having been diagnosed with chronic periodontitis. The researchers followed the participants from January 1, 2005 until they were diagnosed with dementia, died, or until the end of December 2015, whichever came first.

The researchers learned that people with chronic periodontitis had a 6 percent higher risk for dementia than did people without periodontitis. This connection was true despite behaviors such as smoking, consuming alcohol, and remaining physically active. The researchers said that to their knowledge, this is the first study to demonstrate that chronic periodontitis could be linked to a higher risk for dementia even after taking lifestyle behaviors into account.

The researchers suggested that future studies be conducted to investigate whether preventing and treating chronic periodontitis could lead to a reduced risk of dementia.

This summary is from “Association of Chronic Periodontitis on Alzheimer’s Disease or Vascular Dementia.” It appears online ahead of print in the February 2019 issue of the Journal of the American Geriatrics Society. The study authors are Seulggie Choi, MD; Kyuwoong Kim, BSc; Jooyoung Chang, MD; Sung Min Kim, BSc; Seon Jip Kim, RDH; Hyun-Jae Cho, DDS, PhD; and Sang Min Park, MD, PhD, MPH.

Exercise May Lessen Risk of Falling for Older Adults who have Alzheimer’s Disease and Mental Health Challenges

Journal of the American Geriatrics Society Research Summary

Alzheimer’s disease (AD) is a brain disease that causes changes that kill brain cells. AD is a type of dementia, which causes memory loss and problems with thinking and making decisions. People with AD and other forms of dementia have difficulties performing the daily activities others might consider routine.

Dementia takes a toll on those who live with it—and it also places a burden on caregivers. Along with problems connected to memory, language, and decision-making, dementia can cause neuropsychiatric symptoms, such as depression, anxiety, changes in mood, increased irritability, and changes in personality and behavior.  People who have AD/dementia also have twice the risk for falls compared to people without dementia. About 60 percent of older adults with dementia fall each year.

Researchers suggest that having neuropsychiatric symptoms might predict whether an older person with AD/dementia is more likely to have a fall. We also know that exercise can reduce the number of falls in older adults with dementia. However, we don’t know very much about how neuropsychiatric symptoms may increase the risk of falls, and we know even less about how exercise may reduce the risk of falls for people with dementia and neuropsychiatric symptoms. A research team decided to explore whether exercise could reduce the risk of falling among community-dwelling people with AD who also had neuropsychiatric symptoms. Continue reading

Setting Personal Goals for Dementia Care

Journal of the American Geriatrics Society Research Summary

Dementia is a health condition that affects your memory in ways that can make it difficult to carry out your usual daily tasks. The most common cause of dementia is Alzheimer’s disease, which causes abnormal changes that kill brain cells. However, there are many other types of dementia. Overall, dementia is a long-term illness, and most people live from four to 10 years after being diagnosed.

When you are first diagnosed with dementia, your goals may be to preserve your ability to perform your daily activities. But as the disease progresses, your goals may shift and your preferences for your care may shift with them. Eventually, you may wish to make sure that your preferences and expectations are known, particularly for end-of-life care. You may also want to be sure those wishes can be put into action by those who might make decisions for you when you don’t feel comfortable or are no longer able to make them on your own.

Healthcare providers can use a tool called “goal attainment scaling” (GAS) to help you set your personal health goals and measure whether you’re meeting them. Researchers have been using GAS for decades to measure the effects of mental health and rehabilitation efforts.

In a new study, researchers used GAS when caring for people with dementia to learn more about these individuals’ personalized goals for care. Their study was published in the Journal of the American Geriatrics Society. Continue reading

The Link Between Cognitive Function and Sexuality in Older Adults

Journal of the American Geriatrics Society Research Summary

The number of people who live at home with Alzheimer’s Disease (AD), a brain disease that causes abnormal changes that kill brain cells, is expected to grow from 3.2 million today to more than 8 million in 2050.

Experts agree that we know very little about sexuality among people living at home with AD or other cognitive problems. Older adults who have cognitive problems that impact the way they think and make decisions may ask physicians to help managing sexual problems. And caregivers may ask physicians about sexuality in the older adults for whom they provide care.

One frequently asked question is: Do older adults always have the capacity to consent to sexual activity?

Researchers have previously shown that the majority of people aged 57 to 85 have a spouse or other intimate partner and, among those with a partner, most are sexually active. Having an active sexual life is linked to better physical and mental health, higher quality of life, and lower rates of loneliness.

To learn more about the connection between sexuality and cognitive status, researchers designed a new study. They analyzed data from the National Social Life, Health, and Aging Project to learn more about the relationship between sexual behavior, function, and cognition (people’s ability to think and make decisions). Their study was published in the Journal of the American Geriatrics Society. Continue reading

When Do Age-Related Problems with Memory and Decision-Making Begin to Affect Older Adults’ Ability to Drive?

Journal of the American Geriatrics Society Research Summary

For older adults, driving can mean living a more independent, satisfying life. Therefore, it’s no surprise that about 86 percent of adults age 65 and older hold active driver’s licenses, and many of us expect to drive for longer as we age.

Car crashes can be devastating or even deadly for anyone, including older adults and other road users. However, the fatal crash rate based on the distance someone travels in a vehicle begins to rise at age 65. At the same time, when older adults stop driving due to health issues or other concerns, they may experience isolation and depression. They also may be more likely to enter long-term care facilities earlier than they otherwise would.

Researchers have a history of studying driver safety in older adults after they’ve been diagnosed with dementia, a decline in memory and other mental abilities that make daily living difficult. However, we have limited knowledge about the effects on older drivers whose problems with mental abilities are less severe than those associated with dementia.

Recently, a team of researchers designed a study to learn more about cognitive health and older drivers’ crash risks. The study was published in the Journal of the American Geriatrics Society. In this study, the researchers focused on links between levels of cognitive function and crash risk among older drivers without dementia over a 14-year study period. They also assessed the link between changes in cognitive function over time and later risks of crashes. Continue reading