Mediterranean diet for one year promotes gut bacteria linked to 'healthy aging'

It may help curb advance of frailty and cognitive decline, suggest researchers

February 17, 2020

Science Daily/BMJ

Eating a Mediterranean diet for a year boosts the types of gut bacteria linked to 'healthy' ageing, while reducing those associated with harmful inflammation in older people, indicates a five-country study, published online in the journal Gut.

As ageing is associated with deteriorating bodily functions and increasing inflammation, both of which herald the onset of frailty, this diet might act on gut bacteria in such a way as to help curb the advance of physical frailty and cognitive decline in older age, suggest the researchers.

Previous research suggests that a poor/restrictive diet, which is common among older people, particularly those in long term residential care, reduces the range and types of bacteria (microbiome) found in the gut and helps to speed up the onset of frailty.

The researchers therefore wanted to see if a Mediterranean diet might maintain the microbiome in older people's guts, and promote the retention or even proliferation of bacteria associated with 'healthy' ageing.

They analysed the gut microbiome of 612 people aged 65 to 79, before and after 12 months of either eating their usual diet (n = 289) or a Mediterranean diet (n = 323), rich in fruits, vegetables, nuts, legumes, olive oil and fish and low in red meat and saturated fats, and specially tailored to older people (NU-AGE diet).

The participants, who were either frail (n=28), on the verge of frailty (n=151), or not frail (n=433) at the beginning of the study, lived in five different countries: France, Italy, Netherlands, Poland, and the UK.

Sticking to the Mediterranean diet for 12 months was associated with beneficial changes to the gut microbiome.

It was associated with stemming the loss of bacterial diversity; an increase in the types of bacteria previously associated with several indicators of reduced frailty, such as walking speed and hand grip strength, and improved brain function, such as memory; and with reduced production of potentially harmful inflammatory chemicals.

More detailed analysis revealed that the microbiome changes were associated with an increase in bacteria known to produce beneficial short chain fatty acids and a decrease in bacteria involved in producing particular bile acids, overproduction of which are linked to a heightened risk of bowel cancer, insulin resistance, fatty liver and cell damage.

What's more, the bacteria that proliferated in response to the Mediterranean diet acted as 'keystone' species, meaning they were critical for a stable 'gut ecosystem,' pushing out those microbes associated with indicators of frailty.

The changes were largely driven by an increase in dietary fibre and associated vitamins and minerals -- specifically, C, B6, B9, copper, potassium, iron, manganese, and magnesium.

The findings were independent of the person's age or weight (body mass index), both of which influence the make-up of the microbiome.

And while there were some differences in the make-up of a person's gut microbiome, depending on country of origin to start with, the response to the Mediterranean diet after 12 months was similar and consistent, irrespective of nationality.

The study findings can't establish a causative role for the microbiome in health, added to which some of the implications are inferred rather than directly measured, say the researchers.

"The interplay of diet, microbiome and host health is a complex phenomenon influenced by several factors," they emphasise.

"While the results of this study shed light on some of the rules of this three-way interplay, several factors such as age, body mass index, disease status and initial dietary patterns may play a key role in determining the extent of success of these interactions," they explain.

Older people may have dental problems and/or difficulty swallowing, so it may be impractical for them to eat a Mediterranean diet, they add. But the beneficial bacteria implicated in healthy ageing found in this study might yet prove useful therapeutic agents to ward off frailty, they suggest.

https://www.sciencedaily.com/releases/2020/02/200217192025.htm

Drinking 1% rather than 2% milk accounts for 4.5 years of less aging in adults

High-fat milk consumption is connected to significantly shorter telomeres

January 15, 2020

Science Daily/Brigham Young University

A new study shows drinking low-fat milk -- both nonfat and 1% milk -- is significantly associated with less aging in adults.

Research on 5,834 U.S. adults by Brigham Young University exercise science professor Larry Tucker, Ph.D., found people who drink low-fat milk experience several years less biological aging than those who drink high-fat (2% and whole) milk.

"It was surprising how strong the difference was," Tucker said. "If you're going to drink high-fat milk, you should be aware that doing so is predictive of or related to some significant consequences."

Tucker investigated the relationship between telomere length and both milk intake frequency (daily drinkers vs. weekly drinkers or less) and milk fat content consumed (whole vs. 2% vs. 1% vs. skim). Telomeres are the nucleotide endcaps of human chromosomes. They act like a biological clock and they're extremely correlated with age; each time a cell replicates, humans lose a tiny bit of the endcaps. Therefore, the older people get, the shorter their telomeres.

And, apparently, the more high-fat milk people drink, the shorter their telomeres are, according to the new BYU study, published in Oxidative Medicine and Cellular Longevity. The study revealed that for every 1% increase in milk fat consumed (drinking 2% vs. 1% milk), telomeres were 69 base pairs shorter in the adults studied, which translated into more than four years in additional biological aging. When Tucker analyzed the extremes of milk drinkers, adults who consumed whole milk had telomeres that were a striking 145 base pairs shorter than non-fat milk drinkers.

Nearly half of the people in the study consumed milk daily and another quarter consumed milk at least weekly. Just under a third of the adults reported consuming full-fat (whole) milk and another 30 percent reported drinking 2% milk. Meanwhile, 10% consumed 1% milk and another 17% drank nonfat milk. About 13% did not drink any cow milk.

"Milk is probably the most controversial food in our country," Tucker said. "If someone asked me to put together a presentation on the value of drinking milk, I could put together a 1-hour presentation that would knock your socks off. You'd think, 'Whoa, everybody should be drinking more milk.' If someone said do the opposite, I could also do that. At the very least, the findings of this study are definitely worth pondering. Maybe there's something here that requires a little more attention."

Somewhat surprisingly, he also found that milk abstainers had shorter telomeres than adults who consumed low-fat milk.

Tucker said the study findings provide support for the current Dietary Guidelines for Americans (2015-2020), which encourage adults to consume low-fat milk, both nonfat and 1% milk, and not high-fat milk, as part of a healthy diet.

"It's not a bad thing to drink milk," Tucker said. "You should just be more aware of what type of milk you are drinking."

https://www.sciencedaily.com/releases/2020/01/200115120634.htm

High-intensity exercise improves memory in seniors

October 31, 2019

Science Daily/McMaster University

Researchers at McMaster University who examine the impact of exercise on the brain have found that high-intensity workouts improve memory in older adults.

The study, published in the journal Applied Physiology, Nutrition and Metabolism, has widespread implications for treating dementia, a catastrophic disease that affects approximately half a million Canadians and is expected to rise dramatically over the next decade.

Researchers suggest that intensity is critical. Seniors who exercised using short, bursts of activity saw an improvement of up to 30% in memory performance while participants who worked out moderately saw no improvement, on average.

"There is urgent need for interventions that reduce dementia risk in healthy older adults. Only recently have we begun to appreciate the role that lifestyle plays, and the greatest modifying risk factor of all is physical activity," says Jennifer Heisz, an associate professor in the Department of Kinesiology at McMaster University and lead author of the study.

"This work will help to inform the public on exercise prescriptions for brain health so they know exactly what types of exercises boost memory and keep dementia at bay," she says.

For the study, researchers recruited dozens of sedentary but otherwise healthy older adults between the ages of 60 and 88 who were monitored over a 12-week period and participated in three sessions per week. Some performed high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) while a separate control group engaged in stretching only.

The HIIT protocol included four sets of high-intensity exercise on a treadmill for four minutes, followed by a recovery period. The MICT protocol included one set of moderate-intensity aerobic exercise for nearly 50 minutes.

To capture exercise-related improvements in memory, researchers used a specific test that taps into the function of the newborn neurons generated by exercise which are more active than mature ones and are ideal for forming new connections and creating new memories.

They found older adults in the HIIT group had a substantial increase in high-interference memory compared to the MICT or control groups. This form of memory allows us to distinguish one car from another of the same make or model, for example.

Researchers also found that improvements in fitness levels directly correlated with improvement in memory performance.

"It's never too late to get the brain health benefits of being physically active, but if you are starting late and want to see results fast, our research suggests you may need to increase the intensity of your exercise," says Heisz.

She cautions that it is important to tailor exercise to current fitness levels, but adding intensity can be as simple as adding hills to a daily walk or increasing pace between street lamps.

"Exercise is a promising intervention for delaying the onset of dementia. However, guidelines for effective prevention do not exist. Our hope is this research will help form those guidelines."

https://www.sciencedaily.com/releases/2019/10/191031112522.htm

In Alzheimer's research, scientists reveal brain rhythm role

October 23, 2019

Science Daily/Picower Institute at MIT

In the years since her lab discovered that exposing Alzheimer's disease model mice to light flickering at the frequency of a key brain rhythm could stem the disorder's pathology, MIT neuroscientist Li-Huei Tsai and her team at The Picower Institute for Learning and Memory have been working to understand what the phenomenon may mean both for fighting the disease and understanding of how the brain works.

Two papers earlier this year in Cell and in Neuron replicated and substantially extended the initial findings reported in Nature in 2016 and clinical trials with human volunteers recently began. In a special lecture at the Society for Neuroscience Annual Meeting in Chicago Oct. 22, Tsai will share the latest research updates on what she's found -- and the new questions she is asking -- about using light and sound to strengthen the brain' s 40Hz "gamma" rhythm, a technique she calls "GENUS," for Gamma Entrainment Using Sensory stimuli.

"We are eager to learn as much as we can about GENUS for two main reasons," said Tsai, Picower Professor of Neuroscience in the Department of Brain and Cognitive Sciences and a founder of MIT's Aging Brain Initiative. "We hope our findings in mice will translate to helping people with Alzheimer's disease, though it's certainly too soon to tell and many things that have worked in mice have not worked in people. But there also may be exciting implications for fundamental neuroscience in understanding why stimulating a specific rhythm via light or sound can cause profound changes in multiple types of cells in the brain."

Gamma and Alzheimer's disease

In 2016, Tsai and colleagues showed that Alzheimer's disease model mice exposed to a light flickering at 40 Hz for an hour a day for a week had significantly less buildup of amyloid and tau proteins in the visual cortex, the brain region that processes sight, than experimental control mice did. Amyloid plaques and tangles of phosphorylated tau are both considered telltale hallmarks of Alzheimer's disease.

But the study raised new questions: Could GENUS prevent memory loss? Could it prevent the loss of neurons? Does it reach other areas of the brain? And could other senses be stimulated for beneficial effect?

The new studies addressed those questions. In March, the team reported that sound stimulation reduced amyloid and tau not only in the auditory cortex, but also in the hippocampus, a crucial region for learning and memory. GENUS-exposed mice also performed significantly better on memory tests than unstimulated controls. Simultaneous light and sound, meanwhile, reduced amyloid across the cortex, including the prefrontal cortex, a locus of cognition.

In May, another study reported similar advances from exposing Alzheimer's model mice to light for 3 or 6 weeks. Coordinated increases in gamma rhythm power were evident across the brains of GENUS-exposed mice. Memory improved compared to controls. More neurons survived and they maintained more circuit connections, called synapses. In her talk, Tsai will share data showing that longer-term GENUS light exposure also reduced amyloid and tau across the cortex.

Encouraged by the results, the lab has begun human trials. At SfN Tsai will present some initial data, indicating that GENUS safely increases gamma rhythm power and synchrony across the brain in healthy people.

Gamma "signatures" in the brain

Tsai's team has also been working to understand the mechanisms underlying the changes they see. The research has revealed that brain rhythms appear to exert a great deal of influence over the activity of multiple cell types in the brain.

Neuroscientists have known about rhythms for more than a century, but they have only recently begun to acknowledge that they might affect how the brain works. Gamma is associated with brain functions like sensory processing, working memory and spatial navigation, but scientists have long debated whether they are consequential or mere byproducts.

But Tsai will describe how her studies show that increasing gamma power and synchrony with sensory stimulation causes changes in neurons, brain immune cells called microglia, and the brain's vasculature. These changes may be "signatures" of gamma's significance, she says.

Increasing gamma power causes neurons to reduce processing of amyloid precursor protein and changes endosomal physiology as well, the team has found. In Alzheimer's model mice, neuronal gene expression related to synaptic function and biochemical transport within cells is reduced, but with GENUS exposure, gene expression related to those functions improves.

Microglia similarly experience major changes after GENUS exposure, all three studies have found. Gene expression becomes less inflammatory and more consistent with capturing and disposing of amyloid. Indeed, they hunt amyloid more effectively, the data show, and they secrete less of an inflammatory marker.

The March study with audio stimulation showed that amid GENUS exposure, blood vessels in the brain expand and more amyloid co-locates with a protein that draws amyloid to the vessels. The results suggest increased gamma power may help drive a mechanism for clearing amyloid out of the brain.

In several new experiments, Tsai says, the lab is continuing to study these underlying mechanistic changes. Related conference posters from her lab at the conference describe some of that work. The results of these new experiments may both help improve the possibility of translating GENUS for clinical use and further demonstrate the importance of rhythms in affecting brain function.

https://www.sciencedaily.com/releases/2019/10/191023093435.htm

Abnormal blood pressure in middle and late life influences dementia risk

August 14, 2019

Science Daily/Johns Hopkins Medicine

In a study that spanned two and a half decades and looked at data from more than 4,700 participants, Johns Hopkins researchers have added to evidence that abnormal blood pressure in midlife persisting into late life increases the likelihood of developing dementia. Although not designed to show cause and effect, the study suggests that maintaining a healthy blood pressure throughout life may be one way to help decrease one's risk of losing brain function.

"Our results suggest that one's blood pressure during midlife may influence how blood pressure later in life relates to dementia risk," says Keenan Walker, Ph.D., assistant professor of neurology at the Johns Hopkins University School of Medicine. "We found that individuals with high blood pressure in midlife may benefit from targeting their blood pressure to normal levels in later life, as having blood pressure that is too high or too low in late life may further increase dementia risk."

In their study, they found that those people with the high blood pressure condition hypertension during middle age and during late life were 49% more likely to develop dementia than those with normal blood pressure at both times. But, putting one at even greater risk was having hypertension in middle age and then having low blood pressure in late life, which increased one's dementia risk by 62%. The findings were published Aug. 13 in JAMA.

High blood pressure was considered any measurement more than 140/90 millimeters of mercury, whereas low blood pressure was defined as less than 90/60 millimeters of mercury. A cognitive exam, caregiver reports, hospitalization discharge codes and death certificates were used to classify participant brain function and determine cognitive impairment.

High blood pressure can be genetic, but can also be the result of not enough exercise and poor diet. As people age, the top blood pressure number (systolic) oftentimes increases while the bottom number (diastolic) can decrease due to structural changes in the blood vessels. Walker says dementia itself may lead to a lowering of blood pressure, as it may disrupt the brain's autonomic nervous system. Stiffening of the arteries from disease and physical frailty can also lead to low blood pressure in late life.

According to the Centers for Disease Control and Prevention, 75 million people in the U.S. have high blood pressure, and high blood pressure can raise the risk for heart disease, as well as other health conditions.

https://www.sciencedaily.com/releases/2019/08/190814081221.htm

Greater blood pressure control linked to better brain health

August 13, 2019

Science Daily/University of Texas at Austin

For adults with high blood pressure, greater blood pressure control than what's currently considered standard is associated with fewer adverse changes of the brain, which could mean lower risks of dementia and cognitive impairment, according to new research published in the Journal of the American Medical Association.

Specifically, the magnetic resonance imaging (MRI) study of 449 adults showed that those with high blood pressure who achieved systolic blood pressure of less than 120 mm Hg -- known as "intensive" blood pressure control -- had a small but significantly lower amount of white matter lesions on their brain but a slightly greater decrease in brain volume than similar patients who achieved the current standard for healthy blood pressure of 140 mm Hg.

"The great news from this research is that high blood pressure is a treatable condition, and if you treat high blood pressure aggressively, you could have a positive benefit on cognition and brain structure," said R. Nick Bryan, M.D., Ph.D., chair and professor of the Department of Diagnostic Medicine at Dell Medical School at The University of Texas at Austin. "Though the benefit may be small, it's one of the few impactful cognition-related interventions we have."

White matter brain lesions are well-documented to be associated with a greater likelihood or intensity of cognitive decline. According to the American Heart Association, high blood pressure is considered 130 mm Hg or higher.

The current study supports the findings of a related study published in January that showed intensive blood pressure control is associated with fewer incidents of cognitive adverse events. Both studies were part of a larger body of NIH-funded research known as Systolic Blood Pressure Intervention Trial (SPRINT), designed to determine the protective value of lower blood pressure for heart, kidney and brain health. Previous research within SPRINT also showed that intensive blood pressure control among people with hypertension is linked to better outcomes in terms of risks of heart attack, heart failure and death.

In the current study, researchers compared MRI scans of adults age 50 and older, average age 67 years old, with systolic blood pressure between 130 and 180 mm Hg at baseline and four years later, noting white matter lesions and brain volume.

The next step in this investigation is to understand the effects of intensive blood pressure control among younger adults, such as those in their 40s, said Bryan. "We need to understand how aggressive should we be with blood pressure control when we're earlier on in the process," he said.

https://www.sciencedaily.com/releases/2019/08/190813130435.htm

Osteoarthritis can increase your risk for social isolation

Research summary from the Journal of the American Geriatrics Society

October 15, 2019

Science Daily/American Geriatrics Society

Researchers examined whether there is an association between arthritis and social isolation, and have identified the disease's contribution to social isolation.

When older adults become lonely -- a condition health professionals call "social isolation" -- their health and well-being can suffer. In fact, there may be a link between being socially isolated and osteoarthritis (arthritis) which causes joint pain and can limit your ability to get around.

People who have arthritis often have other health issues which may increase their risk of becoming socially isolated. These include anxiety and depression, being afraid to move around (because arthritis makes moving painful), physical inactivity, and being unable to take care of themselves.

Some 30 percent of adults aged 65 and older have arthritis to some degree, especially in their leg joints. Despite that, until now there has been little research on the relationship between arthritis and social isolation.

In a study published in the Journal of the American Geriatrics Society, researchers examined information from the European Project on OSteoArthritis (EPOSA) study. They wanted to learn whether there is an association between arthritis and social isolation, and to identify the disease's contribution to social isolation.

EPOSA is a study of 2,942 adults between the ages of 65 to 85 years old who live in six European countries -- Germany, Italy, the Netherlands, Spain, Sweden, and the UK. In all, 1,967 people, around the age of 73, participated.

The researchers wanted to know whether the participants were socially isolated at the beginning of the study as well as 12 to 18 months later. To do so, the researchers used questionnaires that logged how often and how many times the participants connected socially with friends and family members. They also learned how often the participants volunteered or participated in social activities.

Half the participants were women, and almost 30 percent had arthritis. At the start of the study, almost 20 percent of the participants were socially isolated. Those who weren't socially isolated tended to be younger, had higher incomes and more education. They were also more likely to be physically active, had less physical pain, had faster walking times and were in better all-around health.

Of the 1,585 participants who weren't considered socially isolated at the beginning of the study, 13 percent had become socially isolated 12 to 18 months later. They reported that their health and osteoarthritis had worsened, they were in more pain, had become less physically active, had slower walking times, and had depression and problems with thinking and making decisions.

The researchers said that their study shows that osteoarthritis increases the risk of social isolation. Having problems with thinking and making decisions, as well as having slower walking times, is associated with an increased risk of becoming socially isolated, they said.

Because social isolation can worsen your health, the researchers suggested that older adults with arthritis perhaps could benefit from physical activity and participating in social activities. Specifically, they suggested, healthcare providers might refer people to senior centers where activities are specially designed for people with arthritis.

https://www.sciencedaily.com/releases/2019/10/191015171548.htm

Number of depressed over-65s unchanged but antidepressant use soars

October 7, 2019

Science Daily/University of East Anglia

The proportion of people aged over 65 on antidepressants has more than doubled in two decades -- according to new research led by the University of East Anglia.

Despite a rise in antidepressant use, there was little change in the number of older people diagnosed with depression.

The findings are based on the Cognitive Function and Ageing Studies, conducted at two time points -- between 1991 and 1993, and between 2008 and 2011.

Researchers interviewed more than 15,000 over 65s in England and Wales to see whether the prevalence of depression and antidepressant use is changing.

Lead author Prof Antony Arthur, from UEA's School of Health Sciences, said: "Depression is a leading cause of poor quality of life worldwide and we know that older people may be less likely than other age groups to go to their GP with symptoms of depression.

"Until now, little was known about how the relationship between the prevalence of depression and antidepressant use among older people has changed over time. The Cognitive Function and Ageing Studies led by the University of Cambridge have the ability to exam changes in the health needs of older people across generations based on random sampling and diagnostic methods held constant over time.

"We asked participants about their health, daily activities, use of health and social care services, and the medications they were taking.

"We used a standardised interview process to ascertain the presence or absence of symptoms of depression and then applied diagnostic criteria to see whether the participant was considered to have 'case level' depression, a level of depression more severe than that characterised by minor mood symptoms, such as loss of energy, interest or enjoyment."

The study's lead investigator Prof Carol Brayne, director of the Cambridge Institute of Public Health, said: "Our research has previously shown a dramatic age-for-age drop in dementia occurrence across generations. This new work reveals that depression has not shown the same reduction even in the presence of dramatically increased prescribing, itself not without concern given potential adverse effects we have also shown that are associated with polypharmacy."

Key findings

• ·      The proportion of older people receiving anti-depressant medication more than doubled over two decades -- from 4.2 per cent in the early nineties to 10.7 per cent 20 years later.

• ·      The estimated prevalence of depression among over 65s in the early 1990s was 7.9 per cent, compared to 6.8 per cent 20 years later.

• ·      Depression and antidepressant use was more common in women than men at both time points.

• ·      Depression was associated with living in a more deprived area.

• ·      The proportion of over 65s living in care homes declined, but prevalence of depression in care homes remained unchanged -- affecting around one in ten residents.

• ·      Across both time periods, most people with case-level depression were not on antidepressants, while most of those on antidepressants did not have depression.

Prof Arthur said: "Depression affects one in 15 people aged over 65, and its impact is felt by the individual, their families and friends.

"Between two comparable samples interviewed 20 years apart (1990-93 and 2008-11) we found little change in the prevalence of depression, but the proportion of participants taking antidepressants rose from 4 per cent to almost 11 per cent. This could be due to improved recognition and treatment of depression, overprescribing, or use of antidepressants for other conditions.

"Whatever the explanation, substantial increases in prescribing has not reduced the prevalence of depression in the over-65 population. The causes of depression in older people, the factors that perpetuate it, and the best ways to manage it remain poorly understood and merit more attention."

The research was led by the University of East Anglia in collaboration with the University of Cambridge, the University of Newcastle and the University of Nottingham.

'Changing prevalence and treatment of depression among the over-65s over two decades: findings from the Cognitive Function and Ageing Studies' is published in the British Journal of Psychiatry.

https://www.sciencedaily.com/releases/2019/10/191007100414.htm

As we age, oral health plays increasing role in overall health

All health care professionals need to promote good oral hygiene in the elderly population

September 26, 2019

Science Daily/University of Connecticut

Oral health is a critical component to overall health for all ages, but according to dental and medical experts from UConn Health, vigilance is especially critical for the elderly.

In a review article recently published in the Journal of the American Geriatrics Society, the authors outline the potential complications that can arise from poor oral hygiene in older adults and cite the role of all health care professionals in working to promote good oral hygiene in this population.

"All health care professionals should work to promote good oral hygiene for their older patients," said Dr. Patrick Coll, professor of family medicine and medicine at the UConn School of Medicine and lead author of the review article. They "should consider an oral examination during an annual wellness visit, especially for those patients who are not receiving regular dental care."

The need is evident, say the authors. Data from the National Center for Health Statistics indicates that the prevalence of cavities is more than twice as high in older adults than younger adults. The prevalence of periodontitis -- a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth -- also increases with age. As many as 64% of older adults in the U.S. have periodontitis.

Periodontitis is associated with a variety of medical conditions including cardiovascular disease and diabetes. Patients with replacement heart valves and prosthetic joints should be particularly careful regarding their oral hygiene, according to the authors.

It is well recognized that manipulation of teeth and their support structures can result in bacteria present in the oral cavity being released into the bloodstream, which may lead to infections in parts of the body far removed from the oral cavity, they write.

"Even tooth brushing for those who have poor oral hygiene can cause bacteria to be released into the blood stream and these bacteria can potentially cause joint infections and heart valve infections," says Coll.

Without good oral hygiene, the use of fluoride, and regular dental care, older adults are more prone to damage to the oral cavity and the extension of infection into surrounding tissues.

Tooth loss, for instance, can affect a person's ability to chew, which can lead to malnutrition. Chronic oral infection is a recognized risk factor for heart disease, and can also lead to the spread of infection to artificial joints and endocardial implants.

Researchers noted several populations of older adults who are at increased risk for oral health problems, including patients with diabetes, patients with dementia, and those in long-term care settings.

Patients with dementia -- particularly those with advanced dementia -- may neglect their oral health and may be reluctant to see a dental hygienist.

And, many residents in nursing homes also do not receive adequate dental care, despite federal requirements for nursing homes to provide both routine and emergency dental care. Nursing home facilities, the experts say, should adopt risk assessment tools to identify patients at high risk for poor oral hygiene and educate staff on the importance of good oral hygiene and how to provide it.

The experts recommend that all older adults should have biannual dental cleaning performed by a hygientist and a biannual oral health assessment by their dentist.

"Your mouth is a mirror to your body," says Dr. Sree Raghavendra, co-author of the article and assistant professor in the Department of Craniofacial Sciences at the UConn School of Dental Medicine.

"This article is a prime example of true interprofessional collaboration that emphasizes the importance of the entire health care team coming together to take care of all of our patients and especially our geriatric population."

https://www.sciencedaily.com/releases/2019/09/190926114004.htm