The Impact of Oral Health and Dental Services on the Prevalence of Subjective Cognitive Decline Among Middle-Aged and Older US Adults: Behavioral Risk Factor Surveillance System, 2022.

Introduction: Subjective cognitive decline (SCD) may be associated with poor oral health because of difficulty with self-care or comorbid conditions. Our study aimed to examine oral health status, use of dental services, and the prevalence of SCD among US middle-aged (45-64 y) and older (≥65 y) adults. Methods: We conducted a cross-sectional analysis of 2022 Behavioral Risk Factor Surveillance System (BRFSS) data. Our sample consisted of 83,479 adults aged 45 years or older who completed the cognitive decline module. The associations between SCD and oral health, use of dental services, sociodemographic characteristics, chronic disease conditions, and dementia risk factors were examined by using multivariate regression with a generalized linear model, survey-weighted to account for BRFSS's complex sampling design. All models were stratified by age group (45-64 y vs ≥65 y). Results: Middle-aged and older adults with poor oral health had a higher weighted prevalence of SCD (13.6%) compared with those with good oral health (7.7%). After controlling for covariates, SCD prevalence was increased among adults aged 45 to 64 years with more tooth loss and was lower for those in the same age group who had visited a dentist in the past year (PR = 0.77; 0.65-0.90). Among people aged 65 years or older, SCD prevalence was significantly higher for people with tooth loss compared with no tooth loss, though this pattern was not linear. Conclusion: A significant association was found between the number of teeth lost, dental service use, and SCD, particularly among adults aged 45 to 64 years. Maintaining good oral health and having regular dental visits may be a strategy to reduce the risk of SCD in middle age. People should be encouraged to seek regular dental care.