# Pathways from co-occurrence of poor oral health and diabetes to Alzheimer's disease and related dementia (ADRD) and mortality

> **NIH NIH R56** · NEW YORK UNIVERSITY · 2020 · $519,034

## Abstract

Project summary
Alzheimer's disease and related dementias (ADRD) is irreversible, progressive brain disease that affects 5.7
million Americans. It is the sixth leading cause of death among all adults and the fifth leading cause of death
for those aged 65 or older. ADRD is devastating for individuals and families financially and emotionally.
Identifying both individual and combined risk factors of ADRD and evaluating the impact of comorbidities on
cognitive impairment is essential to improve cognitive health of older adults. Diabetes and poor oral health are
common among older adults and both are risk factors for ADRD. The proposed study is the first to examine the
joint effect (additive or interactions) of both DM and poor oral health on ADRD and mortality, and the pathways
from the co-occurrence to the onset of ADRD and mortality. Specific aims are: Aim 1a: To examine the
relationship between the co-occurrence of DM and poor oral health and the incidence of ADRD using a
propensity matched sample within the study period. We hypothesize that persons with both DM and poor oral
health will be more likely to have ADRD than those without either condition, or those with only one of these two
conditions. Aim 1b: To examine the association between the co-occurrence of DM and poor oral health and
the age of first diagnosis of ADRD among persons who developed ADRD during the study period. We
hypothesize that persons with both DM and poor oral health will have a younger age of diagnosis of ADRD.
Aim 1c: To test the pathways from the co-occurrence of DM and poor oral health to the onset of ADRD by
examining the mediation effect of key mediating variables (i.e., CVD and stroke developed after baseline). The
relationship between the co-occurrence and the incidence of and the onset of ADRD is mediated by CVD and
stroke. Aim 2a: To examine the pathways of the co-occurrence of DM and poor oral health and the effect of
key mediators, listed in Aim 1c, on death within 5 years of the study baseline. We will divide the study sample
into four groups: alive with ADRD, alive without ADRD, died with ADRD, and died without ADRD. We
hypothesize that the co-occurrence has both direct and indirect effects on death. Aim 2b: To use predictive
modeling to identify moderators (e.g., childhood adversity, dietary intake, and genetic factors) of the
relationship between the co-occurrence of DM and poor oral health and death within 5 years of the baseline
survey. The proposed study is the first to examine the effect of the co-occurrence of DM and poor oral health
on ADRD and mortality, using large national samples. The proposed study will contribute to a better
understanding of the risk profile of ADRD by providing important empirical evidence on the combined risk of
both DM and oral health for ADRD. Further, it may identify modifiable factors that can serve as targets to
reduce the risk of ADRD. The findings will have important implications for clinical practice and policy initiati...

## Key facts

- **NIH application ID:** 10228283
- **Project number:** 1R56AG067619-01
- **Recipient organization:** NEW YORK UNIVERSITY
- **Principal Investigator:** Huabin Luo
- **Activity code:** R56 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $519,034
- **Award type:** 1
- **Project period:** 2020-09-15 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10228283

## Citation

> US National Institutes of Health, RePORTER application 10228283, Pathways from co-occurrence of poor oral health and diabetes to Alzheimer's disease and related dementia (ADRD) and mortality (1R56AG067619-01). Retrieved via AI Analytics 2026-06-03 from https://api.ai-analytics.org/grant/nih/10228283. Licensed CC0.

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