Spouse Caregivers of Alzheimer’s Patients Show Higher Risk of Gingivitis

• Dental Health • Nov 22, 05

Caregiver spouses of patients with Alzheimer’s disease develop gum disease at twice the rate of their non-caregiver counterparts, researchers report in the latest issue of Psychosomatic Medicine.

Because there was little difference in oral hygiene between the two groups in the study, the researchers say the difference may be related to stress.

Gingivitis is a mild form of gum disease that causes swelling and bleeding. It can progress to more serious disease leading to bone destruction and tooth loss.

Lead investigator Peter Vitaliano, Ph.D., of the University of Washington School of Medicine in Seattle, said of the results: “On a practical level, they speak to relationships between chronic stress and oral health in the general population and suggest that these are independent of oral care. They show that caregivers are at risk for oral health problems and not just physical health problems.”

The investigators enrolled 240 subjects, 123 caregivers of spouses with Alzheimer’s disease and 117 demographically similar non-caregiver spouses. The percentage of caregivers (17 percent) reporting gum disease was twice that of the non-caregivers (8.5 percent), although there was no significant difference in oral healthcare behaviors between the groups.

In addition to evaluating participants’ gum disease, self-reports and medical records, investigators measured blood insulin levels, obesity and intra-abdominal fat. All these are components of metabolic syndrome, the group of symptoms that put people at higher risk for type 2 diabetes. The caregiver spouses scored higher on these measures.

“The implication of this study is considerable,” says Neil Schneiderman, Ph.D., director of the University of Miami Behavioral Medicine Research Center. “The study shows that the relationship between caregiver stress and oral health can be explained by psychosocial factors such as depression and hassles, constitutional factors such as obesity and physiological factors such as insulin metabolism.”

“The links among psychosocial factors, obesity, insulin metabolism and inflammation are particularly intriguing,” Schneiderman added, “because inflammation can have important consequences in terms of the progression of atherosclerosis and coronary heart disease.”

The authors note that the link between chronic stress and gingivitis was first observed in World War I when oral infections among soldiers fighting in the trenches was so high that their teeth became loose and the tips between their teeth eroded away. Since then, studies have continued to show a correlation between various forms of stress and oral disease.

According to the authors, this is the first study to specifically examine oral health in caregivers.

Psychosomatic Medicine is the official bimonthly peer-reviewed journal of the American Psychosomatic Society. For information about the journal, contact Victoria White at (352) 376-1611, ext. 5300, or visit http://www.psychosomaticmedicine.org.