Social isolation is prevalent and associated with dementia, yet the directionality and mechanisms are less understood. This study examined the association between social isolation and cognitive functioning and explored the mediating role of sleep disturbance on the social isolation-cognition relationship. Data from 5,753 dementia-free Americans aged ≥50 of 2006 (T1), 2010 (T2), and 2014 (T3) waves of the Health and Retirement Study. Social isolation was measured by the Steptoe Social Isolation Index. Cognitive functioning was measured by the Telephone Interview of Cognitive Status. Sleep disturbance was measured with the modified Jenkins Sleep Scale. We used cross-lagged panel models to determine the associations between social isolation, sleep disturbance, and cognitive functioning. Social isolation is significantly associated with subsequent cognitive functioning (T1 to T2: β = -0.055, standard error [SE] = 0.014, p < 0.001; T2 to T3: β = -0.044, SE = 0.016, p < 0.001). Lower cognitive functioning is significantly associated with greater subsequent social isolation (T1 to T2: β = -0.101, SE = 0.020, p < 0.001; T2 to T3: β = -0.058, SE = 0.011, p < 0.001). Sleep disturbance at T2 partially mediated the effect of social isolation (T1) on cognitive functioning (T3), accounting for 6.2% of the total effect (β = -0.003, SE = 0.001, p < 0.01). Social isolation may deteriorate cognitive functioning and vice versa. The association between social isolation and cognition is partially explained by sleep disturbance.

The aim of this research was to assess the association between inflammation and oral health and diabetes, as well as the mediating role of oral hygiene practice in this association. Data were from the 2009–2010 National Health and Nutrition Examination Survey. The analytical sample consisted of 2,191 respondents aged 50 and older. Poor oral health was clinically defined by significant tooth loss (STL) and periodontal disease (PD). Diabetes mellitus (DM) was determined by glycemic levels. The outcome variable was serum C-reactive protein (CRP) level, dichotomised as ≥1 mg/dL (elevated CRP) vs <1 mg/dL (not elevated CRP). Two path models, one using STL and DM as the independent variable, the other using PD and DM as the independent variable, were estimated to assess the direct effects of having poor oral health and DM on elevated CRP and the mediating effects of dental flossing. In path model 1, individuals having both STL and DM (adjusted odds ratio [AOR], 1.92; 95% confidence interval [CI], 1.30–2.82) or having STL alone (AOR, 2.30; 95% CI, 1.68–3.15) were more likely to have elevated CRP than those with neither STL nor DM; dental flossing (AOR, 0.92, 95% CI, 0.88–0.96) was associated with lower risk of elevated CRP. In path model 2, no significant association was found between having both PD and DM and elevated CRP; dental flossing (AOR, 0.91; 95% CI:, 0.86–0.94) was associated with lower risk of elevated CRP. Findings from this study highlight the importance of improving oral health and oral hygiene practice to mitigate inflammation. Further research is needed to assess the longer-term effects of reducing inflammation.

The coronavirus disease 2019 (COVID-19) pandemic has highlighted the importance of understanding the underlying conditions that lead to COVID-19. Oral health has systemic implications in the maintenance of a healthy state. This study aimed to summarize evidence on the prevalence of oral health conditions in participants with COVID-19 and assess the associations between oral health conditions and COVID-19 related outcomes. Article searches were conducted in five databases and the gray literature from December 1, 2019 to March 1, 2021. Studies that reported oral health conditions for participants with COVID-19 and/or examined associations between oral health and COVID-19 were included. We identified 15 articles that encompassed 5,377 participants with COVID-19 from 10 countries. Dry mouth was the most common oral health condition reported (41.0%), followed by oral lesions (38.8%), orofacial pain (18.3%), and periodontal symptoms (11.7%). Based on the pooled odds ratios (ORs), periodontal symptoms were not associated with COVID-19 positivity (OR = 1.1; 95% confidence intervals [CI], 0.73–1.65) or mortality (OR = 2.71; 95% CI, 0.64–11.51), but were associated with COVID-19 severity (OR = 3.18; 95% CI, 1.81–5.58). Oral health conditions are common in participants with COVID-19 and should be considered in both the onset and progression of this disease. Knowledge in this area is still limited, and the quality of the data extracted was low. Further longitudinal studies are needed to ascertain whether oral health conditions are a consequence of infection with SARS-CoV-2 or whether they predate infection and are risk factors for COVID-19.

Asian Americans were the fastest-growing population segment in the United States in the last two decades. The population growth of all Asians was 34% from 2010 to 2019, compared with 6% for all Americans ( Budiman, 2020). In the older population, aged 65 years and above, Asian Americans are also the fastest-growing minority group ( Budiman & Ruiz, 2021). The older Asian American population was 2.5 million in 2019 and is projected to grow to 7.9 million by 2060. In 2019, Asian Americans made up 4.6% of the older population. By 2060, the percentage is projected to be 8% ( Administration for Community Living, 2021). Asian Americans are very diverse in their nations of origins and languages, with more than 50 ethnicities and 100 different languages and dialects ( Budiman, 2020). Most Asian Americans trace their roots to countries in East Asia, Southeast Asia, and the Indian subcontinent. The following six origin groups account for the majority of the U.S. Asian population (85%): Chinese, Filipino, Indian, Vietnamese, Korean, and Japanese. Aside from Native Hawaiians and Other Pacific Islanders, Asian Americans accounted for 31% of the U.S. older immigrant’s population and by the year 2055 will surpass Hispanics as the largest immigrant group ( Mizoguchi et al., 2019), and they represent distinct cultural beliefs and customs, incomes, levels of education, geographic locations, religions, languages, immigration patterns, and levels of acculturation ( Budiman & Ruiz, 2021). Thus, in this paper, the term Asian Americans did not include Native Hawaiian and Other Pacific Islanders.