Mapping the Oral–Nutrition–Brain Axis in Aging: A Scoping Review of Evidence Linking Oral Health, Nutrition, and Cognitive Outcomes
10 affiliations
- 1School of Dental Medicine, Pacific Northwest University of Health Sciences, Yakima, WA 98901, USA
- 2Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- 3The Health and Aging Brain Study-Health Disparities, Fort Worth, TX 76107, USA
- 4School of Dental Medicine, University of Colorado Anschutz, Medical Campus, Aurora, CO 80045, USA
- 5Familia Dental LLC, Midland, TX 79701, USA
- 6Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53706, USA
- 7College of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA 98901, USA
- 8Next S-Miles, San Antonio, TX 78205, USA
- 9School of Social Work, University of Washington, Seattle, WA 98195, USA
- 10Department of Nutrition, Dietetics, and Food Sciences Quinney, College of Agriculture and Natural Resources, Utah State University, Logan Campus, Logan, UT 84322, USA
Abstract
Background: Oral health, nutrition, and neurocognitive health are increasingly recognized as components of healthy aging; however, their multidimensional relationships and plausible biological connections relevant to Alzheimer’s disease and related dementia (AD/ADRD) risk remain incompletely characterized. Objective: To systematically map evidence linking oral conditions and function, nutrition-related factors and biomarkers, and neurocognitive outcomes in adults aged ≥65 years, and conceptualize an integrative Oral–Nutrition–Brain Axis (ONBA). Methods: This scoping review followed Joanna Briggs Institute methodology and PRISMA-ScR guidance. Five electronic databases were searched for studies published from 2010 through June 2025. Evidence was harmonized across oral and functional indicators, nutritional/metabolic/inflammatory biomarkers, and neurological and cognitive outcomes. Results: Of 3415 records identified, 1988 unique records were screened, and 120 studies met eligibility criteria. Evidence was predominantly observational and geographically concentrated in East Asia. Periodontal inflammation, compromised dentition, impaired functional occlusion and masticatory performance were consistently associated with nutritional vulnerability, poorer cognitive performance, cognitive decline, and adverse AD/ADRD outcomes. Co-occurring nutritional and systemic markers included low body weight, hypoalbuminemia, low serum vitamin B12 and folate, hyperhomocysteinemia, and elevated inflammatory biomarkers. Mapped findings aligned across three proposed conceptual frameworks: inflammatory–microbial, nutritional–metabolic, and sensorimotor deafferentation axes. Studies incorporating neuroimaging biomarkers or integrating all three ONBA domains simultaneously remained limited. Conclusions: Oral health and functional dentition may represent key modifiable proxies associated with nutritional and neurocognitive vulnerability in older adults. Longitudinal studies incorporating harmonized oral, nutritional, inflammatory, and neurological phenotypes are needed to clarify temporal sequence, evaluate potential explanatory relationships, and inform multi-domain risk assessment for healthy cognitive aging.
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BibTeX
@article{chamut2026mapping,
title = {{Mapping the Oral–Nutrition–Brain Axis in Aging: A Scoping Review of Evidence Linking Oral Health, Nutrition, and Cognitive Outcomes}},
author = {Steffany Chamut and Holly Nowak and Saeideh Dadras and Rajni Kumari and Roberto Carlos Castrejón-Pérez and Jacqueline Pontes Monteiro and Kathaleen Briggs Early and Denisse Chamut and Melanie Morris and Joana Pico and Matt Glittenberg and HABS-HD Study Team HABS-HD Study Team and Marc Weisskopf},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18213637},
url = {https://www.mdpi.com/2072-6643/18/21/3637},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Mapping the Oral–Nutrition–Brain Axis in Aging: A Scoping Review of Evidence Linking Oral Health, Nutrition, and Cognitive Outcomes
AU - Steffany Chamut
AU - Holly Nowak
AU - Saeideh Dadras
AU - Rajni Kumari
AU - Roberto Carlos Castrejón-Pérez
AU - Jacqueline Pontes Monteiro
AU - Kathaleen Briggs Early
AU - Denisse Chamut
AU - Melanie Morris
AU - Joana Pico
AU - Matt Glittenberg
AU - HABS-HD Study Team HABS-HD Study Team
AU - Marc Weisskopf
PY - 2026
DA - 2026/10/31
JO - Nutrients
DO - 10.3390/nu18213637
UR - https://www.mdpi.com/2072-6643/18/21/3637
AB - Background: Oral health, nutrition, and neurocognitive health are increasingly recognized as components of healthy aging; however, their multidimensional relationships and plausible biological connections relevant to Alzheimer’s disease and related dementia (AD/ADRD) risk remain incompletely characterized. Objective: To systematically map evidence linking oral conditions and function, nutrition-related factors and biomarkers, and neurocognitive outcomes in adults aged ≥65 years, and conceptualize an integrative Oral–Nutrition–Brain Axis (ONBA). Methods: This scoping review followed Joanna Briggs Institute methodology and PRISMA-ScR guidance. Five electronic databases were searched for studies published from 2010 through June 2025. Evidence was harmonized across oral and functional indicators, nutritional/metabolic/inflammatory biomarkers, and neurological and cognitive outcomes. Results: Of 3415 records identified, 1988 unique records were screened, and 120 studies met eligibility criteria. Evidence was predominantly observational and geographically concentrated in East Asia. Periodontal inflammation, compromised dentition, impaired functional occlusion and masticatory performance were consistently associated with nutritional vulnerability, poorer cognitive performance, cognitive decline, and adverse AD/ADRD outcomes. Co-occurring nutritional and systemic markers included low body weight, hypoalbuminemia, low serum vitamin B12 and folate, hyperhomocysteinemia, and elevated inflammatory biomarkers. Mapped findings aligned across three proposed conceptual frameworks: inflammatory–microbial, nutritional–metabolic, and sensorimotor deafferentation axes. Studies incorporating neuroimaging biomarkers or integrating all three ONBA domains simultaneously remained limited. Conclusions: Oral health and functional dentition may represent key modifiable proxies associated with nutritional and neurocognitive vulnerability in older adults. Longitudinal studies incorporating harmonized oral, nutritional, inflammatory, and neurological phenotypes are needed to clarify temporal sequence, evaluate potential explanatory relationships, and inform multi-domain risk assessment for healthy cognitive aging.
SN - 2072-6643
ER -