Association between Tooth Loss and Alzheimer’s Disease in a Nested Case–Control Study Based on a National Health Screening Cohort

Kim, Jihee; Oh, Jae Keun; Wee, Jee Hye; Kim, Yoo Hwan; Byun, Soo-Hwan; Choi, Hyo Geun

doi:10.3390/jcm10173763

Cited by 11 publications

(31 citation statements)

References 33 publications

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“… 5 , 6 , 7 Among the many risk factors for dementia and cognitive decline, oral health measures (e.g., periodontitis, tooth loss) have only started to be recently explored. 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 …”

Section: Introductionmentioning

confidence: 99%

“…19 The available evidence on periodontal health and cognitive deterioration is insufficient and subject to limitations. 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 Most individual studies lack comprehensive exposure and outcome assessments and have a shorter duration. Also, in the past two years, several studies have been published 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 which warrant synthesis and evaluation.…”

Section: Introductionmentioning

confidence: 99%

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Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Asher

Stephen

Mäntylä

et al. 2022

J American Geriatrics Society

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Background Emerging evidence indicates that poor periodontal health adversely impacts cognition. This review examined the available longitudinal evidence concerning the effect of poor periodontal health on cognitive decline and dementia. Methods Comprehensive literature search was conducted on five electronic databases for relevant studies published until April 2022. Longitudinal studies having periodontal health as exposure and cognitive decline and/or dementia as outcomes were considered. Random effects pooled estimates and 95% confidence intervals were generated (pooled odds ratio for cognitive decline and hazards ratio for dementia) to assess whether poor periodontal health increases the risk of cognitive decline and dementia. Heterogeneity between studies was estimated by I2 and the quality of available evidence was assessed through quality assessment criteria. Results Adopted search strategy produced 2132 studies for cognitive decline and 2023 for dementia, from which 47 studies (24 for cognitive decline and 23 for dementia) were included in this review. Poor periodontal health (reflected by having periodontitis, tooth loss, deep periodontal pockets, or alveolar bone loss) was associated with both cognitive decline (OR = 1.23; 1.05–1.44) and dementia (HR = 1.21; 1.07–1.38). Further analysis, based on measures of periodontal assessment, found tooth loss to independently increase the risk of both cognitive decline (OR = 1.23; 1.09–1.39) and dementia (HR = 1.13; 1.04–1.23). Stratified analysis based on the extent of tooth loss indicated partial tooth loss to be important for cognitive decline (OR = 1.50; 1.02–2.23) and complete tooth loss for dementia (HR = 1.23; 1.05–1.45). However, the overall quality of evidence was low, and associations were at least partly due to reverse causality. Conclusions Poor periodontal health and tooth loss appear to increase the risk of both cognitive decline and dementia. However, the available evidence is limited (e.g., highly heterogenous, lacking robust methodology) to draw firm conclusions. Further well‐designed studies involving standardized periodontal and cognitive health assessment and addressing reverse causality are highly warranted.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Asher

Stephen

Mäntylä

et al. 2022

J American Geriatrics Society

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“…While it is not clear whether poor oral health predicts dementia, substantial data suggests that oral health declines as cognitive impairment and dementia progresses [ 7 , 12 , 14 , 15 , 16 ]. Furthermore, it has been demonstrated that masticatory exercise improves cognitive function in older adults [ 17 ] and thus the link between cognitive decline and masticatory dysfunction is now clear [ 8 , 18 , 19 , 20 , 21 , 22 ]. As loss of masticatory activity [ 8 , 11 , 12 , 13 , 18 , 19 , 20 , 21 , 22 ] and sedentary life style [ 23 , 24 ] are risk factors for age-related cognitive decline, there is a need to focus attention on those sub-populations that experience greater oral health deterioration or impairment of the stomatognathic system, and those having living sedentary lives.…”

Section: Introductionmentioning

confidence: 99%

The Sedentary Lifestyle and Masticatory Dysfunction: Time to Review the Contribution to Age-Associated Cognitive Decline and Astrocyte Morphotypes in the Dentate Gyrus

Mendes

Almeida

Falsoni

et al. 2022

IJMS

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As aging and cognitive decline progresses, the impact of a sedentary lifestyle on the appearance of environment-dependent cellular morphologies in the brain becomes more apparent. Sedentary living is also associated with poor oral health, which is known to correlate with the rate of cognitive decline. Here, we will review the evidence for the interplay between mastication and environmental enrichment and assess the impact of each on the structure of the brain. In previous studies, we explored the relationship between behavior and the morphological features of dentate gyrus glial fibrillary acidic protein (GFAP)-positive astrocytes during aging in contrasting environments and in the context of induced masticatory dysfunction. Hierarchical cluster and discriminant analysis of GFAP-positive astrocytes from the dentate gyrus molecular layer revealed that the proportion of AST1 (astrocyte arbors with greater complexity phenotype) and AST2 (lower complexity) are differentially affected by environment, aging and masticatory dysfunction, but the relationship is not straightforward. Here we re-evaluated our previous reconstructions by comparing dorsal and ventral astrocyte morphologies in the dentate gyrus, and we found that morphological complexity was the variable that contributed most to cluster formation across the experimental groups. In general, reducing masticatory activity increases astrocyte morphological complexity, and the effect is most marked in the ventral dentate gyrus, whereas the effect of environment was more marked in the dorsal dentate gyrus. All morphotypes retained their basic structural organization in intact tissue, suggesting that they are subtypes with a non-proliferative astrocyte profile. In summary, the increased complexity of astrocytes in situations where neuronal loss and behavioral deficits are present is counterintuitive, but highlights the need to better understand the role of the astrocyte in these conditions.

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“…However, most previous studies have focused on all-cause or cardiovascular and/or cancer-related mortality and have not considered various causes of mortality that are possibly affected by missing teeth. In addition, although many previous studies have examined the effects of a considerable number of missing teeth (<20 teeth remaining or edentation) on mortality, (1,4,5,(10)(11)(12) only a few prior studies have suggested the effects of a small number of missing teeth on morbidities (7,8).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, having <20 teeth and masticatory dysfunction were connected with a greater risk of cognitive deficits in a meta-analysis (OR = 2.24, 95% 95% CI = 1.73–2.90) ( 6 ). Another meta-analysis demonstrated a 1.48 times greater risk of cognitive impairment (95% CI = 1.18–1.87) in individuals with missing teeth with a dose-response association according to the number of missing teeth from 4 to 32 teeth or 0 to 32 teeth ( 7 , 8 ). A prospective cohort study estimated a 1.85 times greater risk of dementia in Japanese elderly individuals with few teeth (95% CI = 1.04–3.31) ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Is the Number of Missing Teeth Associated With Mortality? A Longitudinal Study Using a National Health Screening Cohort

et al. 2022

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This study aimed to estimate the risk of mortality related to the number of missing teeth in a South Korean population. The ≥ 40-year-old population of the Korean National Health Insurance Service-Health Screening Cohort 2002–2003 was analyzed. Participants were selected from a total of 220,189 participants and included in groups of 0 teeth lost, 1–2 teeth lost, and ≥ 3 teeth lost. Among the total population, 17,211 participants were included in no missing teeth, 1–2 missing teeth, and ≥ 3 missing teeth and were randomly matched 1:1:1 for age and sex. Mortality from specific causes and all-cause mortality were compared among the groups. The hazard ratio (HR) of the number of missing teeth for all-cause mortality or each cause of mortality was analyzed using Cox proportional hazard models. According to the cause of death, the HRs for metabolic disease, digestive disease, and trauma were greater in the group with ≥ 3 missing teeth than in the no missing teeth group. The group with ≥ 3 missing teeth indicated a 1.19-fold higher HR for all-cause mortality than the no missing teeth group [95% confidence intervals (95% CIs) = 1.12–1.27, P < 0.001]. The group with 1- 2 missing teeth did not show a higher HR for all-cause mortality. In the group with 1–2 missing teeth, the HRs for mortality from mental disease and digestive disease were higher than those in the no missing teeth group. The group with 1–2 missing teeth did not show a higher HR for all-cause mortality. The number of missing teeth was linked with a higher risk of mortality. For specific causes of mortality, mortality from metabolic disease, digestive disease, and trauma was higher in the participants with the number of missing teeth.

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Association between Tooth Loss and Alzheimer’s Disease in a Nested Case–Control Study Based on a National Health Screening Cohort

Cited by 11 publications

References 33 publications

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

The Sedentary Lifestyle and Masticatory Dysfunction: Time to Review the Contribution to Age-Associated Cognitive Decline and Astrocyte Morphotypes in the Dentate Gyrus

Is the Number of Missing Teeth Associated With Mortality? A Longitudinal Study Using a National Health Screening Cohort

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