Dementia and the Risk of Periodontitis: A Population-Based Cohort Study

Abstract

Dementia and Alzheimer’s disease (AD) are proposed to be comorbid with periodontitis (PD). It is unclear whether PD is associated with dementia and AD independent of confounding factors. We aimed at identifying the relationship between the longitudinal risk of developing PD in a cohort of patients with dementia and AD who did not show any signs of PD at baseline. In this retrospective cohort study, 8,640 patients with dementia without prior PD were recruited, and 8,640 individuals without dementia history were selected as propensity score–matched controls. A Cox proportional hazard model was developed to estimate the risk of developing PD over 10 y. Cumulative probability was derived to assess the time-dependent effect of dementia on PD. Of the 8,640 patients, a sensitivity test was conducted on 606 patients with AD-associated dementia and 606 non-AD propensity score–matched controls to identify the impact of AD-associated dementia on the risk for PD. Subgroup analyses on age stratification were included. Overall 2,670 patients with dementia developed PD. The relative risk of PD in these patients was significantly higher than in the nondementia group (1.825, 95% CI = 1.715 to 1.942). Cox proportional hazard models showed that patients with dementia were more likely to have PD than individuals without dementia (adjusted hazard ratio = 1.915, 95% CI = 1.766 to 2.077, P < 0.0001, log-rank test P < 0.0001). The risk of PD in patients with dementia was age dependent ( P values for all ages <0.0001); younger patients with dementia were more likely to develop PD. The findings persisted for patients with AD: the relative risk (1.531, 95% CI = 1.209 to 1.939) and adjusted hazard ratio (1.667, 95% CI = 1.244 to 2.232; log-rank test P = 0.0004) of PD in patients with AD were significantly higher than the non-AD cohort. Our findings demonstrated that dementia and AD were associated with a higher risk of PD dependent of age and independent of systemic confounding factors.

Fibromyalgia and periodontitis: Bidirectional associations in population‐based 15‐year retrospective cohorts

“…On the other hand, the age‐dependent increase in fibromyalgia incidence in our study was in line with previous studies 13,14,24 . In our study, patients aged below 30 had the greatest risk of developing fibromyalgia following periodontitis, which is similar to previous studies suggesting that younger periodontitis cases are often assocaited with more active host immune responses and more severe periodontal destruction 25 . Although in the present study, patients of both sexes and all age groups had significantly greater risks for fibromyalgia following periodontitis, population subgroups with more inflammatory traits for periodontitis 23,25 were predisposed to even greater risks of fibromyalgia.…”

“…13,14,24 In our study, patients aged below 30 had the greatest risk of developing fibromyalgia following periodontitis, which is similar to previous studies suggesting that younger periodontitis cases are often assocaited with more active host immune responses and more severe periodontal destruction. 25 Although in the present study, patients of both sexes and all age groups had significantly greater risks for fibromyalgia following periodontitis, population subgroups with more inflammatory traits for periodontitis 23,25 were predisposed to even greater risks of fibromyalgia. Further examining the link between perodontitis and fibromyalgia revealed that fibromyalgia patients who never had periodontitis were at greater risk of developing periodontitis.…”

Higher Dementia Risk in People With Gastroesophageal Reflux Disease: A Real-World Evidence

“…Hence misclassification bias could exist. However, we tried our best to address misclassification bias by utilizing definitions of exposure and outcome that has been validated by previous studies ( Chang et al, 2016 ; Chen et al, 2016 ; Ling et al, 2021 ; Ma et al, 2021 ). The definition of GERD in this study included not only ICD-9 diagnosis records, but also prescription of PPIs.…”

Human Papillomavirus Infection and the Risk of Erectile Dysfunction: A Nationwide Population-Based Matched Cohort Study

“…In this cohort study, we employed a nationwide population-based registry to provide epidemiological evidence on the risks of new-onset ED in patients with HPV infection. The effect of measurable confounders was minimized by PS matching [ 71 , 72 , 73 , 74 , 75 ]. Sensitivity and negative control analyses were conducted to manage residual confounding and to ascertain the impact of HPV infection on ED development.…”