Longitudinal evaluation of periodontitis and development of cognitive decline among older adults

Nilsson, Helena; Berglund, Johan; Renvert, Stefan

doi:10.1111/jcpe.12992

Cited by 20 publications

(46 citation statements)

References 38 publications

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“…For example, a study showed that the multivariable adjusted OR between low MMSE score and periodontal disease was 2.21 (95%CI, 1.01–4.84), and it concluded that periodontal disease was significantly associated with cognitive impairment [ 62 ]. Further, two cohort studies also supported this result [ 42 , 63 ]. For instance, a 6-year follow-up cohort study described a statistically significant association between the prevalence of periodontitis and cognitive decline [ 42 ].…”

Section: Discussionmentioning

confidence: 60%

“…Further, the study conducted by Chen [ 40 ] showed the mixing percent calculus, plaque and gingival bleeding. Two papers were omitted which assessed dementia/cognitive impairment with sole indexes, such as the digit symbol test (DST) [ 41 ], and the MMSE (where points decreased by 3.00) [ 42 ]. A study where the proportion of periodontitis in different groups was based on scores of the digit symbol substitution test (DSST) [ 43 ] was excluded, and a study using the mean score of symbol digit substitution test (SDST) [ 44 ] in different groups based on periodontitis was also excluded.…”

Section: Resultsmentioning

confidence: 99%

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The Effect of Periodontitis on Dementia and Cognitive Impairment: A Meta-Analysis

Guo

Chang

et al. 2021

IJERPH

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The association between periodontal disease and dementia/cognitive impairment continues to receive increasing attention. However, whether periodontal disease is a risk factor for dementia/cognitive impairment is still uncertain. This meta-analysis was conducted to comprehensively analyze the effect of periodontitis on dementia and cognitive impairment, and to assess the periodontal status of dementia patients at the same time. A literature search was undertaken on 19 October 2020 using PubMed, Web of Science, and Embase with different search terms. Two evaluators screened studies according to inclusion and exclusion criteria, and a third evaluator was involved if there were disagreements; this process was the same as that used for data extraction. Included studies were assessed with the Newcastle-Ottawa Scale (NOS), and results were analyzed using software Review Manager 5.2. Twenty observational studies were included. In the comparison between periodontitis and cognitive impairment, the odds ratio (OR) was 1.77 (95% confidence interval (CI), 1.31–2.38), which indicated that there was a strong relationship between periodontitis and cognitive impairment. There was no statistical significance in the effect of periodontitis on dementia (OR = 1.59; 95%CI, 0.92–2.76). The subgroup analysis revealed that moderate or severe periodontitis was significantly associated with dementia (OR = 2.13; 95%CI, 1.25–3.64). The mean difference (MD) of the community periodontal index (CPI) and clinical attachment level (CAL) was 0.25 (95%CI, 0.09–0.40) and 1.22 (95%CI, 0.61–1.83), respectively. In this meta-analysis, there was an association between periodontitis and cognitive impairment, and moderate or severe periodontitis was a risk factor for dementia. Additionally, the deterioration of periodontal status was observed among dementia patients.

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Section: Discussionmentioning

confidence: 60%

Section: Resultsmentioning

confidence: 99%

The Effect of Periodontitis on Dementia and Cognitive Impairment: A Meta-Analysis

Guo

Chang

et al. 2021

IJERPH

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“…Several researchers have investigated the association between cognitive impairment and oral health status, with particular attention to chronic periodontitis; the direction of this association needs to be clarified [11,13,[40][41][42][43][44][45][46]. Chen et al have demonstrated that periodontitis increased the risk of AD 1.7-fold after 10 years [42].…”

Section: Discussionmentioning

confidence: 99%

“…In conclusion, case-control studies have evaluated the relationship between AD and periodontitis but the results were inconclusive due to the wide heterogeneity in the studies performed and their methodologies. Some studies were hospital-based [46,59,60] and others were based on population-based cohorts [42,43,61]. Furthermore, the majority of studies were retrospective cohorts [42,46,60,61] with only a few being classified as prospective cohort [60].…”

Section: Discussionmentioning

confidence: 99%

Oral Health Status in Subjects with Amnestic Mild Cognitive Impairment and Alzheimer’s Disease: Data from the Zabút Aging Project

Panzarella

Mauceri

Baschi

et al. 2022

JAD

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Background: The relationship between Alzheimer's disease (AD) and periodontitis has been recently investigated with heterogenous results. Objective: This study aims to evaluate the oral health status and its relationship with cognitive impairment of participants, enrolled in the Zabút Aging Project, a community-based cohort study performed in a rural community in Sicily, Italy. Methods: A case-control study (20 subjects with AD, 20 with amnestic mild cognitive impairment [aMCI], and 20 controls) was conducted. The protocol included a comprehensive medical and cognitive-behavioral examination. Full-mouth evaluation, microbial analysis of subgingival plaque samples (by RT-PCR analysis), and oral health-related quality of life (OHR-QoL) were evaluated. Results: The decayed, missing, and filled teeth (DMFT) total score of AD subjects was significantly higher than aMCI (p = 0.009) and controls (p = 0.001). Furthermore, the "M" component of DMFT (i.e., the number of missing teeth) was significantly higher in AD than in aMCI (p < 0.001) and controls (p < 0.001). A Poisson regression model revealed that age (p < 0.001), male gender (p = 0.001), and AD (p = 0.001) were positively correlated with DMFT. Concerning oral microbial load, the presence of Fusobacterium nucleatum was significantly higher in AD than in controls (p = 0.02), and a higher load of Treponema denticola was found in aMCI than with AD (p = 0.004). OHR-QoL scores did not differ among the groups. Conclusion: The current research suggests that AD is associated with chronic periodontitis, which is capable of determining tooth loss due to the pathogenicity of Fusobacterium nucleatum. These data remain to be confirmed in larger population-based cohorts.

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“…Descriptive summaries of 23 included articles published between 1994 and 2018, are chronologically presented in (Supplement Tables 1 and 2) [14,. The studies were conducted in four continents including Europe, North America, South America and Asia (Supplement Tables 1 & 2) [14,22,23,[26][27][28][29][30][31][32][33][34][35][38][39][40][41][42][43][44][45]. The number of participants in each study ranged from 42 in the study by Ship and Puckett to 27,963 in the study by Chen [14,38].…”

Section: Description Of Included Studiesmentioning

confidence: 99%

The association between periodontal disease and dementia: a systematic review and meta-analysis

Ju¹,

Kapellas²,

Jamieson³

et al. 2019

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Background and Objective: Periodontal disease is a chronic infection and inflammatory condition of the tooth-supporting tissues. Dementia is a degenerative condition of the brain affecting memory and brain function. The objective of this review is to evaluate associations between the two conditions. Methods: Systematic review with meta-analysis of published articles that involved participants aged ≥45 years with either periodontal disease or dementia. Electronic database searches of PubMed, Embase, Web of Science and Scopus were conducted to source articles that met the inclusion criteria. The Newcastle-Ottawa Scale was used for quality appraisal. Two random effects meta-analyses were conducted to investigate the bi-directional association between periodontitis and dementia. Results: Of 1,670 titles and abstracts found, quality assessment was conducted on 23 articles that met the inclusion criteria. Eight articles presenting findings on the association between dementia and periodontitis, and four studies on the converse association, were subsequently combined into meta-analysis. People with periodontal disease are more likely to suffer from dementia (Odds Ratio=1.17, 95% CI=1.02-1.34, P heterogeneity=0.33, I2 =13%). Conversely, people with dementia are 69% more likely to have periodontal disease (Odds Ratio =1.69, 95% CI=1.23-2.30, P heterogeneity=0.00, I2 =76%). Conclusion: A bi-directional association exists between periodontitis and dementia. With the aging population increasing, degenerative conditions such as dementia and periodontal disease are becoming more common. Family members and healthcare providers need to be aware that the effects of dementia may impede adequate oral hygiene, the cornerstone of prevention of periodontitis, and increase the likelihood of periodontal disease.

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Longitudinal evaluation of periodontitis and development of cognitive decline among older adults

Abstract: A history of periodontitis may be of importance for cognitive functions among older adults.

Cited by 20 publications

References 38 publications

The Effect of Periodontitis on Dementia and Cognitive Impairment: A Meta-Analysis

The Effect of Periodontitis on Dementia and Cognitive Impairment: A Meta-Analysis

Oral Health Status in Subjects with Amnestic Mild Cognitive Impairment and Alzheimer’s Disease: Data from the Zabút Aging Project

The association between periodontal disease and dementia: a systematic review and meta-analysis

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