Ryan T Demmer1, Faye L Norby2, Kamakshi Lakshminarayan2, Keenan A Walker2, James S Pankow2, Aaron R Folsom2, Thomas Mosley2, Jim Beck2, Pamela L Lutsey2. 1. From the Division of Epidemiology and Community Health (R.T.D., F.L.N., K.L., J.S.P., A.R.F., P.L.L.), School of Public Health, University of Minnesota, Minneapolis; Department of Epidemiology (R.T.D.), Mailman School of Public Health, Columbia University, New York, NY; Department of Neurology (K.A.W.), Johns Hopkins School of Medicine, Baltimore, MD; Department of Medicine (T.M.), University of Mississippi Medical Center, Jackson; and Division of Comprehensive Oral Health-Periodontology (J.B.), Adams School of Dentistry, University of North Carolina at Chapel Hill. demm0009@umn.edu. 2. From the Division of Epidemiology and Community Health (R.T.D., F.L.N., K.L., J.S.P., A.R.F., P.L.L.), School of Public Health, University of Minnesota, Minneapolis; Department of Epidemiology (R.T.D.), Mailman School of Public Health, Columbia University, New York, NY; Department of Neurology (K.A.W.), Johns Hopkins School of Medicine, Baltimore, MD; Department of Medicine (T.M.), University of Mississippi Medical Center, Jackson; and Division of Comprehensive Oral Health-Periodontology (J.B.), Adams School of Dentistry, University of North Carolina at Chapel Hill.
Abstract
OBJECTIVE: To test the hypothesis that periodontal disease would be associated with increased risk for dementia and mild cognitive impairment (MCI) by assessing dementia/MCI outcomes after a baseline periodontal examination. METHODS: Participants enrolled in the Atherosclerosis Risk in Communities study with a clinical periodontal examination (or edentulous participants) at visit 4 (1996-1998; mean ± SD age 63 ± 6 years, 55% female, 21% black) and adjudicated dementia outcomes through 2016 were included (n = 8,275). A subgroup of 4,559 participants had adjudicated dementia and MCI assessments at visit 5 (2011-2013). Participants received a full-mouth periodontal examination and were classified into periodontal profile classes (PPCs) based on the severity and extent of gingival inflammation and attachment loss. MCI and dementia were determined via neurocognitive testing, neurological examination and history, informant interviews, and brain MRI in a subset. Cox proportional hazards models regressed incident dementia on PPCs. Relative risk regression models were used for the composite of MCI/dementia. RESULTS: The cumulative incidence and incidence density of dementia during follow-up (average 18.4 years) were 19% (n = 1,569) and 11.8 cases per 1,000 person-years. Multivariable adjusted hazard ratios for incident dementia among participants with severe PPC or edentulism (vs periodontal healthy) were 1.22 (95% confidence interval [CI] 1.01-1.47) and 1.21 (95% CI 0.99-1.48), respectively. For the combined dementia/MCI outcome, adjusted risk ratios among participants with mild/intermediate PPC, severe PPC, or edentulism (vs periodontal healthy) were 1.22 (95% CI 1.00-1.48), 1.15 (95% CI 0.88-1.51), and 1.90 (95% CI 1.40-2.58). Results were stronger among younger (≤62 years) participants (p for interaction = 0.02). CONCLUSION: Periodontal disease was modestly associated with incident MCI and dementia in a community-based cohort of black and white participants.
OBJECTIVE: To test the hypothesis that periodontal disease would be associated with increased risk for dementia and mild cognitive impairment (MCI) by assessing dementia/MCI outcomes after a baseline periodontal examination. METHODS: Participants enrolled in the Atherosclerosis Risk in Communities study with a clinical periodontal examination (or edentulous participants) at visit 4 (1996-1998; mean ± SD age 63 ± 6 years, 55% female, 21% black) and adjudicated dementia outcomes through 2016 were included (n = 8,275). A subgroup of 4,559 participants had adjudicated dementia and MCI assessments at visit 5 (2011-2013). Participants received a full-mouth periodontal examination and were classified into periodontal profile classes (PPCs) based on the severity and extent of gingival inflammation and attachment loss. MCI and dementia were determined via neurocognitive testing, neurological examination and history, informant interviews, and brain MRI in a subset. Cox proportional hazards models regressed incident dementia on PPCs. Relative risk regression models were used for the composite of MCI/dementia. RESULTS: The cumulative incidence and incidence density of dementia during follow-up (average 18.4 years) were 19% (n = 1,569) and 11.8 cases per 1,000 person-years. Multivariable adjusted hazard ratios for incident dementia among participants with severe PPC or edentulism (vs periodontal healthy) were 1.22 (95% confidence interval [CI] 1.01-1.47) and 1.21 (95% CI 0.99-1.48), respectively. For the combined dementia/MCI outcome, adjusted risk ratios among participants with mild/intermediate PPC, severe PPC, or edentulism (vs periodontal healthy) were 1.22 (95% CI 1.00-1.48), 1.15 (95% CI 0.88-1.51), and 1.90 (95% CI 1.40-2.58). Results were stronger among younger (≤62 years) participants (p for interaction = 0.02). CONCLUSION: Periodontal disease was modestly associated with incident MCI and dementia in a community-based cohort of black and white participants.
Authors: Marilyn S Albert; Steven T DeKosky; Dennis Dickson; Bruno Dubois; Howard H Feldman; Nick C Fox; Anthony Gamst; David M Holtzman; William J Jagust; Ronald C Petersen; Peter J Snyder; Maria C Carrillo; Bill Thies; Creighton H Phelps Journal: Alzheimers Dement Date: 2011-04-21 Impact factor: 21.566
Authors: Thiago Morelli; Kevin L Moss; James Beck; John S Preisser; Di Wu; Kimon Divaris; Steven Offenbacher Journal: J Periodontol Date: 2016-09-13 Impact factor: 6.993
Authors: Hamdi S Adam; Kamakshi Lakshminarayan; Wendy Wang; Faye L Norby; Thomas Mosley; Keenan A Walker; Rebecca F Gottesman; Katie Meyer; Timothy M Hughes; James S Pankow; Dean F Wong; Clifford R Jack; Souvik Sen; Pamela L Lutsey; Jim Beck; Ryan T Demmer Journal: J Clin Periodontol Date: 2022-01-27 Impact factor: 8.728
Authors: K S Ma; H Hasturk; I Carreras; A Dedeoglu; J J Veeravalli; J Y Huang; A Kantarci; J C Wei Journal: J Dent Res Date: 2021-10-13 Impact factor: 6.116
Authors: Harper S Kim; John Son; Donghwan Lee; Joy Tsai; Danny Wang; E Sandra Chocron; Seongwoo Jeong; Pamela Kittrell; Charles F Murchison; Richard E Kennedy; Alejandro Tobon; Carlayne E Jackson; Andrew M Pickering Journal: BMC Neurol Date: 2022-02-21 Impact factor: 2.903
Authors: João Botelho; Yago Leira; João Viana; Vanessa Machado; Patrícia Lyra; José Manuel Aldrey; Juan Manuel Pías-Peleteiro; Juan Blanco; Tomás Sobrino; José João Mendes Journal: Nutrients Date: 2021-03-12 Impact factor: 5.717
Authors: Haiying Guo; Shuli Chang; Xiaoqin Pi; Fang Hua; Han Jiang; Chang Liu; Minquan Du Journal: Int J Environ Res Public Health Date: 2021-06-25 Impact factor: 3.390