Joseph Malone1, Jeah Jung2, Linh Tran2, Chen Zhao1,3. 1. Department of Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA. 2. Department of Health Policy and Administration, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA. 3. Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA.
Abstract
BACKGROUND: Periodontal disease and hepatitis C virus (HCV) represent chronic infectious states that are common in elderly adults. Both conditions have independently been associated with an increased risk for dementia. Chronic infections are thought to lead to neurodegenerative changes in the central nervous system possibly by promoting a proinflammatory state. This is consistent with growing literature on the etiological role of infections in dementia. Few studies have previously evaluated the association of periodontal disease with dementia in HCV patients. OBJECTIVE: To examine whether periodontal disease increases the risk of developing Alzheimer's disease and related dementias (ADRD) among HCV patients in Medicare claims data. METHODS: We used Medicare claims data for HCV patients to assess the incidence rate of ADRD with and without exposure to periodontal disease between 2014 and 2017. Cox multivariate regression was used to estimate the association between periodontal disease and development of ADRD, controlling for age, gender, race, ZIP-level income and education, and medical comorbidities. RESULTS: Of 439,760 HCV patients, the incidence rate of ADRD was higher in patients with periodontal diseases compared to those without (10.84% versus 9.26%, p < 0.001), and those with periodontal disease developed ADRD earlier compared to those without periodontal disease (13.99 versus 21.60 months, p < 0.001). The hazard of developing ADRD was 1.35 times higher in those with periodontal disease (95% CI, 1.30 to 1.40, p < 0.001) after adjusting for all covariates, including age. CONCLUSION: Periodontal disease increased the risk of developing ADRD among HCV patients in a national Medicare claims dataset.
BACKGROUND: Periodontal disease and hepatitis C virus (HCV) represent chronic infectious states that are common in elderly adults. Both conditions have independently been associated with an increased risk for dementia. Chronic infections are thought to lead to neurodegenerative changes in the central nervous system possibly by promoting a proinflammatory state. This is consistent with growing literature on the etiological role of infections in dementia. Few studies have previously evaluated the association of periodontal disease with dementia in HCV patients. OBJECTIVE: To examine whether periodontal disease increases the risk of developing Alzheimer's disease and related dementias (ADRD) among HCV patients in Medicare claims data. METHODS: We used Medicare claims data for HCV patients to assess the incidence rate of ADRD with and without exposure to periodontal disease between 2014 and 2017. Cox multivariate regression was used to estimate the association between periodontal disease and development of ADRD, controlling for age, gender, race, ZIP-level income and education, and medical comorbidities. RESULTS: Of 439,760 HCV patients, the incidence rate of ADRD was higher in patients with periodontal diseases compared to those without (10.84% versus 9.26%, p < 0.001), and those with periodontal disease developed ADRD earlier compared to those without periodontal disease (13.99 versus 21.60 months, p < 0.001). The hazard of developing ADRD was 1.35 times higher in those with periodontal disease (95% CI, 1.30 to 1.40, p < 0.001) after adjusting for all covariates, including age. CONCLUSION: Periodontal disease increased the risk of developing ADRD among HCV patients in a national Medicare claims dataset.
Entities:
Keywords:
Alzheimer’s disease; Alzheimer’s disease and related dementias; Hepatitis C virus; dementia; infection; periodontal disease
Authors: Jenifer F Krüger; Elaine Hillesheim; Amanda C S N Pereira; Carolina Q Camargo; Estela I Rabito Journal: Nutr Rev Date: 2021-01-09 Impact factor: 7.110
Authors: Ryan T Demmer; Faye L Norby; Kamakshi Lakshminarayan; Keenan A Walker; James S Pankow; Aaron R Folsom; Thomas Mosley; Jim Beck; Pamela L Lutsey Journal: Neurology Date: 2020-07-29 Impact factor: 9.910
Authors: James M Noble; Nikolaos Scarmeas; Romanita S Celenti; Mitchell S V Elkind; Clinton B Wright; Nicole Schupf; Panos N Papapanou Journal: PLoS One Date: 2014-12-18 Impact factor: 3.240
Authors: Suzanne Delwel; Tarik T Binnekade; Roberto S G M Perez; Cees M P M Hertogh; Erik J A Scherder; Frank Lobbezoo Journal: Clin Oral Investig Date: 2017-11-15 Impact factor: 3.573
Authors: Chen Zhao; Kevin Strobino; Yeseon Park Moon; Ying Kuen Cheung; Ralph L Sacco; Yaakov Stern; Mitchell S V Elkind Journal: Neurol Genet Date: 2020-07-07