Peres Marco A, Bastos João L, Watt Richard G, Xavier André J, Barbato Paulo R, D'Orsi Eleonora
a Australian Research Centre for Population Oral Health, School of Dentistry , The University of Adelaide , Adelaide , Australia.
Aging Ment Health. 2015;19(10):876-84. doi: 10.1080/13607863.2014.977770. Epub 2014 Nov 19.
A consistent and low-to-moderate association between markers of oral infection and loss of cognitive function has been demonstrated in the literature. However, such evidence comes from population studies carried out mainly in the USA.
To assess the association between tooth loss and loss of cognitive function in older people from Southern Brazil, with particular interest on how age may modify such association. In addition, we also test the association between loss of cognition (exposure) and tooth loss (outcome).
Data from a baseline population-based cohort study were cross-sectionally analyzed, including tooth loss, cognitive impairment, sex, income, educational attainment, color/race, smoking status and a range of self-reported chronic diseases. Participants (n = 1705) were 60 years of age and over, from a midsized Southern Brazilian city. Odds ratios (OR) and 95% confidence intervals (95%CI) were estimated using multivariable logistic and partial ordinal logistic analyses.
Edentate status was associated (OR 3.3; 95%CI 1.2-9.3) with severe cognitive impairment in the fully adjusted model. Moreover, there was an interaction between number of teeth and age on severe cognitive impairment. A weak association between severe cognitive impairment (exposure) and tooth loss (outcome) was identified after the adjustment for potential covariates.
This study lends support to hypothesized association between tooth loss and severe cognitive impairment. Older adults seem to be particularly vulnerable to such effects. However, the bidirectional association between tooth loss and severe cognitive impairment cannot be ruled out.
文献表明口腔感染标志物与认知功能丧失之间存在一致的低至中度关联。然而，此类证据主要来自美国开展的人群研究。
评估巴西南部老年人牙齿缺失与认知功能丧失之间的关联，特别关注年龄如何影响这种关联。此外，我们还检验认知丧失（暴露因素）与牙齿缺失（结果）之间的关联。
对一项基于人群的队列研究的基线数据进行横断面分析，包括牙齿缺失、认知障碍、性别、收入、教育程度、肤色/种族、吸烟状况以及一系列自我报告的慢性病。研究对象（n = 1705）来自巴西南部一个中等规模城市，年龄在60岁及以上。使用多变量逻辑回归和偏序逻辑回归分析估计比值比（OR）和95%置信区间（95%CI）。
在完全调整模型中，无牙状态与严重认知障碍相关（OR 3.3；95%CI 1.2 - 9.3）。此外，牙齿数量与年龄在严重认知障碍方面存在交互作用。在对潜在协变量进行调整后，发现严重认知障碍（暴露因素）与牙齿缺失（结果）之间存在微弱关联。
本研究支持牙齿缺失与严重认知障碍之间存在假设关联这一观点。老年人似乎对此类影响尤为脆弱。然而，牙齿缺失与严重认知障碍之间的双向关联不能排除。
