Iwasaki M, Yoshihara A, Kimura Y, Sato M, Wada T, Sakamoto R, Ishimoto Y, Fukutomi E, Chen W, Imai H, Fujisawa M, Okumiya K, Taylor G W, Ansai T, Miyazaki H, Matsubayashi K
Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Division of Community Oral Health Development, Kyushu Dental University, Kitakyushu, Japan.
J Periodontal Res. 2016 Oct;51(5):681-8. doi: 10.1111/jre.12348. Epub 2016 Jan 6.
Epidemiologic data examining the longitudinal relationship between periodontitis and cognitive status are very limited, especially in Asian populations. The present study examined the longitudinal relationship of periodontitis with cognitive decline in 85 Japanese community-dwelling individuals (average age: 79.3 years) for whom data were available from comprehensive health examinations conducted in 2010 and 2013.
Based on a baseline full-mouth periodontal examination, severe periodontitis was defined using a Centers for Disease Control and Prevention/American Academy of Periodontology definition. Cognitive decline during the 3-year study period was defined using the results of the Mini-Mental State Examination (MMSE). Information on age, gender, education, depression, body mass index, smoking status, alcohol use, exercise, hypertension, diabetes, history of cardiovascular disease and stroke, and baseline MMSE scores were obtained and tested as potential confounders in the statistical models.
Among 85 study participants, 21 (24.7%) were defined as having severe periodontitis. Multivariable Poisson regression analyses revealed that severe periodontitis was significantly associated with an increased risk of cognitive decline [adjusted relative risk = 2.2; 95% confidence interval (95% CI): 1.1-4.5]. Furthermore, multivariable linear regression analyses revealed that participants with severe periodontitis had a 1.8-point greater decrease (95% CI: -3.3 to -0.2) in MMSE score than those without severe periodontitis.
Within the limitations related to its small sample size, the findings of the present study suggest that severe periodontitis is significantly associated with future decline in cognitive function among community-dwelling older Japanese subjects.
关于牙周炎与认知状态之间纵向关系的流行病学数据非常有限，尤其是在亚洲人群中。本研究调查了85名居住在日本社区的个体（平均年龄：79.3岁）牙周炎与认知衰退之间的纵向关系，这些个体在2010年和2013年进行了全面健康检查，有相关数据可用。
基于基线全口牙周检查，采用美国疾病控制与预防中心/美国牙周病学会的定义来界定重度牙周炎。使用简易精神状态检查表（MMSE）的结果来定义3年研究期间的认知衰退。获取了年龄、性别、教育程度、抑郁、体重指数、吸烟状况、饮酒、运动、高血压、糖尿病、心血管疾病和中风病史以及基线MMSE分数等信息，并在统计模型中作为潜在混杂因素进行检验。
在85名研究参与者中，21名（24.7%）被定义为患有重度牙周炎。多变量泊松回归分析显示，重度牙周炎与认知衰退风险增加显著相关[调整后的相对风险=2.2；95%置信区间（95%CI）：1.1 - 4.5]。此外，多变量线性回归分析显示，患有重度牙周炎的参与者的MMSE分数比未患有重度牙周炎的参与者降低了1.8分（95%CI：-3.3至-0.2）。
在样本量较小的相关局限性范围内，本研究结果表明，重度牙周炎与居住在社区的日本老年受试者未来的认知功能衰退显著相关。
