Department of Dental Medicine, Division of Oral Diseases, Karolinska Institutet, Huddinge, Sweden.
Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.
J Clin Periodontol. 2018 Nov;45(11):1287-1298. doi: 10.1111/jcpe.13016.
To test the hypothesis that periodontal disease contributes to increased risk of mild cognitive impairment (MCI), subjective cognitive decline (SCD) and Alzheimer's disease (AD).
This case-control study was conducted over a 3-year period in the municipality of Huddinge, Sweden. In total, 154 cases were consecutively enrolled from the Karolinska Memory Clinic at the Karolinska University Hospital and allotted to three diagnostic groups: AD, MCI and SCD, collectively referred to as "cases." Seventy-six cognitively healthy age- and gender-matched controls were randomly sampled through the Swedish population register. All cases and controls underwent clinical and radiographic oral examinations. Statistical analysis was based on logistic regression models adjusted for potential confounders.
Poor oral health and marginal alveolar bone loss were more prevalent among cases than among controls. The cases group was associated with generalized marginal alveolar bone loss (odds ratio [OR] = 5.81; 95% confidence interval [CI] = 1.14-29.68), increased number of deep periodontal pockets (OR = 8.43; CI 4.00-17.76) and dental caries (OR = 3.36; CI 1.20-9.43).
The results suggest that marginal periodontitis is associated with early cognitive impairment and AD. However, the study design does not preclude noncausal explanations.
检验牙周病是否会增加轻度认知障碍(MCI)、主观认知下降(SCD)和阿尔茨海默病(AD)风险的假设。
本病例对照研究在瑞典 Huddinge 市进行了 3 年。总共从 Karolinska 大学医院的 Karolinska 记忆诊所连续招募了 154 例病例,并将其分为 AD、MCI 和 SCD 三个诊断组,统称为“病例”。通过瑞典人口登记册随机抽取了 76 名认知健康、年龄和性别匹配的对照。所有病例和对照均接受了临床和影像学口腔检查。统计分析基于调整了潜在混杂因素的逻辑回归模型。
病例组的口腔健康状况较差,牙槽骨边缘缺失程度较高。与对照组相比,病例组普遍存在牙槽骨边缘缺失(比值比 [OR] = 5.81;95%置信区间 [CI] = 1.14-29.68)、牙周袋深度增加(OR = 8.43;CI 4.00-17.76)和龋齿(OR = 3.36;CI 1.20-9.43)。
结果表明,边缘性牙周炎与早期认知障碍和 AD 有关。然而,研究设计并不能排除非因果关系的解释。