Cerutti-Kopplin D, Feine J, Padilha D M, de Souza R F, Ahmadi M, Rompré P, Booij L, Emami E
1 Department of Dental Public Health, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
2 Oral Health Society Research Unit, Faculty of Dentistry, McGill University, Montreal, Canada.
JDR Clin Trans Res. 2016 Apr;1(1):10-19. doi: 10.1177/2380084416633102.
Emerging evidence suggests that oral health is associated with cognitive function. This review aims to systematically assess this association in adult populations via prospective cohort study designs. Eligible study reports were identified by searching the MEDLINE (via Ovoid), EMBASE, PsycoINFO, and Cochrane Library databases. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated with a random effects model. From 1,251 identified articles, 10 were included in the systematic review and 8 in the meta-analysis. Random effects analysis showed, with statistically low heterogeneity, that individuals with suboptimal dentition (<20 teeth) were at a 20% higher risk for developing cognitive decline (HR = 1.26, 95% CI = 1.14 to 1.40) and dementia (HR = 1.22, 95% CI = 1.04 to 1.43) than those with optimal dentition (≥20 teeth). Studies on the association between periodontal disease and cognitive status showed conflicting results. Within the limits of the quality of published evidence, this meta-analysis lends further support to the hypothesis that tooth loss is associated with an increased risk of cognitive impairment and dementia. Knowledge Transfer Statement: Based on the published literature, the results of this study show that the risk for cognitive impairment and dementia increases with loss of teeth. This information adds to the evidence showing links between oral and general health and suggests that oral health strategies aimed to preserve teeth may be important in reducing risk of systemic disease.
新出现的证据表明，口腔健康与认知功能有关。本综述旨在通过前瞻性队列研究设计系统评估成年人群中的这种关联。通过检索MEDLINE（通过Ovoid）、EMBASE、PsycoINFO和Cochrane图书馆数据库来确定符合条件的研究报告。采用随机效应模型计算合并风险比（HRs）及其95%置信区间（CIs）。在1251篇已识别的文章中，10篇纳入了系统评价，8篇纳入了荟萃分析。随机效应分析显示，在统计学上异质性较低，牙列不佳（<20颗牙）的个体发生认知衰退（HR = 1.26，95%CI = 1.14至1.40）和痴呆（HR = 1.22，95%CI = 1.04至1.43）的风险比牙列良好（≥20颗牙）的个体高20%。关于牙周病与认知状态之间关联的研究结果相互矛盾。在已发表证据质量的限制范围内，这项荟萃分析进一步支持了牙齿缺失与认知障碍和痴呆风险增加有关的假设。知识转移声明：根据已发表的文献，本研究结果表明，认知障碍和痴呆的风险随着牙齿缺失而增加。这些信息补充了表明口腔健康与总体健康之间存在联系的证据，并表明旨在保留牙齿的口腔健康策略可能对降低全身性疾病风险很重要。
